Letteratura scientifica selezionata sul tema "Medico-social coordination"

The aim of the study is to characterize, from the point of view of geriatric aspects, the current problems of the organization of medico-social, palliative and hospice care (PHC) and social services for palliative care in the war conditions based on multidisciplinary, interagency and inter-sectoral approaches, as well as a combination of medical, psychological and social problems. Materials and methods. The research materials were scientific literary sources and regulatory documents. A pilot survey of 200 people was conducted to study the psychological state and psychological support needs of the elderly and internally displaced persons (IDPs). The survey results of 3,705 client’s questionnaires of the “Vseturbota” Project were also evaluated, of which 63.6 % are people aged 67-84 years, 26.4 % are 85–101 years old. The following research methods were used in the work: bibliosemantic, sociological, system approach and system analysis. Results and discussion. After February 24, 2022, IDPs will experience significant difficulties, suffer from reduced income, increased dependence on humanitarian aid, do not feel safe and protected. All these are reflected in their psychological state. It was found that among respondents aged ≥75 years had the most people with medium (57.1 %) and low (25.0 %) levels of anxiety, 71.4 % had a low level of mood. 32.17 % of the “Vseturbota” Project clients needed additional consultation with a family doctor, 3.83 % needed consultation with a psychologist, and 3.35 % with other specialists. Most often, they needed help around the house (26.02 %), buying medicines/foodstuff (22.43 %), 34.97 % needed information, and 13.36 % needed psychological counseling. An important condition for providing geriatric patients, including IDPs, with affordable, high-quality and effective PHC is the creation of a system and service of ambulatory/mobile and inpatient PHC facilities and medico-social care. Conclusions. The military aggression of the Russian Federation caused considerable suffering to the population of Ukraine. The state of anxiety and fear has a negative impact not only on the psycho-emotional, but also on the physical sphere of the elderly, which necessitates the implementation of psychological services and effective strategies for overcoming stress and distress, which requires the development and implementation of mechanisms for interagency coordination and cooperation, involving and training of multidisciplinary teams’ specialists and volunteers, effective advocacy activities, etc.

Abstract Older people are particularly affected by the COVID-19 outbreak because of their vulnerability as well as the complexity of health organisations, particularly in the often-compartmentalised interactions between community, hospital and nursing home actors. In this endemic situation, with massive flows of patients requiring holistic management including specific and intensive care, the appropriate assessment of each patient’s level of care and the organisation of specific networks is essential. To that end, we propose here a territorial organisation of health care, favouring communication between all actors. This organisation of care is based on three key points: To use the basis of territorial organisation of health by facilitating the link between hospital settings and geriatric sectors at the regional level.To connect private, medico-social and hospital actors through a dedicated centralised unit for evaluation, geriatric coordination of care and decision support. A geriatrician coordinates this multidisciplinary unit. It includes an emergency room doctor, a supervisor from the medical regulation centre (Centre 15), an infectious disease physician, a medical hygienist and a palliative care specialist.To organise an ad hoc follow-up channel, including the necessary resources for the different levels of care required, according to the resources of the territorial network, and the creation of a specific COVID geriatric palliative care service. This organisation meets the urgent health needs of all stakeholders, facilitating its deployment and allows the sustainable implementation of a coordinated geriatric management dynamic between the stakeholders on the territory.

For several years, health networks have developed devices enabling coordinated care of patients in France, regarding both medical plans as well as medico-psycho-social and human care. Some have developed computerized health records for sharing useful information for the coordination and continuity of care. Since the 2009 hospital reform, cooperative operating modes between health system professionals and users are being installed. The implementation of a health information system permits, on one hand, to ensure the transversality of the business process with the patient and, on the other hand, to measure the results of the medical and economic evolution of a complex system of information. The possibilities offered by new technologies of information and communication enable the development of applications supporting increased "on line" participation for citizens. The "ambulatory approach" exports healthcare outside hospital walls. This is an innovative medicine allowing the patient to stay at his home. In France, this re-engineering is based on four areas: a medical record, a collective ownership by the medical and paramedical professions, empowerment of patients and networking in the health sector.Keywords: Health; Networks; Information System; Innovation; Medicine; Patients; Science.

