Objectives: During a multi-year community health needs assessment process, we sought to prioritize the health needs of the community served by the Meadville Medical Center (Crawford County, PA) and meet the Affordable Care Act requirement for non-profit hospitals.

Methods: We collected community health perspective data through a voluntary in-person survey. Additionally, we collected data from the Meadville Medical Center Emergency Department and the PA Department of Health. Using qualitative methods we compared the datasets to prioritize community health needs.

Results: Both the perceptions and surveillance data show chronic diseases to be the priority health concern. There was a large perception that mental health is a need; however, surveillance data identified sexually transmitted infections and vaccine-preventable diseases as community health priorities.

Conclusions: Public health interventions, education programs, and further research are needed to address the community health needs that were prioritized. The mixed methodology approach we used to conduct our community health needs assessment can be utilized by other small, rural hospitals that need to complete a community health needs assessment to meet Affordable Care Act requirements.

Intra-articular steroid joint injections have been used for decades for a variety of common medical diseases. The intra-articular steroids have been shown to be more efficacious than some of their precursors such as formalin, glycerin, lipiodol, lactic acid, and petroleum jelly.

Background: Unintended pregnancies constitute a real public health problem in low-income settings. Success in preventing unintended pregnancies is critical in reduction of both maternal and infant mortality.

Objective: To assess the prevalence of contraceptive use and of unintended pregnancies and to identify the correlates of unintended pregnancies among contraceptive users in Brazzaville, Congo.

Methods: This cross-sectional study enrolled 380 new mothers in two public maternities in Brazzaville. The data was collected using a structured questionnaire. Bivariate analysis using Chi-square test and logistic regression was used.

Results: Knowledge of contraceptive methods was high among respondents. Overall contraceptive prevalence was 72%:83% for natural and 17% for modern methods, respectively. Forty percent of pregnancies among contraceptives users were unintended. Use of natural methods (3.34[1.06-10.50], p=0.03) and women’s lack of financial income (1.7[1.01-2.92], p=0.04) were associated with high risk of occurrence of unintended pregnancy. Partners’ education level was inversely related to risk of unintended pregnancies (0.45 [1.01-2.92], p=0.004).

Conclusions: Enhancing counseling for better contraceptive use, promoting modern contraceptives and increasing men involvement in family planning should be considered by family health planners in Congo.

Purpose: Studies have shown an inverse relationship between religiosity and unhealthy lifestyle behaviors. Tobacco and alcohol use is higher among the impoverished. The purpose of this study was to determine if frequent church attendance was associated with lower rates of smoking and alcohol use in adults living below the poverty threshold.

Methods: A secondary analysis of data from the 2005-2008 National Health and Nutrition Examination Survey was assessed. 6219 adults (≥ 40 years), representative of 121.8 million non-institutionalized adults in the United States, were included in the study. Logistic regressions predicting excess alcohol consumption, binge drinking, and current smoking were performed using church attendance as a covariate while controlling for age, gender, race, marital status, education, health, and poverty level.

Results: The sample included 20.1% current smokers and 25.7% excessive alcohol consumers. Individuals who did not attend church and were below the poverty line were more likely to be current smokers (OR: 3.45; 95%CI 2.56-4.64) when compared to those who attended church and lived above the poverty line. Those who did not attend church were more likely to binge drink regardless of poverty level (OR 1.64, 1.02-2.65). When predicting excessive alcohol consumption, only those who did not go to church and lived above the poverty level were more likely to drink (OR 1.24, 1.02-1.49). Those who attended church and were impoverished were actually less likely to consume excessive alcohol (OR 0.74, 0.56-0.97) when compared to the referent group of church attendees who were not impoverished.

Conclusions: Church attendance was associated with healthier lifestyle choices regardless of poverty level. It is unclear as to whether church attendance itself impacts lifestyle choices or perhaps masks another unknown variable. While the results did not differ much based on poverty level, church may be a resource available for individuals that health care providers can utilize.

