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Food prescription programs (Food Rx) have the potential to improve management of diet-related chronic diseases or underlying conditions such as type 2 diabetes (T2D), hypertension, and high body mass index (BMI) among food-insecure patients. The purpose of this study was to examine the effectiveness of a Food Rx program implemented in two community-based clinics in Florida. Data were collected through researcher-administered surveys (food insecurity, demographics, and socio-economic variables) and biometric data (HbA1c, blood pressure, and BMI). Key results include the following: (1) Hispanic patients are more likely to utilize the program than their Black and White counterparts (p < 0.001); (2) older patients (≥50 years) have a higher food redemption rate when compared to younger patients (36–49.9 years); (3) food redemption rate is negatively associated with food security scores indicating improvements in food security status over time (r2 = −0.184, p = 0.036); (4) diabetic patients with higher baseline HbA1c (>9%) have significant reductions in glycated hemoglobin (p = 0.011) over time as compared to patients with lower baseline values (<7%); and (5) patients enrolled in the program for at least 6 months have a significant reduction in systolic blood pressure (p = 0.051). Changes in BMI were not significantly associated with redemption rates. This study is significant as it offers insights into the potential benefits and challenges of implementing Food Rx programs to address diet-related chronic diseases among underserved populations. [ABSTRACT FROM AUTHOR]

Diesel generators are being employed as a means of generating electrical power in various regions across the globe. Considering the imperative to foster environmental sustainability, it appears that conventional electric-producing systems may not be economically viable or environmentally sound, necessitating their replacement with renewable energy alternatives. This study examines the viability of utilizing hybrid electric systems powered by renewable energy sources in health clinics located in Salalah, Oman. The HOMER software, which is utilized for the analysis of system configurations, was employed to examine the application and functional constraints of each hybridized setup. The results indicated that the renewable energy system exhibited the lowest cost of energy in contrast to both the generator set and hybridized energy systems. Renewable energy has superior power generation capabilities in comparison to hybridized energy and standalone generator set systems, rendering it the most economically feasible option and a more favorable choice for meeting the electrification requirements of health clinics.

Introduction: Previous medication adherence studies primarily focused on the domains of non-adherence in hypertension treatment and less attention has been given on domains that encourage adherence to anti-hypertensive medications. The current study is aimed to identify the domains of adherence and non-adherence to anti-hypertensive medications among hypertensive patients in Kuala Lumpur, Malaysia. Methods: Hypertensive patients from two public health clinics in Kuala Lumpur were invited for in-depth interviews until thematic saturation. Audio recordings from these interviews were transcribed verbatim. Transcripts were then analysed deductively with the guidance of the World Health Organization Medication Adherence Framework to extract the domains of adherence and non-adherence to anti-hypertensive medications. Results: Ten patients who were predominantly Malays and aged 34-73 years old participated the study. Patient-related (encompassing knowledge, attitude, belief and culture, lifestyle, personal barriers, self-efficacy, and cue to action), socioeconomic (encompassing social support), condition-related (encompassing nature of illness and presence of multiple co-morbidities), therapy-related (encompassing experience of receiving treatment, barrier in treatment, and side effects of treatment), and healthcare system (encompassing access to healthcare and healthcare center experience) domains were identified as central to the medication-taking behaviour of hypertensive patients. Conclusion: Sixteen codes of adherence and 22 codes of non-adherence to anti-hypertensive medications were identified, which were distributed across five domains (patient-related, socioeconomic, condition-related, therapy related, and healthcare system domains). These findings can help to inform future development of medication adherence questionnaires, individualised interventions for patients with adherence problems, and targeted health promotion programmes to reduce uncontrolled hypertension. [ABSTRACT FROM AUTHOR]

