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1
Bliss, Joy A., and Gregory G. Caputy. "The business education of Canadian plastic surgeons." Canadian Journal of Plastic Surgery 4, no. 1 (September 1996): 1–10. http://dx.doi.org/10.1177/229255039600400103.
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Business and economic aspects of a medical practice are rapidly becoming more complex. Physicians are at a crossroads in the manner by which medical and surgical care will be delivered in Canada, at the very base of which are the business aspects and management of health care. The purpose of this research study was to determine the business acumen of plastic surgeons in active practice. The resource base was Canadian plastic surgeons who are members of the Canadian Society of Plastic Surgeons. The intent of the questionnaire research study was to evaluate whether these surgeons perceive this area as necessary and whether they feel adequately prepared to manage this aspect of their practice. The findings of the research indicate that the plastic surgeons surveyed did perceive a need for business acumen in the practice of medicine. The majority felt they were not prepared adequately to deal with the business side of operating a medical practice and perceived a need for basic knowledge in the area of business. The implications of this research are that medical education has ignored this important aspect of preparing a physician to practise medicine in the present economic environment. Educational materials to structure and systematically disseminate business resource information need to be developed so that this group would be able to deal adequately with business-related problems when faced with them in medical practice. Due to the specialty-specific nature of the business needs, this education should likely occur during residency or fellowship training.
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Black, Douglas. "Expensive Medical and Surgical Technology." International Journal of Technology Assessment in Health Care 5, no. 3 (July 1989): 308–12. http://dx.doi.org/10.1017/s0266462300007376.
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The very title - “Expensive Medical and Surgical Technology” - expresses in coded form a myth that is widely prevalent among those who consider the political and economic aspects of health care. Strangely, it is a myth that finds favor mainly at the extreme ends of the range of attitudes toward health care. Monetarists see it as an incentive toward increasing private provision of health care, while extreme egalitarians see it as another example of unjust privilege. The content of the myth is that there is a definable group of costly procedures, which can somehow be isolated from the general practice of medicine and surgery, after which such procedures can either be made the subject of special private provision or, alternatively, discarded from a rationed system of health care.
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McKenna, M., and A. Abdelaal. "Group & save sampling in lumbar decompression: A review into current practice." Journal of Perioperative Practice 31, no. 1-2 (November 22, 2020): 15–17. http://dx.doi.org/10.1177/1750458920950664.
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The risks, benefits and technical aspects of surgery require careful consideration. One element of this is the requirement of postoperative blood transfusion. Patients who undergo elective lumbar decompression are at a low risk of requiring a postoperative transfusion yet undergo multiple preoperative group & save tests. For those who are at a low risk of bleeding, a single group & save sample may be adequate. This review analysed the postoperative blood loss and transfusion rate associated with lumbar decompression surgery without fusion in one institution. A subsequent cost analysis and review of the literature was performed. The aim was to assess whether single group & save sampling, within the context of lumbar decompression, was cost effective and amenable to the patient without impacting patient care. Average blood loss was estimated as a drop in Hb of 12.3g/dl. Six patients (14%) had Hb loss of over 20g/dl. No patients underwent a blood transfusion. Through examination of medical records, we found that 65% of patients (35) were suitable for single group & save sampling, estimating a saving of £2415.95 (53%). Selective group & save testing holds economic potential and safeguards patients from undergoing unnecessary testing. The next step after this review would be a prospective multi-centre study.
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Springer, Svenja, Peter Sandøe, Thomas Bøker Lund, and Herwig Grimm. "“Patients’ interests first, but … ”–Austrian Veterinarians’ Attitudes to Moral Challenges in Modern Small Animal Practice." Animals 9, no. 5 (May 15, 2019): 241. http://dx.doi.org/10.3390/ani9050241.
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Small veterinary practice is experiencing steady improvement in diagnostics and therapies which enable veterinarians to offer evermore advanced medical care for their patients. This focus group study of veterinarians (n = 32) examined the impact of these improvements and the potential challenges they introduce in small animal practice. It shows that while advanced diagnostics and therapies deliver benefits in patient care, they also add complexities to decision-making. Although the veterinarians participating in the study were aware of their duty to act in the best interests of the animal, their decisions were highly dependent on factors such as the client’s financial background and the emotional bond between client and animal, as well as the veterinarian’s place of work, and level and field of specialization, and certain economic aspects of the practice. The overall conclusion is that small animal veterinarians are increasingly torn between serving the best interests of the animal, medical feasibility and contextual factors related to the client, the veterinarian, and professional colleagues. Further, the findings suggest that services are not only oriented towards the provision of medical care in a strict medical sense. On top of this, veterinarians need to deal with various expectations and wishes of clients which influence their decision-making. As it will be shown, factors like the possibility of referring patients to specialist veterinarians or prompt diagnostic results influence their decision-making.
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Stefanicka-Wojtas, Dorota, Marta Duda-Sikuła, and Donata Kurpas. "Personalised medicine – best practices exchange and personal health implementation in European regions – a qualitative study concept under the Regions4PerMed (h2020) project." Medical Science Pulse 14, no. 1 (June 30, 2020): 1–8. http://dx.doi.org/10.5604/01.3001.0014.2475.
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Personalised medicine (PM) is the adaptation of medical treatment to an individual patient. More importantly, PM offers the potential to detect disease earlier when it is easier to treat effectively. PM is beginning to overcome the limitations of traditional medicine. In PM there are many potential benefits and facilitators but also many barriers. The goals of the Regions4PerMed project are to set up the first interregional cooperation on PM, align strategies and financial instruments, and most importantly, identify primary barriers in personal medicine adoption in the health care system and systematic actions to remove as many of them as possible to create a future where PM is fully integrated into real life settings. Each key action activity will be followed by a focus group or semi-structured qualitative interview. The questions asked during the research will concern barriers and facilitators of PM implementation in the country of a subject and will concern: medical big data and electronic medical records; health technology in connected and integrated care; the health industry; facilitate the innovation flow in health care; socio-economic aspects. The qualitative study outcomes are supposed to bring more qualitative data to the discussion. They could be implemented to the daily practice of the health care system’s stakeholders through the best practices transferred to all five key strategic areas of the Regions4PerMed project.
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Svistushkin, V. M., G. N. Nikiforova, A. V. Zolotova, and V. A. Stepanova. "Using of topical bacterial lysates in modern clinical practice." Meditsinskiy sovet = Medical Council, no. 6 (May 12, 2021): 49–56. http://dx.doi.org/10.21518/2079-701x-2021-6-49-56.
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Acute and chronic infectious and inflammatory diseases of the upper respiratory tract occupy a leading position in the structure of the pathology of the world’s population and remain the most frequent reason for patients seeking medical care. The prevalence and frequency of this disease in this nosological group makes a decisive contribution to the structure of the causes of temporary disability, which entails significant negative social and economic consequences. In this aspect, the spread of resistance of pathogens to etiotropic drugs and the insufficient arsenal of pathogenetic drugs stimulate the medical community to search for alternative approaches to the treatment of patients with respiratory pathology. One of these therapeutic areas is the use of immunomodulators, the most commonly used group of which are bacterial lysates. In the modern literature, sufficiently convincing data have been accumulated on the effectiveness of the use of bacterial lysates of systemic action, as a result of which the immune cells of the gastrointestinal tract are activated, which in turn leads to the restoration of autoregulation of the immune response throughout the body, and a decrease in the frequency of infectious and allergic diseases. The latest developments of domestic pharmacologists are topical bacterial lysates, the principle of which is based on the local activation of mucosal immunity in the respiratory tract. The undoubted advantage is that bacterial lysates, with all their effectiveness, do not harm the human microbiome, practically do not cause side reactions, combine well with other drugs, and can also be used at any stage of the disease, including for prophylactic purposes.
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Movig, Kris LL, Antoine CG Egberts, Albert W. Lenderink, and Hubert GM Leufkens. "Selective Prescribing of Spasmolytics." Annals of Pharmacotherapy 34, no. 6 (June 2000): 716–20. http://dx.doi.org/10.1345/aph.19267.
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BACKGROUND: Daily clinical practice often differs largely from the clinical trial setting, so extrapolation of outcomes from trial data, such as safety, effectiveness, and economic outcomes, can be deceptive. Prescribers may intend to treat a selected group of patients with new drugs; this practice could result in significant bias in assessing outcomes of these agents during their use in daily clinical practice. OBJECTIVE: To evaluate what type of patient received tolterodine compared with the spasmolytic drugs previously marketed (oxybutynin, flavoxate, emepronium). DESIGN: An observational, follow-up study. SETTING: Eighteen collaborating community pharmacies. PATIENTS: Aged ≥18 years, noninstitutionalized; initial therapy with tolterodine, oxybutynin, flavoxate, or emepronium. RESULTS: Tolterodine was often used as a second-line and even as a third-line treatment, and was prescribed to a “polluted” population in terms of concomitant psychotropic medication. Tolterodine users were 7.5 times more likely to have received another spasmolytic drug (RR 7.5, 95% CI 4.8 to 11.9). In addition, these patients more frequently used antiparkinsonian drugs (RR 4.1, 95% CI 1.6 to 10.4) as well as antipsychotic drugs (RR 2.9, 95% CI 1.4 to 6.2). There was a small difference in concomitant use of antidepressants and benzodiazepines between patients receiving tolterodine versus those taking other spasmolytic drugs. CONCLUSIONS: Tolterodine is prescribed for a population differing from that receiving previously marketed spasmolytic drugs. Selective prescribing should be recognized when evaluating new drugs in daily clinical practice. Policy makers, such as pharmacy and therapeutics committees, should consider this aspect in their formulary decisions since selective prescribing can lead to unjustified conclusions about a drug's therapeutic effects (e.g., efficacy, safety, cost-effectiveness).
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V K Singhal, Shalini Ray, Priyanka Sachdeva, and Vishesh Yadav. "A Study on Gender Preferences and its Sociocultural aspects among Married Women (18-45years) in Rural Gurugram." International Healthcare Research Journal 3, no. 5 (August 24, 2019): 185–88. http://dx.doi.org/10.26440/ihrj/0305.08270.