The purpose of the study is a comprehensive hygienic assessment of the relationship between medico-social conditions of educational activities, quality of life and adaptive capabilities of students. During the research conducted on the basis of 5 modern educational institutions of different types: university, college, specialized school, lyceum and school, the significant deviations of indicators of hygienic assessment of daily regimen of pupils and students from generally accepted normative values (p<0.05-0.001)were revealed, which, first of all, concerned the excess of the maximum allowable duration of their daily stay in educational institutions, the length of time required to complete homework, low levels of physical activity, etc. It was found that the highest levels of quality of life among boys and girls are recorded according to the scales of Physical Functioning (PF), Bodily Pain (BP) and Role-Physical (RP), the lowest ones were Mental Health (MH), Vitality (VT) and Social Functioning (SF). The relationships between the values that indicate the characteristics of quality of life and features of the psychophysiological adaptation of pupils and students were revealed. Moreover, the largest number of relationships (r=0.36-0.77; p<0.05-0.001) which characterize quality of life indicators belong to boys according to the scales of Physical Functioning (PF), Mental Health (MH), Vitality (VT) , Bodily Pain (BP); to girls – Bodily Pain (BP), Vitality (VT), Mental Health (MH), General Health (GH), Role-Emotional (RE). When determining the features of intersystem relationships between components of quality of life and indicators of psychophysiological functions, it was found that the closest relationship (r=0.37-0.99; p<0.05-0.001) is observed between the characteristics of the speed of visual-motor reactions, mobility and balance of nervous processes, coordination of movements and indicators of quality of life according to the scales of General Health (GH), Physical Functioning (PF), Social Functioning (SF) and Mental Health (MH).

The article is devoted to the analysis of medico-social factors that determine the outlook Image of the system of medical care for victims in emergency situations in the Arctic Zone of the Russian Federation. The social and economic development of the Russian Arctic zone is a strategic priority of the Russian Federation’s state policy in the Arctic. The goals of Russia’s state policy in the Arctic are to expand the resource base of the Arctic zone, to support the necessary combat potential of groups of troops of the Armed forces of the Russian Federation in the region, to preserve the natural environment, to ensure an adequate level of fundamental and applied scientific research, etc. Strategic priorities of the state policy of the Russian Federation in the Arctic are determined to increase the efforts of the Arctic States in creating a unified regional system of search and rescue, as well as prevention of man-made disasters and elimination of their consequences, including coordination of rescue forces; improving the quality of life of indigenous people and social conditions of economic activity in the Arctic. The main areas of development of the Russian Arctic include hydrocarbon production, fisheries, improvement of transport infrastructure and tourism. Three directions of socio-economic transformation of the Arctic zone of Russia, in the near future, can affect the formation of the appearance of the system of medical care for victims of emergencies: spatial expansion and increase of the economic potential of the Arctic zone of Russia; orientation to the concept of Trinity « innovative economy of energy efficiency sustainable development»; implementation of the concept of the formation in the Arctic eight reference zones of socio-economic development, of which the Kola, Nenets and Yamalo-Nenets reference zones are defined as pilot.

