Public health research

Home-based carers are an integral part in caring for chronically ill patients.  They provide physical, psychosocial, palliative and spiritual care to the patients and their families to help them maintain their independence and optimal quality of life.  The aim of this study was to explore and describe the activities and challenges of volunteer home-based carers of chronically ill patients in Soweto, South Africa.  A qualitative, exploratory-descriptive design was used where focus group discussions were conducted among 33 purposively sampled women and men with hands-on experience in home-based care at four home-based care organisations in Soweto.  A focus group guide developed in English and translated into isiZulu was used to collect data.  Focus group discussions were recorded with a digital recorder with the participants’ permission.  Voice recordings were transcribed verbatim in isiZulu then translated into English. Codes were identified and a code list was developed with themes and sub-themes which were imported into NVivo10 (a qualitative software data analysis programme) for further thematic analysis.  The study revealed that home-based carers are involved in nursing care, household chores, and in counselling patients and their families among other activities.  They experience challenges such as lack of resources, training and support, lack of remuneration, families stigmatising patients and patients not disclosing their diagnosis to significant others.  The frail health system impedes proper functioning of the home-based carers.  It is therefore, important that home based carers’ needs are adequately met in order to sustain the programme.

The specialty of family medicine is centered on lasting, caring relationships with patients and their families. Family physiciansintegrate the biological, clinical and behavioral sciences to provide continuing and comprehensive health care. The scope of family medicine encompasses all ages, sexes, each organ system and every disease entity. Read more about the history, scope and definition of family medicine by reviewing the following resources.



Public-health-family-medicine



Family medicine is a three-dimensional specialty, incorporating (1) knowledge, (2) skill and (3) process. At the center of the process element is the patient-physician relationship with the patient viewed in the context of the family. It is the extent to which this relationship is valued, developed, nurtured and maintained that distinguishes family medicine from all other specialties.



Family physicians integrate the biological, clinical and behavioral sciences to provide continuing and comprehensive health care. Family medicine encompasses all ages, sexes, each organ system and every disease entity. Family physicians also pay special attention to their patients' lives within the context of family and the community.

Adolescent Medicine
Geriatric Medicine
Pain Medicine
Sleep Medicine
Sports Medicine
Sexual Health
Geriatric Medicine
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Europe), was to produce a bibliometric overview of public health research literature for Europe. Methods: A search strategy (‘filter’) was designed to interrogate the Science Citation Index (SCI) and the Social Science Citation Index (SSCI) databases for research articles published between 01/01/1995 and 31/12/2004 in any language. We analysed output for country by population, Gross Domestic Product (GDP), burden of disease using DALYs, and language. Results: Overlap between the two databases SCI and SSCI was 35%. 210433 publications were identified after duplicates were removed, a world total of about 20 000 per year. Approximately 7000 papers per year were produced in Europe and 9400 by the USA. Thirteen of 28 individual European countries produced more than 100 public health papers per year. Publications per capita were highest in northern European countries. In multiple regression analyses, GDP was a modest predictor (r2 0.53, P<0.02) of publications for European countries, w...

Unexplained intellectual disability is a clinical situation in which molecular diagnostic techniques should be indicated. The diagnostic yield of Multiplex Ligation-dependent Probe Amplification (MLPA) in a cohort of patients with intellectual disability and dysmorphic features was investigated to identify microdeletion syndromes. We aimed to provide an example of the utilization of MLPA method in the medical care routine that can be useful for planning the inclusion of molecular genetic testing in the Brazilian public health care system. This study was based on 57 patients who had different degrees of intellectual disability with etiology not determined. All patients had normal brain CT scan or MRI and normal karyotype, and patients with environmental damage history were not included. Two of the 57 patients were referred to molecular genetic testing as they were clinically diagnosed as having Williams syndrome. MLPA test costs were calculated (human resources and equipment costs were not included in the calculation). MLPA revealed chromosomal imbalance in 4 out of 57 patients (7%). These imbalances were associated with well-described microdeletion syndromes: 3 patients had Williams syndrome (1 without clinical diagnosis) and 1 patient had 22q11.21 deletion syndrome. The MLPA analysis cost per individual, considering DNA extraction and laboratory reagents, was US$66.40. In this study, MLPA confirmed its value as a promising technique as it has adequate feasible characteristics to identify microdeletion syndromes in patients who had unexplained intellectual disability. This work suggests that MLPA can be a viable alternative to implement molecular genetic testing in the Brazilian public health care system, considering its cost-effectiveness.