Abstract Background In the Finnish policy on older people preventive activities, which maintain functional capacity and independent living, are emphasized. The Turku Senior Health Clinic, aimed at maintaining independent coping of all home-dwelling 75-year-old citizens in the city of Turku, was founded in the beginning of 2020. The aim of this paper is to describe design and protocol of the Turku Senior Health Clinic Study (TSHeC) and provide results of the non-response analysis. Methods The non-response analysis used data from 1296 participants (71% of those eligible) and 164 non-participants of the study. Sociodemographic, health status, psychosocial and physical functional ability indicators were included in the analysis. Participants and non-participants were also compared in respect to their neighborhood socioeconomic disadvantage. Differences between participants and non-participants were tested using the Chi squared or Fisher´s exact test for categorical variables and t-test for continuous variable. Results The proportions of women (43% vs. 61%) and of those with only satisfying, poor or very poor self-rated financial status (38% vs. 49%) were significantly lower in non-participants than in participants. Comparison of the non-participants and participants in respect to their neighborhood socioeconomic disadvantage showed no differences. The prevalence of hypertension (66% vs. 54%), chronic lung disease (20% vs. 11%), and kidney failure (6% vs. 3%) were higher among non-participants compared to participants. Feelings of loneliness were less frequent among non-participants (14%) compared to participants (32%). The proportions of those using assistive mobility devices (18% vs. 8%) as well as those having previous falls (12% vs. 5%) were higher in non-participants than in participants. Conclusions The participation rate of TSHeC was high. No neighborhood differences in participation were found. Health status and physical functioning of non-participants seemed to be slightly worse than those of the participants, and more women than men participated. These differences may weaken the generalizability of the findings of the study. The differences have to be taken into account when recommendation for the content and implementation of preventive nurse-managed health clinic in primary health care in Finland is going to be given. Trial registration ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.

Background: In the Finnish policy on older people preventive activities, which maintain functional capacity and independent living, are emphasized. The Turku Senior Health Clinic, aimed at maintaining independent coping of all home-dwelling 75-year-old citizens in the city of Turku, was founded in the beginning of 2020. The aim of this paper is to describe design and protocol of the Turku Senior Health Clinic Study (TSHeC) and provide results of the non-response analysis. Methods: The non-response analysis used data from 1296 participants (71% of those eligible) and 164 non-participants of the study. Sociodemographic, health status, psychosocial and physical functional ability indicators were included in the analysis. Participants and non-participants were also compared in respect to their neighborhood socioeconomic disadvantage. Differences between participants and non-participants were tested using the Chi squared or Fisher´s exact test for categorical variables and t-test for continuous variable. Results: The proportions of women (43% vs. 61%) and of those with only satisfying, poor or very poor self-rated financial status (38% vs. 49%) were significantly lower in non-participants than in participants. Comparison of the non-participants and participants in respect to their neighborhood socioeconomic disadvantage showed no differences. The prevalence of hypertension (66% vs. 54%), chronic lung disease (20% vs. 11%), and kidney failure (6% vs. 3%) were higher among non-participants compared to participants. Feelings of loneliness were less frequent among non-participants (14%) compared to participants (32%). The proportions of those using assistive mobility devices (18% vs. 8%) as well as those having previous falls (12% vs. 5%) were higher in non-participants than in participants. Conclusions: The participation rate of TSHeC was high. No neighborhood differences in participation were found. Health status and physical functioning of non-participants seemed to be slightly worse than those of the participants, and more women than men participated. These differences may weaken the generalizability of the findings of the study. The differences have to be taken into account when recommendation for the content and implementation of preventive nurse-managed health clinic in primary health care in Finland is going to be given. Trial registration: ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Introduction: The elderly population is highly vulnerable to malnutrition, including those in the community. The use of nutrition education as part of nutrition intervention is able to improve their nutritional status. Hence, provision of a nutrition resource kit addressing the needs of at-risk and malnourished elderly would be advantageous. This research aimed to develop, validate and evaluate the acceptance of a newly developed nutrition resource kit, which served as an educational material among at-risk and malnourished elderly in Malaysian health clinics. Methods: This study was conducted in three phases: Phase I comprised of qualitative needs assessment to identify the types of nutrition resource kit needed; Phase II was the development and validation of the nutrition resource kit; while Phase III was acceptance evaluation, which involved individual in-depth interview and triangulation. Results: An A5-sized booklet with incorporation of an educational video in a QR code was developed. Both printed material and educational video had excellent content and face validity. Suggestions by experts and elderly from validation were considered and revision was done accordingly. Acceptance evaluation revealed four themes: 1) positive acceptance, 2) elderly-friendly, 3) valuable, and 4) individual preference. Triangulation data revealed that all elderly positively evaluated both resources. Additional suggestions given by elderly were considered for improvement. Conclusion: This newly developed nutrition resource kit, both in the printed and electronic format, was well-accepted among the at-risk and malnourished elderly. It could be used as an important reference for the elderly, especially those attending health clinics, in treating and preventing malnutrition. [ABSTRACT FROM AUTHOR]

