scholarly journals Mental healthcare for older adults in rural Greece

2015 ◽  
Vol 28 (4) ◽  
pp. 698-700
Author(s):  
Vaios Peritogiannis ◽  
Athina Tatsioni ◽  
Thiresia Manthopoulou ◽  
Venetsanos Mavreas

Community mental healthcare in rural and remote areas of Greece is mostly delivered by generic Community Mental Health Teams (CMHTs), namely the Mobile Mental Health Units (MMHUs). In Epirus, north-west Greece, one of the poorest regions in Europe, the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) has been established in 2007 and provides services to a population grossly estimated at 100,000 per size of the catchment area in remote and mostly mountainous rural areas. The establishment of the MMHU I-T and its contribution to the care of patients with psychosis has been described elsewhere (Peritogiannis et al., 2011).

2017 ◽  
Vol 08 (04) ◽  
pp. 556-561 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Thiresia Manthopoulou ◽  
Afroditi Gogou ◽  
Venetsanos Mavreas

ABSTRACTIntroduction: Patients living in rural and remote areas may have limited access to mental healthcare due to lack of facilities and socioeconomic reasons, and this is the case of rural areas in Eastern Europe countries. In Greece, community mental health service delivery in rural areas has been implemented through the development of the Mobile Mental Health Units (MMHUs). Methods: We present a 10-year account of the operation of the MMHU of the prefectures of Ioannina and Thesprotia (MMHU I-T) and report on the impact of the service on mental health delivery in the catchment area. The MMHU I-T is a multidisciplinary community mental health team which delivers services in rural and mountainous areas of Northwest Greece. Results: The MMHU I-T has become an integral part of the local primary care system and is well known to the population of the catchment area. By the end of 2016, the majority of patients (60%) were self-referred or family-referred, compared to 24% in the first 2 years. Currently, the number of active patients is 293 (mean age 63 years, 49.5% are older adults), and the mean caseload for each member of the team is 36.6. A significant proportion of patients (28%) receive care with regular domiciliary visits, and the provision of home-based care was correlated with the age of the patients. Within the first 2 years of operation of the MMHU I-T hospitalizations of treatment, engaged patients were reduced significantly by 30.4%, whereas the treatment engagement rates of patients with psychotic disorders were 67.2% in 5 years. Conclusions: The MMHU I-T and other similar units in Greece are a successful paradigm of a low-cost service which promotes mental health in rural, remote, and deprived areas. This model of care may be informative for clinical practice and health policy given the ongoing recession and health budget cuts. It suggests that rural mental healthcare may be effectively delivered by integrating generic community mental health mobile teams into the primary care system.


2021 ◽  
pp. 002076402098589
Author(s):  
Vaios Peritogiannis ◽  
Sofia Rousoudi ◽  
Theofanis Vorvolakos ◽  
Panagiota Gioti ◽  
Afroditi Gogou ◽  
...  

Background: Mental healthcare service delivery in rural and remote areas in Greece is challenging due to socioeconomic and geographical reasons, and distant facilities. To address the needs of the underserved areas, the Greek state has launched a number of Mobile Mental Health Units (MMHUs). Aim: The objective of the present study was to explore the differences among two MMHUs, one being run by a university general hospital (MMHU UHA) and the other being run by a nongovernmental organization (MMHU I-T). Methods: The two MMHUs deliver services in rural areas of northeast and northwest Greece, respectively. Both MMHUs use the infrastructures of the primary healthcare system and have the potential for domiciliary visits. Results: Medical and nursing staff is much more in the MMHU UHA, whereas MMHU I-T has more psychologists, social workers and health visitors. Patients attended the MMHU I-T were significantly older than the patients attended the MMHU UHA (mean age 64.5 vs. 55.3 years) and the percentage of the elderly patients in treatment with the MMHU I-T (56.5%) is significantly higher than the corresponding percentage of the MMHU UHA (20%). The proportion of patients that received home-based care by the two MMHUs was almost identical. The percentage of patients with schizophrenia spectrum disorders that attended the MMHU UHA was significantly higher. Patients with affective disorders, anxiety disorders and organic brain disorders that attended the MMHU I-T were significantly more. Conclusions: Despite the similarities among the MMHUs in rural Greece, this study recorded some important differences. The differences in staffing may be accounted for by the availability of resources. The differences in the patients’ population may be explained by the fact that the MMHU UHA was designed from its beginning to treat patients with severe mental illnesses, mainly psychoses, and it accepts loss of referrals within the general hospital’s network of psychiatric services. The MMHU I-T is an independent, locally based service that may be better perceived as an expansion of the primary care system. The results of the study could inform service practice and mental health policy.


2021 ◽  
Vol 8 (65) ◽  
pp. 15164-15172
Author(s):  
S. Pratap ◽  
Aziz Fatima

In present scenario of COVID-19, the effect of pandemic on Digital Marketing is visible not only in urban areas but also in rural areas. Customers are searching for various products and services through Google by which they can purchase wide range of products and services to fill their needs and desires at relatively low price. The freedom to select numerous products is available by browsing various websites. Hence this study focuses on Impact of digital marketing particularly in the selected rural areas of Telangana state. This state been formed recently but in the IT sector it is receiving much attention throughout the globe, as many MNC’s are establishing their operations in this state. Therefore, an attempt has been made in this study to find out how the Impact of digital marketing is trickling down in the rural and remote areas of newly formed Telangana state. Hence this study focuses the impact of digital marketing in the selected areas of Telangana state.


