Skills Training of Infectious Diseases in the Community：a Survey Research of Questions

Background As the most basic unit of infectious disease prevention and control，community health service institutions are the frontline and important gateway for the prevention and control of infectious disease. Primary care physicians are responsible for epidemic surveillance，vaccination，health promotion and assistance to centers for disease control in investigating and disposing outbreaks and public health emergencies in their districts，and play an active role in disease prevention and control by groups，susceptible population protection，infectious source control and health education，as well as the effective prevention and control of infectious diseases. Objective To understand the ability of primary care physicians to diagnose and treat infectious diseases in the community，analyse their existing problems and shortcomings，design and conduct a series of intensive training related to infectious diseases for improving the capacity of infectious disease prevention and control at the primary level；To evaluate the effectiveness of online continuing medical education，so as to provide a reference for better continuing medical education on infectious diseases in the community. Methods All participants of the National Community Infectious Diseases Continuing Education Conference held by the Department of Family Medicine of the University of Hong Kong-Shenzhen Hospital in November 2021 were selected as research subjects from November 2021 to March 2022. The questionnaires were distributed to all registered attendees before and after the conference through the QR code of the questionnaire star，and the content of pre-conference questionnaire included demographic characteristics of the participants，participation in infectious disease training in the community since started working，diagnosis and treatment of infectious diseases in the community，subjective attitudes towards the prevention and control of infectious diseases in the community（willingness to manage infectious diseases in the community，satisfaction with their own infectious disease management skills），expertise in infectious disease prevention and control and knowledge related to conference content，attitude towards hepatitis B. The content of the post-conference questionnaire mainly included knowledge about the content of conference，attitude towards hepatitis B and satisfaction survey of this online conference. A total of 301 primary care physicians completed the questionnaire before and after the conference，and a total of 194 completed the questionnaire before and after the conference. Results Among all participants，166 （55.1%） had attended infectious disease training in the community，of whom 49（29.5%） were satisfied with their infectious disease diagnosis and treatment ability；135（44.8%） had not attended the training，of whom 22（16.3%） were satisfied with their infectious disease diagnosis and treatment ability. 143（86.1 %） of 166 participants who had attended infectious disease training in the community indicated their willingness to manage community infectious diseases，99（73.3%） of 135 participants who had not attended infectious disease training in the community indicated their willingness to manage community infectious diseases. 66（27.3%） of participants who were satisfied with their infectious disease diagnosis and treatment ability indicated their willingness to manage community infectious diseases. The top three infectious disease tests conducted by the institutions were hepatitis B，AIDS，and hepatitis C；the top three infectious diseases treated in the past six months were hepatitis B，influenza，hand，foot and mouth disease. Different self-evaluation and willingness to train may affect the willingness to manage community infectious diseases（P<0.05）. Among the participants who completed the questionnaire both before and after the conference，the highest correct answer rate for compulsory management of statutory infectious diseases before the conference was 89.7%，the owest accuracy rate for the type of disinfection of the COVID-19 infection was only 17.0%，the correct rates of other questions ranged from 34.0% to 40.7%. The correct rates of the questions after the conference were higher than those before the conference，and the correct rates ranged from 48.9% to 52.6%. The score of attitude towards hepatitis B after the conference was higher than that before the conference （P<0.05）. In terms of feedback after conference，254（98.1%） expressed satisfaction in the total of 259 questionnaires. In terms of suggestions for online conference，179（69.1%） and 174（67.2%） participants believed that online fluency and online interaction need to be improved. Conclusion The primary care physicians receive relatively less infectious diseases training in the community，inadequate infectious diseases training in the community can improve the confidence of self-competence，attitude of active management of infectious diseases and diagnosis and treatment ability in the primary care physicians. The future direction of continuing medical education should focus on the training of emerging infectious diseases and novel medical concepts，relevant experts should be invited to comment on the necessity and effectiveness of training in the community. © 2023 Chinese General Practice. All rights reserved.

