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Projektom „Klinika za ženske bolesti i porode„ planirana je rekonstrukcija postojeće izgradnje i izgradnja nove „Klinike za ženske bolesti i porode“ namijenjene za dijganostiku, obradu te prihvat perinatoloških i ginekoloških pacijentica i urediti neophodnu infrastrukturu za dovođenje zgrade i okolnih parcela u funkciju. Urbanističko rješenje Klinike za ženske bolesti i porode čini krug zgrada Opće bolnice Virovitica koji obuhvaća pet postojećih građevina i visoko prizemlje objedinjenih poliklinika s dvije nove zgrade uprave te ginekologije. Urbanističko uređenje u formi je kruga bolničkog kompleksa s okolnom cestom te tangirajućim dodatnim sadržajima bolnice na njezinom obodu. Predmetno idejno rješenje odnosi se na objekt visokog prizemlja s pripadajućim lamelama, međusobno funkcionalno povezanih no konstrukcijski odvojene dilatacijom., The project „ Clinic for Women's Diseases and Childbirth “ is planned to reconstruct the existing building and build a new„ Clinic for Women's Diseases and Childbirth“ intended for the diagnosis, treatment, and reception of perinatological and gynecological patients and arrange the necessary infrastructure to bring the building and surrounding plots into operation. The urban design of the clinic is a circle of buildings of the Virovitica General Hospital, which includes five existing buildings and the upper ground floor of the unified polyclinics with two new administration and gynecology buildings. The urban design is in the form of a circle of the hospital complex with the surrounding road and tangential additional facilities of the hospital on its perimeter. The conceptual solution in question refers to a high ground floor building with associated slats, functionally connected to each other but structurally separated by expansion.

Projektom „Klinika za ženske bolesti i porode„ planirana je rekonstrukcija postojeće izgradnje i izgradnja nove „Klinike za ženske bolesti i porode“ namijenjene za dijganostiku, obradu te prihvat perinatoloških i ginekoloških pacijentica i urediti neophodnu infrastrukturu za dovođenje zgrade i okolnih parcela u funkciju. Urbanističko rješenje Klinike za ženske bolesti i porode čini krug zgrada Opće bolnice Virovitica koji obuhvaća pet postojećih građevina i visoko prizemlje objedinjenih poliklinika s dvije nove zgrade uprave te ginekologije. Urbanističko uređenje u formi je kruga bolničkog kompleksa s okolnom cestom te tangirajućim dodatnim sadržajima bolnice na njezinom obodu. Predmetno idejno rješenje odnosi se na objekt visokog prizemlja s pripadajućim lamelama, međusobno funkcionalno povezanih no konstrukcijski odvojene dilatacijom. The project „ Clinic for Women's Diseases and Childbirth “ is planned to reconstruct the existing building and build a new„ Clinic for Women's Diseases and Childbirth“ intended for the diagnosis, treatment, and reception of perinatological and gynecological patients and arrange the necessary infrastructure to bring the building and surrounding plots into operation. The urban design of the clinic is a circle of buildings of the Virovitica General Hospital, which includes five existing buildings and the upper ground floor of the unified polyclinics with two new administration and gynecology buildings. The urban design is in the form of a circle of the hospital complex with the surrounding road and tangential additional facilities of the hospital on its perimeter. The conceptual solution in question refers to a high ground floor building with associated slats, functionally connected to each other but structurally separated by expansion.

