Approach to clinical care in humanitarian contexts

2019 ◽  
pp. 267-274
Author(s):  
Raghu Venugopal
Keyword(s):  
Clinical Care ◽  
Humanitarian Settings ◽  
Key Aspects

This chapter on the approach to clinical care in humanitarian contexts outlines the fundamentals of providing care in humanitarian settings, including overall guidance on clinical care, key aspects of patient triage, and approaches for paediatrics. It providers important overarching considerations for readers, recognizing the realities and challenges in providing care in the field.

Approach to paediatric care

2019 ◽  
pp. 297-306
Author(s):  
Daniel Martinez Garcia ◽  
Harriet Roggeveen ◽  
Jaap Karsten
Keyword(s):  
Decision Making ◽  
Clinical Care ◽  
Clinical Judgement ◽  
Humanitarian Settings ◽  
Paediatric Care ◽  
Paediatric Patients ◽  
Key Aspects

This chapter outlines the fundamentals of providing care in humanitarian settings, including overall guidance to clinical care, key aspects of patient triage, and approaches for paediatrics. This chapter on the approach to paediatric care in humanitarian, conflict, or disaster setting, aims to assist the non-paediatrician presented with paediatric patients, by highlighting approaches, key insights, and guidance to help with clinical judgement and decision-making.

Medical triage

2019 ◽  
pp. 289-296
Author(s):  
Peter Moons
Keyword(s):  
Clinical Care ◽  
Humanitarian Settings ◽  
Key Aspects

This chapter on medical triage outlines the fundamentals of providing care in humanitarian settings, including overall guidance to clinical care, key aspects of patient triage, and approaches for paediatrics, and emergency triage. It outlines the process of rapidly sorting patients into groups based on the urgency of their condition, ensuring that the most appropriate patients get treatment first hand.

Mass casualty triage

2019 ◽  
pp. 275-288
Author(s):  
Christos Giannou ◽  
Jennifer Turnbull
Keyword(s):  
Clinical Care ◽  
Mass Casualty ◽  
Humanitarian Settings ◽  
Large Numbers ◽  
Key Aspects

This chapter on mass casualty triage outlines the fundamentals of providing care in humanitarian settings, including overall guidance to clinical care, key aspects of patient triage, including the rationing of care based on priority for treatment, and approaches for paediatrics. It clarifies the differences between medical triage and mass casualty triage, describes the process of balancing needs with the resources available, recognizing situations where large numbers of patients overwhelm resources, and discusses triage models and organization, triage teams, and triage algorithms.

scholarly journals WHO guidance for refugees in camps: systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027094 ◽  
Author(s):  
Harriet Blundell ◽  
Rachael Milligan ◽  
Susan L Norris ◽  
Paul Garner
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Refugee Camps ◽  
Who Guidelines ◽  
Clinical Guidance ◽  
Humanitarian Settings ◽  
Common Framework ◽  
Evidence Summaries

ObjectivesThe circumstances of people living in refugee camps means that they have distinct medical care requirements. Our objective is to describe clinical guidance in published WHO guidelines that refer to people living in refugee camps; and how evidence and context are used and reported in making recommendations.DesignSystematic review and analysis of WHO guidelines approved by the organisation’s quality oversight body and published between 2007 and 2018. We sought for key terms related to camps and humanitarian settings, and identified text that included guidance. We compared this to Mèdecins Sans Frontièrs (MSF) guidelines.ResultsNo WHO guideline published in the last 10 years focused exclusively on clinical guidance for healthcare in camp settings. Seven guidelines contained guidance about camps; three made recommendations for camps—but only two used formal evidence summaries. We did not find any structured consideration of the situation in camps used in the decision-making process. We examined seven WHO guidelines and six chapters within guidelines that concerned humanitarian settings: none of these documents contained recommendations based on formal evidence summaries for camp settings. One of the eight MSF guidelines was devoted to clinical care in refugees and the authors had clearly linked the health problems and recommendations to the setting, but this guideline is now >20 years old.ConclusionsThere is an absence of up-to-date, evidence-based medical treatment guidelines from WHO and MSF that comprehensively address the clinical needs for people living in camps; and there is no common framework to help guideline groups formulate recommendations in these settings. WHO may wish to consider context of special populations more formally in the evidence to decision-making approach for clinical guidelines relevant to primary care.

scholarly journals AB0874-HPR TELEMEDICINE CONSULTING IN RHEUMATOLOGY: IDENTIFIED PROBLEMS OF NEW TECHNOLOGY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1461.3-1461
Author(s):  
O. Teplyakova ◽  
A. Sarapulova
Keyword(s):  
New Technology ◽  
Clinical Care ◽  
Cross Sectional Study ◽  
Educational Process ◽  
Team Approach ◽  
Cross Sectional ◽  
Modern Health Care ◽  
The Right ◽  
Key Aspects ◽  
Measurement Efficiency