Organizational Management of Primary Care in the Regional Health System in Puno, Peru

Objective To analyze the organizational management of primary health care (APS, by its initials in Spanish) during the COVID-19 pandemic in the Puno regional health system. Methods The methodological design adopted is phenomenology within the framework of the qualitative research paradigm. A theoretical sampling was carried out in addition to the intentional and convenience sampling, identifying actors with decision-making capacity in the health services management process at the different levels of care: director of the Health Regional Directorate (DIRESA, by its initials in Spanish), executive directors of the 11 health networks, two hospital directors, and two heads of health centers. The qualitative data collection has been based on semi-structured interviews, focus groups, and documentary reviews, the results of which were analyzed and inter-preted based on the human talent management approach, the theory of organizational behavior, and the APS paradigm. Results Organizational management of APS in Puno involves addressing six emerging analysis subcategories: unfavorable organizational culture and climate;centralization and prioritization of curative and recuperative medicine;organizational anarchy in the regional health system (poor rectory);institutional and organizational instability;politici-zation of the health system, and deficiencies in the training of health professionals. Conclusions An adequate human talent management of people in health will contribute significantly to the renewed organizational management of the regional and national health system based on a unified and complementary model between APS and curative and recuperative medicine. © 2022, Universidad Nacional de Colombia. All rights reserved.

Social connection: An exploration of screening methods in primary care

Research has found a correlation between a lack of social links and greater prevalence of mental health issues, indicating that social connection is a key determinant in both physical and mental health outcomes. Social isolation has been related to loneliness, all-cause mortality, cardiovascular disease, and other major health problems. Urban lifestyles, technology advancements, and the COVID-19 pandemic have all contributed to this problem. In order to address related physical and mental health issues, healthcare professionals must have a thorough understanding of the prevalence of social connection impairments as well as how to identify and treat them. This study surveyed primary care physicians on their approach to evaluating social connection in patients and identified potential barriers to gathering this information. The purpose of this study was to explore the attitudes and beliefs of primary care physicians in the United States towards the impact of social connection on the health of their patients and the extent to which they screen and assess for social connection. Surveys were collected from 208 licensed primary care physicians. Results showed the majority of participants agreed that addressing a patient's social connection is as important as addressing their medical needs and that they feel comfortable asking about a patient's current social connection. However, fewer participants reported being well informed about self-report tools or using validated measures to screen for social connection in their practice. These results suggest that there may be a need for more resources to help primary care physicians incorporate screening for social connection into their practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A Qualitative Study Exploring the Impact of Covid-19 Pandemic on Teaching and Learning of Family Medicine Course among Undergraduates in a Local University in Malaysia

Introduction: The COVID-19 pandemic significantly impacted the global teaching and learning process (TnL). Unfortunately, to date, not many qualitative studies have been published specifically on the impact of COVID-19 on the Family Medicine course, particularly in Malaysia. Hence, this study aimed to explore the impact of COVID-19 pandemic on the teaching and learning experience of undergraduate students undergoing their Family Medicine course at a local university. Methods: A qualitative study using focused group discussion (FGD), was conducted among undergraduate students during the lockdown period. A semi-structured interview guide was used to interview 20 students, in their fifth undergraduate year, undertaking their fourth to fifth week of a total six-week course. They were selected using purposive snowball sampling method. There were four focus group discussions (FGD) with five students in a group. All interviews were audio-taped, transcribed verbatim, and the contents were analysed using the standard content analysis framework. Subsequently, thematic content analysis was conducted, and three major themes were produced. Results: The three major themes were (1) facilitators to learning, (2) barriers to learning, and (3) rooms for improvement. Conclusion: Although COVID-19 pandemic had significant impact on TnL of Family Medicine course among undergraduates, the students remained optimistic and proposed some improvement from their point of view. However, a creative, realistic, effective, and impactful way of TnL, particularly in clinical aspects should be developed and experimented. Technological progress and advancement should permit this idea to be achievable and implemented in near future. [ FROM AUTHOR] Copyright of Malaysian Journal of Medicine & Health Sciences is the property of Universiti Putra Malaysia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Earthquake Disaster in Turkiye: A Review from Child and Adolescent Psychiatry Perspective

