Effective Health Services Planning and Delivery: A Qualitative Case Study Exploring Health Services Users’ Perspectives

Introduction: Healthcare service is an essential determinant of population health. This qualitative case study aims to explore health service users’ perspectives of effective health services delivery and the current challenges affecting the management and delivery of health services at a primary healthcare facility in Madang Province, Papua New Guinea (PNG).

Prevalence and Concentration of Escherichia coli O157:H7 in Cattle, Products, and the Environment in the United States of America: A Meta-Analysis Study

Shiga toxin-producing Escherichia coli O157:H7 are bacterial pathogens that cause foodborne infections in humans. The objectives of this study were to find the pooled prevalence and concentration of Escherichia coli O157:H7 in cattle, hides, carcass, and the environment in the United States of America using meta-analysis. The PRISMA and MOOSE research protocols were employed in the methodology. Weighted effect size was calculated using MetaXL software. A total of 1737 publications were screened, out of which 53 were selected for the final analysis. The pooled prevalence in feedlot cattle was 10.96% (95% CI: 4.2-18.8%). In dairy cattle a pooled prevalence of 1.5% (95% CI: 0.11-3.5%) was observed. The prevalence between feedlot and dairy cattle was significantly different (p<0.05). The herd prevalence in combined feedlot and dairy cattle was 31.7% (95% CI: 10.2-55.5%). Hide and carcass samples’ pooled prevalences were 54.7% (95% CI: 41.7-67.5%) and 21.3% (95% CI: 9.7-34.2%), respectively. Prevalence of environmental samples was 8.1% for produce (95% CI: 0-29.6%), 4.6% for watershed and sediment samples (95% CI: 0-12.2%), and 2.4% for water taken from troughs (95% CI: 0.39-5.1%). Significant difference was observed in individual, herd, and environment prevalence between regions (χ2 =903.14, p=0.0000; χ2 =11.06, p=0.0039; χ2 =13.59, p=0.0004, respectively). E. coli O157:H7 concentrations were highest in feces (900- 300,000 cfu/g), followed by hides (5-9,800 cfu/100 square cm), and carcass (1-189 cfu/100 square cm). At least one supershedder exists in a herd. The findings in this study showed that Escherichia coli O157:H7 serotype is widespread in feedlots, herds, hides, and carcass in the United States of America necessitating appropriate measures to prevent human illnesses. Improving management programs in cattle herds, reduction of environmental contamination, and hygienic slaughter practices are targets of intervention.

Mortality Risk in People with Type 2 Diabetes: A Large Prospective PopulationBased Cohort Study (The Ayrshire Diabetes Follow-Up Cohort (ADOC) Study)

Background: This study investigated the effects of age, gender, socio-economic status, smoking status, hypertension, ischaemic heart disease, Body Mass Index (BMI), Glycaemic control (HbA1c) and dyslipidaemia in type 2 diabetes in a population-based analysis.

Predicting the Resilience of the Health Care System to New Arrivals: The Case of the Public Health System of Turkey

Purpose/Objectives: Since the start of the Syrian war, a significant population has moved out of the Syrian Republic into its neighborhood environs. Turkey has had a significant effect on its health system and society, as a significant new number has entered the Turkish society, increasingly using the Turkish healthcare system. Our aim is not only to numerically identify the size of the effect to the Turkish system, but to identify the domestic resources that allow the Turkish healthcare system and society to build up resilience against the significant health demand shock. The main objectives of this study is 1) To understand whether there is a complementarity between the earlier efforts in the Turkish health system and the current capabilities that is necessary to meet the Syrian Populations Health Needs. 2) To understand if the newly revamped Turkish Primary Healthcare System Provide a crucial buffer for the negative congestion effects that could have been caused by such a significant and relatively unhealthy refugee population being integrated into the health system, at a relatively rapid pace.

A Prospective Study to Evaluate the Clinical Performance of A Novel MultitargetBased Antigen Test on the Detection of SARS-CoV-2 in Symptomatic PopulationComparison to Nuclear Acid-Based Tests

