Continuity of care for children with special healthcare needs during the COVID-19 pandemic

ABSTRACT Objective: To describe the continuity of care for children with special healthcare needs during the COVID-19 pandemic through the perception of their caregivers in the Northeast of Brazil. Methods: Qualitative descriptive-exploratory research carried out between June and September 2020, in a municipality in the Northeast of Brazil. Eleven caregivers participated through semi-structured interviews conducted at home. The data were submitted to thematic content analysis. Results: The social isolation period and the suspension of health services affected the continuity of care, configuring the category “Implications of the COVID-19 pandemic for the continuity of care”. Caregivers expressed fear of children contracting the coronavirus, characterizing the category “Fears and uncertainties of the COVID-19 pandemic in view of the vulnerability of children with special healthcare needs”. Final considerations: Caregivers’ reports revealed problems in the continuity of care for the studied cohort. Therefore, health care practices must be rethought in times of pandemic.

Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil

ABSTRACT Purpose to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. Methods a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. Results out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). Conclusion the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.

Innovations in Internet of Medical Things, Artificial Intelligence and Readiness of Health Care Sector towards Health 4.0 Adoption

Recent years witnessed lots of advancements in Internet of Medical Things, Innovations in Artificial Intelligence and Big Data Analytics based health care practices. Further, recent pandemic has compelled health care institutions to adopt remote patient care practices throughout the world and India is not an exception. Growth in mobile infrastructure and cheap mobile data packages also encouraged adoption of telemedicine and m-health care practices in India which eventually supports attempts of health care policy makers for transition of traditional health care systems to Health 4.0 in the lines of industry4.0. However, success of Health 4.0 depends upon the coordinated efforts from all the stakeholders. In this regard this research has been conducted to investigate the current status of Health 4.0 implementation in India and readiness of Indian health care sector towards its adoption. This paper further employs the SWOT-AHP analysis to identify the current areas that need immediate improvement to facilitate Health 4.0 adoption.

Study of Health Care Practices and Comorbidities in Diabetic Population at Small Community Level in Biratnagar: A Cross-Sectional Descriptive Study

Background: Death in diabetes mellitus occurs mostly due to co-morbidities and complications resulting from diabetes. To reduce morbidity and mortality, awareness regarding diabetes and its complications is necessary. The aim of the study is to assess the health care practices and co-morbidities associated with the disease. Materials and Methods: A descriptive cross-sectional study was conducted at community level (Kharji ward number 4) at Biratnagar. All diagnosed patients of type II diabetes mellitus ≥ 18 years of age were enrolled for the study. Data for socio-demographic factors and clinical status were collected by pretested semi structured Questionnaire. Random blood sugar was measured using a portable glucometer. Anthropometric measurements were done by measuring height and weight of participants and body mass index was calculated by standard formula. The data was analyzed using SPSS version 21.0. Results: Out of the total 205 participants, 55.7% were found to be within the age group of 45-64 years i.e. middle aged (55.6%). Almost equal participants of the male and female were found, 50.7% and 49.3% respectively. More participants were found of below poverty line 67.31%. More than half 47.8% of the participants were suffering from the diabetes for less than 5 years of duration. All most all participants 98.5% knew about diabetes and its complications. Majority of the respondents 62.4% were having co-morbidity, among them 34.6% of participants were having hypertension. Majority of the participants were utilizing private health care service 79%. Conclusion: The diabetic participants were mostly of middle age with almost equal number of male and female having adequate knowledge about diabetes. Hypertension was the most common co morbidity among participants and they preferred private health care service mostly.

Assessment of Chronic Disease Management Strategies Among Health Care Practices in Medically Underserved South Carolina Counties

Diabetes and heart disease are among the leading causes of death and disability in the United States, and these conditions are especially prevalent in the South. South Carolina’s persistent racial and socioeconomic disparities in chronic disease outcomes are well-documented, yet little is known about how health care practices in medically underserved areas are addressing these challenges. Data were collected through a cross-sectional survey as part of two complementary 5-year cooperative agreements between the Centers for Disease Control and Prevention and the Division of Diabetes and Heart Disease Management (the Division) at the South Carolina Department of Health and Environmental Control. The Division fielded a survey to (a) assist in determining which Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) were best poised to implement specific strategies as part of these cooperative agreements and (b) provide data to establish the baseline for performance measures. FQHCs and RHCs in the top 25% of counties with the highest diabetes and heart disease burden were surveyed about eight domains: staffing/services, electronic health records, team-based care policies, lifestyle change programs, medication therapy management, telehealth, quality improvement collaboratives, and patient demographics. Data representing 71 practices revealed contrasts between RHCs and FQHCs and opportunities for improvement. For example, while most practices reported they were not implementing evidence-based lifestyle change programs (e.g., the National Diabetes Prevention Program), most RHCs and FQHCs expressed interest in starting such programs. Findings are being used to guide efforts to improve diabetes and heart disease prevention and management in South Carolina.