The earthquake has long-lasting various mental and behavioral effects on children and adolescents. The aim of this review was to discuss the nature and extent of psychiatric problems, management options, and the process of organizing psychological interventions for affected children. Individuals show a range of physically, emotionally, and cognitively healthy responses that can help them cope with the aftermath of a disaster. Psychiatric symptoms such as acute stress reactions, post-traumatic stress disorder, depression, anxiety disorder, increased risk of suicide, sleep disorders, substance use disorders, and psychotic disorders may develop in some children. Comorbidities and sub-clinical syndromes are also common. There are many risk factors and protective factors in the development of mental disorders. Close follow-up of children at high risk and interventions for psychosocial support may prevent the development of mental disorders. It is very important to start the intervention at the earliest period. The psychological impacts of young disaster victims can be addressed by skilled local volunteers, medical professionals, and educators in primary health care programs. With the nation's overall social and economic recovery, children can recover more quickly from traumatic experiences.Copyright © 2023, Duzce University Medical School. All rights reserved.

Crise sanitária e atenção primária: a atuação de assistentes sociais nos territórios

Este artigo focaliza a atuação de assistentes sociais na atenção primária em saúde (APS), na pandemia do Covid-19. Discute a crise sanitária, problematizando a ofensiva ultraneoliberal e suas implicações na atenção primária em saúde cuja potencialidade assistencial foi esvaziada por meio de várias medidas tomadas pelo Governo Federal, como mudanças na Política Nacional de Atenção Básica e o Previne Brasil. Foi realizada pesquisa nos Anais do IX Congresso Nacional de Serviço Social em Saúde, destacando trabalhos sobre APS. Foi desenvolvida análise com base no materialismo-histórico-dialético, considerando a historicidade, mediações e contradições. Foram identificados desafios à atuação profissional, como o uso de Tecnologias de Informação e Comunicação (TIC), o teletrabalho, a precarização da política de saúde. Entre as estratégias de ação utilizadas destacam-se: ações educativas, articulação com a rede socioassistencial, entre outras. Considera-se que a negação de direitos como método governamental distancia o horizonte emancipatório do projeto ético-político da profissão.Alternate :The article focuses on the role of social workers in primary health care (PHC) during the covid-19 pandemic. It discusses the health crisis, questioning the ultra-neoliberal offensive and its implications for primary health care, which its care potential has been emptied, through various measures taken by the Federal Government, such as changes in the National Primary Care Policy and Previne Brasil. Research was carried out in the Annals of the IX National Congress of Social Service in Health, highlighting works on PHC. An analysis was developed based on dialectical-historical-materialism, considering historicity, mediations and contradictions. Challenges to professional performance were identified, such as the use of Information and Communication Technologies (ICT), teleworking, and the precariousness of health policy. Among the action strategies used, the following stand out: educational actions, articulation with the social assistance network, among others. It is considered that the denial of rights as a governmental method distances the emancipatory horizon from the ethical-political project of the profession.

Descriptive Study Investigating Impact of Transition to Universal Health Insurance Coverage on Utilization of Healthcare in Sudan, 2016 - 2021

Objectives: Since 2016, Sudan was transitioning from limited healthcare subsidization to universal health coverage (UHC). Increasing healthcare access was widely considered beneficial, but some worried that UHC would overwhelm clinical services. In 2020 and 2021 UHC faced the challenge of Covid-19. We undertook a review of national healthcare utilization and enrolment data in order to better understand the impact of UHC in Sudan. Method(s): We conducted a descriptive study using National Health Insurance Fund databases. We analyzed annual enrolment, participating facilities, prescription volume and utilization from 2016 to 2021. Enrolment was stratified by employment status (government, informal sector, private sector, pensioner, impoverished). Utilization was assessed by type of care: primary, specialty, chronic disease and other;we calculated the ratio of primary to specialty care visits. We used the Mann-Kendall test for evaluating trends. Result(s): Participating facilities increased from 2,083 in 2016 to 3,549 in 2019, with slight contraction to 3,495 during 2020-21. Annual enrolment increased significantly, from 16.4 million in 2016 to 36.5 million in 2021 (p value < 0.01). The impoverished sector had the largest increase in enrolment (217%);informal sector had the lowest enrolment growth rate (7%). Volume of primary healthcare visits and prescriptions increased every year, except 2020, the first year of Covid-19 in Sudan. Specialty healthcare visits decreased over the same period, from 2,461,424 to 1,249,585 (p < 0.01). The ratio of primary to specialty visits increased from 6.0 in 2016 to 15.7 in 2021 (p < 0.001). Conclusion(s): In Sudan, transition to UHC increased utilization of primary care services, but at a slower rate than enrolment growth. The ratio of primary to specialty visits increased and specialty visits declined, suggesting that more primary care may have prevented specialist-requiring disease states and sequelae. Fears of overwhelming the health system were unfounded indicating that other barriers to healthcare might exist.Copyright © 2023

