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Tsarenko, Anatolii V., Vira V. Chaikovska, Nina G. Goyda e Zoya V. Maksimova. "GERIATRIC ASPECTS OF THE ORGANIZATION OF MEDICAL-SOCIAL, PALLIATIVE AND HOSPICE CARE IN THE CONDITIONS OF THE WAR: COMBINATION OF MEDICAL, PSYCHOLOGICAL AND SOCIAL PROBLEMS". Клінічна та профілактична медицина, n.º 3 (8 de maio de 2024): 74–81. http://dx.doi.org/10.31612/2616-4868.3.2024.09.
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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.
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Koeberle, Séverine, Thomas Tannou, Kévin Bouiller, Nicolas Becoulet, Justin Outrey, Catherine Chirouze e Régis Aubry. "COVID-19 outbreak: organisation of a geriatric assessment and coordination unit. A French example". Age and Ageing 49, n.º 4 (6 de maio de 2020): 516–22. http://dx.doi.org/10.1093/ageing/afaa092.
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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.
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Margueritte, Maryline. "Innovating Healthcare Processes for Speed and Effectiveness". International Journal of Innovation 1, n.º 1 (1 de dezembro de 2013): 13–18. http://dx.doi.org/10.5585/iji.v1i1.7.
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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.
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Tymoshchuk, O. V., I. V. Serheta, О. S. Malyshevska, V. I. Melnyk e V. B. Motriuk. "Medico-social conditions of educational activity, quality of life and aspects of psychophysiological adaptation of modern pupils and students: features of interrelation and their hygienic assessment". Medicni perspektivi 28, n.º 1 (30 de março de 2023): 153–61. http://dx.doi.org/10.26641/2307-0404.2023.1.276203.
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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).
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Kotenko, P. K., e V. I. Shevtsov. "ANALYSIS OF MEDICO-SOCIAL FACTORS DETERMINING THE OUTLOOK IMAGE OF THE SYSTEM OF RENDERING MEDICAL AID TO VICTIMS OF EMERGENCY SITUATIONS IN THE ARCTIC ZONE OF THE RUSSIAN FEDERATION". Marine Medicine 4, n.º 4 (15 de janeiro de 2019): 44–54. http://dx.doi.org/10.22328/2413-5747-2018-4-4-44-54.
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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.
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Немченко, А. С., Т. М. Коба e В. М. Назаркіна. "Study of the condition and problems of providing diabetes patients with insulin preparations and means of glycemia monitoring". Farmatsevtychnyi zhurnal, n.º 3 (28 de junho de 2023): 6–17. http://dx.doi.org/10.32352/0367-3057.3.23.01.
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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.
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Khomenko, I. M., e T. V. Shevchuk. "The formation of morpho-functional readiness and peculiarities of student adaptation processes at the graduate stage of education in institution of higher education". Reports of Vinnytsia National Medical University 27, n.º 3 (9 de setembro de 2023): 474–82. http://dx.doi.org/10.31393/reports-vnmedical-2023-27(3)-20.
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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.
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Ramachandra, MBBS, MD, MPH, Srikrishna Sulgodu. "Village-level tsunami disaster assessment: A volunteer’s perspective". Journal of Emergency Management 7, n.º 5 (1 de setembro de 2009): 71. http://dx.doi.org/10.5055/jem.2009.0023.
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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.
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Willig, Thiébaut-Noël, Jean-Paul Blanc, Rémy Assathiany, Claire Bilbault, Laurent Raffier e Andreas Werner. "Ambulatory pediatricians: how to bridge the gaps in diagnosis and care coordination for neurodevelopmental disorders in France". Frontiers in Pediatrics 12 (25 de abril de 2024). http://dx.doi.org/10.3389/fped.2024.1269198.
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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.
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Sebaeng, Jeanette M., Mashudu Davhana- Maselesele e Eva Manyedi. "Experiences of women who reported sexual assault at a provincial hospital, South Africa". Curationis 39, n.º 1 (25 de fevereiro de 2016). http://dx.doi.org/10.4102/curationis.v39i1.1668.
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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.