Background: Healthcare waste management requires special attention and every healthcare teams should be involved in handling of wastes at point of generation. However, less attention is given to healthcare waste management in Ethiopia and there is no evidence about healthcare waste management practices in private clinics in Addis Ababa. Accordingly, this study was conducted to assess healthcare waste management practices and associated factors in private clinics in Addis Ababa, Ethiopia. Methods: A health facility-based cross-sectional study was conducted in 278 randomly selected private clinics in Addis Ababa. Data were collected using questionnaire and observational checklists. Multivariable binary logistic regression analysis was used to identify factors associated with healthcare waste management practices on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P -values <.05. Result: Results showed that 61.2% of the surveyed clinics had poor healthcare waste management practices, out of which, 56.8% had poor waste segregation practice, 55.0% had poor waste collection practice, 85.6% had poor waste transportation practice, 63.3% had poor waste storage practice, 61.9% had poor waste treatment, and 57.9% had poor disposal system. Healthcare waste management practice in the surveyed clinics was significantly associated with presence of guidelines (AOR: 1.98, 95% CI: 1.06, 3.69), budget allocation (AOR: 2.05, 95%, CI: 1.20, 3.49), and inspection by the regulatory bodies (AOR: 2.47, 95% CI: 1.26, 4.84). Conclusion: Healthcare waste management practice was poor in the surveyed clinics. This suggests that the healthcare industries in the studied region may create health treats to healthcare workers, waste handlers, patients, the community, and the environment at large. The following key elements are needed to improve healthcare waste management practices in private clinics: promoting practices that reduce the volume of waste generated and ensure proper waste segregation; developing strategies and systems, as well as strong oversight and regulation, to incrementally improve waste segregation, destruction, and disposal practices with the ultimate goal of meeting national and international standards; and selecting safe and environmentally-friendly management options, to protect people from hazards when collecting, handling, storing, transporting, treating or disposing of waste. [ABSTRACT FROM AUTHOR]

Background: Small clinics are important in providing health care in local communities. Accurately predicting their closure would help manage health care resource allocation. There have been few studies on the prediction of clinic closure using machine learning techniques., Objective: This study aims to test the feasibility of predicting the closure of medical and dental clinics (MCs and DCs, respectively) and investigate important factors associated with their closure using machine running techniques., Methods: The units of analysis were MCs and DCs. This study used health insurance administrative data. The participants of this study ran and closed clinics between January 1, 2020, and December 31, 2021. Using all closed clinics, closed and run clinics were selected at a ratio of 1:2 based on the locality of study participants using the propensity matching score of logistic regression. This study used 23 and 19 variables to predict the closure of MCs and DCs, respectively. Key variables were extracted using permutation importance and the sequential feature selection technique. Finally, this study used 5 and 6 variables of MCs and DCs, respectively, for model learning. Furthermore, four machine learning techniques were used: (1) logistic regression, (2) support vector machine, (3) random forest (RF), and (4) Extreme Gradient Boost. This study evaluated the modeling accuracy using the area under curve (AUC) method and presented important factors critically affecting closures. This study used SAS (version 9.4; SAS Institute Inc) and Python (version 3.7.9; Python Software Foundation)., Results: The best-fit model for the closure of MCs with cross-validation was the support vector machine (AUC 0.762, 95% CI 0.746-0.777; P<.001) followed by RF (AUC 0.736, 95% CI 0.720-0.752; P<.001). The best-fit model for DCs was Extreme Gradient Boost (AUC 0.700, 95% CI 0.675-0.725; P<.001) followed by RF (AUC 0.687, 95% CI 0.661-0.712; P<.001). The most significant factor associated with the closure of MCs was years of operation, followed by population growth, population, and percentage of medical specialties. In contrast, the main factor affecting the closure of DCs was the number of patients, followed by annual variation in the number of patients, year of operation, and percentage of dental specialists., Conclusions: This study showed that machine running methods are useful tools for predicting the closure of small medical facilities with a moderate level of accuracy. Essential factors affecting medical facility closure also differed between MCs and DCs. Developing good models would prevent unnecessary medical facility closures at the national level., (©Young-Taek Park, Donghan Kim, Ji Soo Jeon, Kwang Gi Kim. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 30.08.2024.)

