scholarly journals Delegation of medical services to specially trained medical practice assistants

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Jedro ◽  
C Holmberg ◽  
A Kuhlmey ◽  
F Tille ◽  
J Stumm ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Medical Practice ◽  
Medical Services ◽  
German Population ◽  
Target Groups ◽  
Adequate Care ◽  
Gender Education ◽  
German Speaking ◽  
Study Population ◽  
Study Participants

Abstract Background Germany is one of the countries most affected by demographic change. Meaning the shift towards the population being older is growing. At the same time, the number of doctors is declining. In order to ensure adequate care in Germany, the delegation of medical services to specially trained medical practice assistants (MPAs) is currently discussed. The aim of this study was to assess the attitudes of the German population towards medical delegation. Methods The analysis was based on a population survey of 6.105 German-speaking residents aged 18 years and over. Associations between respondents’ attitudes towards the delegation and social determinants (age, gender, education, employment status, region, self-rated health) were assessed using standardised questionnaires. Bi- and multivariate (logistic regression) analyses were performed. Results In case of a chronic disease half of the German-speaking population (51. 8%) would accept getting treated by a MPA. More older participants (65 years and above) than younger participants (18 to 34 years old) (OR: 1,64; KI [1,24-2,18]), more lower than higher educated participants (OR: 1,20; KI [1,04-1,39]) and more non-German than German participants (OR: 1,61; KI [1,24-2,10]) are significantly more likely to not accept medical delegation in case of a chronic disease. Discussion: In the debate on delegation models the present results should be taken into account in order to be able to address relevant target-groups. Further qualitative studies that investigate the reasons for the critical view on delegation are recommended. Key messages Approximately 50% of the German-speaking study population would accept treatment by a MPA for chronic disease. Especially older study participants, lower educated people and non-German participants would not accept medical delegation in case of a chronic disease.

scholarly journals Knowledge, opinions and expectations of adults concerning personalised genotype-based dietary recommendations: a German survey

2020 ◽  
pp. 1-11
Author(s):  
Sandra Bayer ◽  
Theresa Drabsch ◽  
Gunther Schauberger ◽  
Hans Hauner ◽  
Christina Holzapfel
Keyword(s):  
Weight Management ◽  
German Population ◽  
Dietary Recommendations ◽  
Female Age ◽  
Dietary Recommendation ◽  
The Public ◽  
Direct To Consumer ◽  
Gender Education ◽  
Random Digit Dial ◽  
Study Participants

Abstract Objective: To assess the knowledge, opinions and expectations of persons with and without obesity concerning personalised genotype-based nutrition. Design: Questions about nutrition, weight management and personalised genotype-based dietary recommendations were asked via standardised telephone-based interviews. Sociodemographic and anthropometric data were collected. The data were statistically weighted by age, gender, education, domicile and BMI. Setting: Germany. Participants: Representative sample of the German population (n 1003) randomly sampled via a scientific Random Digit dial method plus 354 adults with a BMI ≥ 30·0 kg/m2 to enlarge the sample. Results: Data of 1357 participants were analysed (51·1 % female, age: 50·5 ± 18·5 years, 15·9 % adults with a BMI ≥ 30·0 kg/m2). About 42 % or 19 % of the survey participants stated to know the terms personalised dietary recommendation or genotype-based dietary recommendation, respectively. Of those, 15·8 % indicated to have an experience with a personalised or genotype-based dietary recommendation. Almost 70 % of the survey participants believed that a genotype-based dietary recommendation is a reasonable measure for weight management. About 55 % of the survey participants pointed out that a genotype-based dietary recommendation is an effective concept in general. One-third of the survey participants (34·6 %) indicated to conceive the usage of a genotype-based dietary recommendation. Conclusion: Most of the survey participants did not know the term personalised or genotype-based dietary recommendation. One-third of the study participants are interested to use a genotype-based dietary recommendation. Therefore, more education of the public is necessary to properly help people making informed and serious decisions and assessing commercially available direct-to-consumer genetic tests.

scholarly journals Knowledge, attitudes, and practices towards COVID-19 among residents of Gujarat, India