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INTRODUCTION: Declining sex ratio is a major concern worldwide, especially in a developing country like India. The role of sociocultural factors in gender preference is known since ages. The skewed sex ratio in India is attributed to selective female feticides and misuse of technological advancements. This also has a strong influence on contraceptive acceptance among couples.
OBJECTIVES: The present study was conducted to explore the contraceptive use, gender preferences and its determinants among married women in rural Gurgaon.
MATERIALS AND METHODS: A cross-sectional study was conducted among married women (18-45years) residing in the rural field practice area of SGT medical college and hospital, Gurugram. The sample size was found to be 400. Systematic random sampling technique was used to recruit the study participants. Pre- tested, pre-designed questionnaire was used for data collection.
RESULTS AND DISCUSSION: Among 400 married women, current contraceptive usage among study population was found to be 58.25%. The most common method of contraception used by the study subjects was intrauterine contraceptive device. The preference for male child was found among 49.5% women. The reasons cited for such preference were propagation of family name (48.2%), financial dependability in the old age (34%), social responsibilities are carried out by males (25.3%) and males are lesser economic liability (31%). Lower age group of mother, nulliparity, Hindu religion, lower educational status and lower socioeconomic status were found to be the determinants of male child preference in the present study.
CONCLUSION: There is need of awareness and education amongst women and both the genders deserve equal respect without any preferences.
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Maric, Nadja, Dragan Stojiljkovic, Zorana Pavlovic, and Miroslava Jasovic-Gasic. "Factors influencing the choice of antidepressants: A study of antidepressant prescribing practice at University psychiatric clinic in Belgrade." Vojnosanitetski pregled 69, no. 4 (2012): 308–13. http://dx.doi.org/10.2298/vsp1204308m.
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Background/Aim. Antidepressants are a widely used class of drugs. The aim of this study was to investigate different aspects of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade. Methods. This cross-sectional study was carried out by retrospective analysis of the patient's medical charts. The study included all patients with antidepressant prescribed at discharge during 2009 (n = 296). The evaluation was focused on patient- related factors (socio-demographic and illness related), psychiatrist-related factors (sex and duration of working experience) and drug related factors (type of antidepressant, dose, polypharmacy and reimbursement by national health insurance). Results. Antidepressants were prescribed for unipolar depression (F32-34, ICD X) either without comorbidity (46.2%) or with comorbidity (24.7%), mostly as a monotherapy (91% had one antidepressant), to the patients who were 65% female, aged 50.1 ? 8.9, most of them with 12 years of education (52.6%), married (69.3%) and employed (55.9%). The majority of patients had a history of two hospitalizations (Med 2; 25th-75th perc. 1-4) during nine years (Med 9; 25th-75th perc. 2-15) after the first episode of depression. Among them, 19% were found to be suicidal in a lifetime. The single most prescribed antidepressant was sertraline (20.4%), followed by fluoxetine (13.3%) and maprotiline (11.7%). Utilization of antidepressants was positively correlated with the rate of reimbursement (p < 0.01). The most prescribed antidepressant group was selective serotonin reuptake inhibitors (SSRI) (47.8%), followed by tricyclic antidepresants (TCA) (25.3%) and new antidepressants - venlafaxine, tianeptine, mirtazapine, bupropion, trazodone (15.1%). Most of the drugs were prescribed in doses which are at the lower end of the recommended dose-range. Regarding severity of the actual depressive episode, TCA were prescribed for severe depression with psychotic features, while SSRI were choice for episodes with moderate symptom severity (p = 0.01). Psychiatrists with longer working age (20-30 years) hesitated to prescribe new antidepressants in comparison to younger colleagues (p = 0.01). Conclusion. Economic issues in Serbia as developing country influence the choice of antidepressants, as well as a psychiatrist?s working age and severity of depression. However, SSRI are the drugs of the first choice, as it was shown in most of the developed countries nowadays.
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Gupta, Anmol K., Anita Thakur, Tripti Chauhan, and Nidhi Chauhan. "A study to determine socio demographic corelates of reproductive tract infection amongst women of reproductive age group." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 8 (July 23, 2020): 3463. http://dx.doi.org/10.18203/2320-1770.ijrcog20203342.
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Background: Reproductive tract infection (RTI) is a public health problem, especially in developing country like India. The associated odium with this reproductive morbidity is often a stumbling block in seeking health care. The aim was to study the prevalence of RTI symptoms and its socio-demographic corelates.Methods: A cross-sectional study was undertaken in the rural field practice area of department of community medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to September 2018. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The prevalence of self-reported reproductive tract infections was found to be 41.2%. The prevalence was more in lower socio-economic classes, and it was statistically significant. Other socio-demographic corelates (age, education, occupation) did not showed any significant association.Conclusions: The reproductive tract infections prevalence is found to be considerably high in the women of reproductive age group. The frequency was higher among multigravida women and those using cloth during menstrual periods. RTIs are usually spurned by women and even the health care providers, so there is a need to give due consideration to this aspect of reproductive health.
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Ha, Do Thi, and Khanitta Nuntaboot. "FACTORS INFLUENCING COMPETENCY DEVELOPMENT OF NURSES AS PERCEIVED BY STAKEHOLDERS IN VIETNAM." Belitung Nursing Journal 6, no. 4 (August 7, 2020): 103–10. http://dx.doi.org/10.33546/bnj.1119.
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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. Competency development is a continuous process of improving knowledge, attitudes and skills, and is influenced by a numerous of factors.Purposes: This study aims to explore factors that influence the development of competencies of nurses working in clinical settings in Vietnam.Methods: A descriptive qualitative research was conducted in Ho Chi Minh City, Vietnam with a purposive sample of twenty-seven participants including nurses, nurse managers, administrators, nurse teachers, medical doctors, and other health care providers. Data collection was by in-depth interviews and focus group discussions. Content analysis was used to analyze the data.Findings: The research participants described numerous of factors that influence the journey of developing nurses’ competencies. The identified factors were relevant to nursing education and training system in Vietnam; working environments of nurses; public image and values of nursing profession; characteristics of nurses themselves; Vietnamese nursing profession; sociocultural-economic and political aspects in Vietnam; and global contexts.Conclusion: The derived knowledge would greatly benefit clinical nurses, administrators, nursing educators, health care services managers, policy makers as well as other relevant health care stakeholders in proposing of solutions to promote nursing education, nursing workplace environments, and the appropriate regulations in order to enhance the nursing competency and quality of nursing services in Vietnam.
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Wernz, Christian, Hui Zhang, and Kongkiti Phusavat. "International study of technology investment decisions at hospitals." Industrial Management & Data Systems 114, no. 4 (May 6, 2014): 568–82. http://dx.doi.org/10.1108/imds-10-2013-0422.
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Purpose – Healthcare costs have increased considerably over the past decades around the world. Major contributors to this trend are expensive medical technologies. The purpose of this paper is to use a case study approach to understand how organizational and country level factors influence hospital investment behavior. Design/methodology/approach – The paper developed a conceptual framework based upon decision theory and institutional theory from which key questions were derived. The paper conducted semi-structured group interviews with relevant stakeholders in six hospitals located in five countries (Germany, India, Thailand, South Korea, USA). Findings – The paper found that the investment decisions of the interviewed hospitals are primarily affected by the healthcare system, the socio-economic and cultural context, and the organization's mission. Most of the interviewed hospitals consider multiple criteria in their decision-making framework and share similar organizational processes. Practical implications – The paper identified an international best practice approach to investment decision making at one of the hospitals. The other hospitals, despite being leading institutions in their respective countries, do not have sufficiently advanced and objective assessment approaches and would benefit from a more data-driven and systematic decision process. Originality/value – Prior research has documented that investment decisions at hospitals are driven by organizational factors. This paper shows how, in addition, country level factors – in particular healthcare system and cultural aspects – affect hospital decision-making behavior.
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Soboleva, Mariya. "The Formation and Development of the Legal Status of a Consumer of Paid Medical Services in the Russian Health Care System in the XVIII – Early XX Centuries." Siberian Law Review 17, no. 3 (December 2, 2020): 300–309. http://dx.doi.org/10.19073/2658-7602-2020-17-3-300-309.
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The socio-economic situation in Russia over the past decades has undergone serious changes that could not but affect the health system. There have been prerequisites for the development of private medicine, which has been supported by the state. Currently, there is an increase in the share of medical services provided on a paid basis. Widespread private practice, covering the chronological period of the Russian Empire, was interpreted by the authorities in the Soviet period as a relic of the capitalist system, contrary to the basic principles of proper health care organization. The Soviet period of Russian history appears to us as a chronological gap, that is, a time gap that characterizes the specifics of the linear existence of paid medical services.
In this regard, it seems relevant and timely to conduct research on the historical aspects of the formation and development of the legal status of consumers of paid medical services in the Russian Empire. In our opinion, such research is of both theoretical and practical interest. The first is due to the lack of development of this topic in the historical and legal literature. The second one will allow us to identify existing shortcomings in legal regulation in the sphere of public health protection based on the generalization of historical experience and formulate practical recommendations for improving the legislation of the Russian Federation in this area.
From the perspective of this work, we aim to assess the legal status of consumers of paid medical services in the XVIII – early XX century, comprehensively examining such elements of legal status as rights, freedoms, interests and duties. The article analyzes the influence of belonging of the inhabitants of the Empire to a particular social group on the formation of the legal status of consumers of paid medical services. For the first time, the main types of rights of consumers of paid medical services are separated from the regulatory legal acts in the field of healthcare of the Russian Empire and formed into a group.
Based on the results of a detailed analysis, we conclude that in the Russian Empire, the duties of consumers of paid medical services took priority over the rights, since it was believed that if the obligations were met, the rights would exist regardless of their formal Declaration. The analysis helps to understand the development of regulation of health ser-vices and allows us to draw historical parallels with the existing regulatory framework of the health care system in Russia.