Most inhabitants of rural communities in Africa lack access to clean and reliable electricity. This has deprived the rural dwellers access to modern healthcare delivery. In this paper, an off-grid renewable energy system consisting of solar PV and wind turbine with hydrogen storage scheme has been explored to meet the electrical energy demands of a health clinic. The health clinic proposed is a group II with 10 beds located in a typical village in South Africa. First, the wind and solar energy resources of the village were analysed. Thereafter, the microgrid architecture that would meet the energy demand of the clinic (18.67 kWh/day) was determined. Some of the key results reveal that the average annual wind speed at 60 m anemometer height and solar irradiation of the village are 7.9 m/s and 4.779 kWh/m2/day, respectively. The required architecture for the clinic composes of 40 kW solar PV system, 3 numbers of 10 kW wind turbines, 8.6 kW fuel cell, 25 kW electrolyser and 40 kg hydrogen tank capacity. The capital cost of the microgrid was found to be $177,600 with a net present cost of $206,323. The levelised cost of energy of the system was determined to be 2.34 $/kWh. The project has a breakeven grid extension distance of 8.81 km. Since this distance is less than the nearest grid extension distance of 21.35 km, it is established that the proposed renewable energy microgrid with a hydrogen storage system is a viable option for the rural community health clinic. • PV/Wind microgrid with hydrogen storage has been designed for a rural health clinic. • The microgrid was compared with grid extension for decision making purpose. • The capital and net present cost of the microgrid were $177,600 and $206,323. • The project has a breakeven grid extension distance of 8.81 km. • The renewable microgrid is a better option compared to grid extension. [ABSTRACT FROM AUTHOR]

Excessive patient waiting time at dispensing pharmacies is attributed to workflow inefficiencies that are difficult to isolate. The objectives of this study are to quantify current operational process and delay times and also to identify bottlenecks that lead to excessive waiting time at the pharmacy unit of primary health clinics in Temerloh district. A multicentre observational cohort study was conducted at a Pharmacy Unit of Bandar Mentakab Health Clinic (KKBM), Temerloh Health Clinic (KKT) and Tanjung Lalang Health Clinic (KKTL). Stopwatch technique was applied for all four operational procedures (greeting, data entry, filling and dispensing) based on workflow analysis. Data collection forms were used to identify factors and their impact on process time. Major components causing long waiting times were found in delay segments. Significant time delay occurred before greeting at KKT; before data entry at KKBM, KKT and KKTL; and before dispensing at KKTL. Among factors found affecting process segment in data entry include presence of intervention and psychotropic substances in the prescription. Filling process was found to be delayed by the presence of more than three items, cold items, intervention and psychotropic substances in the prescription. In addition, dispensing process was found to be delayed by errors in data entry and filling. This study identified several common bottlenecks and isolated issues specific to each pharmacy unit of three health clinics that lead to excessive operational process and delay times in pharmacy dispensing process. This approach laid a solid base to spearhead future optimisation strategies to improve efficiency and shorten waiting time. [ABSTRACT FROM AUTHOR]