2021 ◽  
Vol 10 (8) ◽  
pp. 992
Author(s):  
Dharmesh Domadia ◽  
Jigisha Patadiya ◽  
Prakash Bhabhor
Keyword(s):  
Knowledge Score ◽  
Age Group ◽  
Or Education ◽  
Single Measure ◽  
Attitudes And Practices ◽  
Tv News ◽  
Gender Education ◽  
Education Levels ◽  
Study Population ◽  
Study Participants

Background: India, having diverse demographic profile, any single measure to curtain COVID-19 spread will become ineffective by default. Hence, determining knowledge and behaviours of population regarding COVID-19 is must to extract and decide on an effective approach to reduce the spread of COVID-19. For the same, we conducted KAP study.Methods: It was a KAP study of adult residents of various districts of Gujarat, India; consisting questions with multiple responses pertaining to knowledge, attitude, and practices towards COVID-19. Responses were analysed and represented by their percentage. Knowledge related questions’ responses were statistically analysed based upon responder’s age, gender, education level.Results: Knowledge scores of male and female participants were 7.03 and 6.96. Mean knowledge score of age group of 18-30 years, differed significantly to that of age group of >60 years. Study participants’ scores didn’t differ statistically according their education levels. 91.3% participants felt that COVID-19 can be more effectively managed if person has been diagnosed or tested earlier in the disease. 69.8% participants felt that patients of COVID-19 infection can be safely treated at home. 74.4% of participant were in favour of lockdown if need arises. 77% participants were willing to take COVID-19 vaccine.Conclusions: Knowledge level didn’t differ for any gender or education level. Knowledge scores of populations above age of 60 years were statistically less as compared to the scores of participants aged between 18 to 30 years. TV news channels and newspapers were most sought way of getting information for current study population.

A Transapical or Transluminal Approach to Aortic Valve Implantation Does Not Attenuate the Inflammatory Response

2011 ◽  
Vol 14 (2) ◽  
pp. 110 ◽  
Author(s):  
Benjamin O'Brien ◽  
Miralem Pasic ◽  
Hermann Kuppe ◽  
Roland Hetzer ◽  
Helmut Habazettl ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Aortic Valve ◽  
Inflammatory Response ◽  
Pulmonary Disease ◽  
Outcome Data ◽  
Surgical Trauma ◽  
Retrospective Case ◽  
Study Population ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: Cardiopulmonary bypass (CPB) and cardiac surgery cause an inflammatory response, as measurable by an increase in the concentration of C-reactive protein (CRP), a nonspecific inflammation marker. Previous publications have demonstrated typical perioperative CRP concentration profiles in cases of uncomplicated aortic valve replacement (AVR) with CPB. A regression analysis for modifying factors showed that chronic disease (heart failure, diabetes, and pulmonary disease), along with obesity and sex, all tend to influence the CRP response. We analyzed the inflammatory response to aortic valve implantation (AVI) with interventional techniques, mainly transapical but also transfemoral and transaxillary approaches, in a retrospective case-control study design.Methods: Sixty-eight patients who underwent AVI by the transapical (59 patients), transfemoral (7 patients), or transaxillary (2 patients) approach were matched by age, sex, body mass index (BMI), and chronic-disease state (absence or presence of diabetes, pulmonary disease, and renal impairment) with 68 patients who underwent conventional AVR with CPB. We compared the 2 groups with respect to perioperative CRP concentration, EuroSCORE, and outcome data (time to extubation and 30-day mortality). All data were collected prospectively and analyzed retrospectively.Results: The 2 groupsthe study population (interventional) and the control population (conventional)were similar in age, sex distribution, BMI, and chronic-disease status. As expected, the study population had a significantly higher median EuroSCORE. The 2 groups had similar postoperative CRP profiles over time, but the interventional group had significantly higher peak concentrations on days 2, 3, and 4. The short-term outcomes, as assessed by ventilation time and 30-day mortality, were similar for the 2 groups.Conclusions: Using an interventional transcatheter approach to AVI (thereby eliminating CPB from the procedure and reducing surgical trauma) does not attenuate the patient's innate inflammatory response.