Author(s):  
Judith Byaruhanga ◽  
Christine L. Paul ◽  
John Wiggers ◽  
Emma Byrnes ◽  
Aimee Mitchell ◽  
...  

This study compared the connectivity of video sessions to telephone sessions delivered to smokers in rural areas and whether remoteness and video app (video only) were associated with the connectivity of video or telephone sessions. Participants were recruited into a randomised trial where two arms offered smoking cessation counselling via: (a) real-time video communication software (201 participants) or (b) telephone (229 participants). Participants were offered up to six video or telephone sessions and the connectivity of each session was recorded. A total of 456 video sessions and 606 telephone sessions were completed. There was adequate connectivity of the video intervention in terms of no echoing noise (97.8%), no loss of internet connection during the session (88.6%), no difficulty hearing the participant (88.4%) and no difficulty seeing the participant (87.5%). In more than 94% of telephone sessions, there was no echoing noise, no difficulty hearing the participant and no loss of telephone line connection. Video sessions had significantly greater odds of experiencing connectivity difficulties than telephone sessions in relation to connecting to the participant at the start (odds ratio, OR = 5.13, 95% confidence interval, CI 1.88–14.00), loss of connection during the session (OR = 11.84, 95% CI 4.80–29.22) and hearing the participant (OR = 2.53, 95% CI 1.41–4.55). There were no significant associations between remoteness and video app and connectivity difficulties in the video or telephone sessions. Real-time video sessions are a feasible option for smoking cessation providers to provide support in rural areas.


Author(s):  
Jayanthi Narayan ◽  
Nibedita Patnaik

Education is a fundamental right of all children, including those with special educational needs. Efforts to achieve education for all has resulted in the focused attention of governments around the world, thereby improving the quality of education in schools and leading to dignified social status for students previously marginalized and/or denied admission to schools. This worldwide movement following various international conventions and mandates has resulted in local efforts to reach rural remote areas, with education provided by the government in most countries. Though there has been significant progress in reaching children, it has not been uniform. There are still many barriers for children in rural and tribal areas or in remote parts of the country that prevent them from receiving equitable education. The essence of inclusive education is to build the capacity to reach out to all children, thereby promoting equity. In the 1990s, special needs education was a focus, and integrating it into the overall educational system led to reforms in mainstream schools which resulted in inclusive education that addressed the diverse learning needs of children. How successful have we been in these efforts particularly in the remote and rural areas? There are various models and practices for special and inclusive education in rural and remote areas, but reaching children with special educational needs in such areas is still a challenge. Though there are schools in these areas, not all are sufficiently equipped to address the education of children with special needs. Furthermore, teachers working in rural areas in many countries are not adequately trained to teach those with special needs, nor are there the technological support systems that we find available in urban areas. Yet, interestingly, in some rural/tribal communities, the teachers are naturally at ease with children with diverse needs. The schools in such areas tend to have heterogeneous classes with one teacher providing instruction to combined groups at different grade levels. Evidence shows that rural teachers are less resistant to including children with special needs compared to urban teachers. Because of their homogeneous lifestyle, community supports in rural areas offer another supportive factor toward smooth inclusion. Though primary education is ensured in most rural and remote areas, children have to travel long distances to semi-urban/urban areas for secondary and higher education; such travel is further complicated when the child has a disability. In many rural areas, children with special needs tend to learn the traditional job skills naturally associated with that area, though such skills are not always blended into the school curriculum. Preparing teachers to provide education in rural areas with the latest technological developments and a focus on vocation is bound to make that education more meaningful and naturally inclusive.


2018 ◽  
Vol 13 (6) ◽  
pp. 568-575 ◽  
Author(s):  
Silke Walter ◽  
Henry Zhao ◽  
Damien Easton ◽  
Cees Bil ◽  
Jonas Sauer ◽  
...  

Background In recent years, important progress has been made in effective stroke treatment, however, patients living in rural and remote areas have nil or very limited access to timely reperfusion therapies. Aims Novel systems of care to overcome the detrimental treatment gap for stroke patients living in rural and remote regions need to be developed. Summary of review A possible solution to the treatment disparity between stroke patients living in metropolitan and rural areas may involve the use of specially designed aircrafts equipped with the ability to diagnose and treat acute stroke at remote emergency sites. We describe technical solutions for an Air-Mobile Stroke Unit (Air-MSU) concept, where an aircraft is customized with the ability to perform multimodal computed tomography, in addition to onboard laboratory equipment and telemedicine connection. The Air-MSU is envisioned not only to allow intravenous thrombolysis in the field but also to allow prehospital triage to a comprehensive stroke center through use of contrast intracerebral vascular imaging. Several options for the Air-MSU approach are described, and issues regarding the potential medical benefit, optimal operating environment, technical realization, and integration in pre-existing solutions (e.g., flying doctor service) are addressed. Conclusion The Air-MSU may represent a novel tool to reduce treatment disparity for stroke patients in rural and remote areas. However, this approach requires further implementation research to determine the overall benefit to these communities.


Significance It reports less than 100 cases and one death, but official figures probably underestimate the reality. PNG’s health system was already in serious decline before the pandemic and the government acknowledges a high probability that community transmission continues. Impacts What may slow infections is the fact that much of PNG’s population lives in rural and remote areas. The roll-out of internet access to provincial cities and rural areas will help integrate PNG’s fragmented economy and society. Despite the Bougainville region voting strongly for independence in a non-binding referendum last year, actual independence is years away.


Sign in / Sign up

Export Citation Format

Share Document