Primary Health Care Case Management Through the Lens of Complexity: an Exploratory Study of Naturopathic Practice Using Complexity Science Principles

BackgroundAdvances in systems science creates an opportunity to bring a complexity perspective to health care practices and research. While medical knowledge has greatly progressed using a reductionist and mechanistic philosophy, this approach may be limited in its capacity to manage chronic and complex illness. With its holistic foundation, naturopathy is a primary health profession with a purported alignment with a complexity perspective. As such this pilot study aimed to investigate the application of complexity science principles, strategies, and tools to primary health care using naturopathy as a case study.MethodsA network mapping and analysis of the naturopathic case management process was conducted. Mind maps were created by naturopathic practitioners to reflect their clinical conceptualisation of a common paper clinical case. These mind maps were inputed into Gephi, a network mapping, exploration, and analysis software. Various layouts of the data were produced, and these were analysed using exploratory data analysis and computational network analysis.ResultsSeven naturopathic practitioners participated in the study. In the combined network mapping, 133 unique elements and 399 links were identified. Obesity, the presenting issue in the case, was centrally located. Along with obesity, other keystone elements included: systemic inflammation, dysbiosis, diet, the liver, and mood. Each element was connected on average to 3.05 other elements, with a degree variation between one and 36. Six communities within the dataset were identified, comprising: the nervous system and mood, gastroinstetinal and dietary factors, systemic inflammation and obesity, the endocrine system and metabolism.ConclusionsThis pilot study demonstrates that it is feasible to apply a complexity science perspective to investigating primary health care case management. This supports a shift to viewing the human organism as a complex adaptive system within primary health care settings, with implications for health care practices that are more cognisant with the treatment of chronic and complex conditions and research opportunities to capture the complex clinical reasoning processes of practitioners.

Conceptions About Health and Care Practices of Black Men from a Quilombola Community

Introduction: Universal health coverage will be guaranteed to all individuals, safeguarding the rights of traditional communities, as in the quilombola population, respecting the dimensions of interculturality, gender and ethnicity. Objective: The aim of this study is to describe the conceptions of health and health care practices of Afro-Brazilian men from a quilombola community. Methods: This was a qualitative descriptive study conducted with Afro-Brazilian men from a quilombola community in Bahia, Brazil, where there is a significant concentration of black people and quilombola communities. Results: This group’s conceptions of health are based on the combination of the individual body with the body that is socially and culturally situated in the community. Health care practices are anchored in cultural knowledge and strengthened by the bonds with nature, friends and religious leaders. Conclusion: The black men from quilombola communities are in a state of vulnerability due to the lack of access to health services.

Common Health Problems and Health-seeking Behavior Among the Tribals of Odisha, India

The present study aims to explore the common health problems and the health-seeking behavior among the tribal population in Koraput district of Odisha. In order to assess the common health problems and the treatment-seeking behavior, 300 tribal individuals from 173 households in the age group of 18–64 years and 24 health care staff were recruited for the study. Information regarding health facilities, their affordability, and morbidity status were obtained through pre-structured questionnaires. Data analysis was carried out using SPSS-20 and Microsoft Excel software tools. Anemia, diarrheal problems, cold, pneumonia, vaginal problems, skin infection, fever, malnutrition, and sickle cell anemia were the common health problems reported by the respondents. In addition, the study found that the majority of the respondents relied on traditional health care practices. The initiation of proper awareness can help in reducing traditional health care practices among the tribal communities. Furthermore, the involvement of modern health care practitioners would help to reduce the disease burden in tribal communities.

Reproductive characteristics of female swamp buffalo reared under Kalang production system in South Kalimantan

Swamp buffalo has been an integral component of society in the swamp area in South Kalimantan. The system is characterized by 2-5 farmers rearing herds semi intensively in one shared kalang, a traditional wooden shelter on swamp area. This study was aimed to determine the reproductive characteristics of female swamp buffalo under kalang systems in Hulu Sungai Selatan Regency, The Province of South Kalimantan. The data of reproductive characteristics and farming systems were collected through interviewing 21 farmers in 4 kalang groups who kept 351 buffaloes (153 of them were females). The observed parameters were average of productive females ages, age at first mating, calving interval, post-partum estrus (PPE), percentages of pregnant and lactating cows. Results showed that the average of productive female buffalo ages was 9.9 ± 0.99 years; female swamp buffaloes were first mating at 51.4 months; first calving at 63.4 months; calving interval was 16.5±0.70 months; PPE was 4.9±0.64 month; gestating and lactating cows were 21.6% and 60.1%, of the productive female population, respectively. We concluded reproductive characteristics of female swamp buffalo under kalang production systems can be enhanced through improvements of the production system, including pre-weaning calf management, feed supplementation, and health care practices.

Rehabilitation after COVID-19. Resolution of the International Expert Council of the Eurasian Association of Therapists and the Russian Society of Cardiology

By the middle of 2021, the official global number of coronavirus disease 2019 (COVID-19) patients was close to 230 million, but the number accounting for asymptomatic patients was much higher. Consequences and rehabilitation after COVID-19 are of particular interest and raise many controversial and unresolved issues. On May 18, 2021, the Eurasian Association of Therapists organized an international panel of experts to analyze challenges associated with the post-COVID-19 period. This panel aimed to develop approaches to identify gaps in the discussed issues. This interdisciplinary team of leading experts reviewed the current literature and presented their data to formulate practical guidance on management of patients after COVID-19. The panel of experts also presented recommendations on how to implement the gained knowledge into health care practices.