The study was designed to evaluate the clinical performance characteristics of the First Sign® SARS-CoV-2 Antigen Test, a visual read lateral flow immunoassay (W.H.P.M., Inc.). Individuals presenting at the study sites were evaluated by health care providers for COVID-19 symptoms and sequentially enrolled. The standard of care nasopharyngeal swab sample was first collected for RT-PCR testing. Participant self-collection nasal swab sample was then obtained for the Antigen Test. The clinical performance characteristics of the study device were calculated by comparing participant study device test result recorded at the point of care with the participant matched RT-PCR results provided by qualified CLIA high complexity laboratories. A total of 128 symptomatic adult participants were included in the study, of which 46.8% (60/128) were determined to be RT-PCR positive for SARS-CoV-2. The mean comparator cycle threshold value (Ct) for RT-PCR positive participants included in the study was Ct 25 (range Ct 18-Ct 39). The First Sign® SARS-CoV-2 Antigen Test demonstrated an overall clinical sensitivity of 96.7% (58/60) and a clinical specificity of 98.5% (67/68) when compared with EUA RT-PCR comparator results for the detection of SARS-CoV-2 in symptomatic individuals within 5 days of symptom onset. The clinical sensitivity for samples with RT-PCR Ct<30 was 100% (48/48), 90% (10/12) for samples with RT-PCR Ct ≥ 30, and 98.2% (55/56) for samples with RT-PCR Ct ≤ 34. Study results indicate that during the initial phase of infection, when upper respiratory viral loads and viral shedding levels are typically highest, an observed anterior nasal swab self-collected by the patient and applied to the First Sign® SARS-CoV-2 Antigen Test may be as effective in detecting the presence of SARS-CoV-2 in symptomatic individuals as a EUA RT-PCR assay. Additionally, the ability to obtain a low-cost qualitative result within 15 minutes, combined with the simplicity of the anterior nasal self-sampling procedure, may dramatically increase testing efficiency while significantly reducing risk to health care providers by minimizing or eliminating the need for close contact with the patient.

It’s not Okay! The Importance of Educating our Population Taking Prescribed Controlled Substances, Regarding the Risks for Dependency and Addiction

This article will focus on the major narcotic, and opioid prescription epidemic that is overpowering our nation destroying lives, families, and resulting in death. As healthcare professionals, nursing educators, family nurse practitioner, and Doctor of Nursing Practice with prescription privileges in New York State, in our scopes of practice we always inform and educate all individuals we care for concerning all medications they are prescribed. While we have sought to achieve this educational goal in our professional capacity, as human beings with medical issues like anyone else, we have also been the patients. Our life altering experiences resulted in extensive hospital stays and physical rehabilitation therapy, which required the need of opiate, controlled medications during our inpatient and outpatient recoveries. What we found alarming about the state of our care was not the management of the injuries we sustained, but the lack of education that should have been directed towards us and our families, regarding the use and discontinuance of prescribed opioids upon discharge. We personally observed that there is an overall lack of education in this area. As healthcare practitioners, we are all on the front line and serve to ensure safety of all individuals and the diverse populations we serve. Everyone in healthcare beginning with prescribers, medical staff, and nursing staff, must have the knowledge to explain to the patient and family what a controlled substance is, as well as the inherent risk of becoming addicted, tapering methods, signs and symptoms of withdrawal, and a basic understanding of the dangers that become apparent with self-administration of controlled substances upon discharge. Without proper education, many community populations are at risk for harm. Education is indeed the key and a priority at the forefront of medicine and nursing that ensures patients and their families have a thorough understanding of all the risks associated with these potent narcotics.

Knowledge, Attitude and Practices among Pupils towards Hand Washing in Basic Schools-Ombadda Locality-Khartoum State

Proper hand washing technique is very easy to learn and can significantly reduce the infectious diseases among children. This descriptive crosssectional school-based study was conducted in Ombadda locality Khartoum State Sudan, with an objective to study the knowledge, attitude and practices among basic schools pupils towards hand washing. A sample size of 400 pupils was determined using statistical formula, data were collected using interview and observation, and a pre-prepared and pre-tested questionnaire, and data were analyzed using SPSS. The majority of the pupils 95% knew the proper way of hand washing with soap and water, 96% knew the appropriate times for hand washing, sixty five percent of the pupils knew the benefits of hand washing and 88.2% knew diseases related to the practice of not washing hands. The twenty five percent of the pupil’s information about hand washing is from family members, 94.8% had positive attitude towards hand washing with soap and water, 70.3% of the pupils practice hand washing with soap and water at appropriate times, 39.5% practice hand washing in time ranged.

Thoughts on Higher Medical Education under Major Public Health Emergencies: Thinking Ahead after COVID-19 Outbreak--A Descriptive Study

Background: The spread of coronavirus disease 2019 (COVID-19) has posed great threat to the global population’s health and nearly every medical school throughout the world suspended classes as a precaution against the virus. This study is aimed at exploring a more advanced online teaching and learning pattern for medical school in the future especially during a Public Health Emergency of International Concern (PHEIC) and to evaluate the efficacy of the teaching methods in improving students’ professionalism, knowledge and learning skills including problem analyzing and solving, teamwork skills, self-directed learning, as well as adaptability and acceptance to the courses.

Knowledge on Breast Cancer and Practice of Self-Examination among Schoolgirls in Democratic Republic of the Congo

Background: The breast cancer represents a major problem of public health in Democratic Republic of the Congo. This study aims at assessing the knowledge about breast cancer and the practice of breast self-examination among schoolgirls, and to propose effective intervention measures to promote early diagnosis and treatment of breast cancer in Mbujimayi.