Cilj ovog rada je predstaviti prednosti i analizirati nedostatke Hrvatske kao destinacije za zdravstveni turizam. Republika Hrvatska je popularna turistička destinacija i turizam kao takav čini značajan udio u bruto domaćem proizvodu Republike Hrvatske, istovremeno zdravstveni turizam je nedovoljno zastupljen u ukupnom postotku turizma i kao takav pruža mogućnost razvoja pa time utječe i na razvoj Hrvatske kao turističke destinacije kroz cijelu godinu. Nastavno, zdravstveni turizam bilježi godišnji rast od 15 do 20% diljem svijeta i time se postavlja kao novi trend na tržištu koji proizlazi iz potrebe (a ne želje), što je izrazita prednost i snaga spram proizvoda, u ovom slučaju turizma, koji proizlazi iz želje za posjetom određenoj destinaciji. Zdravstveni turizam temelji se na prirodnim lječilištima, preventivnim, medicinskim i rehabilitacijskim programima te raznim vrstama wellness ponuda. Zdravstveni turizam u Hrvatskoj ima prirodne predispozicije, dugu tradiciju te temeljnu infrastrukturu koja zahtjeva unaprjeđenje i kontinuriano ulaganje. Trenutna situacija u Hrvatskoj u pogledu zdravstvenog turizma nije obećavajuća jer velike javne zdravstvene ustanove, poput kliničkih bolničkih centara, opće bolnice ili poliklinike, ne pokazuju interes za zdravstveni turizam. Zdravstveni turizam u Hrvatskoj još uvijek je sporadičan, nedovoljno diverzificiran, relativno nesređen i slabo prepoznatljiv. Najniža razina zadovoljstva među gostima iskazana je u odnosu na inovativnost ponude i prilagođenost wellness centra osobama s posebnim potrebama. Potrebno je ulagati u kapacitete hotelske i zdravstvene suprastrukture prateći zahtjeve suvremene svjetske turističke potražnje, što uključuje i obrazovanje osoblja i povećanje konkurentnosti na međunarodnom tržištu. Provedeno je istraživanje i rezultati prikazani grafički. Na temelju istraživanja može se zaključiti da Hrvatska ima preduvjete za razvoj zdravstvenog turizma, posebice grane medicinskog turizma. U samom radu se predstavlja razvoj istoga, te prednosti i nedostaci Hrvatske kao destinacije za zdravstveni turizam. The aim of this paper is to present the advantages and analyze the disadvantages of Croatia as a destination for health tourism. The Republic of Croatia is a popular tourist destination and as such tourism makes up a significant share of the gross domestic product of the Republic of Croatia, at the same time health tourism is underrepresented in the total percentage of tourism and as such provides the opportunity for development and thereby affects the development of Croatia as a tourist destination throughout the year. Furthermore, health tourism records an annual growth of 15 to 20% worldwide and thus sets itself up as a new trend in the market arising from need (and not desire), which is a distinct advantage and strength compared to the product, in this case tourism, which arises from wishes to visit a certain destination. Health tourism is based on natural spas, preventative, medical and rehabilitation programs and various types of wellness offers. Health tourism in Croatia has natural predispositions, a long tradition and basic infrastructure that requires improvement and continuous investment. The current situation in Croatia regarding health tourism is not promising because large public health institutions, such as clinical hospital centers, general hospitals or polyclinics, do not show interest in health tourism. Health tourism in Croatia is still sporadic, insufficiently diversified, relatively unsettled and poorly recognizable. The lowest level of satisfaction among guests was expressed in relation to the innovativeness of the offer and the suitability of the wellness center for people with special needs. It is necessary to invest in the capacities of the hotel and health superstructure following the requirements of contemporary world tourism demand, which includes staff education and increasing competitiveness on the international market. The research was conducted and the results are presented graphically. Based on the research, it can be concluded that Croatia has the prerequisites for the development of health tourism, especially the branch of medical tourism. The paper itself presents the development of the same, as well as the advantages and disadvantages of Croatia as a destination for health tourism.

У статті подано аналіз ефективності застосування комплексної методики фізичної реабілітації дітей зі сколіозом в умовах поліклініки. У дослідженні взяли участь 174 дитини дошкільного віку зі сколіозом І ступеня. До плану лікувально-відновлювальних заходів були включені: цілодобове дотримання ортопедичного режиму, щоденні заняття лікувальною гімнастикою (спеціальні симетричні, асиметричні та деторсійні вправи), лікувальний масаж з елементами точкового масажу, лікувальне плавання, електростимуляція м’язів, лікувальна хореографія, коригуюча гімнастика після денного сну (виконання ігрових вправ у початковому положенні лежачи з метою підготовки м’язів до активної та ефективної роботи у вертикальному положенні). Завдяки проведенню комплексу реабілітаційних заходів вдалося нормалізувати функціональні можливості хребта у 24,1 % дітей, досягнути покращення постави в 42,6 % хворих та стабілізувати сколіотичний процес у 28,7 % пацієнтів.

Background: Infertility is an inability of a spouse to get pregnant within twelve months seeking pregnancy without using any contraception. The duration of infertility affects the chance to get pregnant. Objective: To identify the factors causing infertility patient came late to Polyclinic Merpati RSUP Dr. Kariadi Methods: This study was an observational descriptive with a cross-sectional design. The data were obtained from medical records and questionnaires. Twenty-six respondents were infertility patients who met the inclusion and exclusion criteria and came to Polyclinic Merpati RSUP Dr. Kariadi in September 2020. Results: The number of infertility patients in September 2020 was 76 patients, 72,4% of them came to Polyclinic Merpati late. Most people came after being referred from the previous doctors. Three factors causing infertility patients came late were economic factors, a social factor, and another difficulty. Conclusion: Factors causing the late coming of infertility patients were economic factors, a social factor, and another difficulty

in its writing, inclusion of information, improper prescription, and even incorrect prescription. The impact of these errors can lead to several factors that can be detrimental, ranging from the inaccuracy of drugs given to certain individuals, errors in measuring the dose given, or incompatibility of drugs with certain patients so that it can result in disability or death. This study aims to determine the completeness of outpatient prescriptions according to prescribing SOP compliance served in the internal disease polyclinic of MM Indramayu Hospital. This study used a descriptive method which was carried out retrospectively using activity data for the period January - December 2020. Sampling was carried out using the Slovin formula and obtained 380 recipes. Based on the data collection and analysis carried out in this evaluation, it can be seen that the administrative completeness of prescriptions that meet the requirements are (74.73%), while the administrative completeness of prescriptions that do not meet the requirements are (25.26%). Administrative documents that meet the criteria are Signature, Incryptio, Invocation, Patient Name and Age (100%), while other administrations are Praescriptio/Ordonatio (28.68%), Subscriptio (45.26%), and Address (75.78%). From this evaluation, it can be concluded that many outpatient prescriptions meet the completeness aspect of the prescription SOP at MM Indramayu Hospital. However, improvements in prescribing need to be done so that there are no prescriptions that do not meet the requirements. This can be done by reviewing doctors to be more thorough and clear in prescription writing, communication between pharmacists and doctors or medical audits of prescription writing

