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   2007| September-December  | Volume 14 | Issue 3  
    Online since June 28, 2012

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Determinants of birth spacing among Saudi Women
Moataz Abdel-Fattah, Tamer Hifnawy, Tarek I El Said, Maha M Moharam, Mahmoud A Mahmoud
September-December 2007, 14(3):103-111
Background: High fertility levels are of major concern to planners and policy makers in most countries in the developing world. In Saudi Arabia, the rate of population growth is the third highest of the countries of the Eastern Mediterranean Region. Objectives: This study aimed at identifying determinants of birth spacing and attitudes toward family planning among Saudi women. Methods: A cross sectional survey of all women who have been married before, aged 15-49 years attending Al Hada armed forces hospital (primary health care and antenatal care clinics), was conducted between 1 st February 2005 and 31 st January 2006. Data was collected on socio-demographic, biological characteristics, beliefs, attitudes, and utilization of family planning services, pregnancy intervals and medical history Results: For the 786 women included in the study, the mean duration of interbirth interval was 2.38±1.24 years. The multivariate Cox regression revealed that a woman's education, work status, husband's work status, a woman's history of chronic diseases, and husband's encouragement of interbirth spacing were the only significant predictors of longer interbirth intervals. Shorter interbirth intervals were independently predicted by lower family income, and presence of female offspring only or equal number of male and female offspring as opposed to presence of more males. The great majority of participating women (98%) had a positive opinion of the effect of birth spacing on the family. Conclusion: This study showed that certain factors were significant predictors of interbirth spacing for the Saudi women. This should lead to the encouragement of longer intervals between births. However, further studies are needed to ascertain a cause-effect association..
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Developing an integrated organ/system curriculum with community-orientation for a new medical college in Jazan, Saudi Arabia
Mostafa M El-Naggar, Hussein Ageely, Mohamed A Salih, Hamdy Dawoud, Waleed A Milaat
September-December 2007, 14(3):127-136
Background : Jazan province is located in the south-west of the Kingdom of Saudi Arabia. The province is offlicted with a wide spectrum of diseases and therefore have a special need for more health services. The Faculty of Medicine at Jazan has been following the traditional curriculum since its inception in 2001. The traditional curriculum has been criticized because of the students inability to relate what they learned in the basic sciences to medicine, thus stifling their motivation. It was felt that much of what was presented in preclinical courses was irrelevant to what the doctor really needed to know for his practice. The College therefore, decided to change to an integrated curriculum. Design: The study was conducted in 2004-2005 in the Faculty of Medicine, Jazan University. It began with a literature survey/search for relevant information and a series of meetings with experts from various institutions. A Curriculum Committee was formed and a set of guiding principles was prepared to help develop the new curriculum. A standard curriculum writing format was adopted for each module. It was decided that an independent evaluation of the new curriculum was to be done by experts in medical education before submission for official approval. There were several difficulties in the course of designing the curriculum, such as: provision of vertical integration, the lack of preparedness of faculty to teach an integrated curriculum, and difficulties inherent in setting a truly integrated examination. Curriculum: The program designed is for 6 years and in 3 phases; pre-med (year 1), organ/system (years 2 and 3), and clinical clerkship (years 4, 5, and 6). This is to be followed by a year of Internship. The pre-med phase aims at improving the students' English language and prepare them for the succeeding phases. The organ/ system phase includes the integrated systems and the introductory modules. The curriculum includes elective modules, early clinical training, behavioral sciences, medical ethics, biostatistics, computer practice, and research methods. The curriculum provides active methods of instruction that include: small group discussion/ tutorials, problem-based learning (PBL), case-study/ clinical presentations, seminars, skills practice (clinical skill lab), practical, demonstration, and student independent learning. Methods of evaluating students include continuous and summative assessment. Conclusion: The new curriculum adopted by the Jazan Faculty of Medicine is an integrated, organ/ system based, community-oriented, with early clinical skills, elective modules, and innovative methods of instructions.
  2,987 376 -
A community-based screening campaign for the detection of diabetes mellitus and hypertension in the eastern province, Saudi Arabia: Methods and participation rates
Ageel J Al-Ghamdi, Khalid A Al-Turki, Nadira A Al-Baghli, Ahmad G El-Zubaier
September-December 2007, 14(3):91-97
Objective: To describe a community-based diabetes and hypertension screening campaign, the percentage of screened positive individuals, identified the participation rate, and the factors affecting the participation. Campaign design and methods: A community-based screening campaign whose main objective was the screening for diabetes and hypertension was conducted in the Eastern Province of Saudi Arabia for three and half months in the year 2004. A structured questionnaire was used. Diabetes mellitus was diagnosed on the basis of repeated detection of a fasting blood sugar equal to or more than 126 mg/dl, and hypertension when the blood pressure was 140/90 mm Hg or more.. Results: Of the 650,000 target population, 214,381 (33%) participated, and 197,681 questionnaire were completed. Of the number of individuals screened, 31,711 (16%) were positive for abnormal blood pressure and /or glucose, and needed confirmation of their results. Only 17296 (54.5%) of them were referred to health facilities for confirmation of results Conclusion: Community screening campaigns for diabetes mellitus and hypertension is extremely efficient in identifying undiagnosed diabetic and hypertensive individuals. The most successful strategy for the screening and confirmation of results was through PHCCs, especially in the rural areas, where there was good organization and strict adherence to guidelines on methodology.