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Todorovic-Djilas, Ljiljana, Tijana Icin, Jovanka Novakovic-Paro, and Ivana Bajkin. "Autoimmune thyroid disease and other non-endocrine autoimmune diseases." Medical review 64, no. 3-4 (2011): 183–87. http://dx.doi.org/10.2298/mpns1104183t.
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Introduction, Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens. They constitute heterogeneous group of disorders, in which multiple alterations in the immune system result in a spectrum of syndromes that either target specific organs or affect the body systematically. Recent epidemiological studies have shown a possible shift of one autoimmune disease to another or the fact that more than one autoimmune disease may coexist in a single patient or in the same family. Numerous autoimmune diseases have been shown to coexist frequently with thyroid autoimmune diseases. Autoimmune thyroid disease and other organ specific non-endocrine autoimmune diseases. This part of the study reviews the prevalence of autoimmune thyroid disease coexisting with: pernicious anaemia, vitiligo, celiac disease, autoimmune liver disease, miastenia gravis, alopecia areata and sclerosis multiplex, and several recommendations for screening have been given. Autoimmune thyroid disease and other organ non-specific non-endocrine autoimmune diseases. Special attention is given to the correlation between autoimmune thyroid disease and rheumatoid arthritis, systemic lupus erythematosus, syndrome Sj?gren, systemic sclerosis and mixed connective tissue disease. Conclusions. Screening for autoimmune thyroid diseases should be recommended in everyday clinical practice, in patients with primary organ-specific or organ non-specific autoimmune disease. Other?wise, in patients with primary thyroid autoimmune disease, there is no good reason of seeking for all other autoimmune diseases, although these patients have a greater risk of developing other autoimmune disease. Economic aspects of medicine require further analyzing of these data, from cost/benefit point of view to justified either mandatory screening or medical practitioner judgment.
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Kosherbayeva, Lyazzat, David Hailey, Kural Kurakbaev, Adlet Tabarov, Ainur Kumar, Gulnara Gutzskaya, and Elena Stepkina. "A PROCESS OF PRIORITIZING TOPICS FOR HEALTH TECHNOLOGY ASSESSMENT IN KAZAKHSTAN." International Journal of Technology Assessment in Health Care 32, no. 3 (2016): 147–51. http://dx.doi.org/10.1017/s0266462316000222.
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Objectives: The aim of this study was to develop criteria for the prioritization of topics for health technology assessment (HTA) in the healthcare system of Kazakhstan.Methods: Initial proposals for criteria were suggested through consultation with Ministry of Health (MoH) policy areas. These were refined through a workshop attended by HTA department staff, persons from medical universities and research institutes, and MoH policy makers. The workshop included discussion on methods used in international HTA practice. Opinions of participants on selection of criteria from those specified in a review of prioritization processes were used to define a list for inclusion in an instrument for routine use. A scoring system was established in later discussion.Results: Selected criteria for HTA prioritization were burden of disease, availability of alternative technology, clinical effectiveness, economic efficiency, budget impact, and ethical, legal, and/or psychosocial aspects. For each criterion, a health technology under consideration is given a score from 3 (High) to 1 (Low). The total score determines whether the technology is of high to medium priority or of low priority. Determination of priorities for assessment, using the instrument, should be carried out by an expert group appointed by the MoH. The process was applied in 2014 to a selection of topics, and three health technologies were chosen for full assessments.Conclusions: Criteria for prioritization have evolved with development of the HTA program in Kazakhstan. A method for HTA prioritization has been developed that is easy to apply, requires comparatively few resources, and is compatible with processes required by the MoH.
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Sekh, M. Ya. "Rational pharmaceutical management of medical oxygen in community-acquired pneumonia." Farmatsevtychnyi zhurnal, no. 3-4 (September 4, 2018): 21–29. http://dx.doi.org/10.32352/0367-3057.3-4.18.04.
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Medical oxygen has been currently considered as a medication according to the Ukrainian and worldwide data. The WHO has included it into the list of the main medical agents. Moreover, medical oxygen has a broad application spectrum and here it may be the only remedy that cannot be replaced by the analogous one. The most common symptoms of respiratory problems are oxygenation disorder and hypoxemia which require the application of medical oxygen. This factor determined the target group of our research, namely, the patients with community-acquired pneumonia of moderate and severe course.
The aim of the research was to study the state and expense of oxygen provision for patients with community-acquired pneumonia who were admitted to the internal unit of one of the health care institutions in Lviv. Medical documentation was the object of the research. It included: reporting/control documentation and medical prescriptions of patients diagnosed with community-acquired pneumonia. The study involved the application of systemic analysis, as well as analytical and comparative, information and search, clinical and economic, bibliographic of research methods.
The paper describes the importance of oxygen therapy for hypoxia treatment in certain pathological conditions, in particular community-acquired pneumonia. We performed an analysis of the state and expense of oxygen provision in the Lviv Regional Clinical Hospital as well as the patients with community-acquired pneumonia. The study was carried out in two periods (2006 and 2017). It has been established that the total expenses associated with oxygen were increased by 10 times in the hryvnia and by 2 times in dollar equivalents for 11 years. In addition, from the cost of all medicines purchased by the hospital during 2017, 8% was spent on medical oxygen. In the course of our study, the need for oxygen for a single therapeutic patient with non-hospital pneumonia is about 25 m3. The total cost of providing them with this category of patients has also grown almost 10 times in hryvnia and 2 times in dollar equivalents – from 41.56 UAH (8.23 $)/patient) to 477.72 UAH (17.63 $)/patient in 2006 and 2017, respectively. This certainly leads to a significant increase in the costly pharmacotherapy of patients with community-acquired pneumonia. Вeside this, the analysis has revealed a list of problems associated with outdated material and technical equipment, weariness of equipment, danger of explosion, and continuously growing expense of medical oxygen which forces the search for new and safer patient provision methods. Medical oxygen becomes a financial burden in clinical practice particularly under conditions of restricted financing in the branch of health care. Herein, it remains the main and compulsory component of pathogenic therapy in community-acquired pneumonia. The abovementioned problematic aspects require the urgent solution that, in our opinion, can be reached with the application of rational pharmaceutical management.
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Darmant, N., F. Fayet, C. Lambert, B. Pereira, M. Rodere, A. Fan, M. Soubrier, and M. Duclos. "POS1475-HPR EFFECT OF ARGENTINE TANGO PRACTICE ON TOTAL PHYSICAL ACTIVITY TIME IN PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATISM: A PILOT STUDY." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1022.3–1023. http://dx.doi.org/10.1136/annrheumdis-2021-eular.690.
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Background:Most patients with chronic inflammatory rheumatism (CIR) have a physical activity (PA) level below recommendations [1,2]. Currently, adapted structures offer a range of activities supervised by adapted physical activity educators. To the best of our knowledge, Argentinean tango is not yet offered in these structures.Objectives:The objective of this pilot study was to study the effect of 24 consecutive sessions of Argentinean tango on the total PA level in patients with CIR, including rheumatoid arthritis (RA) and spondyloarthritis (AS).Methods:In this controlled, randomized, open-label, clinical trial with two parallel arms, patients were required to attend two tango sessions per week, 48 sessions from 0 (M0) to 6 months (M6) for the intervention group (IG) and 24 sessions from 3 months (M3) to M6 for the control group (CG). Total PA time was measured at M3 using the Global Physical Activity Questionnaire (GPAQ) [3].Results:A total of 27 patients (23 women) were included, including 15 with RA and 12 with AS. Mean age was 59 ± 12 years, and median disease duration was 10 years (IQR: 3-19). The majority of patients had background treatment (conventional and/or biological). At M3, 22 patients could be evaluated (11 GC patients and 11 GI patients), as 3 patients were lost to follow-up and 2 were unable to come in due to health or professional reasons. The 11 GI patients attended a median of 16 sessions (IQR: 8-22), i.e., approximately one session per week. At M3, the total PA time was not increased, regardless of the measurement method, GPAQ questionnaire (effect size and 95% confidence interval (CI): 0.03 [-0.60; 0.67], p=0.91) or accelerometer (effect size and 95% CI: 0.43 [-0.37; 1.24], p=0.26), and regardless of the intensity of the PA. No significant change was found for sedentary time, disease activity, fatigue, or anxiety. However, improvements were found in body appreciation as assessed by the Body Appreciation Scale 2 questionnaire (p=0.016), balance (p=0.053), wrist bending angle (p=0.092), and shoulder amplitude (p=0.093). The few participants in this study is explained by the geographic distance of the classes and their homes, the lack of availability of patients in professional activity, fatigue, or not liking dance (mainly among men).Conclusion:The results of this pilot study suggest that one Argentinean tango session per week in CIR patients is more achievable than two sessions as originally planned. As the practice of classes in hospitals is constrained due to geographic distance, the sessions could be offered in adapted structures. Nevertheless, our pilot study shows that the Argentinean tango is beneficial for body appreciation in patients with CIR. A qualitative study is needed to better understand these effects.References:[1]Haute Autorité de Santé (2007). Rheumatoid arthritis: therapeutic aspects excluding drugs and surgery - medico-social and organizational aspects. Professional recommendations service - Medical-economic evaluation and public health service.[2]Haute Autorité de Santé (2008). Spondylarthritis: guide - long-term condition. Good Professional Practices Department - Communication Department.[3] Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. (2014 Dec). Validity of the global physical activity questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 10;14:1255. doi: 10.1186/1471-2458-14-1255.Disclosure of Interests:None declared
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Norri-Sederholm, Teija, Minna Joensuu, and Johanna Lammintakanen. "Opportunities and challenges for multi-professional units in rural areas." International Journal of Emergency Services 8, no. 2 (August 5, 2019): 163–74. http://dx.doi.org/10.1108/ijes-02-2018-0017.