Background:A feature of healthcare in 2020 was the work in conditions of massive incidence of COVID-19, limited and redistribution of human resources. One of the right decisions in these conditions is to organize schools for patients, which allow simultaneous education and convey the necessary information to a large number of people. The key aspects of the organization of telemedicine schools for patients are presented.Objectives:To assess the feasibility of telemedicine schools for patients as a technology of modern health care in rheumatology.Methods:The work was carried out by the method of a one-stage cross-sectional study of the questionnaire survey of participants of education in rheumatology, conducted in an on-line mode. The number of participants in rheumatology schools was 197 people, the results of the questionnaire were received from 36 respondents. The questionnaire based on the Google platform.Results:10 key principles of organizing online patient education at the present stage were identified: the use of distance technologies, the interest of a medical institution administration, the team approach, the technical possibilities of implementing schools, adaptation of lecture material for patients, the role of a specialized specialist in the educational process, patient participation, measurement efficiency and timely correction, development and improvement of educational technology for patients, desire for cooperation and exchange of experience.Conclusion:The emergence of new opportunities related to online health education of the population, including educational activities for patients, opens up new prospects for improving clinical care aimed at promoting health and preventing disease.Disclosure of Interests:None declared

scholarly journals Cavernous angiomas: deconstructing a neurosurgical disease

2019 ◽  
Vol 131 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Issam A. Awad ◽  
Sean P. Polster
Keyword(s):  
Clinical Care ◽  
Cavernous Angioma ◽  
Mendelian Inheritance ◽  
Vascular Lesion ◽  
Developmental Venous Anomaly ◽  
Loss Of Function ◽  
Immune Mediated ◽  
Familial Form ◽  
Disease Behavior ◽  
Key Aspects

Cavernous angioma (CA) is also known as cavernoma, cavernous hemangioma, and cerebral cavernous malformation (CCM) (National Library of Medicine Medical Subject heading unique ID D006392). In its sporadic form, CA occurs as a solitary hemorrhagic vascular lesion or as clustered lesions associated with a developmental venous anomaly. In its autosomal dominant familial form (Online Mendelian Inheritance in Man #116860), CA is caused by a heterozygous germline loss-of-function mutation in one of three genes—CCM1/KRIT1, CCM2/Malcavernin, and CCM3/PDCD10—causing multifocal lesions throughout the brain and spinal cord.In this paper, the authors review the cardinal features of CA’s disease pathology and clinical radiological features. They summarize key aspects of CA’s natural history and broad elements of evidence-based management guidelines, including surgery. The authors also discuss evidence of similar genetic defects in sporadic and familial lesions, consequences of CCM gene loss in different tissues at various stages of development, and implications regarding the pathobiology of CAs.The concept of CA with symptomatic hemorrhage (CASH) is presented as well as its relevance to clinical care and research in the field. Pathobiological mechanisms related to CA include inflammation and immune-mediated processes, angiogenesis and vascular permeability, microbiome driven factors, and lesional anticoagulant domains. These mechanisms have motivated the development of imaging and plasma biomarkers of relevant disease behavior and promising therapeutic targets.The spectrum of discoveries about CA and their implications endorse CA as a paradigm for deconstructing a neurosurgical disease.

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties

2020 ◽  
Vol 29 (4) ◽  
pp. 738-761
Author(s):  
Tess K. Koerner ◽  
Melissa A. Papesh ◽  
Frederick J. Gallun
Keyword(s):  
Hearing Aids ◽  
Questionnaire Survey ◽  
Patient Population ◽  
Clinical Care ◽  
Normal Hearing ◽  
Auditory Training ◽  
Training Methods ◽  
Hearing Sensitivity ◽  
Considerable Benefit ◽  
High Level

Purpose A questionnaire survey was conducted to collect information from clinical audiologists about rehabilitation options for adult patients who report significant auditory difficulties despite having normal or near-normal hearing sensitivity. This work aimed to provide more information about what audiologists are currently doing in the clinic to manage auditory difficulties in this patient population and their views on the efficacy of recommended rehabilitation methods. Method A questionnaire survey containing multiple-choice and open-ended questions was developed and disseminated online. Invitations to participate were delivered via e-mail listservs and through business cards provided at annual audiology conferences. All responses were anonymous at the time of data collection. Results Responses were collected from 209 participants. The majority of participants reported seeing at least one normal-hearing patient per month who reported significant communication difficulties. However, few respondents indicated that their location had specific protocols for the treatment of these patients. Counseling was reported as the most frequent rehabilitation method, but results revealed that audiologists across various work settings are also successfully starting to fit patients with mild-gain hearing aids. Responses indicated that patient compliance with computer-based auditory training methods was regarded as low, with patients generally preferring device-based rehabilitation options. Conclusions Results from this questionnaire survey strongly suggest that audiologists frequently see normal-hearing patients who report auditory difficulties, but that few clinicians are equipped with established protocols for diagnosis and management. While many feel that mild-gain hearing aids provide considerable benefit for these patients, very little research has been conducted to date to support the use of hearing aids or other rehabilitation options for this unique patient population. This study reveals the critical need for additional research to establish evidence-based practice guidelines that will empower clinicians to provide a high level of clinical care and effective rehabilitation strategies to these patients.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

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