DM is a global medico-social problem, characterized by threatening trends in the spread and development of complications. One of the key elements of the system of effective treatment of DM is the continuous supply of patients with hypoglycemic preparations & means of means of glycemic control. Therefore, it is advisable to investigate approaches to ensuring the availability of MT for the prevention, diagnosis & treatment of DM in different countries. The purpose of the work is to analyze the condition & problems of providing patients with the necessary pharmaceuticals & diagnostic products to achieve the appropriate level of compensation for diabetes. The research used: analysis of documents, marketing analysis, comparison, generalization, mathematical and statistical methods, graphic method. The analysis of official statistics shows a constant increase in the incidence of diabetes in the world among the population of different ages. Analysis of international experience shows significant differences in approaches to the organization of care for patients with diabetes, in particular, reimbursement of the cost of insulin therapy & glycemic control. In low- and middle-income countries, due to insufficient financing of antidiabetic measures, higher rates of mortality & disability related to complications of DM are recorded. In Ukraine, a government program for the reimbursement of sugar-lowering drugs has been introduced to increase the availability of drugs. Reimbursement is subject to 45 insulin preparations for 12 INNs (of which 18 are without copayment). According to the NHS, 226,200 patients receive insulin under PMG (since 2019, 2.27 mln prescriptions have been paid). The analysis of prescriptions shows that insulin analogues of foreign production are most often used. Based on the results of the research on the availability of modern MTs for the diagnosis and treatment of diabetes, it can be concluded that a wide range of glycemic control tools, including Continuous Monitoring Systems, are available on the domestic market. Providing patients with means of glycemic control is carried out at the expense of regional programs. The problem of providing patients with DM with the necessary medicines & medical devices requires a complex solution & coordination of central & local authorities actions. The priority direction of improving the efficiency and accessibility of medical care for patients with DM is to carry out proper OMT diagnosis & treatment of DM in order to include them in the reimbursement lists & procurement nomenclature.

Annotation. A comprehensive assessment of the morpho-functional state of the human organism is impossible without taking into account the features of its functional component, first of all, indicators that provide information about the level of development of psychophysiological functions of the organism and the degree of formation of personality traits. The research, during which 64 students (33 young women and 31 young men) were under supervision during their studies at the 1st year of the medical faculty, was conducted using medico-social, psychophysiological and psychodiagnostic methods. The analysis of the obtained data involved the application of descriptive statistics procedures using statistical analysis programs “Statistica 6.1” (license № ВXXR901E245722FA). The results obtained during the hygienic assessment of the peculiarities of the development of the psychophysiological functions of the organism of young women and young men who are at the initial stage of education in a medical institution of higher education testify to fairly stable changes in their nature, which mainly consist in a slight improvement in the values of criterion indicators of the functional state of the higher nervous system activity, visual sensory system and somatosensory analyzers. At the same time, a number of unfavorable trends attract attention, which are characterized by the appearance of negative shifts in the indicators of the mobility of nervous processes among young women and young men, the degree of involvement in activities and coordination of movements among young women, as well as the level of work efficiency among young women and young men, which determine the presence of pronounced tension of the adaptation mechanisms of the students, which ensure the optimal course of psychophysiological adaptation processes. Among the most characteristic changes in terms of the leading indicators of temperament and character properties of student youth should be included an increase in the level of extroversion both among young women and young men over the course of their studies, a significantly lower level of neuroticism observed throughout the entire period of observation among young men, a certain increase indicators of situational anxiety and, at the same time, a certain decrease in indicators of personal anxiety in both sex groups, a moderate advantage in the structure of the characterological properties of students in indicators on the scales of hypomania (Ma), psychasthenia (Pt), schizoidness (Se) and paranoia (Ra). The results obtained during the study of the features of the level of subjective control and mental states testify to the emergence of rather unfavorable trends from the prognostic point of view, consist in a gradual decrease in the dynamics of learning in the number of persons with internal manifestations in the motivational structure of the personality, and allow us to assert the presence in the student population of personal manifestations of maladaptive content.