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Purpose The purpose of this paper is to investigate opportunities and challenges for multi-professional paramedic-firefighter units in small municipalities in Finland. Design/methodology/approach The data were collected by means of four focus group interviews conducted with managers (N =12) and a questionnaire comprising open-ended questions for the personnel working in the units (n =73). Data from both sources were analyzed using inductive content analysis. Findings The empirical results suggest that the use of multi-professional units (MPUs) may be one means of providing a better standard of service in rural areas. However, the working practices and different professional backgrounds in MPUs are considered challenging by the personnel. Managers had a broader perspective; during the interviews they raised matters such as citizen characteristics, legal issues like varying working hours, and economic aspects. Both the personnel and the managers agreed on the strengths and weaknesses of the MPU model in principle. Practical implications The results of this study may clarify the opportunities and challenges posed by MPUs in rural areas from the perspectives of personnel and managers. Originality/value The study provides novel information on MPUs comprising paramedics and firefighters, who function at the interface of emergency medical services and rescue services and who have new tasks in rural areas, including home healthcare support and accident prevention.
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Matviienko, Nataliia, and Volodymyr Matviienko. "TOURIST-RECREATIONAL RESOURCES OF JAPAN." GEOGRAPHY AND TOURISM, no. 60 (2020): 16–25. http://dx.doi.org/10.17721/2308-135x.2020.60.16-25.
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The purpose of the study is to consider the features of tourist and recreational resources of Japan and to identify those types of tourism that are most developed on their basis. Method. The study was conducted in three stages: 1) preparation of the study (problem statement); 2) the stage of accumulation of scientific information: bibliographic search of scientific information, study of documents, main sources of the topic, compiling a review of the literature, the choice of aspects of research; 3) information processing (methods: comparative, statistical, scientific systematization); 4) analysis of the received information (interpretation of results, formulation of the general conclusions). Results. Tourist activity, as the main form of recreation, belongs to the types of social practice with a pronounced resource orientation. It is determined that tourist resources include everything that can be used to meet the needs of tourists. Three main groups of tourist and recreational resources of Japan are identified and analyzed: natural-recreational, cultural-historical and socio-economic resources. Within the group of natural and recreational resources, the geographical location, relief, climate, water, forest, flora and fauna resources and objects of the nature reserve fund are characterized. Emphasis is placed on the fact that the uniqueness of natural and recreational resources is due to the insularity of the country. Based on the analysis of cultural and historical resources, it was found that although Japan accepts Western standards of living, as a cultural region, it continues to be a unique and inimitable phenomenon. The high socio-economic standard of living has made the Japanese one of the most traveling nations in the world. The main socio-economic resources that contribute to the development of tourism in Japan – the level of socio-economic development of the country, demographic and infrastructural resources. It is determined that Japan has unique tourist and recreational resources that determine the specifics of its tourism product. She skillfully attracts them to improve the country's image in the world tourism market. It was found that the country attracts a large number of tourists with exotic nature, cultural monuments and a high level of infrastructure development, especially transport accessibility. It is determined that taking into account the trends of world tourism and the uniqueness of available tourist and recreational resources in Japan, the following types of tourism have developed: health, medical, environmental, skiing, beach, cultural and educational and business. The scientific novelty of the study lies in the modern analysis of the peculiarities of the tourist potential of Japan and the characteristics of the predominant types of tourism. The practical significance of the study is determined by the possibility of using the results of the article, both by travel agencies to form a tourism product and by potential tourists to understand the specifics of recreation in the country, as well as for educational purposes.
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Bourne, IHJ. "Economic Aspects of Tender Spot Injection Therapy." Acupuncture in Medicine 14, no. 2 (November 1996): 114–16. http://dx.doi.org/10.1136/aim.14.2.114.
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One partner of a four man general practice in Essex used injection therapy to tender spots for musculo-skeletal pain. In a financial audit it was found that the prescription costs for this doctor were significantly less than the average for the other partners. It is speculated that the savings were due to effective elimination of musculo-skeletal pain by tender spot injection, thus reducing the need for analgesic and non-steroidal anti-inflammatory medication in these patients. If one doctor in every group practice nationwide were to adopt a similar, effective technique for treating musculo-skeletal pain, extrapolation of the savings to this practice suggest a national saving in excess of £95 million per year.
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Ortiz, Cristian. "Changing time." Journal of the Foot & Ankle 14, no. 2 (August 30, 2020): 115. http://dx.doi.org/10.30795/jfootankle.2020.v14.1188.
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Any forecast of the pandemic dynamics has proven to be far away from what has really happened, particularly in South America. In most of our countries, we are still struggling with what has been called the first wave. The virus has impacted not only our health status but also every aspect of our lives, including our daily work. Spending less time in the operating room has a positive side that each one has experienced differently. It has provided the opportunity for more quality time with the family and an understanding of how vulnerable we all are, how complicated politics and economic decisions are, and how important the way we all communicate and share experiences is.Most of us have seen our workplaces becoming busy with an increasing number of patients, which has led us to cancel any elective surgery and stay home in isolation. This difficult time we are going through has allowed us to think about our purpose in life, especially as physicians. We have been forced to develop new ways of teaching medicine, researching, and even practicing medicine. Most importantly, difficult times require that we learn a new way of living.This has led us to reflect on the importance of research and on how important it is that all of us give our best for our patients. Treating patients well impels us to be informed, to be updated about new knowledge, and to practice our skills while continuously looking for answers. The virtuous circle to be a good doctor should always include clinical practice, medical education, and research.When I was asked to write this editorial, one thought immediately came to my mind: how easily some journalists and public figures get into trouble after making a comment, writing an editorial, or even after publishing a post on social media. A recent example is what happened to J. K. Rowling, the famous author of the Harry Potter series. Last December, she tweeted her support for Maya Forstater, who was fired for what were deemed “transphobic” tweets. Rowling has received accusations and threats from trans activists and many worldwide famous people. A single ‘like’ was deemed evidence of ‘wrongthink’, and a persistent level of harassment began. The world has definitely changed, and everyone’s comments and behaviors are completely public. We should not be afraid to speak up and express our opinion, we should not be stopped by the fear of having people against us. As physicians, we are all exposed by expressing our medical opinion every day in the office, in a meeting, or even in a remote setting. Every decision and opinion should be based on evidence, but they will inevitably include our personal background-which is a mix of knowledge and personal life experience. Hopefully, these opinions will always express our genuine interest in the patients and their families as our main focus.As I get older, I pay more attention to the basis of my daily practice, which begins with proper information provided by good sources of medical education such as this journal. However, acquiring reliable information is just the beginning of the path toward good medical practice. The remainder of the path-the most important part of it-must be trodden by a human being truly interested in doing the best for his/ her patients every day.
It has always amazed me that everyone who I admire as a physician is, at the same time, a professor, a researcher, and an amazing human being. This journal is the result of the efforts of a group of people who are truly committed to learning, teaching, and investigating, thus producing friendly feedback and updated knowledge.
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Shaderkin, I. A. "Economic aspects of telemedicine." Russian Journal of Telemedicine and E-Health 7, no. 3 (September 6, 2021): 65–72. http://dx.doi.org/10.29188/2712-9217-2021-7-3-65-72.
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Introduction. For the recent years telemedicine (TM) has been actively integrated into daily life, and its growth was especially significant during COVID-19 pandemic. However, its economic component has its own specificities depending on the health financing system. The aim of this article is to analyze reasons of economical inefficiency of TM technologies in different health financing systems and to determine its further development path in economic terms. Results. It’s not justified to expect cost reduction of health care after integrating TM technologies into medical practice. In private health-care system TM technologies in the form of TM consultation aren’t cost-effective for beneficiaries. Representatives of private clinics use TM as a part of lead generation. From private clinics’ point of view, it’s cost-effective to use distant monitoring technologies integrated into programs of patients’ management. It’s economically appropriate to apply all varieties of TM including TM consultation on the voluntary health insurance (VHC) system. However, due to the low prevalence of VHC in Russia we can’t expect significant growth of TM in Russia based on using this sector. Conclusions. TM technologies require financing in its formative stage, implementation, development and further functioning phases.
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Vlasenko, P. O., and D. N. Seryakov. "USE OF ADSORPTION OXYGEN CONCENTRATOR IN MEDICAL PRACTICE." Marine Medicine 4, no. 4 (January 15, 2019): 55–63. http://dx.doi.org/10.22328/2413-5747-2018-4-4-55-63.
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The article deals with the use of pure oxygen in medicine. In a comparative vein, the main ways of providing medical and prophylactic institutions with oxygen are considered, information on the requirements for modern equipment of specialized medical facilities and departments is provided. Those problematic aspects of a fatigue, which are regularly encountered by the heads of medical institutions, are highlighted, taking into account many factors that were not taken into account when the well-established work of the centralized supply of medical oxygen (climate, the transport component, the economic issue, the situation with competent technical personnel, document flow work in supervising institutions, etc.). The regulatory frameworks on the arrangement of various oxygen supply systems are presented. Information on safety requirements when working with liquid and gaseous oxygen in vessels under pressure is provided. With reference to the regulatory documentation, the point of view is stated that, taking into account modern economic and economic aspects, in a number of medical institutions, in addition to the traditional-cryogenic method of obtaining medical oxygen, a short-cycle adsorption without heat is very often an expedient method of obtaining oxygen. This absorption allows to produce pure gas with relatively low pressure and ambient temperature directly at the place of the gas consumption. The method of non-heating absorption is described, and information on design of the installation for the production of oxygen is given in detail. The technical characteristics of various types of oxygen concentrators of various production capacities are given.
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Luber, M. Philip. "Overcoming Barriers to Teaching Medical Housestaff about Psychiatric Aspects of Medical Practice." International Journal of Psychiatry in Medicine 26, no. 2 (June 1996): 127–34. http://dx.doi.org/10.2190/y2uh-ay7c-p26g-9fvy.