INTRODUCTION Patients with chronic diseases face difficulties when navigating the healthcare system. Using the Healthcare System Hassles Questionnaire (HSHQ) developed by Parchman et al, this study aimed to explore the degree of hassles faced by patients in primary care in Singapore and identify the characteristics associated with greater hassles. METHODS A cross-sectional study was conducted on patients with chronic diseases at Hougang Polyclinic, Singapore, using the interviewer-administered HSHQ. The mean HSHQ score was compared with that reported by Parchman et al. The associations between the number of chronic diseases, demographic variables and healthcare hassles were assessed using multivariate linear logistic regression analysis. RESULTS In total, 217 outpatients aged 21 years and above were enrolled. Their overall mean HSHQ score (4.77 ± 6.18) was significantly lower than that of patients in the study by Parchman et al (15.94 ± 14.23, p < 0.001). Patients with five or more chronic diseases scored 3.38 (95% confidence interval [CI] 0.11–6.65, p = 0.043) points higher than those with one chronic disease did. With each increasing year of age, the mean HSHQ score decreased by 0.17 (95% CI −0.26 to −0.08, p = 0.001) points. Patients with polytechnic/diploma/university education and higher scored 2.65 (95% CI 0.19–5.11, p = 0.035) points higher than those with primary education and lower did. CONCLUSION Patients in our population reported less hassles than those in the study by Parchman et al did. Increasing age and lower education level were associated with less hassles. Further analysis of the types of chronic diseases may yield new information about the association of healthcare hassles with the number and types of chronic diseases.

Introduction. The article considers an approach to organization of research activity using medical information system. Materials and methods. Authors carried out retrospective analytical cohort study of adults with temporary incapacity to work based on the data from the State Medical Institution Galichskaya District Hospital (Kostroma Region of the Russian Federation) for a period 2014–2019. Sampling was done using the medical information system. Results. As the medical information system has been operating for many years and is designed in the way that the key information gaps should be filled, we consider the results of our study on research activity in a polyclinic using medical information system successful. Discussion. The organization of research activity is discussed using results of an epidemiological study aimed at identifying the correlation between the incidence of acute respiratory diseases and further development of circulatory system diseases carried out in Galichskaya District Hospital. For citation: Papicheva MA, Yakushina II. Organization of research activity in a polyclinic using medical information system. City Healthсare. 2021; 2(3):24-34. doi: 10.47619/2713-2617.zm.2021.v2i3;24-34

The results of the joint work of a panel of experts from Rospotrebnadzor and healthcare professionals of the Republic of Uzbekistan on organizing activities to counter the spread of the SARS-CoV-2 virus are described in the paper.The goal of the study was to determine the main driving forces of COVID-19 spread in the Republic of Uzbekistan and develop an action plan to reduce the incidence of coronavirus infection caused by the SARS-CoV-2 virus.Materials and methods. The organization of work in 14 health care institutions in Tashkent and Samarkand, as well as in Tashkent and Samarkand Regions, was analyzed: in 7 laboratories, 6 hospitals and 1 polyclinic. The routes for the movement of personnel, the demarcation of green and red zones, the features of disinfection and the use of personal protective equipment were studied. Attention is drawn to the diagnosis of COVID-19, the use of therapy aimed at reducing the period of virus shedding, the criteria for lifting quarantine restrictions for patients.Results and discussion. The main factors in the organization of work of institutions that contribute to the spread of COVID-19 among medical personnel and the population have been identifed: the lack of equipped gateways between the red and green zones with the accessibility of adequate disinfection, the wrong choice of personal protective equipment, monitoring of contact persons for 10 days, discharge from hospitals based on clinical improvement. The incorrect use of antiviral therapy, the lack of differentiated approaches to the selection of optimal regimens have been noted. Proposals are formulated for organizing the work of healthcare institutions, taking into account the requirements of biological safety. The introduction of targeted measures in addition to those previously adopted has led to a signifcant improvement in the epidemic situation: the total number of active cases in the Republic of Uzbekistan, despite the increase in testing volumes, decreased from 3,686 people on August 23 to 2335 on October 27. Towards December 20, 2020, 97 % of patients recovered completely. All diagnostic triage centers in the Republic of Uzbekistan are closed due to the absence of patients with COVID-19, most of the country’s medical institutions previously re-profled for patients with coronavirus infection have returned to the routine operations.