5th International Conference on Tropical Medicine and Infectious Diseases 2022 (ICTMID 2022), Ipoh, Malaysia, 23-25 August 2022

This proceedings contains 112 s that cover a wide range of topics related to microbiology. The s cover a wide range of topics related to microbiology, including new paradigms in a microbe-threatened world, the human-animal spillover of SARS-CoV-2 and its implications for public health, preparing for the next pandemic, antimicrobial resistance and the fight against it. Furthermore, tuberculosis, monkeypox, and their potential threat on a global scale are also discussed. The presentations also cover a variety of other topics, such as vaccines and vaccinations, COVID-19 vaccines, addressing vaccine hesitancy, key issues related to the COVID-19 healthcare system, regional support for outbreak preparedness, enhancing regional health security in Asia through genomic surveillance, the role of molecular diagnostic capacity in COVID-19 control, antimicrobial resistance in COVID-19 times, paediatric nosocomial infections, prescription ethics from a primary care perspective, the BCG vaccine and its relevance in the prevention of tuberculosis and beyond, tuberculosis as a forgotten pandemic, vector-borne diseases during COVID-19, the role of media advocacy in vector-borne diseases control and management, engaging communities in tackling vector-borne diseases, the way forward in managing mental health in the COVID-19 endemic phase, the spread of zoonotic diseases, and whole genome sequencing of SARS-CoV-2: clinical applications and experience.

Changes in medication safety indicators in England throughout the covid-19 pandemic using OpenSAFELY: population based, retrospective cohort study of 57 million patients using federated analytics.

Objective: To implement complex, PINCER (pharmacist led information technology intervention) prescribing indicators, on a national scale with general practice data to describe the impact of the covid-19 pandemic on safe prescribing. Design: Population based, retrospective cohort study using federated analytics. Setting: Electronic general practice health record data from 56.8 million NHS patients by use of the OpenSAFELY platform, with the approval of the National Health Service (NHS) England. Participants: NHS patients (aged 18-120 years) who were alive and registered at a general practice that used TPP or EMIS computer systems and were recorded as at risk of at least one potentially hazardous PINCER indicator. Main outcome measure: Between 1 September 2019 and 1 September 2021, monthly trends and between practice variation for compliance with 13 PINCER indicators, as calculated on the first of every month, were reported. Prescriptions that do not adhere to these indicators are potentially hazardous and can cause gastrointestinal bleeds; are cautioned against in specific conditions (specifically heart failure, asthma, and chronic renal failure); or require blood test monitoring. The percentage for each indicator is formed of a numerator of patients deemed to be at risk of a potentially hazardous prescribing event and the denominator is of patients for which assessment of the indicator is clinically meaningful. Higher indicator percentages represent potentially poorer performance on medication safety. Results: The PINCER indicators were successfully implemented across general practice data for 56.8 million patient records from 6367 practices in OpenSAFELY. Hazardous prescribing remained largely unchanged during the covid-19 pandemic, with no evidence of increases in indicators of harm as captured by the PINCER indicators. The percentage of patients at risk of potentially hazardous prescribing, as defined by each PINCER indicator, at mean quarter 1 (Q1) 2020 (representing before the pandemic) ranged from 1.11% (age ≥65 years and non-steroidal anti-inflammatory drugs) to 36.20% (amiodarone and no thyroid function test), while Q1 2021 (representing after the pandemic) percentages ranged from 0.75% (age ≥65 years and non-steroidal anti-inflammatory drugs) to 39.23% (amiodarone and no thyroid function test). Transient delays occurred in blood test monitoring for some medications, particularly angiotensin-converting enzyme inhibitors (where blood monitoring worsened from a mean of 5.16% in Q1 2020 to 12.14% in Q1 2021, and began to recover in June 2021). All indicators substantially recovered by September 2021. We identified 1 813 058 patients (3.1%) at risk of at least one potentially hazardous prescribing event. Conclusion: NHS data from general practices can be analysed at national scale to generate insights into service delivery. Potentially hazardous prescribing was largely unaffected by the covid-19 pandemic in primary care health records in England.