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Objective: This article describes a training program in psychiatric aspects of medical practice. It is aimed at medical residents. Methods: Six fundamental elements have been identified that contribute to the effectiveness of this program. 1) It directly confronts resistance to such training. 2) Practical skills are emphasized. 3) Learning is active. 4) Attention to group process during training is used. 5) Integration by on-site location of the psychiatrist and co-teaching with medical faculty is essential. 6) Teaching efforts are integrated with clinical service. Results: All 112 medical housestaff participate in the program with a generally enthusiastic response. Conclusions: Successful educational programs for primary care residents require teaching collaboration between psychiatric and medical faculty and impart specific clinical skills while addressing perceived burdens of time and emotional reactions.
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Alves, Á. T. L. S., F. V. Alves, E. V. Melo, and E. F. D. Oliva-Costa. "Medical Students Assessment from a Public University Considering the Relevant Aspects of Medical Practice." European Psychiatry 41, S1 (April 2017): S728. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1327.
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IntroductionIn traditional medicine curriculum, internship is the moment in which students experience medical practice more intensively. Attitudes can be considered predictors of behaviors and actions. Evaluate them contributes to improve medical graduation.ObjectiveEvaluate medical internship attitudes, considering medical practice and associated factors in a Brazilian public university.MethodsCross-sectional study with 69 students, using a structured questionnaire and an attitude scale. Descriptive statistic was carried out, classification of the attitude tendency, group analysis (‘clusters’) and F statistic.ResultsThe average age was 25.1 and 56.5% were male. Students presented positive attitudes towards four from six aspects and negative attitudes toward death.ConclusionResults suggest the necessity of educational intervention, which follows the educational objectives.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Vargas, Rafael. "Knowing, Proposing and Acting: Epistemological Aspects of Medical Practice in the New Millennium." Journal of Family Medicine 1, no. 1 (July 4, 2018): 22–29. http://dx.doi.org/10.14302/issn.2640-690x.jfm-18-2180.
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In this work, it is analysed how the medical practice is imbued with Cartesian rational thought as well as empiricist thought and it is stated that medicine is an art and is science. It is proposed that the object of knowledge of the medical practice is not the concept of disease but health. It is from the concept of health and normality that medical taxonomy labels individuals as sick. This taxonomy is frequently re-evaluated and reorganized by scientific societies. This sometimes occurs according to new knowledge, but this categorization may also be questioned due to direct intervention or indirect pressure related to interests, especially economic, that are sometimes not clearly visible. Accordingly, an ongoing discussion is needed to keep the medical practice neutral against struggles of interest derived from the health industry. These topics must be considered and debated in medical schools including undergraduate and postgraduate programs.
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Kondratenko, N. O., I. A. Ternova, and T. M. Kolesnyk. "The Theoretic-Methodical Aspects in Management of Foreign Economic Activity of Ukrainian Economic Entities." Business Inform 2, no. 517 (2021): 21–26. http://dx.doi.org/10.32983/2222-4459-2021-2-21-26.
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The article examines the theoretic-methodical aspects of management of foreign economic activity by economic entities in Ukraine. It is specified that foreign economic activity has a huge impact on the development of all world countries. The practice of recent decades justifies the expediency of expanding the participation of all countries in various forms of international business and cooperation. From this point of view, all globalization processes are consistent, since the economic interdependence of countries in terms of solving economic and social issues increases year after year. As to their content, the methods of management of foreign economic activity be identified similar to the main functions of management: planning, motivation, control, organization, regulation. They are divided into economic, administrative, social, psychological, technological, legal methods, which act in practice by means of certain instruments. It is noted that when planning foreign economic activity, the operational determination of problematic issues arising during the activities of the economic entity allows to quickly respond to changes in both the internal and the external environment of the enterprise business conduct. Also, it is important to have separate units at the enterprises for carrying out controlling of foreign economic activity; analysis of the processes of planning and accounting of the major indicators of foreign economic activity, which will provide an opportunity to solve existing economic and organizational problems, eliminate disparities in planning and obstacles within the information collection systems, to form a group of indicators of foreign economic activity of the economic entity, etc. It is concluded that achieving the efficiency of foreign economic activity management should, first of all, be based on the adaptation of the enterprise to the requirements of the international market and the prompt definition of problematic issues that arise during the activity, which allows to quickly respond to changes both in the internal and external environment of conducting business and in the conditions for foreign economic activity.
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Greene, V. W. "Reuse of Disposable Medical Devices: Historical and Current Aspects." Infection Control 7, no. 10 (October 1986): 508–13. http://dx.doi.org/10.1017/s0195941700065140.
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AbstractThe “plastics revolution” of the last quarter century disrupted a hospital tradition. Since the 1890s, hospitals processed, packaged, and sterilized most of the medical-surgical items they needed in their own sterile supply departments–a “cottage industry” developed specifically for recycling. Only those consumable items that were too difficult, expensive, or inconvenient to reprocess were purchased from outside manufacturers as presterilized, single-use “disposables.” Since the plastics revolution, however, the “disposables” started to displace the “reusables,” and while claiming to be an economical innovation, have become a significant item in the budget. Some hospitals feel that if disposables save money, reusing the disposable several times will save more. The practice is spreading. The manufacturers, in turn, claim that hospitals do not have adequate quality assurance programs or skills to reprocess their items properly. The debate is further complicated by legal and ethical ramifications, as well as commercial and economic arguments.
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Zhidkova, E. A., E. M. Gutor, M. A. Sorokin, M. R. Kalinin, and K. G. Gurevich. "Medical aspects of safety of the movement in russian railways." Sechenov Medical Journal, no. 4 (December 30, 2018): 34–40. http://dx.doi.org/10.47093/22187332.2018.4.34-40.
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Purpose: studying of efficiency of medical support of the workers of locomotive crews (WLC) on decrease in the incidence connected with temporary disability.Materials and methods. Data on five-year incidence (2013-2017) of WLC and costs of JSC "Russian Railways" of their medical maintenance are used. Calculations of the economic losses connected with temporary disability of WLC are executed.Results. The health service of JSC “Russian Railways” works effectively. About 5.9 billion rubles/year are spent for its contents. Due to decrease in the average duration of one case connected with temporary disability, the health service allows to save JSC “Russian Railways” to 5.3 billion rubles annually. Calculation shows that at reduction of a difference in the average duration of one case of temporary disability in JSC “Russian Railways” and one case of temporary disability for men of working-age of the all-Russian level up to 1.7±0.2 days, the health service can become inefficient from economic positions.Conclusions. From the economic point of view, the health service of JSC “Russian Railways” is justified at an essential difference in duration of one case of temporary disability for WLC and temporary disability of the all-Russian level for similar gender and age group.
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Dubovych, Olesia, Nataliia Vasylieva, and Iryna Drohomeretska. "LEGAL ASPECTS OF MEDICAL REFORM’S IMPLEMENTATION: POLAND’S EXPERIENCE FOR UKRAINE." PUBLIC ADMINISTRATION AND LAW REVIEW, no. 3 (October 1, 2020): 128–38. http://dx.doi.org/10.36690/2674-5216-2020-3-128.
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The academic paper has analyzed the experience of implementing the reform of the health care system in Poland, taking into account the legal regulation of the measures taken.The attention is focused on the basic stages of the medical reform, as well as the features of each stage. The legal aspects of the process of reforming the health care system in Poland have been investigated; they determine the sources and methods of financing health services, the level of quality of health care and the functioning of the health care system in general. The individual components of the health care system related to compulsory health insurance have been described. Based on the analysis, it has been proved that in practice there is no single universal model of financing the health care system. The experience of the functioning of health care in Poland has shown that the experience of reforming the health care system in Poland can be successfully implemented in the practice of medical reform in Ukraine, provided that the historical, economic and cultural features of the country are taken into account. It has been concluded that in order to improve measures to reform the medical system of Ukraine it is necessary to develop and implement measures aimed at the development of health insurance and medical self-government. Introduction of health insurance in Ukraine will help improve medical services, improve the management of the entire health care system and its financing.
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Tselovalnikova, I. Yu. "Transformation of Legal Understanding of Cross-Border Bankruptcy: Some Aspects of Theory and Judicial Practice." Rossijskoe pravosudie 7 (June 25, 2021): 17–22. http://dx.doi.org/10.37399/issn2072-909x.2021.7.17-22.
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This article discusses the issues of transforming the legal understanding of cross-border bankruptcy in European and Russian theory and practice, as well as some examples of judicial practice on insolvency (bankruptcy). The characteristic of a foreign element in a bankruptcy case is considered. The trends accelerated economic integration associated with processes of globalization, in which at the state level there was close cooperation in economic, international legal and political spheres, as well as the situation with the pandemic coronavirus infection – all this was reflected in entrepreneurial activities, which led to cross-border business and the recent increase in cross-border bankruptcy. Currently, European law is re-evaluating the importance of the institution of bankruptcy, with the focus shifted to issues of preventive mechanisms for restructuring, consideration of the possibility of providing a «second chance» and measures to improve the effectiveness of restructuring, insolvency and exemption from liability procedures.
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Vignadelli, Lidyane Zambrin, Enio Ricardo Vaz Ronque, Maria Raquel De Oliveira Bueno, Luiz Roberto Paez Dib, and Helio Serassuelo Junior. "Motives for sports practice in young soccer and volleyball athletes." Brazilian Journal of Kinanthropometry and Human Performance 20, no. 6 (February 19, 2019): 585–97. http://dx.doi.org/10.5007/1980-0037.2018v20n6p585.
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The reasons why athletes, especially young people, seek to adhere to sports practice has aroused the interest of research. The aim of this study was to identify the reasons for the sports practice of young soccer and volleyball athletes according to gender, age, family economic class, practice time and level of competitiveness. 188 athletes, 56 volleyball athletes and 132 soccer players aged 10-16 participated in the study. The reasons for the sport were identified through the Participation Motivation Questionnaire (PMQ). The data were analyzed through Covariance Analysis. The results indicated that, in general, the most important reason for sports practice was “Technical Competence” (4.51±0.54), followed by factors of intermediate importance: “Competition” (4.30±0.73), “Group Activity” (4.29±0.71) and “Physical Fitness” (4.25±0.64). Low-income families (C) attributed greater importance to the motivation factors related to “Social Recognition” and “Group Activity”. Athletes with lower practice time conceded less relevance to “Group Activity” and “Affiliation”, while those with a national competitive level demonstrated greater importance to all motivation factors, with the exception of “Competition.” Young athletes have been motivated to practice sports, especially for reasons related to self-realization, improvement of technical skills and overcoming challenges. Differences were also identified between family economic class groups, practice time and competitive level in the motivation factors for sports practice.
