The effectiveness of active prophylactic screening analysis at family medicine clinic

The aim is to assess the effectiveness of active prophylactic screening analysis by identifying risk factors at the family medicine clinic of Lithuanian University of Health Sciences. Tasks: 1. To assess the prevalence of risk factors in the analysed population by the means of active prophylactic screening analysis. 2. To compare the prevalence of risk factors determined during the period of 2 years before the commencement of active prophylactic program and during the period when the program was in operation. 3. To assess the factors that influence patients’ motivation to participate in the active prophylactic program. 4. To assess the literacy of patients’ regarding the importance of analysed risk factors (BMI, physical activity) for health. Methodology. A quantitative research was carried out in the years 2016 – 2017 at the Family medicine clinic of Lithuanian University of Health Sciences. A permit to carry out the research was granted by the Centre of Bioethics of Lithuanian University of Health Sciences. Analysed population – patients from 18 years old who have participated in the program of active prophylactic screening. The method – search of assessment of risk factors in patient medical records for the period of 2 years before the commencement of prophylactic program and patient telephone survey. 147 patient medical records were analysed. 121 person agreed to participate in the study (response rate 82,3 %). A questionnaire prepared by the author including investigative questions about knowledge, opinion, and previous experience of respondents was used for the survey. Results. 32 percent of males and 68 percent of females participated in the survey, median age of investigated persons was 59,3 (±16) years. After assessment of physical activity of investigated persons it was established that 25,2 percent were physically active, 39,5 percent were insufficiently physically active and 35,4 percent were physically inactive. 3,4 percent of investigated persons had insufficient body mass, 27,2 percent had normal body mass, 32,7 percent were overweight, and 36,7 percent were obese. During the two years before the commencement of active prophylactic screening 25,9 percent of investigated persons had their physical activity assessed, 29,9 percent had their BMI assessed, 20 percent of which was carried out under the Heart and cardiovascular disease prevention program. 52,9 percent of the respondents were advised to participate in the program by health professionals, and 47,1 percent of investigated persons participated on their own initiative. 80,2 percent of investigated persons evaluated the program from 2 to 10 points, median 8, average 8,23, standard deviation 1,526, the rest of the respondents refused to provide assessments. It was established that the program received more positive evaluations from male persons, rural dwellers, working persons, health professionals and the persons who participated on their own initiative. When literacy on the subject was investigated, it was established that 71,1 percent of investigated persons did not know how to calculate BMI, and 81,8 percent knew about the influence of physical activity on health. It was established that women, persons of 18-64 years of age, persons having higher than primary education, working persons, persons having insufficient or normal body mass, and health professionals had better knowledge of the influence of physical activity on health. When investigated persons were assessed based on their physical activity, it was established that their knowledge of the influence of physical activity on health and their actual physical activity did not correspond. Conclusions: 1. Having assessed risk factors within the scope of prophylactic program and having determined their prevalence during the program it was established that more than a half of investigated persons were insufficiently physically active or physically inactive, had increased BMI, increased arterial blood pressure, deteriorated vision, and consumed alcohol. Every fifth investigated person had impaired hearing, every fourth was a smoker. 2. The screening rates for investigated characteristics before the introduction of active prophylactic program were low, it was established that the major part of screened characteristics was assessed during other prophylactic programs. 3. The major part of investigated persons check their health when health professional informs them about the importance of prophylactic health checks and their availability. Male persons, city dwellers, working persons, health professionals and persons who check their health on their own initiative gave more positive evaluations of the program. 4. Investigated persons have more knowledge about the influence of physical activity on health than about the calculation of BMI. Female persons, persons of younger age, persons having higher education, working persons, persons having sufficient physical activity and lower or normal BMI have higher literacy level on the investigated issues. Recommendation: Having assessed risk factors within the scope of prophylactic program and having determined their prevalence, target risk groups may be identified and necessary care may be planned to achieve better health status of a person

Adverse Events and Immunogenicity of mRNA-Based COVID-19 Vaccine among Healthcare Workers: A Single-Centre Experience

Background and Objectives: The safety and effectiveness of vaccines are among the key priorities in COVID-19 pandemic management. Moreover, evidence-based data regarding vaccine safety and immunogenicity can play an important role in building the trust of the community regarding vaccination. The aim of this study was to investigate the safety and immunogenicity of Pfizer-BioNTech vaccine among healthcare workers in one hospital, 21 days after first dose. Materials and Methods: This study was conducted in the Hospital of the Lithuanian University of Health Sciences between February and March 2021. Hospital employees who arrived to receive the second dose of the Pfizer-BioNTech vaccine 21 days after the first one were invited to participate in the study: they were asked to complete an anonymous adverse events questionnaire and were offered a SARS-CoV-2 IgG/IgM rapid test. The study was performed at a single point, 21 days after the first dose of the vaccine. Results: Data of 4181 vaccine recipients were analysed. The first vaccine dose was associated with a 53.6% incidence of adverse events, mainly local reactions. Adverse events occurred more frequently in younger participants and women. Moderate adverse events were experienced by 1.4% of the vaccine recipients; 6.2% were incapacitated. Of the 3439 participants who performed a rapid IgG test, 94.5% were positive for IgG antibodies after the first vaccine dose. Seroconversion rates were lower in participants older than 47 years. Conclusions: Despite 1.4% moderate adverse events, no safety concerns or anaphylaxis were identified. The Pfizer-BioNTech vaccine induced an immune response in the overwhelming majority of recipients after a single dose. Younger participants experienced adverse events and were positive for IgG antibodies more frequently than older counterparts. It is important to mention that this study specifically considered short-term safety and reactions following vaccination and that long-term adverse effects were not investigated in the study. Thus, future research into both long-term adverse reactions and immune system programming is essential