Use of eco-mapping in health services research: a scoping review protocol.

INTRODUCTION: People with complex health and social needs often require care from different providers and services. Identifying their existing sources of support could assist with addressing potential gaps and opportunities for enhanced service delivery. Eco-mapping is an approach used to visually capture people's social relationships and their linkages to the larger social systems. As it is an emerging and promising approach in the health services field, a scoping review on eco-mapping is warranted. This scoping review aims to synthesise the empirical literature that has focused on the application of eco-mapping by describing characteristics, populations, methodological approaches and other features of eco-mapping in health services research. METHODS AND ANALYSIS: This scoping review will follow the Joanna Briggs Institute methodology. From the date of database construction to 16 January 2023, the following databases in English will be searched: Ovid Medline, Ovid Embase, CINAHL Ultimate (EBSCOhost), Emcare (Ovid), Cochrane Central Register of Controlled Trials (Ovid) and Cochrane Database of Systematic Reviews (Ovid) Study/Source of Evidence selection. The inclusion criteria consist of empirical literature that uses eco-mapping or a related tool in the context of health services research. Two researchers will independently screen references against inclusion and exclusion criteria using Covidence software. Once screened, the data will be extracted and organised according to the following research questions: (1) What research questions and phenomena of interest do researchers address when using eco-mapping? (2) What are the characteristics of studies that use eco-mapping in health services research? (3) What are the methodological considerations for eco-mapping in health services research? ETHICS AND DISSEMINATION: This scoping review does not require ethical approval. The findings will be disseminated through publications, conference presentations and stakeholder meetings. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/GAWYN.

Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries.

Responsive primary health-care facilities are the foundation of resilient health systems, yet little is known about facility-level processes that contribute to the continuity of essential services during a crisis. This paper describes the aspects of primary health-care facility resilience to coronavirus disease 2019 (COVID-19) in eight countries. Rapid-cycle phone surveys were conducted with health facility managers in Bangladesh, Burkina Faso, Chad, Guatemala, Guinea, Liberia, Malawi and Nigeria between August 2020 and December 2021. Responses were mapped to a validated health facility resilience framework and coded as binary variables for whether a facility demonstrated capacity in eight areas: removing barriers to accessing services, infection control, workforce, surge capacity, financing, critical infrastructure, risk communications, and medical supplies and equipment. These self-reported capacities were summarized nationally and validated with the ministries of health. The analysis of service volume data determined the outcome: maintenance of essential health services. Of primary health-care facilities, 1,453 were surveyed. Facilities maintained between 84% and 97% of the expected outpatient services, except for Bangladesh, where 69% of the expected outpatient consultations were conducted between March 2020 and December 2021. For Burkina Faso, Chad, Guatemala, Guinea and Nigeria, critical infrastructure was the largest constraint in resilience capabilities (47%, 14%, 51%, 9% and 29% of facilities demonstrated capacity, respectively). Medical supplies and equipment were the largest constraints for Liberia and Malawi (15% and 48% of facilities demonstrating capacity, respectively). In Bangladesh, the largest constraint was workforce and staffing, where 44% of facilities experienced moderate to severe challenges with human resources during the pandemic. The largest constraints in facility resilience during COVID-19 were related to health systems building blocks. These challenges likely existed before the pandemic, suggesting the need for strategic investments and reforms in core capacities of comprehensive primary health-care systems to improve resilience to future shocks.

The Work of Nurses in Primary Health Care: Crossings of the New Public Management.