Introduction: The Tsunami hit Indian coastal line between 8.30 and 9.30 AM Indian Standard Time (IST) on the December 26, 2004. A lot of damage to life and property—both movable and immovable— occurred to approximately 3-4 km of land adjacent to the coastal line. It mainly took away lives, shelter, fishing boats, and fishing nets of the fishermen folk. Relief in terms of money, manpower, food, water, clothing, medicines, and all other resources poured in plenty. However, any amount of relief or compensation could not match the amount of damage that had occurred. A team of 11 volunteers (two Public Health Specialists, seven Medical Interns, and two Medico Social Workers) led by the author went through ActionAid International and Community Health Cell (CHC), Bangalore, for relief work in Nagapattinam District of Tamil Nadu, which is one of the worst affected districts in India.Objectives: To conduct a rapid assessment of the amount of damage at village level to lives, social and economic losses, and damage to community resources in 15 villages of Sirkali taluk of Nagapattinam district in Tamil Nadu with an ultimate goal to provide long-term services in that community. To assess the relief needed and relief that was actually provided in these 15 villages through Government and various Non Governmental Organizations (NGOs).Methods: A 1-day (December 27, 2004) training and orientation on rapid disaster assessment, the tool to be used for the village level disaster assessment and handling relief operations in a Tsunami affected situation was given by the Country Coordinator for Disaster Management, ActionAid India, at CHC, Bangalore. Then, a 1-day (December 28, 2004) Planning and Review meeting was conducted at ActionAid Office, Chennai, to draw up an action plan for the areas to be covered and the steps to be followed during the assessment. The Survey Team was then divided into two groups of five members and six members each and set out to the villages selected for the actual data collection. The 15 villages that were part of the survey were selected by the ActionAid Chennai Office, based on the severity of destruction caused in those areas, and also since, they were the villages that ActionAid had longterm plans of adoption. A standard pretested semistructured questionnaire was provided by ActionAid and the data was collected by using participatory methods: (i) observations, (ii) key informant interviews (KIIs), and (iii) focus group discussions (FGDs). (KIIs were conducted with the Village Panchayat leaders, informal leaders, and the local residents. FGDs were conducted with the local residents. The information obtained through these participatory methods was validated against the records that were available with the local government.)Results and Discussion: An analysis of the data from the rapid assessment done in these 15 villages of Sirkali taluk are presented and discussed in this article. A discussion about some of the best practices, major pitfalls in handling certain issues, challenges faced during data collection in these disaster situations, the preparedness for this kind of a situation in India, and developing systems for warning and reporting of this kind of a disaster are also discussed.Conclusions: A disaster of this magnitude in a developing country like India clearly shows the need and commitment for Disaster Preparedness and Management. There is an urgent need to develop systems at the local, state, regional, and national levels and also ensure implementation. By doing so, although we cannot totally avoid natural disasters, we could probably be more prepared to face it and also minimize loss to lives and property to the least possible extent. Agencies involved in disaster management need to realize the ground realities of the effected area for planning a mitigation operation since each situation would be unique.

Introduction and aimsThe organization of healthcare pathways for neurodevelopmental disorders (NDD) relies on different levels of expertise depending on the complexity of these disorders. NDDs affect between 8% and 15% of children. Historically, national recommendations and healthcare planning measures were initially devoted to autism spectrum disorders and were gradually extended to Attention deficit hyperactivity disorder (ADHD) and specific learning and development disorders. Private doctors play an increasing role in these pathways at different levels of care due to difficulties in organization, particularly in the health and social sector. The aim of this work was to evaluate the contribution of second-line private doctors in the diagnosis and care of children affected by NDD.MethodsA first series of surveys in 2016 evaluated the level of commitment of primary care pediatricians; this online national survey was repeated in 2023 among 1,430 members of the French Association of Ambulatory Pediatrics (Association Française de Pédiatrie Ambulatoire: AFPA) to assess their training, current and future involvement, and activity in NDD care. Analysis was performed by the main author using Epi-Info software.ResultsThe study identified in 2023 214 second-line private doctors (14% of all pediatricians in activity), of which 185 agreed to appear in a directory published the same year by the AFPA to facilitate referrals from other professionals. Sex ratio of responders is usual for paediatricians: 79.5%/20.5% (F/M), with a distribution among ages showing a slight increase of the age range between age 51–60 (30.5%). Our data indicate that in France in 2022, second-line private doctors made 48%–53% of NDD diagnoses, 24%–26.4% of follow-up consultations and declare to be accountable for 21% of initial prescriptions for Methylphenidate. Among these second-line doctors, 40% had completed a post-university degree on NDD, 74.3% had completed professional development training (PDT) and 85.2% had completed either or both types of training. Most doctors participating in the survey wanted to improve their level of practice, suggesting that in five years, the number of second-line private doctors will increase by 20% to 244 despite 24 planned retirements within the same period. This data probably underestimates the role of private doctors in NDD diagnosis, follow-up, and initial Methylphenidate prescriptions given the unfavourable working conditions (no financial compensation for long appointments, difficulty accessing paramedical and psychological assessments).ConclusionsOur data confirms that diagnosis and care coordination in the various presentations of NDD may rely on different types of practices and specializations: medical and social professionals, mental health professionals, but also a growing body of medical doctors involved in developmental and behavioural pediatrics. This data and reflection will be helpful for organizing healthcare in France or in other countries. Main study limitation relies in the self-declaration of MD's involvement in NDD and could not evaluate the activity of employed MD's from the social and medico social sector, nor be based on the national databases for prescription. It remains however the first attempt of characterization of medical activity at the national level in France for NDD.