Currently, work in any medical organization carries a risk of coronavirus infection, and, first of all, this applies to medical organizations dealing with the treatment of patients infected with coronavirus. Medical workers are a group at increased risk of infection with the SARS-CoV-2 virus in the provision of medical care in modern conditions, which determines their incidence of COVID-19 [1–3]. The aim of the study is to explore the prevalence of cases of COVID-19 infection in medical workers providing medical care on an outpatient basis. The analysis of the incidence of COVID-19 medical workers in one of the large medical organizations of the Samara region during the period of the pandemic was carried out. The medical staff of the medical organization includes 207 doctors. There are 11 subdivisions in the structure of the medical and prophylactic institution. Research methods: content analysis of the modern regulatory framework (2020-2021), statistical, expert. For the period from May 2020 to March 2021 71 cases of infection of medical workers on an outpatient basis with SARS-CoV-2 were identified, of which 32 doctors (45%) and 39 people (55%) nurses. Based on the results of the expert assessment, the insurance nature of the infection case was established in 50 people (70%). Among the medical and nursing categories of medical workers, the largest number of cases was made by doctors and nurses of primary contact — specialists of the district service: general practitioners (40%), pediatricians (32%), doctors — obstetricians-gynecologists (12%), nurses adults (76%) and children (20%) polyclinic departments. A third of health workers received inpatient treatment for severe COVID-19, an average of 60 days. Medical workers are a risk group of COVID-19 who need support measures, since the possibility of occupational infection has been sufficiently proven, and the risk probably depends on the work performed and the conditions of direct contact of medical personnel, which requires further study in the current persisting epidemic conditions. © 2021, Izmerov Research Institute of Occupational Medicine. All rights reserved.

The Eagle's syndrome is a disease is caused by irritation of the nervous, vascular and muscular structures the surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deep part of the lateral region of the face, which irradiates in to the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are founding various otolaryngological, dental, neurological diseases. Aim: due to the lack of information on the development and course of the stylohyoid syndrome, conservative treatment and the complexity of diagnosis, the anatomical features of the hypertrophied styloid process, their length and angles of deviation and the need for local impact on the process, the stylohyoid ligament and the neurovascular bundle, to varying degrees presenting to the styloid process, it becomes necessary to develop the most effective and simple method for diagnosis a hypertrophied styloid process and to optimize the need for CT examination with contrasting of the great vessels of the neck and performing functional tests. Materials and methods: Over the past 9 years, we examined and treated 184 patients. The appeals were random, with no specific focus. Of these, there were 133 women (72.3%), men – 51 (27.7%); age – from 25 to 70 years old: 25-30 years old – 15 people (8.1%), 30-45 years old – 116 (63%), 45-60 years old – 38 (20.6%), 60-70 years old – 15 (8.1%); the duration of the disease is from 1 to 10-15 years. Our work was aimed at improving and simplifying the diagnosis of the hypertrophied styloid process during the initial treatment of the patient in an outpatient and polyclinic conditions using functional tests, determining the need to refer patients to CT examination to visualize the relationship of the elongated styloid process with the main vessels of the neck, the possibility of pressure of the append age on the vessels and nerves of the neck, both at rest and in the movement of the head and neck, the development of impaired blood circulation in the brain due to impaired blood flow through the arteries and impaired out flow through the veins, and the development of corresponding symptoms in addition to those described in the literature. Due to the difficulty of diagnosing hypertrophy of the styloid process of the temporal bone in an outpatient and polyclinic conditions and the lack of awareness of practical otolaryngologists about this problem, we proposed a scheme for examining patients with suspicion of this problem.

This study, conducted between October 2018 and May 2019, aimed to develop an Exercise Attitude Scale in Turkish (EAS-Turkish) for pregnant women and to determine its validity and reliability. The scale was prepared in Turkish to comprehensively measure pregnant women's exercise attitudes. Then, it administered in 253 pregnant women, who were native speakers of Turkish and older than 18 years, in the Obstetrics Polyclinic at Ataturk Training and Research Hospital, Ankara, Turkey. Validity with exploratory and confirmatory factor analysis and reliability with test-retest and internal consistency methods were tested. The 37-item scale was found to be 2-dimensional (knowledge and benefit; barrier). All indexes of the goodness of fit (χ2/df = 2.0, Comparative Fit Index = 0.90, Goodness-of-fit Index = 0.85, Root Mean Square Error of Approximation = 0.06) indicated that the fit between the model and the sample data was acceptable. The item-total score correlations varied between r = 0.22 and 0.60. The Cronbach alpha coefficients were found as 0.90 for the whole scale, 0.91 for the knowledge and benefit sub-dimension, and 0.87 for the barrier sub-dimension. In the test-retest analysis conducted with 41 pregnant women, the reliability coefficients were detected as 0.93 for the whole scale and 0.84 for each sub-dimension. The EAS-Turkish for pregnant women was found to be a valid and reliable tool.