The literature in the field of health management mentions a concept called new public management (NPM), introduced in Brazil and France at the end of the 20th century. The objective of the study was to analyze the repercussions of the work of nurses in primary health care in Brazil and France under the influence of NPM. This is an excerpt of a double-titled thesis, which is a research intervention with nurses from two Brazilian states and five French departments. Data were produced between February 2019 and July 2021. The public policy Health on the Hour acted as an institutional transducer, provoking a reduction in access and producing effects on professional practices. In both countries, NPM amplified the predominance of technical and quantifiable acts, the focus on individual care, and the loss of autonomy. Nurses reported insurmountable situations, using the metaphor "Sophie's choice". The results showed that making dilemmatic decisions has been the daily routine of nurses, which has not resulted in debureaucratization and higher quality of care.

Patient Characteristics Associated with Telehealth Scheduling and Completion in Primary Care at a Large, Urban Public Healthcare System.

Understanding patient characteristics associated with scheduling and completing telehealth visits can identify potential biases or latent preferences related to telehealth usage. We describe patient characteristics associated with being scheduled for and completing audio and video visits. We used data from patients at 17 adult primary care departments in a large, urban public healthcare system from August 1, 2020 to July 31, 2021. We used hierarchical multivariable logistic regression to generate adjusted odds ratios (aOR) for patient characteristics associated with having been scheduled for and completed telehealth (vs in-person) visits and for video (vs audio) scheduling and completion during two time periods: a telehealth transition period (N = 190,949) and a telehealth elective period (N = 181,808). Patient characteristics were significantly associated with scheduling and completion of telehealth visits. Many associations were similar across time periods, but others changed over time. Patients who were older (≥ 65 years old vs 18-44 years old: aOR for scheduling 0.53/completion 0.48), Black (0.86/0.71), Hispanic (0.76/0.62), or had Medicaid (0.93/0.84) were among those less likely to be scheduled for or complete video (vs audio) visits. Patients with activated patient portals (1.97/3.34) or more visits (≥ 3 scheduled visits vs 1 visit: 2.40/1.52) were more likely to be scheduled for or complete video visits. Variation in scheduling/completion explained by patient characteristics was 7.2%/7.5%, clustering by provider 37.2%/34.9%, and clustering by facility 43.1%/37.4%. Stable and dynamic associations suggest persistent gaps in access and evolving preferences/biases. Variation explained by patient characteristics was relatively low compared with that explained by provider and facility clustering.

Poor glycemic control: a public health challenge prepandemic and pandemic

Objective. To compare glycemic control in patients with type 2 diabetes mellitus who attended primary healthcare units in Mexico City, prepandemic and during the COVID-19 pandemic. Materials and methods. Records of 23 912 diabetes patients were analyzed;78.7% were from the prepandemic group (2016 to 2020) and 21.3% from the pandemic group (March 2020 to July 2021). Central tendency and dispersion measures were calculated, Student's t-test and multiple logistic regression model were performed. Results. Patients with diabetes were mainly women (66.6 and 62.6%) with an average age of 59 and 58 years, respectively. Glycosylated hemoglobin (HbA1) levels were 7.7 in the prepandemic group and (8.0) in the pandemic group. The variables associated with poor glycemic control included period, HbA1 level, overweight, obesity, history of parents with diabetes, number of medications and type of insulin. Conclusions. Most patients with diabetes continued to have poor glycemic control in both groups. Patients in the pandemic group had poor glycemic control compared to the prepandemic group.After medical intervention, patients improved their glycemic control in both groups © 2023,Salud Publica de Mexico. All Rights Reserved.