Introduction: Creating engagement with generated content has become a major challenge for health-oriented brand communities. Therefore, the present study seeks to fully understand the brand - consumer and consumerconsumer engagement with the content generated by the Instagram social network health clinics. Method: The present study was conducted in two steps. In the first step, data was collected by interviewing nine native experts and a review of previous studies. And designed research model with the axial, open, and selective coding. In the second step, with the Nethnography method, 1572 posts of Instagram 8 health clinics were coded for 1 year period and analyzed by SPSS using multiple variance analysis and correlation tests. In general, the present study was conducted as a multiple case study method. Results: 95% confidence level there is a meaningful relationship between content type, hashtag, content agility (except saved post and discovery percentage), content day (except discovery percentage and reach), content context (except profile visit and percentage discovery) and tone of voice (except like, impression, discovery percentage and new follower) with brand-consumer engagement and also between the content type, content day, content context, content agility (except mention), tone of voice (except comment) and hashtag (except mention) with consumer-consumer engagement. Conclusion: In order to creating engagement, we must raise brand-consumer and consumer-consumer engagement, this requires the production of appropriate content

This article aims to describe the phenomenon of learning at a university-based nursing student–run health clinic, as experienced by student nurses and lecturers. The study is based on a reflective lifeworld research approach founded on continental philosophy. Eight group interviews were conducted with 38 student nurses and 5 lecturers. The data were explored and analysed for meaning. The results show that learning is supported by a permissive learning environment that builds on both individual and common learning as well as equal relationships within the student group, in relation to the visitors at the health clinic and, to a certain extent, in relation to the lecturers. The most significant finding is that reflective, development-oriented learning takes place when the students, supported by each other and their lecturers, reflect on how to relate to problems and situations. A situation-based learning approach is thus shown to create the prerequisites for lecturers being nearby, reflective dialogue partners but also supervisors in situations where the students ask for support and guidance. [ABSTRACT FROM AUTHOR]

Introduction: Primary care is the first level of contact with the health system to promote health, prevent illness, care for common illnesses, and manage on-going health problems. Maternal health services were one of the important components of primary care delivered through health clinics and community clinics. It is crucial to ensure scarce resources in health clinic were utilized efficiently. Data envelop analysis is a technique which had advantage in assessment of efficiency of primary care because the technique can handle multiple inputs and outputs in efficiency score calculation. Objectives: To assess technical efficiency of maternal health services and it determinants in primary care setting of health clinics in Negeri Sembilan using data envelopment analysis (DEA). Methodology: This evaluation research employing cross-sectional study design using primary data from health district offices and health clinics in Negeri Sembilan. Sources of data includes administrative records and expenditure records from district health offices, and maternal health services utilization obtained from clinic records. The study randomly selected 16 maternal health services of health clinics as DMUs. Data for 2016 and 2017 were used in the analysis. Analysis of DEA used two-stage DEA. In the first stage DEA to efficiency score, namely: overall technical efficiency (OTE), pure technical efficiency (PTE) and scale efficiency (SE) scores. In the second stage, four environmental variables namely location of health clinic, distance of health clinic to the nearest health facility, years of service of nurses and comorbidity of patient regressed against PTE score using Tobit regression analysis. Results: In 2016, average pure technical efficiency (PTE) for maternal health services were 60.50% (SD 35.50). An increased in mean PTE in 2017 for maternal health services with the score of 67.30% (SD 34.30). Maternal health services in type 2 health clinic were efficient as compared with other types of health clinic in 2016. In 2017, maternal health services in health clinic type 6 were efficient. One determinant was found to significantly affect TE (comorbidity of patient). Conclusion: The findings from this study found that technical efficient maternal health services in Negeri Sembilan were in Health Clinic Type 5 (31.25%) and Health Clinic Type 6 (37.50%) in 2016 and 2017 respectively. Patients with more comorbidity significantly decrease technical efficiency of maternal health services. [ABSTRACT FROM AUTHOR]

