This study aimed to assess the impact of oral Fe+2 iron preparations on weight, body composition, metabolic, and appetite parameters in adults undergoing treatment for iron deficiency.

In this observational prospective study, a total of 119 patients, aged 18–45, initiating Fe+2 iron therapy for iron deficiency within the last month at Family Medicine Outpatient Clinic, were included. Data on sociodemographic variables, health, dietary habits, anthropometric measurements, metabolic parameters, and appetite scores were collected. The Power of Food (PFS), Visual Analogue Scale (VAS), and Three-Factor Eating Questionnaire (TFEQ) were utilized for appetite assessment.

After three months of iron treatment, a statistically significant increase was found in the mean values of Hb, Hct, MCV, ferritin, iron, and transferrin saturation; anthropometric measurements displayed a significant reduction in body weight, body mass index (BMI), fat percentage, waist circumference, hip circumference, and waist/hip circumference ratios post-treatment. Notably, VAS scores for certain food items decreased, while carbonated drinks VAS score increased. Appetite-related factors, as per PFS, exhibited a significant decrease in PFS factor 1 (food available), PFS factor 2 (food present).

In conclusion, our findings indicate that oral Fe+2 iron preparations positively influence the treatment of iron deficiency anaemia by improving haematological parameters and concurrently leading to a significant reduction in body weight, BMI, and appetite scores related to specific food items. The study underscores the multifaceted impact of iron supplementation on both physiological and behavioural aspects, providing valuable insights for optimizing iron deficiency anaemia management.

Demographic transitions, societal changes, and evolving population health needs are placing increasing pressure on healthcare systems, necessitating ongoing reforms. Primary health care (PHC) is a foundational component of Universal Health Coverage (UHC) and sustainable health systems. Many countries have undertaken PHC reforms aimed at improving population health. This review explores the objectives, implementation mechanisms, challenges, and outcomes of these reforms.

We conducted a systematic review of studies sourced from five databases (PubMed, Scopus, Proquest, Embase, and Science Direct), applying the World Health Organization’s Health Systems Framework for deductive content analysis. The PRISMA guidelines were followed to ensure transparency and rigour in summarizing the published literature.

A total of 147 types of interventions were identified, with most targeting service delivery and financing. Key reform objectives included expanding access to care, improving financing and payment systems, scaling up family physician programmes, increasing government health expenditure, leveraging private sector capacities, and strengthening the PHC workforce. These interventions resulted in expanded public health coverage, enhanced access to PHC, increased utilization of services among low-income populations, broader social insurance coverage, and improved service quality, contributing to better community health outcomes.

The success of PHC reforms depends on their alignment with political, social, and cultural contexts, as well as consideration of the social determinants of health. Strong governmental support, managerial stability, decentralization, and regional capacity building are essential for sustainable implementation. Reforms should be gradual, supported by accurate forecasting, adequate and sustainable resources, and evidence-based strategies, drawing on international experiences.

The aim of this study was to explore primary health care professionals’ (PHCP) experiences of frailty assessment with the Tilburg Frailty Indicator (TFI) with focus on feasibility aspects.

Primary health care (PHC) is often the first point of contact for older people and assessment of frailty is therefore often recommended in this setting. There is however a lack of awareness of frailty in PHC. The TFI has been proposed as a suitable instrument for frailty assessment in PHC. It consists of 25 questions, where ten questions aim to identify risk factors for frailty and 15 questions assess physical, psychological, and social frailty. There are no previous studies of feasibility aspects of TFI in PHC.

A qualitative interview study with physicians, nurses, and physiotherapists that had used TFI in face-to-face interviews during a care visit. Interviews were transcribed and the text was thematically analyzed using qualitative content analysis.

Nine interviews were performed. The PHCPs experiences were expressed in one theme: TFI is useful and feasible but requires time and knowledge. TFI was described as easy to use and providing a holistic assessment of the patient. Using the TFI was time-consuming but provided useful information for care planning. In conclusion, the TFI could be a clinically useful tool to assess frailty in PHC. The result indicates a need of educational efforts to increase knowledge about frailty and a need for primary health care to adjust to older people in order to allow care visits to include both assessment and management of frailty.

The objectives of this study were to study the psychometric properties of the Implementation Drivers Scale (IDS), for the mhGAP programme, both clinical and community; to test its structural validity, and to propose an instrument to accompany the implementation of the mhGAP in similar contexts. For this purpose, a cross-sectional quantitative methodology study was conducted.

Mental health programmes proposed in low- and middle-income countries to address gaps in care have implementation problems.