Despite of the controversy of antidepressant use during the gestational period, the reported antidepressant use at any time during pregnancy has increased. Our study assessed antidepressant prescription medication use patterns during pregnancy among insured, low-income women in the United States. This retrospective study used South Carolina Medicaid claims data (2004-2009). Included were pregnant women (≥ 18 years) with single or multiparous live birth(s) with a diagnosis for major depression or reported pharmacy claims for antidepressant prescriptions 1 year before becoming pregnant or while pregnant. Antidepressant prevalence prior to and during pregnancy, type of antidepressant, and trimester when the antidepressant use started, characterized antidepressant prescription use patterns. Among 24,077 pregnant women with live births, the prevalence of antidepressant use before becoming pregnant and during pregnancy was 5.5% and 6% respectively. A total of 3,237 pregnant women met inclusion criteria. Of the 1,456 women prescribed antidepressants during pregnancy, 16% showed a history of major depression predating their pregnancy and 67% initiated antidepressant medications after becoming pregnant. Nearly 80% took selective serotonin reuptake inhibitors (SSRIs) during pregnancy, and 32% initiated antidepressants during the first trimester. Age, race, and preexisting depression were associated with antidepressant use. In pregnant, insured low-income women, the majority prescribed antidepressants were new users. Pharmacologic treatment for pregnant women with depressive symptoms, particularly in newly diagnosed major depression remains challenging.

Despite of the controversy of antidepressant use during the gestational period, the reported antidepressant use at any time during pregnancy has increased. Our study assessed antidepressant prescription medication use patterns during pregnancy among insured, low-income women in the United States. This retrospective study used South Carolina Medicaid claims data (2004-2009). Included were pregnant women (≥ 18 years) with single or multiparous live birth(s) with a diagnosis for major depression or reported pharmacy claims for antidepressant prescriptions 1 year before becoming pregnant or while pregnant. Antidepressant prevalence prior to and during pregnancy, type of antidepressant, and trimester when the antidepressant use started, characterized antidepressant prescription use patterns. Among 24,077 pregnant women with live births, the prevalence of antidepressant use before becoming pregnant and during pregnancy was 5.5% and 6% respectively. A total of 3,237 pregnant women met inclusion criteria. Of the 1,456 women prescribed antidepressants during pregnancy, 16% showed a history of major depression predating their pregnancy and 67% initiated antidepressant medications after becoming pregnant. Nearly 80% took selective serotonin reuptake inhibitors (SSRIs) during pregnancy, and 32% initiated antidepressants during the first trimester. Age, race, and preexisting depression were associated with antidepressant use. In pregnant, insured low-income women, the majority prescribed antidepressants were new users. Pharmacologic treatment for pregnant women with depressive symptoms, particularly in newly diagnosed major depression remains challenging.

This study was conducted to assess the level and association of demographic factors on risky sexual behaviors and pattern of condom use among students of a Nigerian university. Final and penultimate year students in University of Nigeria were recruited and purposively sampled. Using a well structured and pre-validated questionnaire, questions on HIV awareness, sexual experiences and condom use were asked and responses collected. Data obtained were analyzed using descriptive statistics and analysis of variance. Exactly 524 students (mean age, 24 years; mean sexual debut age 19 years) participated. More females than male students had bisexual or homosexual partners (4.8% vs. 0.7%, p < 0.01); did not use a condom in the most recent sex (48.3% vs. 22.9%, p < 0.01) and in the last twelve months (31.5% vs. 11.7%, p < 0.05); had been forced for sex (23.2% vs. 18.7%, p < 0.05). More male students did not know their status (37.1% vs. 25.7%, p < 0.05); had oral and anal sex (41.3% vs. 27.3%, p < 0.01). As regards age at first sex, students who debuted earlier (≤ 19 years) performed oral/anal sex (53.6% vs. 40.1%, p < 0.05), did not use a condom during that first sex (70.1% vs. 45.4%, p < 0.01) and have had more than five sexual partners since then (38.5% vs. 10.1%, p < 0.01). This study showed that being male was associated with poor awareness of the virus and risky sexual behaviors and being female was associated with poor/inconsistent condom use. Also having started sex at an early age and being single was linked with risky behaviors. Such behaviors could be cautiously put in check by re-introducing HIV/AIDS prevention awareness strategies in universities.