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Effects of dietary flavonoids intake in Saudi patients with coronary heart disease
Mohammed A Alsaif, Latifa A Khan, Adel A.H. Alhamdan, Saada Alorf, Abdulaziz M Al-Othman, Shatha Alawami
September-December 2007, 14(3):119-126
Objectives: The aim of the study was to assess the dietary intake of flavonoids and their effect on serum lipid levels in Saudi patients with coronary heart disease (CHD). Methodology: A cross-sectional study with a sample of 50 CHD patients and 50 controls. A 24-hour recall method was used to collect data on the dietary intake of macronutrients, flavonoids, and antioxidant vitamins. A food frequency questionnaire (FFQ) was used to collect data on habitual consumption during the year preceding the interview. Baseline data collection included medical history, anthropometric measurements, physical activity, and smoking status. Results: CHD patients showed significantly less intake of fruits and vegetables compared to the controls. Serum lipids including total cholesterol (TC), triglycerides (TG), and low density lipoproteins (LDL) were found to be significantly higher in CHD patients than in the controls. The main sources of flavonoids in a typical Saudi diet are tea, fruits (apples), vegetables (onions), and chocolate. The intake of flavonoids and antioxidant vitamins was significantly lower in CHD patients compared to the controls. A negative correlation between the dietary intake of different flavonoids and serum LDL was observed in CHD patients. Significant correlation was found between the intake of flavonol and waist to hip ratio Conclusions: The findings of the study support a potential protective effect of dietary flavonoids in relation to CHD. The study showed that consuming more Flavonoids may have positive effect on lowering blood lipids.
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Quality of primary care referral letters and feedback reports in buraidah, Qassim region, Saudi Arabia
Mohammed A Al-Alfi, Abdullah M Al-Saigul, Ashraf M Abed-Elbast, Atef M Sourour, Hasnin A Ramzy
September-December 2007, 14(3):113-117
Objective: To evaluate the quality of referral letters and feedback reports written according to the standards of Quality Assurance Manual of Ministry of Health from primary health care centers (PHCC's) in Buraidah. Methodology: This study was conducted during October and November 2004. A total of 330 referral letters and feedback reports were randomly selected from six PHCCs (20% from PHCCs in Buraidah City). About 55 referral and feedback letters were selected from each PHCC by systematic sampling method. The referral letters and feedback reports were reviewed thoroughly for the main items required in ideal referral letters and feedback reports according to the standard of Quality Assurance Manual of Ministry of Health, and a scoring system was used Result: Many of the referral letters lacked such important information as the history in 36%, vital signs in 30%, results of clinical examination in 45%, results of basic investigations in 52%, provisional diagnosis in 50%, and treatment given in PHCCs in 47%. The legibility of referral letters and feedback reports was good in 75%, and 63% respectively, and the quality of referral letters and feedback reports was good in 63% and 39% respectively. The rate of feedback reports received by PHCCs was 30% of total number of referrals to the hospitals. The referral rate was (4%) from total number of patients seen in PHCCs. The most frequent reasons for referrals were for general treatment 36.7%, for general diagnostic evaluation 28%, and for laboratory investigation 18.8%. Conclusion: The referral rate from PHCCs in Buraidah fell within the standard set in Quality Assurance Manual. However, the quality of referral letters and feedback reports was poor in 17.6% and 29.7% respectively. The quality of both referral letters and feedback reports should improve to guarantee the quality of patient care..
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Appointment system in primary care: Opinion of consumers and providers
Ali I Al-Haqwi, Ali M Al-Shehri
September-December 2007, 14(3):99-102
Background : The appointment system in primary care is widely used in developed countries, but there seems to be a problem with its use in Saudi Arabia. Objectives : (1) To explore opinions and satisfaction of consumers and providers of care in Primary Health Care regarding walk-in and the introduction of the appointment system. (2) To examine factors which may affect commitment to an appointment system in PHC. Subject and method : Two hundred sixty (260) consumers above the age of 15 years as well as seventy (70) members of staff were randomly selected from 10 Primary Health Care Clinics in the National Guard Housing Area, Riyadh and asked to complete a structured questionnaire designed to meet the study's objectives. Results: The majority of consumers and providers of care were in favour of introducing appointments despite their satisfaction with the existing walk-in sysem. Respondents saw many advantages in the appointment system in PHC such as time saving, reduction of crowds in the clinics and guarantee of a time slot. The main perceived disadvantage was the limitation of accessibility to patients especially with acute conditions. The main organizational advantages and disadvantages perceived by providers were related to follow-ups of chronic patients, no shows and late arrivals. The majority of the patients preferred appointments in the afternoon and the possibility of obtaining an appointment over the telephone. Conclusion : In this study, both consumers and providers supportted the idea of introducing the appointment mixed system in primary care, but further study is required
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Public health schools in Saudi Arabia: A necessity or a luxury?
Waleed A Milaat
September-December 2007, 14(3):89-90
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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010