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Payne-James, J. Jason, and Peter J. Dean. "Assault and Injury in Clinical Forensic Medical Practice." Medicine, Science and the Law 34, no. 3 (July 1994): 202–6. http://dx.doi.org/10.1177/002580249403400303.
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A prospective study was undertaken of 150 individuals in police custody, seen by a Forensic Medical Examiner (FME) for documentation of alleged assault and associated injuries. Ninety-six per cent consented to participate in the study of whom 86% were male. The mean age was 29.8 years. Most assaults (35%) were said to be unprovoked, 26% of injuries were alleged to have occurred at the time of arrest, 17% as a result of domestic incidents and 8% due to driving incidents. Twenty-nine per cent of examinees were victims of assault, 21% complained of alleged police assault and 20% were police officers injured during arrests. There was no significant difference between the mean ages of victims and assailants, and no significant difference in the proportions of each group under the influence of alcohol. Those individuals alleging police assault were all male, and significantly more likely to be unemployed and single. Victims of assault were significantly more likely to be female. Weapons were used in only 15% of cases. The head was the most common site of injury. Twenty-three per cent of the study population required hospital assessment. The study has characterized the different groups of individuals requiring medical assessment for assault and injury in police custody. The findings in this study population differ from similar studies undertaken in alternative settings.
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Jauhari, Akhilesh Chandra, A. Pokharel, N. Palikharel, N. Shrestha, and BS Rao. "Pharmaco-Economic Aspects of Antibiotic Prescriptions in Clinics of Kathmandu." Journal of Nepal Medical Association 43, no. 152 (March 1, 2004): 83–87. http://dx.doi.org/10.31729/jnma.575.
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Antibiotics (AB) are the most widely prescribed group of drugs and their use is associated with increasingrate of AB resistance. Nearly one third of prescriptions of physicians for colds, upper respiratory tractinfections and bronchitis are of AB as documented in previous studies. Antibiotic use is associated withincreased cost of financial burden, which may be difficult to be borne by the patients in developing countrieslike Nepal.The objective was study the prescribing pattern of Antibiotic preparations in various diseases and to findout how the treatment could become more pharmaco-economic without compromising the quality of service.A cross sectional study of prescription pattern of antibiotics/drugs in which antibiotics were used fromrandomly selected 20 private clinics of four major specialties in Kathmandu valley.Total No. of prescriptions audited were 386, average number of drugs/per prescription was 2.74.Maximum antibiotics were prescribed for age group 21-40 years in gynecological, surgical and medicalproblems, in Pediatrics maximum AB were prescribed between 1-12 years.Minimum antibiotics were prescribed between 13-20 years for gynecological and Pediatric problems. Inmedical and surgical problems, minimums AB were administered between 41-60 years. Above 60 yearsalmost no AB were used.Males were prescribed more AB than females (73% for surgical, 62% for medical and 53% for Pediatricproblems)Only in 20.25% patients, AB were prescribed after proper diagnosis and sensitivity testsMaximum cost of prescription was 510 Nepali rupees (NR) for treatment of STD in Gynecology.Key Words: Antibiotics, Cost, Human Immune deficiency Virus, Kathmandu, Private Clinics, Pharmacoeconomic, Sexually Transmitted Diseases.
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Horn, Jeff, and Ann T. Shaw. "An Assessment of the Impact That Chemotherapy Treatment Has on Employment Status in Individuals with Lymphoma." Blood 108, no. 11 (November 16, 2006): 5492. http://dx.doi.org/10.1182/blood.v108.11.5492.5492.
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Abstract A significant proportion of individuals undergoing treatment for lymphoma are of working age and are in employment prior to diagnosis and during subsequent chemotherapy treatment. This small-scale study seeks to explore the impact that chemotherapy treatments have on employment. Specifically, the reasons for the decision to continue to work or not, and any perceived benefits or disadvantages encountered as a result are explored. Methods: All individuals presenting with newly diagnosed lymphoma, over a 12 month period, were identified retrospectively. Individuals of official working age, and who were receiving out-patient chemotherapy (i.e. who had the ability to be working at the time) were invited to participate. Participants were asked to complete a questionnaire that was designed to explore their experiences of employment during this time. Results: A total of 33 patients were invited to participate. A return rate of 70% was achieved. Of those who responded, 5 (22%) had already retired prior to diagnosis. A total of 12 patients (52%) continued to work during their chemotherapy treatment. Of these, 6 (50%) continued to work the same hours in the same conditions, whereas 6 (50%) worked an altered or flexible pattern. 6 patients (26%) stopped working for the duration of treatment, one of whom has not returned since. There were no obvious differences in patients with Hodgkin’s Lymphoma as opposed to Non-Hodgkin’s Lymphoma. The response rate was much higher in those who had received intravenous chemotherapy than oral preparations, preventing analysis of any potential variation in experiences. The qualitative data obtained gives a clearer insight into the many issues faced by the patient when undergoing chemotherapy treatment. Familiar themes were identified in many cases, and these were grouped into 5 main theme categories: Diversion from the reality of diagnosis and treatment Psychological Issues Issues of retained normality Practical Issues Physical or medical issues. Difficulty in coping with the side-effects of treatment, particularly fatigue, were commonly cited. Emotional effects such as stress and anxiety were also alluded to. Despite this, those who continued to work reported benefit from retaining a normal lifestyle, gained support from co-workers and experienced a diversion of focus from treatment. Several of those who continued to work cited financial reasons for this decision. Feedback suggested that advice given by the health-care team was often lacking or inconsistent. This did not reflect our perception of current practice, so it may suggest that it is the way that information is given that is ineffective. Conclusion: The majority of patients continued to work during their treatment and there appear to be many benefits to this. Difficulties encountered related mainly to treatment side-effects, logistical and practical problems associated with undergoing chemotherapy. It is envisaged that a greater understanding of the impact that lymphoma and its treatment has on employment may improve the level of support that can be offered by the multi-disciplinary team. The curative nature of many Lymphomas demands that long-term complications of the disease and treatment are fully addressed at the time of diagnosis. Social, economic and employment welfare are integral aspects to be considered, especially in a group of individuals who are likely to be long-term survivors.
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Zadros, Katarzyna. "The assessment of medical subject mamagers’ knowledge on topic of social responsibility." Management 18, no. 1 (May 1, 2014): 96–108. http://dx.doi.org/10.2478/manment-2014-0008.
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Summary Over the years the notion of social responsibility in management was only related to economic subjects. Nowadays, a growing number of researchers is of the opinion that in managing subjects which offer social services including medical subjects, we also should implement its rules. However, it seems that in practice the knowledge of managers and employees on that subject is very limited and therefore, it has no reflection is the activities of medical subjects. The author of the article focuses on theoretical and practical aspects of using CSR in managing health care facilities.
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Russell, Holly Ann, Mechelle Sanders, Lynn Moll, Melanie Murphy, Angela M. Lanigan, and Jennifer K. Carroll. "Using a group medical visit model to promote healthy behaviour change with an underserved population." Family Practice 37, no. 4 (March 29, 2020): 507–12. http://dx.doi.org/10.1093/fampra/cmaa028.
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Abstract Background Models of care are needed to address physical activity, nutrition promotion and weight loss in primary care settings, especially with underserved populations who are disproportionately affected by chronic illness. Group medical visits (GMVs) are one approach that can help overcome some of the barriers to behaviour change in underserved populations, including the amount of time required to care for these patients due to socio-economic stressors and psychosocial complexities (1). GMVs have been shown to improve care in coronary artery disease and diabetes, but more evidence is needed in underserved settings. Objective This project sought to evaluate a GMV incorporating a physical activity component in an underserved patient population, measuring biometric and motivation outcome measures. Methods This project used a pre–post intervention study design through patient surveys at baseline and 12 weeks. We included validated motivational measures along with self-reported demographic information. A GMV intervention promoting physical activity and nutrition to promote weight loss was delivered by an interdisciplinary primary care team and community partners in a Federally Qualified Health Center in Rochester, NY. The intervention consisted of six, 2-hour sessions that occurred every other week at the clinic site. Results Participants lost a significant amount of weight and maintained the weight loss at 6 months. In addition, there was a significant improvement in motivation measures. Conclusion This study provides preliminary evidence that our GMV model can improve weight loss and autonomous motivation in an underserved population. This project has potential for scalability and sustainability.
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Varandas, P. "Transcultural Aspects in CL-Psychiatry." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70448-1.
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Modern psychiatry must take into account more and more the so called cultural differences in its practice. These differences are not merely the evident cultural aspects of diverse ethnic origin, but also the differences determined by economic, social and cultural reasons.The main paradox of our times is that we try to believe on the ilusion of people homogenicity consequent to the globalization process, when we see that everyone access to the same markets, products, services and news or when we see that everyone can communicate with everyone all over the world. This ilusion is reinforced by the higher cosmopolitism levels of our towns, where we can see people from different ethnic or cultural backgrounds sharing the same space in a reasonable harmonic way.However, this ilusion is covering the intimate aspiration of any person or group to preserve his identity and afirm his own values. In fact we are living in a society that expresses multiethnic, multiculture and multisocial differences in an interdepedent diversity.Hospitals are in a way microsocieties where this paradox emerge or in purely sociologic terms described above, but also by the clinical expression of this diversity.CL-Psychiatry is the field where this subject must be known and researched. This presentation will reviewed the situation.