scholarly journals Disability pension among persons with chronic disease: Differential impact of a Danish policy reform

2021 ◽  
Author(s):  
Jimmi Mathisen ◽  
Natasja Koitzsch Jensen ◽  
Jakob Bue Bjorner ◽  
Henrik Brønnum-Hansen ◽  
Ulla Christensen ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Labour Market ◽  
Disability Pension ◽  
Policy Reform ◽  
Disease Type ◽  
Functional Disorders ◽  
Differential Impact ◽  
Hazard Ratios ◽  
Study Population ◽  
The Impact

Abstract Background In 2013, Denmark implemented a reform that tightened the criteria for disability pension, expanded a subsidized job scheme (‘flexi-job’) and introduced a new vocational rehabilitation scheme. The overall aim of the reform was to keep more persons attached to the labour market. This study investigates the impact of the reform among persons with chronic disease and whether this impact differed across groups defined by labour market affiliation and chronic disease type. Methods The study was conducted as a register-based, nationwide cohort study. The study population included 480 809 persons between 40 and 64 years of age, who suffered from at least one of six chronic diseases. Hazard ratios (HR) and 95% confidence intervals (CI) of being awarded disability pension or flexi-job in the 5 years after vs. the 5 years prior to the reform were estimated. Results Overall, the probability of being awarded disability pension was halved after the reform (HR = 0.49, CI: 0.47–0.50). The impact was largest for persons receiving sickness absence benefits (HR = 0.31, CI: 0.24–0.39) and for persons with functional disorders (HR = 0.38, CI: 0.32–0.44). Also, the impact was larger for persons working in manual jobs than for persons working in non-manual jobs. The probability of being awarded a flexi-job was decreased by one-fourth (HR = 0.76, CI: 0.74–0.79) with the largest impact for high-skilled persons working in non-manual jobs. Conclusion Access to disability pension and flexi-job decreased after the reform. This impact varied according to labour market affiliation and chronic disease type.

scholarly journals Negligible import of enteric pathogens by newly arrived asylum seekers and no impact on incidence of notified Salmonella and Shigella infections and outbreaks in Rhineland-Palatinate, Germany, January 2015 to May 2016

2018 ◽  
Vol 23 (20) ◽  
Author(s):  
Lutz Ehlkes ◽  
Maja George ◽  
Donald Knautz ◽  
Florian Burckhardt ◽  
Klaus Jahn ◽  
...  
Keyword(s):  
Public Health ◽  
Asylum Seekers ◽  
Enteric Bacteria ◽  
Host Population ◽  
Enteric Pathogens ◽  
German Population ◽  
Target Groups ◽  
Targeted Approach ◽  
Country Specific ◽  
Children Under 5

Introduction The 2015 refugee crisis raised concerns about an import of infectious diseases affecting the German population. Aims: To evaluate public and individual health benefits of stool screening, and explore whether importation of enteric pathogens by newly arrived asylum seekers impacts on the host population. Methods: We used data from mandatory stool screening to determine the overall, age, sex, and country-specific prevalence of enteric bacteria and helminths. We used surveillance data to assess whether the number of incoming asylum seekers influenced notifications of salmonellosis and shigellosis in Rhineland-Palatinate. Results: Salmonella were found in 0.2% (95% confidence interval (CI) 0.2–0.3%) of 23,410 samples collected from January 2015 to May 2016. Prevalence was highest in children under 5 years (0.8%; 95% CI: 0.5–1.3%). No Shigella or invasive Salmonella spp. were detected. In a subset of 14,511 samples, the prevalence of helminth infestation was 2.4% (95% CI: 2.1–2.6%), with highest proportions detected in adolescents (4.6%; 95% CI 3.8–5.4%) and among Eritreans (9.3%; 95% CI: 7.0–12.0%); in the latter particularly Schistosoma mansoni and Taenia spp. The increase in asylum applications did not increase notifications of salmonellosis and shigellosis. No transmission from asylum seekers to German residents was notified. Conclusion: Public health risk associated with imported enteric pathogens is very low overall. Addressing individual and public health risks, we recommend replacing stool screening of all newly arrived asylum seekers by a targeted approach, with target groups and approaches being adapted if necessary. Target groups supported by our data are children, adolescents, and Eritreans.