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Maguire, Angela M., Julieann Keyser, Kelly Brown, Daniel Kivlahan, Madeline Romaniuk, Ian R. Gardner e Miriam Dwyer. "Veteran families with complex needs: a qualitative study of the veterans’ support system". BMC Health Services Research 22, n.º 1 (15 de janeiro de 2022). http://dx.doi.org/10.1186/s12913-021-07368-2.
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Abstract Background Families with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans’ non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers’ and families’ experiences of accessing and navigating the veterans’ support system. Methods The study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data. Results Both service providers and families found the veterans’ support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture. Conclusion The health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.
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Donio, V., M. M. Defebvre, R. Pamart, B. Caron, C. Delval-Bugny, D. Dambre, C. Di Martino e J. B. Beuscart. "Evaluation of the health pathway through the patient-experience in the French program PAERPA". European Journal of Public Health 29, Supplement_4 (1 de novembro de 2019). http://dx.doi.org/10.1093/eurpub/ckz186.684.
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Abstract The patient-experience is an emerging concept in research and medico-social action, and its consideration in the development of care pathways is encouraged (e.g. ’Ma Santé 2020’ national plan in France). In addition, the patient-experience of the elderly subject has specific dimensions and his collection presents difficulties insufficiently explored. PAERPA (elderly people at risk of loss of autonomy), French national experiment for the care of frail elderly patients, offers an opportunity to return to these issues. The objective of this study, mandated by the ARS of Hauts-de-France, was to collect the experience of the elderly PAERPA. Faced with the difficulties of current methodologies, several methodological approaches have been combined: semi-structured individual interviews face-to-face or by telephone, dedicated questionnaire. In addition, a specific grid was developed to explore the home-based patient experience, including seven dimensions of the patient-experience identified in the literature. This study was conducted in the second half of 2018 (3 years and a half of the start of the project). The experience of 43 seniors and / or caregivers was collected. Patients PAERPA are generally satisfied with their care but they have difficulties in making the link between their care and the actors and devices specific to PAEPRA experimentation. Human connection and listening seem essential for the elderly patients included. Other dimensions, such as stakeholder coordination, remain controversial and more difficult to grasp. Methodologically, the particular situation of seniors, such as sensory or memory disorders, requires a major adaptation of the survey tools. In PAERPA, the patient-experience of the frail elderly subject passes mainly through the feeling of a human connection. Current methodologies do not seem fully adapted to collectively capture the experience of frail elderly patients. Key messages Evaluating the patient-experience to improve the health pathway is possible and necessary through a qualitative collection, regularly, in itinere. The peculiarities of older people often require the participation of carers, who need to be involved in the assessment of the patient-experience and raised awareness.
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Tavassoli, N., A. Piau, C. Berbon, J. De Kerimel, C. Lafont, P. De Souto Barreto, S. Guyonnet et al. "Framework Implementation of the INSPIRE ICOPE-CARE program in collaboration with the World Health Organization (WHO) in the Occitania region". Journal of Frailty & Aging, 2020, 1–7. http://dx.doi.org/10.14283/jfa.2020.26.
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Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.
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Norman, Ishmael D., Emmanuel D. Kpeglo e Raymond Agalga. "Cross-Sectional and Medico-Legal Investigations of Covid-19 Response, Ghana". European Journal of Medical and Health Sciences 2, n.º 6 (30 de novembro de 2020). http://dx.doi.org/10.24018/ejmed.2020.2.6.587.
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From the 12th of March 2020, Ghana took bold steps against Covid-19, aimed at controlling the spread among the population, protecting against community infections, treating those with the disease and ensuring public trust in the healthcare delivery system. This cross-sectional survey, assessed the effectiveness of Ghana’s risk communication, legal framework and response approaches to the Covid-19 Pandemic.
The first part was a Cross-Sectional approach. The authors used data collected on-line via a self-reported questionnaire between 16th March and 16th April from [127] participants. Differences in mean scores and other factors associated with awareness; as a function of risk communication; to Covid-19, knowledge of safety protocols, and practices towards the disease, were conducted using univariate and multivariate data analytical methods. The second approach was a literature review of Ghana’s legal framework existing prior to the outbreak of Covid-19 and those enacted by Parliament during the emergency period towards the management of the pandemic. A content analyses of the legal framework, to assess official compliance with the framework in relation to the aim of this study was conducted.