Lean management technologies to optimize COVID-19 vaccination in adults

Introduction. Lean process improvements are needed to meet the increased adult demand for COVID-19 vaccinations. The purpose of the study is to develop interventions to improve adult vaccination against COVID-19 based on lean manufacturing strategies. Material and methods. We conducted 200 timings of the COVID-19 vaccination process and surveyed 200 vaccinated people. The time of the process, the time of creation of the value stream was calculated, production losses were analyzed. Results. After optimizing the COVID-19 vaccination process, the process time decreased by 2.3 times (from 5474.3 ± 127.3 to 2354.6 ± 22.5 sec;p < 0.01). The time for the prophylactic vaccination against COVID-19 in the vaccination room was reduced by 3 times (from 600.6 ± 23.3 to 181.3 ± 25.6 sec;p < 0.01). Production losses in the form of overproduction, excessive data processing, and unnecessary movements are excluded from the activities of the doctor and the nurse at the vaccination room. The time to value stream creation during vaccination increased from 68% to 97% (p < 0.01). Limitations. The research materials are limited to the results of scientific research of the North-Western State Medical University named after I.I. Mechnikov received over 2021. Conclusion. The use of lean manufacturing technologies made it possible to identify the nature of production losses and analyze the causes of their occurrence in the process of vaccination of the adult population against COVID-19. The organizational measures taken in the form of patient flow management, standardization of work processes, redistribution of functional responsibilities, elimination of production losses contributed to a significant increase in the throughput of the vaccination room in the context of the COVID-19 pandemic. © AUTHORS, 2023.

The Impact of Work Stress on Doctor's Performance through Employee Engagement and Moderation of the COVID-19 Pandemic (Study on Primary Health Care)

BACKGROUND: Doctors at primary health care are prone to have work stress and it can affect their performance. Employee engagement may have close relationship with the doctor's performance during the COVID-19 pandemic. AIM: This study aims to determine the relationship between work stress and the doctor's performance at primary health care using employee engagement mediation and COVID-19 pandemic moderation. METHOD(S): This research is a descriptive study using a quantitative approach which was conducted on 354 doctors at Malang primary health care. The questionnaire was analyzed using partial least square. RESULT(S): The work stress had a significant positive effect on the doctor's performances (beta = 0.257, t-stat = 3.324). Work stress has a significant positive effect on employee engagement (beta = 0.726, t-stat = 22,967). Employee engagement does not significantly affect the doctor's performance (beta = 0.044, t-stat 0.105). Employee engagement does not mediate the work stress effect on doctor's performance (beta = 0.032, t-stat = 0.105). The COVID-19 pandemic did not moderate the work stress effect on doctors' performance (beta = -0.222, t-stat = 0.981). CONCLUSION(S): Primary health care leaders still need to pay attention to factors that can reduce the doctor's performance and employee engagement, include factors that can increase the work stress during the COVID-19 Pandemic.Copyright © 2023 Fida Rahmayanti, Noermijati Noermijati, Armanu Armanu, Fatchur Rohman.

The COVID-19 Pandemic Influence on Doctor's Service Performance Using Workload as a Mediation Variable

BACKGROUND: The COVID-19 pandemic greatly affected doctors' increasing workload, especially in Primary Health Care Facilities. If this is not addressed immediately, it will affect the performance or quality of a doctor's service. AIM: This research objective is to identify the role of Primary Healthcare Facility doctors' workload in moderating the impact of the COVID-19 Pandemic on their performance. METHOD(S): The explanatory-descriptive research was conducted using a quantitative approach. The research respondents were 103 general practitioners who worked at a Primary Healthcare Facility in Malang City (35.0% male and 65.0% female, the most extensive age range was 26-35 years (74.8%), with a working period of 1-5 years. 57 (55.3%) The research instrument was a questionnaire declared valid and reliable, distributed online, and analyzed using Partial Least Square. RESULT(S): The findings demonstrated that the COVID-19 pandemic significantly positively affected the performance of Primary Healthcare Facility doctors (beta = 0.455, t stat = 11.390). The pandemic also significantly impacted workload (beta = 0.283, t stat = 4.347). Workload impacted performance significantly and positively (beta = 0.224, t stat 4.157). Workload mediates the COVID-19 Pandemic influence on doctors' performance (beta = 0.063, t stat = 3.005). CONCLUSION(S): Doctors at Primary Health Care have not all experienced a decline in performance despite the increased workload due to the COVID-19 Pandemic. It forces doctors to juggle between completing their tasks, fighting against disease, and improving their performance.Copyright © 2023.