Workplace Wellness (WPW) programs are rapidly appearing as one tactic to control healthcare costs and decrease chronic conditions. The Patient Protection and Affordable Care Act (PPACA) addresses these concerns by encouraging employers to adopt evidence-based employee WPW programs. One WPW program option focuses on Integrative Health Practices (IHPs) that have the potential to shift wellness responsibility to the individual, which may result in increased WPW effectiveness, individual self-care and overall improved health and wellness. This article presents current supporting evidence on specific IHPs for the eight most common costly and chronic conditions in the workplace. When introduced and examined via the case study method into WPW at one organization, employees reported that as a result of their participation, they were highly likely to take better care of themselves. The review portion of this research serves as the foundation for IHP selection and provides much needed evidence for employers to make more informed and inclusive decisions about WPW program content. The case study results provide a tested model for IHPs that can be integrated into existing WPW offerings. The findings of this observational study support the need for future investigative research on the use of IHPs in WPW programs

Safety and healthy workplace has received many researches attention in the recent years. Safety behaviors are one of the major issues of organizations, because a safe workplace is a critical factor of the quality of work life [1]. Safety climate in an organization is expected to influence safety behavior positively in the health sector. Thus when employees perceive the organizational safety climate to be positive, they are more likely to participate in positive safety behaviors.

Background: Traditional and Complementary Medicine (T&CM) becomes a truly global phenomenon. The primary health care recognizes its importance. Number of patients seeking T&CM treatments increased butmost of the health professionals is ignorant of the risks and benefits of T&CM because of lack of knowledge. Health professionals’ view on T&CM is very important for healthcare. The study was designed to assess the opinion of the health professionals in five selected hospitals in Malaysia on their perception of their practice of T&CM in Malaysia, usage and recommendation of T&CM, knowledge on T&CM, integrating T&CM into Conventional Medicine (CM), and opinion on future medical training in T&CM respectively.

Methods: An in-depth semi-structured face-to-face interview was carried out on ten health professionals from five selected hospitals in this qualitative study.

Results: All the participants used some types of T&CM personally and generally recommended T&CM for treatment in this study. Most of them agreed with the statement that T&CM is popular among the population and thought that people trusted in T&CM and were afraid of CM. All the medical staff believed that T&CM has therapeutic value. Almost all respondents agreed with the statement on an integration of T&CM with CM and most of them agreed for T&CM to be a part of future training for health professionals.

Conclusion: From the interview, it shows that all the participants have experienced in using some types of T&CM in their life for whatever reason they might have. However, a small number of participants have negative idea about T&CM but all the health professionals interviewed believed the therapeutic value of some types of T&CM.

Objective: The purpose of the study is to explore the symptoms expressed by patients who experienced an acute coronary disease, trying to identify typologies and explore the hypothesis that the different stages of family life cycle can modulate groups of patients showing specific patterns of presentation of symptoms and signs. Patients and

Methods: A methodology qualitative, descriptive, of multiple case, and document analysis was used. It was revised and retrospectively analyzed the narrative included in medical history of family medicine, reports of hospital specialists, and the family life cycle according to the genogram, for building a category (“type”), in patients with clinical history in a consultation of Family Medicine in Toledo, Spain, and who were diagnosed with coronary heart disease in the last 20 years.

Results: 32 cases were treated by a clinical cadre of coronary heart disease. Two of them were not included for lack of information. Patients from 35 years to >65 years without children at home (empty nest) experience symptoms in “Peculiar or Ostentatius” type. The women > 65years do it in “Anxious” type. Patients aged 35years to >65 with children at home experience symptoms in “Discreet” type, and >65 years living with adult children tend to relate stressful events: “Stressed” type. Patients >65 years living alone experience symptoms in a “Stoic” type.

Conclusion: When an acute coronary syndrome occurs, the different stages of family life cycle can show differences in the presentation of symptoms. The recognition of these types of patients who express a particular clinic, and they show different shades in certain respects with the classic syndrome of chest pain, it may be useful to family physicians for diagnosis, providing additional information to factors risk, history and exploration, and this is a working hypothesis to be validated with other research methods.

Gestational Diabetes Mellitus (GDM), known as glucose intolerance is diagnosed for the first time in pregnancy; usually between 24 and 28 weeks of gestation.