Background: Sexual assault poses a serious health problem to both the survivor and the health system. Experiencing sexual assault requires women to seek medical and psychological assistance as part of their journey towards recovery. This study examined the experiences of women who received post-sexual assault services from a specialised care centre within a provincial hospital.Methods: A qualitative, exploratory and contextual design was used to explore and describe experiences of women. Data were obtained through individual in-depth interviews from a total of 18 women aged between 18 and 55 years. Interviews were supplemented by the researcher’s field notes and audiotape recordings.Results: Findings yielded two main themes: Women expressed their lived experiences of sexual assault characterised by different forms of trauma. The second theme was an expression of a need for safety and support.Conclusion: Women who experience sexual assault are left with devastating effects such as physical and psychological harm and social victimisation. There is also a need for safety and support towards the recovery of these women. This study recommends that professional practitioners involved in the management of sexual assault be sensitised regarding the ordeal experienced by women and stop perceiving survivors as crime scene ‘clients’ from whom only medico-legal evidence has to be collected. Professional practitioners and family members must be supportive, non-judgemental and considerate of the dignity of survivors. The establishment of sexual assault response teams (SART) is also recommended. There should also be inter-professional education for better coordination of services rendered to sexually assaulted women.

Cette thèse étudie les recompositions de l'action médico-sociale auprès des exilés en situation de précarité sous l'effet des logiques de dispersion territoriale dans les politiques politiques migratoires. S'appuyant sur une enquête auprès d'acteurs de l'action sanitaire et sociale sur un département périurbain en Île-de-France, elle analyse les (re)configurations locales des acteurs publics et privés associatifs, dans leurs pratiques de soin et leurs dynamiques partenariales en réponse à l'accueil croissant d'exilés sur le territoire. Cette thèse démontre la prégnance des dynamiques de spécialisation dans l'accès aux soins, marquées par le développement de dispositifs dédiés aux exilés et la construction d'une expertise locale relative à leur santé. Face à l'enjeu de décloisonner l'accès des exilés à l'ensemble du système de santé, elle analyse alors les ambivalences et les limites de ces approches spécialisées et explore les pratiques d'orientation négociées vers les services de santé non dédiés aux populations précaires. Alors que s'affirme la démarche d'« aller-vers » dans les politiques sanitaires et sociales, ce travail analyse enfin le déploiement de l'intervention mobile comme modalité d'extension territoriale des services de santé. Nous montrons comment cette dynamique de « mise en mobilité » représente non seulement une reconfiguration des territoires d'intervention et des conditions de travail des professionnels de l'accueil et du soin, mais bouscule également la construction d'une relation d'aide et les rapports au politique dans lesquels ces derniers s'inscrivent. En explorant ces recompositions sociales et territoriales de l'action médico-sociale, cette thèse s'inscrit ainsi dans les réflexions sur la mise en œuvre et les enjeux de la lutte contre les inégalités sociales de santé
This thesis explores the transformation of medico-social action aimed at exiles facing precarious situations in response to territorial dispersion policies. Leveraging a survey of health and social care workers across a peri-urban territory in the Parisian region impacted by those policies, we unravel the (re )configurations of local care actors, services, and practices prompted by an increasing reception of exiles. Among those reconfigurations, we identify the emergence of specialized services and the development of local expertise tailored to the specific health needs of exiles. While addressing the challenge of enabling exiles' entry into the entire healthcare system, this work scrutinizes the ambivalence of these specialized approaches and investigates the abilities as well as practices to direct individuals towards healthcare services not explicitly designed for populations in precarious situations. Given the rising prominence of the 'outreach' approach in health and social policies, we then explore the deployment of mobile interventions as a strategy to extend health services across the territory. The work not only underscores the resulting shifts in territorial and working conditions but also examines how this process reshapes partnerships and the political engagement of social and medical actors. By navigating the evolving landscape of medico-social action, this thesis actively contributes to the ongoing debate on the implementation and challenges of reducing social and health inequalities