A cross-sectional quantitative methodology study was conducted. During 2022 and 2023, the instrument was administered to 204 individuals, including primary care professionals (50%), national administrative leaders (19.11%), and community strategy leaders. Three departments of Colombia participated, two with low levels of implementation in mental health programmes and one with high levels of implementation of programmes and services.

The Kaiser-Meyer-Olkin factor analysis resulted in 0.861, which indicated the suitability of the data for a factor analysis. Bartlett’s Test of Sphericity had a value of 2480.907 (153 degrees of freedom, p <.001). The exploratory factor analysis explained variance of 66.781%. The four factors proposed in the AIF model (System enablers for implementation, Accessibility of the strategy, Adaptability and acceptability, and Strategy training and supervision) were confirmed, with all items with loadings greater than 0.4. For the entire instrument, a Cronbach’s alpha was 0.907. The IDS could contribute to the monitoring of some components of mhGAP implementation, both clinical and community-based, in low- and middle-income settings through appropriate validation processes.

We aimed to explore concerns and feeling of safety among quarantined and non-hospitalized COVID-19 patients.

We conducted a qualitative study of free text answers from participants of an online survey. The survey was conducted between March 2020 and June 2021. COVID-19 positive adults in home isolation and adults in quarantine were eligible for participation. 698 participants answered one or more of three open-ended questions about concerns and safety. We analyzed free-text answers using thematic analysis according to Braun and Clarke with an inductive approach.

Analysis of the free-text answers from all participants identified three main themes: (1) Fear of the unknown, (2) Views on personal care and public health measures, and (3) Concern for the future of a country in crisis. Participants’ feelings revolved around health-related concerns and societal related concerns. They were concerned about their own and other’s health, and possible long-term consequences of COVID-19 infection. Some participants were satisfied with the health care system, others thought follow-ups, testing, vaccination, and information would increase their feeling of safety.

People quarantined and isolated due to the COVID-19 pandemic had concerns regarding personal health and societal consequences of infection control measures. Health care follow-ups and individualized information would increase participants’ feeling of safety.

To understand mental suffering from the point of view of the people affected.

A qualitative study was carried out with 22 users of Primary Health Care units in Ribeirão Preto, São Paulo, Brazil. The data were collected through individual interviews using the Oral Life History technique and analysed using Thematic Analysis.

Two categories emerged: ‘Vulnerabilities in the life history of people with mental suffering’ and ‘Perceiving and living with suffering and/or mental disorder’. The experience was permeated by situations of violence, poverty and abandonment, from childhood to adulthood. The recognition of mental suffering and its consequences was based on behavioural changes and work difficulties, which did not lead them to seek immediate treatment. The difficulty of living with suffering and/or mental disorder is directly related to adherence to treatment.

Subjective aspects present in human life are still disregarded and the late search for professional help seems to result in the stigma and self-stigma of people with mental suffering and/or disorders.

This study aims to assess the effect of primary health care (PHC) service provision continuity on inpatient admissions for people with chronic diseases in Estonia.

Non-communicable diseases (NCDs) were collectively responsible for more than 7 out of 10 deaths worldwide in 2019. As the burden of NCDs increases, PHC has an increased role of coordinating care management. High-performing PHC can reduce unnecessary hospitalizations. Estonia has a strong PHC system focusing on multidisciplinary care. Yet it has not been evaluated for its effect on hospitalizations. Therefore, it is imperative to evaluate PHC continuity to improve care for NCD patients.

This study used routinely collected electronic medical billing data of the Estonian population aged 15 years or older from 2005 to 2020 identifying patients with seven ambulatory care sensitive chronic (ACSC) conditions. We developed an indicator to describe the continuity of PHC. Charlson Comorbidity Index (CCI) was used to assess the impact of comorbidities and we controlled the patient’s age, gender, county of residency and socio-economic status. We estimated multilevel logistic regression models with family doctor patient list random effects to assess how the odds of hospitalization depend on continuity of care, allowing for confounders.

We identified that 45% of the adult Estonian population had at least one of the target diagnoses. Among the target population, 96% had contact with their PHC providers. We found that there is a non-linear relationship between PHC continuity and patient outcomes. Any contact with PHC provider during the past 5 years decreases odds for hospitalization, but hospitalization risk is higher for people who are elderly and have higher CCI score. We found that after accounting for patient characteristics, differences among patient lists minimally impact outcomes. Further research should explore policies to better support family doctors in reducing hospitalizations for chronic patients.