Securing Health-Effective Medicine in Practice

2013 ◽  
pp. 35-50
Author(s):  
Rupert Whitaker
Keyword(s):  
Critical Theory ◽  
Medical Practice ◽  
Complex Interventions ◽  
Medical Model ◽  
Care Patient ◽  
Medical Services ◽  
Royal Infirmary ◽  
British Government ◽  
Managed Health Care ◽  
Concept Of Health

The movement for public participation in medical practice and its governance (‘participative medicine’) lacks an understanding of the historical and theoretical contexts within which it has emerged. This paper discusses the problems with physician-centred medicine (previously called ‘the medical model’), administrator-centred medicine (‘managed health-care’), patient-centred medicine, and participative medicine. The concept of health-effectiveness of medical services is emphasised as fundamental in an applied, critical theory of medical practice that equates health-effectiveness with pro-social medical services. The critical theory provides a framework for understanding the movement’s purpose, its misuse by consumerist methods, and the problems when medicine is delivered by pro-market or provider-centred systems, as shown most notably in the Bristol Royal Infirmary Inquiry by the British government. The paper outlines the Tuke Institute model of health-effective services, secured by participative medical practice and its governance and integrated with translational science. Together, the Tuke Institute model and the critical theory provide a scientific framework by which to determine the health-effectiveness of different models of practice through properly scientific research, indicating the necessity of studying models of practice as complex interventions.

scholarly journals Awareness Among Undergraduate Students of Mangalore City Regarding Novel Coronavirus (COVID-19): A Questionnaire Study

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Deeksha Das ◽  
Ramya Shenoy ◽  
Megha Mukherjee ◽  
Bhaskaran Unnikrishnan ◽  
Nikita Rungta
Keyword(s):  
Undergraduate Students ◽  
Hand Washing ◽  
Questionnaire Study ◽  
Public Places ◽  
Study Population ◽  
Novel Coronavirus ◽  
Imminent Threat ◽  
Study Participants ◽  
Age Range ◽  
And Control

ABSTRACT Objectives: COVID-19 outbreak has surfaced as an imminent threat for the public health. Because India is a populous country, it is important for Indians to be aware of the basic modes of prevention that can diminish the spread of the coronavirus disease 2019 (COVID-19) infection. Aim: The present questionnaire study was carried out among the undergraduate students to assess the awareness regarding the spread and control of COVID-19. Methods: The questionnaire was circulated among the undergraduate students as a Google form. Results: The study included responses of 868 undergraduate students belonging to 2 university colleges. The majority of the participants were females (63%; n = 547) in the age range of 18-23 y. Approximately 98.3% (853) had awareness regarding COVID-19. Approximately 94.7% (822) were washing their hands after visiting public places, out of which only 90.6% (786) were aware of proper steps to be followed in hand washing. It was concluded that it is required to create awareness among 20.8% (181) of our study participants regarding the importance of hand washing to control COVID-19. Conclusions: Awareness regarding COVID-19 among study participants was good. However, a small part of the study population is required to be educated on proper steps to be followed in hand washing.

Alcohol Intoxication and Suicide by Hanging in Poland

2020 ◽  
Vol 55 (3) ◽  
pp. 278-283 ◽  
Author(s):  
Dorota Lasota ◽  
Witold Pawłowski ◽  
Paweł Krajewski ◽  
Anna Staniszewska ◽  
Krzysztof Goniewicz ◽  
...  
Keyword(s):  
Metropolitan Area ◽  
Alcohol Intoxication ◽  
World Health ◽  
Target Groups ◽  
Demographic Differences ◽  
Alcohol Group ◽  
Demographic Groups ◽  
Study Population ◽  
Health Organization ◽  
Medical University