Health is one of the indicators of community welfare, so the community needs quality health services to meet their basic needs. To improve services and increase patient satisfaction, hospitals need to apply the Covid-19 policy in screening and service flows which are predicted to affect patient satisfaction. The aim of this study was to determine the effect of service quality on patient satisfaction during the COVID-19 pandemic. The research method in this study used a cross-sectional approach. The population was outpatients at the obstetrics and gynaecology polyclinic. The sample was determined using the accidental sampling technique with a total of 360 patients. The data were analyzed to determine the most dominant factor by using a logistic regression test. Based on the results of multivariate analysis, the variables with the greatest influence on patient satisfaction are the assurance variable (95% CI 1.50-6.06 with a p-value of 0.012), empathy (95% CI 1.38-4.65 with a p-value of 0.006), and tangible (95% CI 1.04- 4.08 with a p-value of 0.001). Based on the results, it can be concluded that there is a relationship between the dimensions of service quality and patient satisfaction. The quality of service during the Covid-19 pandemic is considered good but needs to be optimized on the dimensions of assurance, empathy, and tangible. Abstrak: Kesehatan adalah indikator kesejahteraan masyarakat yangpaling utama, dan untuk memenuhi kebutuhan dasarnya masyarakat membutuhkan pelayanan yang bermutu . Rumah sakit berusaha meningkatkan pelayanan dan kepuasan pasien perlu adanya kebijakan mengatasi penularan Covid-19 berupa prosedur pelayanan, keharusan screening, serta alur proses pelayanan yang berubah diduga juga berpengaruh terhadap kepuasan pasien dan mutu pelayanan. Tujuan penelitian ini bertujuan untuk mengetahui pengaruh mutu pelayanan terhadap kepuasan pasien dalam masa pandemic covid-19. Metode Penelitian menggunakan pendekatan cross sectional . Populasi penelitian adalah pasien rawat jalan di poliklinik kebidanan dan kandungan, Prosedur sampel Accidental Sampling sebanyak n=360. data hasil survey di analysis untuk mengetahui factor yang paling dominan dengan menggunakan uji regresi logistic. Berdasarkan hasil analisis multivariate variabel yang paling besar pengaruhnya terhadap kepuasan pasien adalah variabel Assurance dengan nilai 95%CI 1.50-6.06 dan p =0.012, Emphaty 95%CI 1.38-4.65 p=value 0.006 dan Tangiable dengan nilai 95%CI 1.04-4.08 dan p=value 0.001. Berdasarkan hasil pada penelitian ini dikatakan bahwa terdapat hubungan pada dimensi mutu pelayanan dengan kepuasan pasien. Mutu pelayanan yang terjadi selama masa pandemi Covid-19 dinilai mulai sudah baik, akan tetapi harus di tingkatkan da dioptimalkan pada dimensi jaminan, emphaty dan tangibles.

PROFILE OF CONDYLOMA AKUMINATA PATIENTS IN THE SKIN AND SEX POLYCLINIC OF PERTAMINA BINTANG AMIN HOSPITAL FOR THE PERIOD OF JANUARY 2016 TO DECEMBER 2019. Introduction : Sexually transmitted infection (STI) is one of the diseases and causes of health, social and economic problems in many countries. According to WHO, more than 1 million sexually transmitted infections are acquired every day in various parts of the world and more than 290 million women have human papillomavirus infection. In America, data from the CDC shows new cases with more than 19.7 million sexually transmitted infections each year, and about 14.1 million cases are human papillomavirus infections. Objective : This study aims to find out information about the profile of condyloma acuminata sufferers at the Dermatology and Venereology Polyclinic at Pertamina Bintang Amin Hospital for the period January 2016 to December 2019. Methods: This study used quantitative descriptive analysis with the aim of knowing the profile of patients with condyloma acuminata. Sampling was done by using the total sampling method. The sample in this study were patients with condyloma acuminata who were treated at the Dermatology and Venereology Polyclinic at Pertamina Bintang Amin Hospital for the period January 2016 to December 2019 totaling 22 patient medical records. Results: It was found that patients with condyloma acuminata were more commonly found in the age group of 26 to 35 years (early adulthood), as many as 9 patients (40.9) in the female sex, namely 17 patients (77.3%) with married status. as many as 17 patients (77.3) while based on the management of patients more were given treatment using electric surgery, namely as many as 8 patients (36.4%). Conclusion : Patients with condyloma acuminata in order to maintain their health condition, and avoid risk factors that can increase the occurrence of condyloma acuminata, it is hoped that health workers can hold health promotion activities about the prevention of sexually transmitted diseases, especially condyloma acuminata and this research can be used as additional information to develop further research regarding the factors that have not been studied in this study Keywords: Condyloma acuminata, sexually transmitted infection, HPV