The majority of the study participants were knowledgeable about how Covid-19 was transmitted. An independent samples t-test was performed to determine if a difference existed between the mean scores of COVID-19 knowledges for males and females. The outcome variable was found to be normally distributed and equal variances are assumed based upon results of Levene’s test (F (125) = 0.097, p-value = 0.756). There was no significant difference in knowledge scores (with minimum = 1, and maximum = 3) for males (mean = 1.61, standard deviation = 0.665) and females (mean = 1.56, standard deviation = 0.698; t- value t (125) =0.374, p-value = 0.709, two-tailed). The magnitude of the difference in the means (mean difference = 0.054, 95% confidence interval: -0.234, 0.343) and the effect size was very small (Cohen d = 0.08). The independent samples t-test was also performed to test the hypothesis that males and females were associated with statistically significant different COVID-19 awareness mean scores. The test showed no significant difference in the awareness scores for males and females. The results from the content analyses of the legal framework show there was lax adherence of government to the legal framework for Pandemic response on these dimensions: Planning and Coordination; Surveillance, Situation monitoring and Assessment; Prevention, Containment and Management; Communications; and Social Mitigation. It further shows that neither the existing legislation nor the Executive Instruments, E. I. 63 - 66, and 164 directed at Covid-19 administrative and epidemiologic controls, have helped to stop the spread of Covid-19, considering the uptick of new infections of Covid-19.
Covid-19 has exposed the lack of effective risk communication modalities in Ghana and the government’s lack of adherence to the legal framework on disasters and emergencies in general, a vacuum which is filled by social media.
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Roux, Enora Le, Florence Menesguen, Isabelle Tejedor, Marc Popelier, Marine Halbron, Pauline Faucher, Sabine Malivoir, Michel Polak, Christine Poitou e Philippe Touraine. "MON-LB308 Studying the Care and Social Pathway of Young Adults With Endocrine and Metabolic Diseases During Transition: The “Transend” Cohort". Journal of the Endocrine Society 4, Supplement_1 (abril de 2020). http://dx.doi.org/10.1210/jendso/bvaa046.2138.
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Abstract Context. The transition period between pediatric and adult medicine is associated with poor patient outcomes and an important number of patients lost to follow up. Intervention exist but the few published randomized trials do not allow to study long-term patient outcomes nor intervention sustainability in time. Objective. Describe the cohort of patients in adult care who benefit from a new transition program based on case management approach, its activity and follow-up outcomes. Methods. A longitudinal study was led since September 2016 in adult services of endocrinology, nutrition and diabetology of a French University Hospital. Patients with any endocrine disease diagnosed during childhood and transferred to adult care were included. The care pathway for these patients was built in three steps. Step 1 is dedicated in liaising with pediatric services and patient to facilitate its first visit in adult care. Step 2 defines the care pathway in adult service based on the needs assessment realized by the coordinator upon the patient’s arrival in adult service. Step 3 focuses in liaising with structures outside hospital (GP, educational and social sector). Thorough the follow-up, the coordinator is identified as the key contact by the patients. Attendance to medical appointments, clinical, and social data are collected throughout patient follow-up. Results. Since 3 years, 500 patients benefited from the case management mainly for their obesity (n=91, 18%), type 1 diabetes (n=54, 11%), malignant brain tumor (n=68, 14%) or congenital hypopituitarism (n=42, 8%). They were aged 19 in median at transfer in adult care, sex ratio: 0,5, A large majority live in the parental home (409, 82%), 169 (34%) are university students, 130 (26%) are in high school, 90 (18%) are in medico-social institution. Patients who required most of support from the coordinator usually combine one (or more) somatic disease and either a neuro-cognitive disorder or a psychiatric disorder, they all have social difficulties. In patients with more than 3 months of follow-up (median: 18 months), 22/418 (5%) are out of follow-up. Concerning the patients for whom the follow-up is 36 months or more, the percentage of out of lollow-up is the same: 5% Conclusions. The case manager addresses the complex needs of diverse patients. With time, the cohort will provide unprecedented long-term results of patients with various conditions who went through transition.