The changes in work process of community health agent in Brazil during the COVID-19 pandemic / As mudanças no processo de trabalho dos Agentes Comunitários de Saúde no Brasil durante a pandemia da COVID-19

Objetivo: analisar as mudanças no processo de trabalho do Agente Comunitário de Saúde, entre os anos de 2019 e 2020, em meio ao cenário da pandemia da COVID-19. Metodologia: caracteriza-se por um estudo documental, quantitativo, do tipo ecológico, de série temporal. Os dados foram coletados na base de dados do Sistema de Informação em Saúde para a Atenção Básica. As variáveis do estudo tratam-se de dados referentes às atividades do Agente Comunitário de Saúde quanto às atividades coletivas, visitas domiciliares e os indicadores de desempenho elencados pelo sistema. Os dados foram analisados no SPSS versão 24.0, por meio de um cálculo do percentual de variação (%V) entre os anos coletados. Logo após, foi realizado o Teste T de Student para verificar diferenças estatisticamente relevantes entre os anos avaliados (p<0,05). Resultados: quanto às atividades coletivas, houve redução significativa (p<0,001) de 51,1% entre os anos. As visitas domiciliares também apresentaram uma diminuição do percentual de variação (18,6%); já os indicadores de desempenho não demonstraram significativas mudanças. Conclusões: diante do estudado, as ações de prevenção e promoção da saúde foram as mais prejudicadas nesse cenário, sendo necessário um maior empenho do Poder Público para a melhoria desses indicadores.

Objective: to analyze the changes in the work process of the Community Health Agent, of the Family Health Strategy, between 2019 and 2020, amid the COVID-19 pandemic scenario. Methods: characterized by a documentary, quantitative, ecological study, with a time series. Data were collected from the database of the Health Information System for Primary Care. The study variables are data referring to the activities of the Community Health Agent regarding collective activities, home visits, and the performance indicators listed by the system. Data were analyzed using SPSS version 24.0, by calculating the percentage of variation (%V) between the years collected. Soon after, the Student's T-test was performed to verify statistically relevant differences between the evaluated years (p<0.05). Results: regarding collective activities, there was a significant reduction (p<0.001) of 51.1% between the years. Home visits also showed a decrease in the percentage of variation (18.6%); performance indicators did not show significant changes. Conclusions:given the study, prevention, and health promotion actions were the most affected in this scenario, requiring greater efforts by the Government to improve these indicators.

Nursing practice and teleconsultations in a pandemic context: A mixed-methods study.

AIM: To explore the use and implementation of teleconsultations by primary care nurses in the context of the COVID-19 pandemic. BACKGROUND: Teleconsultation use increased rapidly during the COVID-19 pandemic. Its implementation has been documented for physicians and specialists, but knowledge is still limited in nursing practice. DESIGN: A sequential mixed-methods study. METHODS: Phase 1: A cross-sectional e-survey with 98 nurses (64 nurse clinicians [NCs] and 34 nurse practitioners [NPs]) was conducted in 2020 in 48 teaching primary care clinics in Quebec (Canada). Phase 2: Semi-structured interviews with four NCs and six NPs were conducted in 2021 in three primary care clinics. This study adheres to STROBE and COREQ guidelines. RESULTS: During the pandemic, telephone was the principal teleconsultation modality used by NPs and NCs compared to other teleconsultation modalities (text messages, email and video). The only variable associated with a higher likelihood of using teleconsultations was type of professional (NCs). Video consultation was almost absent from the modalities used. The majority of participants reported several facilitators to using teleconsultations in their work (e.g. web platforms and work-family balance) and for patients (e.g. rapid access). Some barriers to utilisation were identified (e.g. lack of physical resources) for successful integration of teleconsultations at the organisational, technological and systemic levels. Participants also reported positive (e.g. assessment of cognitive deficiency) and negative (e.g. rural population) impacts of using teleconsultations during a pandemic that made the use of teleconsultations complex. CONCLUSION: This study highlights the potential for nurses to use teleconsultations in primary care practice and suggests concrete solutions to encourage their implementation after the pandemic. RELEVANCE TO CLINICAL PRACTICE: Findings emphasize the need for updated nursing education, easy-to-use technology and the strengthening of policies for the sustainable use of teleconsultations in primary health care. IMPLICATIONS FOR THE PROFESSION: This study could promote the sustainable use of teleconsultations in nursing practice. REPORTING METHOD: The study adhered to relevant EQUATOR guidelines; the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies were used for reporting. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution, as the study focused on the use of teleconsultation among health professionals, specifically primary care nurses.