Introduction: Diabetic foot syndrome is one of the most common and devastating preventable complications of diabetes mellitus. Knowledge and awareness about the disease can have a positive influence on attitude and practices of patients. Objectives: We aimed to evaluate the knowledge, beliefs, and practices (KBPs) regarding diabetes and diabetic foot syndrome among Omani type 2 diabetic patients. Patients and Methods: We studied 150 participants from the diabetes clinic, Bausher Polyclinic, Muscat. A questionnaire was used to determine KBPs around diabetic foot care. Results: There were 90 females and 60 males, 67.9% were older than 50 years, 42.7% were illiterate, and 72% of them were not working or retired. Only 38% checked their feet regularly; 5.6% had diabetic foot syndrome. Over half of the respondents (55.3%) did not know the causes of diabetic foot syndrome and half of the respondents did not know symptoms of the same. Just over one-third (37.3%) thought that their doctor alone was responsible for foot examination. Only 32.7% thought that they should examine their own feet. The majority believed that walking barefoot and diabetic foot syndrome are “big” problems (84% and 80%, respectively). More than three-quarters (78%) reported checking water temperature before use, 38.7% use warm water for washing feet, and 39.3% reported drying their feet after washing. Only 38% check their feet regularly. Finally, only one-third confirmed checking their blood sugar regularly. Conclusions: The KBP triad must be interconnected in order to achieve successful preventive foot care.

Introduction: Down Syndrome is a common chromosome abnormality among infants. This condition is Present in 1 over 800 deliveries. Advanced maternal age is a risk factor for Down syndrome. Other miscellaneous factors are radiation, infection, autoimmune and paternal age. The Aim is to determine maternal age distribution of Down syndrome at pediatric growth and development polyclinic, Wahidin Sudirohusodo hospital. Methods: A Descriptive study. Study population was all outpatients at Pediatric Growth and Development polyclinic, Wahidin Sudirohusodo hospital in Makassar 2015-2019. Samples in this study were collected from total sampling of population data that met the criteria of new Down syndrome patients with complete medical records Results: This study found 237 new pediatric down syndrome patients admitted to growth and development polyclinic from January 2015 – December 2019, 95 complete medical records from 237. 52% (49) boys, 48 % (46) girls from 95 children. No gender difference was found in the presentation. Parental age of Down syndrome patients, the most advanced maternal age was >35, found 46 (48,42%), the most advanced paternal age was >35, found 63 (66,32%). Parity < 3rd, the most maternal age between 25-35 (23,16%), parity > 3rd, the most maternal age was >34, found 30 (31,57%). Conclusion. Advance maternal and/ or paternal age is a risk factor of Down Syndrome.

Bu çalışmanın amacı Türkiye geneli ve bölgesel olarak turizmin konut fiyatları üzerindeki etkisini belirlemektir. Ülkelerin turizmden beklenen ekonomik faydaları elde edebilmesi açısından etkin pazarlama ve tanıtım faaliyetleri ile uluslararası arenada tanınırlığını artırmak önemlidir. Bu tanınırlık ülkelerden gelen yabancı turist sayısında artışa neden olabilir. Ülkelere gelen yabancı turist sayısındaki artışlar ise doğal olarak söz konusu ülkelerin konut fiyatlarını etkileyebilir. Bu doğrultuda çalışmada uzun dönemde turizmin konut fiyatları üzerindeki etkisi 2010:01-2018:12 dönemine ait aylık verilerle Gecikmesi Dağıtılmış Otoregresif (ARDL) sınır testi yaklaşımı kullanılarak araştırılmıştır. Elde edilen bulgular, uzun dönemde Avrupa ve Ortadoğu’dan gelen yabancı turist sayısının Akdeniz bölgesi konut fiyatları üzerinde pozitif etki yaratırken, Asya ve Bağımsız Devletler Topluluğu ülkelerinden gelen yabancı turist sayısının negatif etki yarattığını göstermiştir. Ayrıca, uzun dönemde Avrupa ve Bağımsız Devletler Topluluğu ülkelerinden gelen yabancı turist sayısı Karadeniz bölgesi konut fiyatları üzerinde negatif etkiye sahipken, Asya’dan gelen yabancı turist sayısının Karadeniz bölgesi konut fiyatları üzerinde pozitif etki yarattığı belirlenmiştir. Asya’dan gelen yabancı turist sayısı da Marmara2 bölgesi konut fiyatları üzerinde uzun dönemde pozitif etki meydana getirmiştir., The goal of this study is to determine the effect of tourism on housing prices in Turkey both nationally and regionally. It is important for countries to increase their recognition in the international arena through efficient marketing and promotional activities in order to achieve the economic benefits that are expected from tourism. This recognition may cause an increase in the number of arriving foreign tourists. The increase in the number of incoming foreign tourists may affect the housing prices of the relevant countries naturally. In this context, the effect of tourism on housing prices in the long term has been researched by using the Autoregressive Distributed Lag (ARDL) bound testing approach through monthly data belonging to the 2010:01-2018:12 period. The findings acquired indicated that the number of foreign tourists coming from Europe and the Middle East created a positive effect on the housing prices of the Mediterranean region in the long term while the number of foreign tourists coming from Asia and Commonwealth Independent States created a negative effect on the housing prices in the Mediterranean region. Moreover, it has been determined that the number of foreign tourists coming from Europe and the Commonwealth Independent States had a negative effect on the housing prices in the Black Sea region in the long run, while the number of foreign tourists coming from Asia created a positive effect on the housing prices in the Black Sea region. The number of foreign tourists coming from Asia also created a positive effect on the housing prices in Marmara2 region in the long run.