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"Conceptual basis of organization of medical care for school students in the period of reforming healthcare and education systems". Actual problems of modern medicine, n.º 7 (2021). http://dx.doi.org/10.26565/2617-409x-2021-7-07.
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Negative trends in the health status of the child population, the spread of non-communicable diseases require optimization of the system of their medical support. According to WHO, an educational institution can become a powerful tool for the preservation and strengthening of children's health through the rational use of human and material potential, opportunities for intersectoral interaction between education and medicine systems, and support for actions at the legislative level. The aim of the work is to develop a conceptual model of medical support for students of general secondary education institutions to prevent the spread of non-infectious diseases and the formation of health-oriented behavior of schoolchildren. Materials and methods: Analytical assessment of regulatory documents and scientific foreign and domestic publications on the health status and medical support of school-age children. Results and discussion. In the context of the innovative transformation of the health care system, the problematic issues of medical support for children in educational institutions are the issues of ensuring algorithms for monitoring the health of children, determining the influence of intraschool and medico-social factors on health and the formation of health-oriented behavior; systems for improving the skills and knowledge of school health workers on the issues of maintaining children's health, assessing health indicators and the results of preventive interventions.The solution of these issues is possible by introducing a unified coordinating structure of medical support for students of general secondary education institutions, with the development of its structural and functional model and defining the functions of all participants / performers to ensure an adequate system of medical support preserve the health of children in school conditions. The proposed Conceptual Model with substantiation of the functions and composition of specialists, elements of communication is aimed at preventing the spread of non-communicable diseases among students, the formation of a value attitude towards health in schoolchildren, will contribute to the formation of health-oriented behavior.
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"8.C. Workshop: Networking for life: How European regions develop/strengthen cross-border health". European Journal of Public Health 32, Supplement_3 (1 de outubro de 2022). http://dx.doi.org/10.1093/eurpub/ckac129.484.
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Abstract The WHO European Programme of Work (2020-2025) emphasizes the importance of “supporting local living environments that enable health and well-being”. Through engaging with regulatory arrangements that support an environment that responds to citizens’ concerns for safer, healthier and better living, the EPW intertwines with the aims of the EPH Conference to promote population health and to strengthen health systems. The Covid-19 pandemic shows that health threats do not stop at national borders. Different responses amongst cross-border regions, based on national policies in terms of Public Health and Social Measures (PHSM), may even weaken their effectiveness. The importance of cooperation across border is not only relevant in the framework of pandemic preparedness and responses, but in many other fields: healthcare cooperation, emergency medical care, medico-social cooperation and health promotion. All have shown to be beneficial to population health when developed at the subnational level across border regions. Consequently, cross-border health (care) gained importance in recent years and there are various border regions who showcase successful cross-border cooperation in the field of health. Projects are being implemented along neighbouring European regions, translating into improved access to healthcare for the border populations, promoting prevention and health education as well as increasing healthcare availability and equity. Via various health networks, border regions can learn to engage with neighbours and build up tailor-made health services for their citizens. More so, through active participation in various well-established public health networks, the exchange of ideas, knowledge and solutions to strengthen cross-border health becomes part of region's daily work. Through strong networks and partnerships, joint solutions for a strengthened citizens’ health in rural areas could be found. Creating synergies between the healthcare capacities of the two sides of the border, collaboration between border area medical teams, access to equipment located one or other side of the border can make a positive impact on the users of health services and facilities. In this round table workshop, the role and impact of health networks on a sub-national level (regional) will be further examined. Based on selected well-established health networks, their work and value will be outlined. The Keynote speech will be given by the Coordinator of the WHO Europe Regions for Health Network, Dr. Bettina Menne. Subsequently, 3-4 well-established health networks will take the floor with a short presentation (5 min) in order to present their ‘business case’ and value. The presentations will be followed by a short round table discussion in order to highlight the role and strengths European health networks can bring to regions in order to improve cross-border healthcare (WHO RHN, Healthacross /Lower Austria, euPrevent, AEBR, EUREGHA). Key messages • Role and impact of health networking for cross-border health on a sub-national level. • Outlining the benefits and challenges for border regions to participate in health networks in order to strengthen cross-border health (also during Covid-19).