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Onoi, Mihail, Maria Grosu, and Vasile Mindrigan. "The Role of Tourist March in Socializing Teenagers." GYMNASIUM XX, no. 1 (Supplement) (December 30, 2019): 29. http://dx.doi.org/10.29081/gsjesh.2019.20.1s.03.
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Socializing in tourist march also targets the adolescent and the group. Skills and habits, as well as rules assimilated by adolescents in tourist march, will be effective in any other social sphere. Tourist activities including tourism marches are very attractive, and those who practice them are convinced of their benefits, including socializing. The social, economic and environmental aspects of the young people of the last years impose the necessity to use the pedagogical potential of the tourism marches, for the formation of the collectivism, the mutual assistance and the activity in the group and other social skills necessary for the adolescents. Thus, these aspects give us the possibility to mention that, the tourism marches have an enormous psychological and pedagogical potential for the socialization of adolescents. The analysis of scientific literature allowed us to determine basic and theoretical approaches that are based on ideas about various aspects of socialization.
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Dudnik, Elizabeth, Laila Roisman, Jair Bar, Nir Peled, Ariel Hammerman, Sameh Daher, Mor Tal Moskovitz, et al. "Economic aspects of nivolumab in non-small cell lung cancer (NSCLC): Lessons from real life." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18322-e18322. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18322.
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e18322 Background: Novel immunotherapy agents' costs have a significant impact on healthcare system budgets. Aside from the cost per dose of the compound, the total treatment cost (TTC) is affected by the duration of treatment (DOT). DOT in real life may differ significantly from that observed in the randomized clinical trials because of the differences in baseline patient characteristics and treatment patterns. Methods: Advanced NSCLC patients (pts) (n=192) treated with nivolumab 3mg/kg q2w (expanded access program/standard of care) at five Israeli cancer centers between January 2015 and March 2016 were included in the analysis. DOT and TTC were assessed in 2 groups (group A: ECOG PS 0/1, n=92; group B: ECOG PS ≥2, n=100). In addition, response for a subgroup of 49 pts was evaluated by RECIST, v.1.1. In this subgroup, DOT and TTC of treatment (Tx) beyond progression (PD) were assessed as well. Nivolumab cost per dose was calculated for a 78 kg pt based on current market price in Israel: 3 mg/kg X 78 kg = 240 mg = 11,250 NIS (2,993 USD). Results: Pt baseline characteristics: median age 67y (range, 41-99); males 68%; smokers 77%; ECOG PS ≥2 52%; Non-squamous/Squamous/NA 78%/19%/3%. 27% of pts continued nivolumab at the time of last follow-up. DOT and TTC are presented in the table below. Conclusions: DOT and TTC are similar for ECOG PS 0/1 and ECOG PS ≥2 pts. Tx beyond PD increases the TTC by 32%. These facts should be taken into consideration when evaluating budget impact of novel immunotherapy agents' implementation into routine practice. [Table: see text]
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Fouché, L., J. Bezuidenhout, C. Liebenberg, and A. O. Adefuyea. "Medico-legal aspects regarding drunk driving: experience and competency in practice of community service doctors." South African Family Practice 60, no. 2 (June 7, 2018): 63–69. http://dx.doi.org/10.4102/safp.v60i2.4869.
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Background: Drunk driving has been reported to increase the risk of road traffic accidents associated with death and severe injury. In South Africa, an increase in blood alcohol concentration of as little as 0.01 g per 100 ml above the legal limit may warrant criminal prosecution or the denial of an insurance claim for damages. However, multiple court cases have been withdrawn because of the incompetence of officials at various stages of the investigation. The scope of the mistakes range from poor scene handling to the incorrect handling of blood samples at the laboratory to eventual laboratory testing of blood samples. Using a group of community service doctors (CSDs) as a cohort study group, this study investigated the competency of medical graduates in relation to the medico-legal aspects of drunk driving.Methods: A self-administered questionnaire-based study was done with 150 CSDs. The questionnaire was administered in Afrikaans and English and was dispatched electronically via e-mail. All potential participants were contacted telephonically to obtain verbal consent. Results are displayed as percentages.Results: A response rate of 59.3% was achieved. The results obtained in this study confirm that some CSDs lack competency in handling medico-legal aspects relating to drunk driving, and are thus unable to serve the communities they have been assigned to adequately. Their lack of skills and knowledge suggests that the present undergraduate Clinical Forensic Medicine curriculum is inadequate.Conclusion: It would be beneficial to revise the curriculum for Clinical Forensic Medicine in undergraduate medical training to address the gap in knowledge and practice of various demands of forensic medicine required from new medical graduates and CSDs.
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Pyrohova, V. I., and O. O. Oshurkevich. "Antifibrinolytic therapy in the clinic for miscarriage – aspects of medical tactics." HEALTH OF WOMAN, no. 4(120) (May 30, 2017): 78–82. http://dx.doi.org/10.15574/hw.2017.120.78.
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The objective: to evaluate the efficacy of tranexamic acid (Tranexam drug) accompanied by pregnancy with a partial detachment of a normally located placenta in the second trimester of pregnancy in women with a history of obstetrical gynecological anamnesis. Patients and methods. Under observation were 75 patients with complicated retrochorial hematoma at first trimester of pregnancy, re-hospitalized at the time of 18–21 weeks with signs of premature placental abruption. The blind method of the patient was randomized into two groups (baseline and comparison), which differed in the type of haemostatic therapy. Clinical groups were formed by age (26.5±0.8 and 27.4±1.1 years, respectively), parity, gestational age, somatic and obstetric-gynecological history, localization and approximate sizes of retroplacental hematomas were comparable. Patients from both groups received sublingual micronized progesterone at a dose of 200 mg, anti-anemia and symptomatic therapy according to indications. In the main group, 45 pregnant women received a haemostatic therapy with the drug Tranexam (Stada): 750 mg at a single dose at a single dose of 1500 mg for 5 to 7 days before bleeding stopped. 30 patients, who underwent haemostatic therapy with sodium etamzilate in a complex of therapeutic measures, made a comparison group. The duration of hemorrhage from the genital tract, the regression of the retrohorial hematoma, the length of stay in the hospital, the prolongation and the consequences of pregnancy were estimated. Results. Clinically, a decrease in the intensity of bleeding with Tranexam was observed 24.6±2.1 hours after the initial dose, bleeding duration averaged 3.5±0.3 days, whereas in the group taking sodium etamzilate, the bleeding time was significantly longer – 4.9±0.2 days (p<0.05). These data correlated with ultrasound data confirming the absence of progression of retrochorial hematomas from the second day with the use of Tranexam in 34 (75.6%) of the women in the main group, whereas in the comparison group, similar changes occurred at the same time in only 10 (33.3%) of patients (p<0.5). The faster stopping of bleeding and, as a consequence, the organization and resorption of hematomas in the region of placental detachment in a shorter period affected the effects of pregnancy (the frequency of preterm labor in the comparison group occurred 2.2 times more often than in the main group). Conclusion. Taking into account the peculiarities of the physiological mechanisms of the functioning of the fibrinolytic system during the gestation period and the significance of their disturbances in the genesis of early and late gestational bleeding allows us to choose the most effective therapeutic tactics. Tranexam in effective daily doses with course duration of treatment of 5–7 days gives a pronounced haemostatic effect, does not cause side effects, and allows successfully prolonging the pregnancy and reducing the frequency of late gestational complications. Inclusion in the treatment complex of patients with recurrence of retroplacentar hematomas and formation of partial placental detachment in the second trimester of gestation of the preparation of antifibrinolytic action to Tranexam is an effective means not only to stop bleeding, but also to preserve pregnancy, prevent the formation of placental insufficiency and ensure favorable pregnancy outcomes. Accumulated experience allows attributing Tranexam to the drugs of the first choice in the clinic for miscarriage and recommending it for widespread use in practice. Key words: retroplacentar hematoma, pregnancy, antifibrinolytic therapy, Tranexam.
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Bispo, Marcelo de Souza, and Eduardo Paes Barreto Davel. "Educational Impact of Research." Organizações & Sociedade 28, no. 97 (June 2021): 233–40. http://dx.doi.org/10.1590/1984-92302021v28n9700en.
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Abstract To think about the impacts of academic research on education is to think dynamically: education affects the ways of doing research (from the point of view of formal education) and is affected by research results that are little predictable and perceived due to constant negotiations among social actors in their daily socializations in different contexts. Management education (formal, non-formal and informal) affects and is affected by conflicting views of the world, which are produced within the field of management itself and whose impact as “beneficial” is not just a matter oriented primarily by economic, instrumental and financial aspects, but also for a negotiated understanding of the world that moves towards the common good. All research must be concerned with its power to affect educational vision and practice, directly or indirectly. How can this concern become perennial and central to the practice of academic research?
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Bispo, Marcelo de Souza, and Eduardo Paes Barreto Davel. "Impacto Educacional da Pesquisa." Organizações & Sociedade 28, no. 97 (June 2021): 233–40. http://dx.doi.org/10.1590/1984-92302021v28n9700pt.
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Abstract To think about the impacts of academic research on education is to think dynamically: education affects the ways of doing research (from the point of view of formal education) and is affected by research results that are little predictable and perceived due to constant negotiations among social actors in their daily socializations in different contexts. Management education (formal, non-formal and informal) affects and is affected by conflicting views of the world, which are produced within the field of management itself and whose impact as “beneficial” is not just a matter oriented primarily by economic, instrumental and financial aspects, but also for a negotiated understanding of the world that moves towards the common good. All research must be concerned with its power to affect educational vision and practice, directly or indirectly. How can this concern become perennial and central to the practice of academic research?
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Sampson, Deborah A. "Alliances of Cooperation: Negotiating New Hampshire Nurse Practitioners’ Prescribing Practice." Nursing History Review 17, no. 1 (January 2009): 153–78. http://dx.doi.org/10.1891/1062-8061.17.153.