The novel coronavirus disease (COVID-19) pandemic has become a strength test for the national healthcare systems and medical professional communities. The pandemic gave a revealing insight into the provision of resuscitation care, a shortage of personnel and protective equipment, and the lack of effective drugs to treat a novel, poorly studied infection. Objective. To identify the attitude towards immunoprophylaxis in general and against the coronavirus infection (COVID-19) in particular among medical students and pediatricians and to assess the dynamics of compliance to vaccination in these groups. Materials and methods. The survey was conducted among the 5-6-year students of the medical and pediatric faculties of the Ryazan State Medical University (RSMU) of the Ministry of Health of Russia in 2017 and 2021, the groups of students included 250 and 225 people, respectively. The children’s polyclinic pediatrician groups included 45 and 60 people in 2017 and 2021, respectively. The survey was conducted anonymously, face-to-face, and without compulsion. The identical questionnaires asked students 13 questions and pediatricians 10 questions with suggested response options. Results and discussion. The percentage of students who correctly named the number of vaccine preventable diseases in the National Immunisation Schedule has significantly decreased; the number of students who were not aware of the availability of the chickenpox vaccine has increased by 1.9 times. In 2021, the number of students giving priority to domestic vaccines decreased by 2.3 times, and the number of those choosing imported drugs as better and safer ones has increased by 1.5 times. In 2021, the number of senior students who were vaccinated against influenza doubled as compared to 2017. At the same time, the students agreed to recommend their patients to be vaccinated against influenza 1.4 times more often. During the 2021 pediatrician survey, the number of respondents, who preferred imported vaccines as better and safer ones, increased by 4 times, and the number of domestic vaccine advocates decreased by 1.8 times. In addition, the number of pediatricians who did not decide on this issue has increased by 9.8 times. Сonclusion. The results of the survey showed that there is still a lack of compliance to vaccine prophylaxis in certain groups of the professional medical community. The student cohort showed a decrease in knowledge and confidence in the vaccine prophylaxis. Among practitioners, there has been a positive trend towards an increase in the percentage of pediatricians, who considered it expedient to vaccinate children with chronic pathology.

Prefentive and currative efforts of COVID-19 in pesantren is a crucial points to be done in order to conduct conducive and safe learning situation. This community service aims to form, train and assist Santri Husada in carrying out its role in the health sector of Islamic boarding schools. This campus environmental service program offers many paradigm shifts for students by allowing them to participate in maintaining the health of pesantren residents who have previously appeared to disregard health protocols. It was carried out in three phases, namely education and outreach, training, and intensive mentoring from March to May 2021 at Darul Faqih Islamic Boarding School Malang. The survey results on students’ knowledge, attitudes and practices towards COVID-19 showed a good score with the correlation (R-square: P-Value) knowledge-attitude (0.167: 0.000), knowledge-practice (0.060: 0.000) and attitude-practice ( 0.051: 0.000). This community service program was carried out in collaboration with LP2M Universitas Negeri Malang, UPT Wagir Health Center, Polyclinic of Universitas Negeri Malang and the COVID-19 Task Force, Wagir District, Malang Regency. The Santri Husada Program has made a real contribution in suppressing the spread of COVID-19 in the Islamic boarding school environment and led it a tough Islamic boarding school area.

The availability and quality of medical care is determined by the state of primary health care. Optimization and development of outpatient care is the primary task of healthcare. For the Penza region, according to the resolution of the Government of the Penza region of 02.10.2013 N 743-PP, improving the quality of outpatient care in the field of maxillofacial surgery and increasing its availability is one of the primary tasks for our region. In this regard, the assessment of the work of the outpatient office of the Department of Maxillofacial Surgery of the Consultative Polyclinic of the State Budgetary Healthcare Institution of the Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Aim: to analyze the work and effectiveness of a dentist - surgeon in the outpatient office of the consultative polyclinic GBUZ Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Materials and methods. To achieve this goal, a retrospective analysis of the primary accounting and reporting medical documentation for 2018–2020 was carried out, a questionnaire survey of patients hospitalized through an outpatient office in the Department of Maxillofacial Surgery of the N.I. N.N. Burdenko. Statistical data analysis procedures were carried out using MS Office Excel 2010 spreadsheets and PASW Statistics 18 statistical software package. Results. The analyzed accounting and reporting medical documentation for 2018–2020, the results of the questionnaire indicate the ineffective work of the doctor surgeon - dentist in the outpatient office of the consultative polyclinic GBUZ POKB im. NN Burdenko, the workload of the department with non-core hospitalizations, the increased workload on doctors - the department of maxillofacial surgery. The ways of solving the problem of replacing a dentist-surgeon with a doctor-maxillofacial surgeon are proposed; on the organization of a rehabilitation room for patients of the adult and pediatric population with pathology of the maxillofacial region; to create a single case history. Conclusion. Carrying out the above changes will reduce the burden on doctors - maxillofacial surgeons of the Department of Maxillofacial Surgery, transfer some of the manipulations from the inpatient to the outpatient service (inpatient replacement technology), thereby improving the medical care service in the field of maxillofacial surgery in the Penza region.