Background: Primary care services are delivered through health clinics. Issue of resource scarcity and wastage cannot be denied in health care. Evaluating efficiency of health clinics will provide information on resource utilization, therefore optimization of resources used can be carried out. Several techniques used to measure efficiency including data envelopment analysis (DEA). Environmental variables have been documented to have impact on values of efficiency score and rank of units. Knowledge on the environmental variables used in measuring efficiency of health clinic to equip policy makers with more accurate results and subsequently assist in decision making. The aim of this manuscript is to review literature on environmental variables used in measuring efficiency of health clinics with DEA. Materials and Methods: A review was conducted using online databases namely Pub Med, Science Direct, CINAHL and MEDLINE to identify articles and publications that were related to measuring efficiency in health clinics using DEA. Result: 423 studies were obtained from the initial search. After excluding non-English literature, limiting publication from year 2007 and applying inclusion and exclusion criteria, a total of 11 publications were selected for review. Conclusion: This review identified different environmental variables used in measuring efficiency of health clinics. The variables can be categorized into staff characteristics, patient characteristics, facility characteristic and others. Many variables were also found to be significant in affecting efficiency of health clinics regardless of the stage of DEA used. Taking into consideration the importance of environmental variables, they should be included in measuring efficiency of health clinic. It will help health managers to make an informed decision. [ABSTRACT FROM AUTHOR]

Background: Palestinian refugees have been a displaced group of people since 1948, many of whom are living in refugee camps in the Middle East. They are entitled to free health care from the United Nations Relief and Work Agency (UNRWA). They show a higher prevalence of diabetes than the population in their host countries in the Middle East. This study examined the realities of care for diabetic patients in UNRWA health clinics in Damascus, Syria. The aim was three‑fold: To investigate the level of diabetes care, to probe patients′ level of general understanding of their disease and its management, and to search for areas of potential improvement. Methods: Data on patient education and care was gathered over a 1 month period from August 4, 2008 to September 4, 2008 using questionnaires and direct observation of the workflow at the clinics. Clinic‑led care was observed by the study team using checklists during patient visits. All of the clinic staff and sampled patients were interviewed. The main areas of care assessed were: Patient follow‑up; examination of eyes and feet; availability of medications; and patient education. A total of 154 people with diabetes were sampled from three refugee camps situated around Damascus. Results: A total of 154 patients, three doctors and seven nurses composed the sample of the study. Foot examinations were almost always neglected by health staff and eye examinations were not offered by the UNRWA clinics. Interviews with patients showed that: 67% (95% confidence intervals [CI]: 0.59‑0.70) had to buy their medication at their own expense at least once due to medication shortage in the UNRWA clinics, 48% (95% CI: 0.40‑0.55) displayed poor knowledge regarding the cause and exacerbating factors of diabetes, 65% (95% CI: 0.56‑0.72) had not heard of insulin, and 43% (95% CI: 0.35‑0.51) did not know for how long they needed to take their medications.

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Integrating applied learning and research experiences into the curriculum at any academic level represents hands-on, student-centered learning at its best. It provides expanded opportunities for instructional innovations and faculty-student mentorships that can both translate to the classroom and extend beyond the classroom. Here we propose an interdisciplinary, comprehensive, and immersive approach to integrating service-learning and research into the science, technology, engineering and math (STEM) classroom by devising the infrastructure necessary for students to have the opportunity to actively participate in a local food security network. Presented here are two examples of experiential-learning activities integrated into STEM curricula that align learning objectives with food security stakeholder needs. We hypothesize that the sense of personal responsibility to serve and empower food security network stakeholders will be a very important motivating factor for students to master the accompanying STEM learning objectives that have been integrated into the framework of the service-learning project.

This paper aims to introduce the architectural design for the headquarters of the Rheumatics Association of Uberlândia and Region (Associação de Reumáticos de Uberlândia e Região - ARUR). This project is a result of an extension program developed by professors, technicians and students in the Projects Laboratory of the Faculty of Architecture and Urbanism and Design (Laboratório de Projetos da Faculdade de Arquitetura e Urbanismo e Design - FAUeD) at the Federal University of Uberlândia (UFU). The activities to be carried out in that space includes physiotherapy, hydrotherapy, acupuncture and occupational therapy and gymnastics. The project envisions rooms for medical, psychological and legal services and seeks to provide an environment for the members to interact, in addition to promoting social events to raise funds for the association. [ABSTRACT FROM AUTHOR]