Factors contributing to physicians’ current use and satisfaction of electronic health records (EHRs) in Kuwait’s public health care: A cross- sectional study. (Preprint)

BACKGROUND The Electronic Health Record (EHR) is the backbone of the integration of information to help physicians in making effective decisions in patient care. The adoption of E-health care system, Health Information Communication Technologies (HICT) and EHR is raising in Kuwait OBJECTIVE This study aims to (i) identify the factors associated with physician’s current use, satisfaction, and prevalence with EHRs (ii) assess the factors’ relative importance in terms of predicting current use, satisfaction and prevalence with EHRs. METHODS This study took place at a public hospital in 2019. Using an anonymous self-administered paper-based survey, two hundred and ninety-five physicians were recruited. The survey contained 35 statements and the Technology Acceptance Model was used as the theoretical framework to guide the survey development. The dependent variables were “Physicians' current use of EHR" and “Physicians’ Satisfaction with EHR.” The independent variables were the demographics factors, Length of use of EHR, training quality, perceptions of barriers toward using EHR, the EHR effect on physicians’ Work, and level of ease of EHR function. Descriptive analysis, followed by bivariate, and multivariate linear regression adjusted for demographics were conducted. RESULTS Among the 295 research participants, 75% indicated that they are currently using the EHR system. The effect that the EHR use had on physician’s work was the most significant predictor of physician’s satisfaction using EHR (β=.377, p=0.000), followed by the level of ease of EHR function and (β=.341, p=.00) and barriers to using EHR (β=.170, p=0.000). Regarding the prediction of the current use of EHR it was found that the perceptions of barriers to using EHR was the most significant predictor (β= .145, p=0.000) followed by the effect on physician’s work (β=.645, p=0.01) and length of EHR (β= .111, p=0.03). CONCLUSIONS In the promotion of EHR current use and related satisfaction, enhancing and promoting the positive effect of EHR use on the physicians’work while making the implementation of the EHR system as easy as possible by removing barriers seem to be key factors. CLINICALTRIAL Not applicable .

Demand for Competence-based Education for Worker of Public Health Care Service in Ulsan Metropolitan City

Introduction: In order to strengthen the core competencies of workers, systematic education tailored to their needs is necessary. In this study, a survey was conducted on workers in public health care service in Ulsan Metropolitan City (Ulsan) to investigate the demand for education according to core competencies.Methods: A total of 70 workers who work for public health care service in Ulsan participated in this online survey. The questionnaire consisted of socio-demographic factors, work ability, education demand, and preference of education form.Results: The core competency with a high level of work ability is ‘Expertise on health and disease’ (41, 58.6%). On the other hand, the core competency with a low level of work ability was found to be the ‘Evaluation-related theories of public health care service’ (57, 81.4%). The core competencies with the highest demand for education were “Resident-centered service implementation” and “Public health care service strategy development” (64, 91.4%), followed by ‘Public health care service cases review’ and ‘knowledge of public health service plan’ (63, 90.0%). The preferred form of education is offline education (49, 40.8%). The most important factor in education was ‘work utilization’ (Offline: 57, 81.4%; Online: 48, 68.6%), both online and offline.Conclusions: Through the research results, it was possible to find out education demand according to core competencies and preference of education form. Based on these results, we will develop a core competency education program tailored to actual demand. In the future, it is necessary to continuously conduct research on such education demand.

Drug cartels respond to the pandemic

More than 13.6 million Brazilians live in large poor communities known as favelas. Historically, these territories suffer due to social rights insufficiency and violent conflicts orchestrated by the police and the drug cartels. In this context, the dismantling of the public health care system and denialism of the pandemic by the federal government increases the vulnerability within the favelas during the COVID-19 crisis. Although the federal government failed to take up measures to control the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a criminal organization that dominates the trafficking of drugs in several Brazilian favelas, known as Comando Vermelho, instead dictated those protective actions. This study aimed to discuss the ethical aspects of the relationship between primary health care professionals and the drug cartels in order to promote health care in the favelas.

Production of Public Goods as a Space for the Development of Human Potential: Contradictions and the Potential of Soviet Practices

The article analyzes the contradictions in the development of public goods production sphere in the USSR. It is shown that, on the one hand, such spheres as science, education, public health care, culture, etc. in this economic system were developing on the principles of general accessibility, egalitarianism, guarantees of employment. This provision has become one of the foundations for the formation of creative potential among a wide range of citizens, boost of creative activity, high results in the development of human potential, technology, culture. On the other hand, in these areas, as in the economy as a whole, this progress was hampered by numerous deformations of progressive trends (bureaucracy, shadow commercial relations, etc.). Critical use of the experience of the USSR shows that the development of spheres in which prevails creative labor as spaces for the creation and distribution of public goods can give high economic, social and humanitarian results, provided they are organized in the democratic mode.

Accessing HIV care may lead to earlier ascertainment of comorbidities in health care clients in Khayelitsha, Cape Town

Successful antiretroviral rollout in South Africa has greatly increased the health of the HIV-positive population, and morbidity and mortality in PLHIV can increasingly be attributed to comorbidities rather than HIV/AIDS directly. Understanding this disease burden can inform health care planning for a growing population of ageing PLHIV. Anonymized routine administrative health data were analysed for all adults who accessed public health care in 2016–2017 in Khayelitsha subdistrict (Cape Town, South Africa). Selected comorbidities and age of ascertainment for comorbidities were described for all HIV-positive and HIV-negative healthcare clients, as well as for a subset of women who accessed maternal care. There were 172 937 adult individuals with a median age of 37 (IQR:30–48) years in the virtual cohort, of whom 48% (83 162) were HIV-positive. Median age of ascertainment for each comorbidity was lower in HIV-positive compared to HIV-negative healthcare clients, except in the case of tuberculosis. A subset of women who previously accessed maternal care, however, showed much smaller differences in the median age of comorbidity ascertainment between the group of HIV-positive and HIV-negative health care clients, except in the case of chronic kidney disease (CKD). Both HIV-positive individuals and women who link to maternal care undergo routine point-of-care screening for common diseases at younger ages, and this analysis suggests that this may lead to earlier diagnosis of common comorbidities in these groups. Exceptions include CKD, in which age of ascertainment appears lower in PLHIV than HIV-negative groups in all analyses suggesting that age of disease onset may indeed be earlier; and tuberculosis for which age of incidence has previously been shown to vary according to HIV status.

Oral Health Promotion in Children With Microcephaly After Social Isolation by Covid-19 Experience Report

The purpose of this study was to report extracurricular activities performed by professors and students of the Dentistry course at the State University of Southwest Bahia. Their goal was to promote oral health to microcephaly patients and their parents, after the period of social isolation due to the COVID-19 pandemic. In this context, a university extracurricular activity, more than ever, must assume its social responsibility, establishing new paths for public health care and regarding these actions correlating the academic community and society.

Bounded Solidarity as an Asset for Public Health Care Intervention

The relationship between social capital and public health has been extensively analyzed. However, not much has been written about the formation of social capital among citizens and public health workers in times of a pandemic. Our aim is to analyze social capital development through the prism of bounded solidarity and seek its manifestations toward public health workers. A qualitative self-administered survey was used to analyze what actions, practices, attitudes, and reasons inspired citizens to behave as they did with respect to public health workers during the first weeks of lockdown under the COVID-19 pandemic. Respondents, mostly from European countries, reveal that citizens aimed to prevent the collapse of the public health system through reinforcing trust toward institutions, legitimizing health care personnel expertise, practicing reciprocity and altruism, giving recognition to public health workers, and providing them with means. Finally, recommendations for public health communication on risks and crises are discussed.