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Nurse practitioner legislation varies among states, particularly in relation to practice without physician oversight, altering the legal environment within which nurse practitioners can use knowledge and skills to meet patient needs. Using New Hampshire as a case study, this historical analysis of nurse practitioners’ negotiations over time for independent practice, defined in state practice acts, illuminates the complex social and economic factors affecting nurses’ struggle to gain legal rights over their own professional practice without supervision and intervention from another profession. In New Hampshire, not only did organized medicine oppose nurses’ rights to practice, but pharmacists demanded the right to control all aspects of medication management, including who could prescribe and under what circumstances prescribing could occur. Shifting social and political terrain as well as changes in legislative and state professional board leadership affected the environment and negotiations of a small group of nurses who were ultimately successful in obtaining the right to define their own professional practice.
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Kadriu, Besa, and Blerta Arifi. "Policymaking in a Multiethnic State, the Legal Changes, Practice of Macedonia." European Journal of Social Sciences Education and Research 8, no. 1 (December 1, 2016): 140. http://dx.doi.org/10.26417/ejser.v8i1.p140-143.
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In contemporary terms and conditions, in addition to economic and social factors, political processes are one of the basic components of the proper functioning of a multi-ethnic state. Examples of proper practices of multiethnic states which operate in conformity with international standards, within the EU structures abound. This is in a group of countries which have previously significantly overcome the problems of transition and reform of the political system and have managed to establish standard which are inaccessible and levels of genuine democracy. The paper has aspirations to take into consideration the comparative aspects which can serve as a good example of the changes and development of the country towards Euro-Atlantic structures. That it happens with Western Balkan countries. The situation becomes even more difficult, especially in those cases where states and societies of the population is heterogeneous structure; Case of Macedonia, being convinced that has to do with a diverse population, the country still today fails to cross the barriers of the past from the old system. Institutions and decision-making bodies, now more than ever need to change policymaking process, prevention of discrimination and compliance values of the political, economic and social conformity with European standards
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Sporrong, Sofia Kälvemark, Anna T. Höglund, and Bengt Arnetz. "Measuring Moral Distress in Pharmacy and Clinical Practice." Nursing Ethics 13, no. 4 (July 2006): 416–27. http://dx.doi.org/10.1191/0969733006ne880oa.
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This article presents the development, validation and application of an instrument to measure everyday moral distress in different health care settings. The concept of moral distress has been discussed and developed over 20 years. A few instruments have been developed to measure it, predominantly in nursing. The instrument presented here consists of two factors: level of moral distress, and tolerance/openness towards moral dilemmas. It was tested in four medical departments and three pharmacies, where 259 staff members completed a questionnaire. The two factors were found to be reliable. Differences in levels of moral distress were found between pharmacies and clinical departments, and between the youngest and oldest age groups; departmental staff and the youngest group experienced higher levels of moral distress. Departments reported less tolerance/openness towards moral dilemmas than pharmacies. The instrument needs to be tested further, but its strengths are the focus on everyday ethical dilemmas and its usefulness in different health care settings.
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Nazar, Nataliia. "The ecosystem approach in health social work." Mental Health: Global Challenges Journal 4, no. 2 (October 13, 2020): 16–18. http://dx.doi.org/10.32437/mhgcj.v4i2.90.
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Introduction
Health is the greatest value in our lives. Analyzing the current approaches of the WHO (2014), we consider this concept not only from the standpoint of physical health and the absence of disease, but understand this phenomenon as a holistic state of complete well-being, which includes, in addition to physical, emotional, mental, social, spiritual, sexual, environmental and many other aspects. This is the so-called holistic model of health (Orzhekhovska, 2013).
Our reasoning suggests (given various aspects of health) that this value does not depend only on an individual's choice to be or not to be healthy, and cannot be governed solely by personal actions. Here are some examples. The lack of geographically close medical services and / or free medical services causes the inability to receive emergency medical care and / or to systematically monitor health. Negative relationships in the family, the absence of a father or mother in the family can lead to emotional rejection of the child (psycho-emotional disorders), the acquisition of undesirable behavior (child addictive behavior or delinquent behavior), lack of self-care skills (this can cause various infectious diseases), getting into institutional care, which usually do not contribute to the full development of personality, etc. Inadequate social policies and an imperfect health care system in the country can cause outbreaks of socially dangerous diseases and provoke the spread of pandemics. Aggressive urbanization creates uncomfortable living conditions in cities due to traffic jams, pollution, noise, which causes other health risks from stress to cancer. As we can see, good health depends not only on the individual being healthy in the broad context of this word, but on the complex impact on us of a number of systems in which we are included. It is important to emphasize the role of social work in this context, the theory and practice of which aim, inter alia, to promote social development and well-being, as well as to improve the health care system and reduce social inequalities. Therefore, the task of social work in general and social workers together with other professionals in particular is to support the individual, family, community, society in the context of strengthening and maintaining the health of both individual and public. An ecosystem approach in social work helps us to understand the process of maintaining and strengthening health, which explains well the mutual influence of each element of the system.
Purpose
The aim of the article was to consider health social work according to ecosystem approach.
Methodology
The study used theoretical methods of research, in particular, analysis, comparison, synthesis and implementation of the results of the study of health social work based on the principles of integral ecology and ecosystem approach.
Results and Discussion
The ecosystem approach is used in various spheres of practical and scientific activity: public health, ecology, economy, legal and social spheres, church-religious sphere and even education (Forget, Lebel, 2001; Deinega, 2018; Veklych, 2017; Voronkin, 2017).
Kabanenko and T. Semigina (2004) write about the separation of the ecological approach in social work on the basis of systems theory (sociological group of social work theories). Within this approach, the authors consider the main models of work and tools that can be used by social workers in their practice: eco-maps, genograms, etc. Systems theory and environmental theory are mentioned in the manual "Introduction to Practical Social Work". In systems theory, "a whole is greater than the sum of its parts", so it is important to consider "the interaction of the client and the environment." Ecological theory considers a person in the context of his or her entourage, but not only the family, society, but also the environment (Klos, Mykytenko, 2005, 52-54). In contrast to the mentioned researchers, T. Syla (2012) explores the problem of violence in the context of the ecosystem approach, she notes that this approach originates from the socio-ecological theory of Bronfenbrenner in psychology. So, no matter what theories the ecosystem approach is based on, the idea behind this concept is a wide range of interconnections. Every smaller object, such as a person, is part of a large range of interactions of larger systems: family, community, society, environment, and so on. Each element of the system affects the other, so solving a problem situation in one area can be an impetus for positive change in another.
Chaikovska and O. Hlavatska talk about the need to train social workers with a "high level of environmental culture" (2019). In scientific works on social work we find the concepts "ecosystem approach" and "ecological approach", which are virtually identical in content. This perspective has formed over time one of the modern concepts of social work: "environmental social work", or "eco-social work", or "green social work". The latter in her current research is much covered by T. Semigina (2018). The researcher notes that "a healthy environment is seen as an inalienable human right, a component of human dignity and non-discrimination." However, today there is no research on health social work from the standpoint of an ecosystem approach.
The ecosystem approach resonates with another very important concept. It is an integrated ecology. This concept appeared in the church-religious sphere, and was covered in the Encyclical (papal document) "Laudato si" by the head of the Catholic Church Pope Francis (2015/2019). According to the vision of Francis, there can be no question of ensuring the common good, guaranteeing fundamental rights, social justice, if humanity understands nature as something separate and does not link environmental pollution with economic activity, behavior, etc.
Conclusion
Therefore, it is obvious that today, in the conditions of social transformations and globalization processes, the solution of any social problem should be considered from the standpoint of the ecosystem approach. Health issues in social work cannot be considered without taking into account changes in the environment. For such activities, it is necessary to train social workers in the context of the ecosystem approach, programs and projects should be developed to help overcome the problems of clients' health in a comprehensive way. Further research is needed to study existing and develop new forms and models of social work on the basis of strengthening and maintaining the health of clients, taking into account the ecosystem approach and the basics of integral ecology
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Shartanova, N. V., and N. V. Shartanova. "Place ofcromoglicate acid in clinical practice." Russian Journal of Allergy 6, no. 2 (June 15, 2009): 55–62. http://dx.doi.org/10.36691/rja1048.
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According to the statistics data about 40% of the population of the world suffer from allergic diseases. A variety of the factors participate in activation and formation of allergic illnesses, assume the use of a wide spectrum of medical products for correction and changes arising at an allergic inflammation. It is necessary to note that a basis of treatment of these diseases is preventive maintenance. We will stop in detail at the group of preparations of cromoglicate acid, which is widely used in clinical practice for prevention of exacebrations and treatment of allergic diseases. Some features of cromons such as a high profile ofsafety, good tolerance, possibility of long using in pediatrics and during pregnancy, low system bioavailability and economic advisability will be discussed.
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Latysheva, Tat'yana Vasil'evna, A. V. Polyakov, A. V. Dmitrieva, E. N. Medunitsyna, T. V. Latysheva, A. V. Polyakov, A. V. Dmitrieva, and E. N. Medunitsyna. "THE GENETIC AND CLINICAL ASPECTS OF HAE, NEWPOSSIBILITIES OF THE DISEASE EXACERBATIONS TREATMENT." Russian Journal of Allergy 8, no. 3 (September 15, 2011): 14–18. http://dx.doi.org/10.36691/rja774.
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Continued study of genetic and clinical aspects of hereditary angioedema (HAE) types I and II, which belongs to the group of primary (genetically determined) immunodeficiencies and is connected with the qualitative or quantitative genetically determined defect of C1 Inhibitor. HAE is an «orphan» disease and requires the establishment of a Government strategy for patients with this rare diagnosis. To improve the quality of HAE diagnostics, the Institute of Immunology jointly with Medical Genetics Centre started the work in order to develop and introduce the methods of genetic screening of patients with recurrent angioedema into the national practice. In the world as well as in Russian medical practice a new generation of medicines for the treatment of HAE attacks has been appeared. Integrated assessment of the problems of diagnostics and treatment of HAE and their consistent solution will significantly improve the quality of life of HAE patients.