В статье проведено изучение основных факторов и акторов, характеризующих систему управления, применяемой в амбулаторно-поликлиническом учреждении с помощью метода анализа иерархий и построенной схемы системной динамики с помощью программы Ithink. Для понимания основных действующих механизмов управления был выявлена основная цель деятельности поликлинического учреждения и ряд факторов, влияющих на ее достижение. Этот тип изучения процессов основан на методе анализа иерархий. Основной целью применения данного метода является выявление ряда факторов и акторов, оказывающих на механизм управления наибольшее влияние, а также помогает выявить основные проблемы функционирования, устранение которых позволит обеспечить такое качество оказываемых медицинских услуг, которое бы соответствовало установленным нормам и стандартов оказания первичной медико-санитарной, скорой, специализированной и паллиативной помощи. Выявление существующих проблем управления позволит определить основные направления улучшения работы амбулаторно-поликлинического учреждения. Для оптимальной работы системы управления и обеспечения высокого качества оказываемых услуг важной составляющей является экономический фактор. В условиях дефицита финансовых средств он становится все более значимым для сферы медицинского обслуживания The article deals with the study of the main factors and actors characterizing the management system used in an outpatient clinic using the hierarchy analysis method and the constructed system dynamics scheme using the Ithink program. To understand the main operating mechanisms of management, the main goal of the activity of the polyclinic institution and a number of factors affecting its achievement were identified. This type of process learning is based on the hierarchy analysis method. The main purpose of using this method is to identify a number of factors and actors that have the greatest impact on the management mechanism, and also helps to identify the main problems of functioning, the elimination of which will ensure such quality of medical services that would meet the established norms and standards for the provision of primary health care. emergency, specialized and palliative care. Revealing the existing management problems will determine the main directions for improving the work of an outpatient clinic. For the optimal operation of the management system and ensuring the high quality of the services provided, an important component is the economic factor. In the context of a shortage of financial resources, it is becoming more and more important for the health care sector

Background : Cervical cancer is one of the main problems in women's health in the world, including Indonesia. According to the 2018 Global Cancer Observatory from the World Health Organization (WHO), the most common cancer cases in Indonesia are breast cancer, which is 58,256 cases or 16.7% of the total 348,809 cancer cases. Cervical cancer (neck of the womb) is the second most common type of cancer in Indonesia, with 32,469 cases or 9.3% of the total cases. Objective: To determine the risk factors associated with early detection of cervical cancer using Visual Inspection with Acetic Acid (IVA) ) in women of childbearing age in the Work Area of the Ternate City Health Center for Siko Treatment. Methods: This research is a quantitative analytic study with a cross sectional design. Data collection was carried out from December 2020 to January 2021. The population was all patients who underwent examinations at the Maternal and Child Health Polyclinic (KIA) at the Siko Care Health Center in Ternate City as many as 227 patients and a sample of 145 female patients of childbearing age from January to September 2020. Techniques sampling is simple random sampling. Data analysis used univariate and bivariate with chi-square test. The research variable consists of the dependent variable, namely early detection of cervical cancer, while the independent variables are knowledge, husband's support, access to information and culture. Results: Shows that age (46.9%), knowledge of VIA (50.3%), attitude (55.2%), husband's support (52.4%), access to information (62.1%), culture (51.7%), Support Officer (48.3%), early detection of cervical cancer IVA method (55.2%), while the bivariate results include: Age (0.000, OR=19,011; CI=8.095-44,647), knowledge (0.001; OR=2.86; CI=1.563-18.367), attitude (0.000; OR=215.524 CI=53,456-868.955), husband's support (0.002; OR=1.448 CI=1.688-11.933), access to information (0.000; OR=2,294; CI=1,574-15,976), culture (0,003; OR=2,202 CI=1,648-10,717), health worker support (0,000; OR=27,111 CI;11,023-66,680). Conclusion: There is a relationship between knowledge, husband's support, access to information and culture with early detection of cervical cancer against the IVA method. Based on the results of the study, it is recommended that the relevant agencies, namely the Siko Health Center, always improve health education to the community, especially mothers and husbands regarding early detection of cervical cancer through various media tools including leaflets, posters, flipcharts and other media. Through this counseling, it is hoped that the community will be more interested and understand the material presented more quickly

Health statistics help the heads of medical organizations to manage promptly, and doctors to judge the quality and effectiveness of treatment and prevention work. Qualified analysis of statistical data, assessment of events and relevant conclusions allow making the right management decision, contribute to better organization of work, more accurate planning and forecasting. Statistics helps to monitor the activities of the institution, to manage it promptly, to judge the quality and effectiveness of treatment and prevention work, including dental work.