AbstractThis chapter is based on an internal evaluation of the of the 2012–2019 cooperation between the Pakistani National Trade Union Federation (NTUF), the German humanitarian organisation medico international, and the Berlin-based European Center for Constitutional and Human Rights (ECCHR). Written from a first-person perspective by three members of these organisations, it offers invaluable insights into the internal coordination and strategic deliberations of the partners’ evolving transnational efforts to hold the German retail company KiK and Italian social auditing firm RINA to account on behalf of the survivors and victims’ families of the 2012 Ali Enterprises factory fire. The authors elaborate on the multi-dimensional effects and aftermath of the Ali Enterprises tragedy, and recount the lessons learned from their different perspectives as trade unionists, activists, and lawyers based in both Pakistan and Germany. On this basis, the chapter then maps additional possible avenues for supporting the transnational struggles of workers around the globe. All in all, it offers rich insights into the experiences and complex debates ongoing amongst the authors and their organisations on how to develop common positions and further enhance their mutual understanding in order to collectively imagine and work towards transformative political goals.

Three themes underlie the topics in this chapter. Physical, psychological, and social problems often occur together, linked by chance or causality in the life of the old person. Very rarely can one problem be dealt with in isolation, and many different sources of expertise may be engaged with a single individual. Therefore good coordination between different agents is essential in old age psychiatry, both for the individual patient and in the overall planning of services. Many of the pathologies characteristic of old age are gradual in onset and degenerative in nature, and more due to failures in processes of repair than to an ‘external foe’, so the distinction between disease and health is often quantitative rather than qualitative. ‘Normality’ becomes a social construct with fluid borderlines, containing the overlapping (but not identical) concepts of ‘statistically common’ and ‘functionally intact’. Thus the popular perception of normal old age includes the ‘statistically common’ facts of dependence and failing function, whereas ‘intactness’ (excellent health and vigorous social participation) is seen as remarkable rather than the norm. But the boundaries of ‘old age’ are also socially constructed—in developed countries good health at the age of 65 would nowadays be regarded as a normal middle-aged experience, whereas superb health at 95 would still be something noteworthy. Since some degree of physical dependence, forgetfulness, and vulnerability to social exclusion is expected in old age, meeting those needs is also regarded as a ‘normal’ demand on families and community agencies such as social services, rather than the responsibility of health care providers. As the severity of the needs increases, however, so also does the perceived role of health professionals, both as direct service providers and in support of other agencies. Because of the high prevalence of cognitive impairment in old age (especially among the ‘older old’), questions frequently arise as to the competence of patients to make decisions. Older people who cannot manage decisions alone may come to depend increasingly on others for help; or, resisting dependence, they become vulnerable through neglect of themselves or through the injudicious decisions they make. When an incompetent person is cared for by a spouse or family member, the danger of self-neglect or of ill-considered decisions is lessened, but instead, there are the risks of faulty decisions by the caregiver (whether through ignorance or malice), and also risks to the health of the caregiver from the burden of dependence by the incompetent person. Legal mechanisms, differing from one country to another, exist to safeguard the interests of incompetent people. These three themes will be developed further, and with them the following special topics: 1 multiple problems: including sleep disorders in old age, medication in old age psychiatry, and psychological treatments in old age psychiatry; 2 blurred boundaries of normality: including the role of specialist services and support between agencies; 3 incapacity and dependence: including balancing the needs of patients and caregivers, abuse of older people, ethical issues, and medico-legal arrangements for safeguarding decisions.