Abstract Aims An integral part of the World Health Organization (WHO) plan to reduce suicide by 10% by 2020 is to identify areas and demographic groups, which should be priority target groups for preventive activities. This study aimed to present the demographic differences between victims of suicide by hanging in the Warsaw metropolitan area, in Poland, by examining the sobriety of victims. Methods Data for analysis were obtained from the documentation of the Department of Forensic Medicine (DFM) at the Medical University of Warsaw (MUW). The retrospective analysis included 358 out of 466 victims of suicides by hanging in the Warsaw metropolitan area, in Poland, recorded in the DFM documentation covering 2011–2013. The data gathered included age, gender, the cause of death, a post-mortem examination as well as the level of ethanol in the blood and muscles of victims. Results In both groups, men accounted for a larger percentage of victims than women, P = 0.068. In the no-alcohol group, the victims were older than in the alcohol group (47.52 ± 19.21 vs. 40.88 ± 12.77) (P < 0.001). The majority of the studied population were victims aged 25–34 (22.90%), mainly men (20.95%). Young men were also the largest group among victims in the alcohol group (28.33%). The most numerous age group among no-alcohol group were older victims aged 55–64 (19.10%), especially men (16.29%). Conclusion Regardless of sobriety, men were the largest group of suicide victims in the study population, which means that men die suicide more often than women. Differences in gender proportions are related to age. In the studied population, it was primarily young victims, mainly men. These are the groups that should be priority target groups for preventive activities aimed at reducing the number of suicides. The presence of ethanol in more than half of the victims of suicide in the study population indicates that alcohol is an important suicidal risk factor.

Sequenced Treatment Alternatives to Relieve Depression

2018 ◽  
Author(s):  
Eric Lin ◽  
Pochu Ho
Keyword(s):  
Long Term Outcomes ◽  
Population Number ◽  
Study Population ◽  
Location Study ◽  
Study Participants ◽  
Study Intervention ◽  
Treatment Alternatives ◽  
Relapse Rates

This chapter provides a summary of the landmark Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial on major depressive disorder. The STAR*D trial was designed to address some basic questions about depression treatment. What are the outcomes and the remission rates for depression? What are the long-term outcomes, especially the relapse rates, for patients receiving sequential depression therapies? Starting with these questions, this chapter describes the basics of the STAR*D trial, including funding, study location, study population, number of study participants, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. In addition, this chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Prevalence of Tobacco Habits in Dental Outpatients

2016 ◽  
Vol 8 (1) ◽  
pp. 9-11
Author(s):  
Podutwar Priyanka Diliprao ◽  
GS Madhushankari ◽  
KP Mohankumar ◽  
SB Praveen ◽  
Pramod Redder Chandrappa
Keyword(s):  
Causes Of Death ◽  
Tobacco Consumption ◽  
Pharyngeal Cancer ◽  
Chi Square ◽  
Oral And Pharyngeal Cancer ◽  
Chi Square Test ◽  
Study Population ◽  
Study Participants ◽  
Tobacco Usage ◽  
Tobacco Chewing

ABSTRACT Background Tobacco usage in any form has devastating effects on the health of the person including oral and pharyngeal cancer, which is one of the major causes of death. Aim This study aims to evaluate the prevalence of tobacco consumption in various forms among dental outpatients. Materials and methods Patients reporting to the outpatient department of the College of Dental Sciences, Davangere, Bengaluru, India, were evaluated for the presence or absence of habit. Habit history was recorded using standardized proforma from every patient, and the obtained data was assessed in relation to age, gender, duration of habit, and frequency of tobacco consumption. Results Among the 507 study participants, habits were present in 115 (22.68%), among which 101 (87.82%) were males and 14 (12.17%) were females. Among males, raw tobacco chewing and gutkha chewing had equal prevalence [25 (21.73%)] followed by cigarette smoking [23 (20%)]. In females, tobacco chewing [10 (8.69%)] was the most common habit and none of them smoked tobacco. Habits were more prevalent between the age group of 16 and 30 years. The results were found to be highly significant on applying chi-square test. Conclusion Higher prevalence of tobacco usage among the study population as compared with other studies needs to be addressed and counseled. How to cite this article Diliprao PP, Madhushankari GS, Mohankumar KP, Praveen SB, Chandrappa PR, Nandini DB. Prevalence of Tobacco Habits in Dental Outpatients. CODS J Dent 2016;8(1):9-11.

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