scholarly journals COVID-19 pandemic, the scarcity of medical resources, community-centred medicine and discrimination against persons with disabilities

2021 ◽  
pp. medethics-2020-107198
Author(s):  
Nicola Panocchia ◽  
Viola D'ambrosio ◽  
Serafino Corti ◽  
Eluisa Lo Presti ◽  
Marco Bertelli ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Poor Quality ◽  
Ethical Theories ◽  
Medical Resources ◽  
Medical Treatments ◽  
Persons With Disabilities ◽  
Ethical Problems ◽  
Medical Paradigm ◽  
Guidelines And Recommendations

This research aims to examine access to medical treatment during the COVID-19 pandemic for people living with disabilities. During the COVID-19 pandemic, the practical and ethical problems of allocating limited medical resources such as intensive care unit beds and ventilators became critical. Although different countries have proposed different guidelines to manage this emergency, these proposed criteria do not sufficiently consider people living with disabilities. People living with disabilities are therefore at a higher risk of exclusion from medical treatments as physicians tend to assume they have poor quality of life, whereas access to medical treatment should be based on several parameters, including clinical data and prognosis. However, the COVID-19 pandemic shifts the medical paradigm from person-centred medicine to community-centred medicine, challenging the main ethical theories. We reviewed the main guidelines and recommendations for resources allocation and examined their position toward persons with disabilities. Based on our findings, we propose criteria for not discriminating against people with disabilities in allocating resources. The shift from person-centred to community-centred medicine offers opportunities but also risks sacrificing the most vulnerable people. The principle of reasonable accommodation must always be considered to guarantee the rights of persons with disabilities.

scholarly journals ‘Quality of Life’ of Persons with Disability: An Assessment in Selected Flood Prone Areas of Bangladesh

2017 ◽  
Vol 1 (1) ◽  
pp. 1-21
Author(s):  
Mir Hasan Shakil Mahmud ◽  
Md. Abul Kalam Azad
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Quantitative Research ◽  
Structured Interview ◽  
Poor Quality ◽  
Persons With Disabilities ◽  
Prone Area ◽  
Post Disaster ◽  
Flood Prone Areas

The present study is on “Quality of Life” of person with disabilities living in flood prone areas of Bangladesh. In this aspect the specific objectives have been designed to determine the effects of disaster on physical and psychological health and social relationship between disabilities and community. The study has also assessed the adaptive capacity of persons with disabilities during and post-disaster period and find out the challenges faced by the persons with disabilities during disaster and post disaster that undermining their quality of life. In the determination of quality of life of PWDs in the selected flood prone area in Bangladesh a mixed method incorporating both qualitative and quantitative research approaches was used to conduct this study by using the tools of observation, case study, and face to face semi structured interview, with PWDs in Northern district of Gaibandha. The study shows that out of 110 respondent, nearly 63 per cent required assistance, while over 38 per cent respondent are required partial assistance, and 20 percent are required supervision. The study reveals that more than 9 per cent of the respondents maintains very poor quality of life while 20 per cent are maintaining poor quality of life, nearly 34 per cent respondents are identified their life neither poor or nor good in selected area.

scholarly journals Updated Understanding of the Degenerative Disc Diseases - Causes Versus Effects - Treatments, Studies and Hypothesis

2020 ◽  
Vol 21 (6) ◽  
pp. 464-477
Author(s):  
Cristian Muresanu ◽  
Siva G. Somasundaram ◽  
Margarita E. Neganova ◽  
Elena V. Bovina ◽  
Sergey V. Vissarionov ◽  
...  
Keyword(s):  
Complete Recovery ◽  
Research Strategies ◽  
Medical Treatments ◽  
Degenerative Disc ◽  
Biological Transformation ◽  
Medical Paradigm ◽  
The Mind

Background: In this review we survey medical treatments and research strategies, and we discuss why they have failed to cure degenerative disc diseases or even slow down the degenerative process. Objective: We seek to stimulate discussion with respect to changing the medical paradigm associated with treatments and research applied to degenerative disc diseases. Method Proposal: We summarize a Biological Transformation therapy for curing chronic inflammations and degenerative disc diseases, as was previously described in the book Biological Transformations controlled by the Mind Volume 1. Preliminary Studies: A single-patient case study is presented that documents complete recovery from an advanced lumbar bilateral discopathy and long-term hypertrophic chronic rhinitis by application of the method proposed. Conclusion: Biological transformations controlled by the mind can be applied by men and women in order to improve their quality of life and cure degenerative disc diseases and chronic inflammations illnesses.

scholarly journals Globalization, medical travel and healthcare management in Bangladesh

2016 ◽  
Vol 14 (2) ◽  
pp. 360-375 ◽  
Author(s):  
Muhammad Mahboob Ali ◽  
Anita Medhekar
Keyword(s):  
Medical Treatment ◽  
Low Cost ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Poor Quality ◽  
Healthcare Management ◽  
Medical Travel ◽  
Medical Facilities ◽  
Quality Of Nursing

There is an increasing evidence of people from Bangladesh travelling to neighboring countries of Asia, such as India, Thailand, Malaysia and Singapore for medical treatment due to poor quality of healthcare services, high cost, and non-availability of speciality medical treatment and facilities. Medical travel is a practise where patients travel to other countries for diagnostic, pathological and complex invasive surgeries due to various push factors in their home country which prevents them for getting affordable, accessible and accredited quality of medical treatment in a timely manner, due to high cost of surgery, uninsured, long waiting period, non-availability of treatment, lack of medical facilities and proper care, lack of trained doctors and nurses, ethical and regulatory reasons, corruption and inadequate public or private medical facilities. This study is based on qualitative and quantitative analysis to examine why people are travelling from Bangladesh to India for medical treatment. Quantitative data were randomly collected from six divisional cities of Bangladesh: Dhaka, Chittagong, Sylhet, Rajshai, Barisal and Khulna and two districts Comilla and Bogra. A total of 1282 participants, out of 1450 returned the questionnaires. Data were analyzed using regression analysis. The results concluded that the pull factors that motivated Bangladeshis to travel to India for medical treatment were: low cost of surgery, qualified experienced doctors, quality of nursing care, non-availability of treatment in Bangladesh, and state of the art medical facilities and treatment in India, which concurs with the literature

scholarly journals Expert Assessment of Typical Problems in Medical Treatment of Patients with Bronchial Asthma

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Alsim Kharisov ◽  
Aleksey Bereznikov ◽  
Evgeniya Berseneva ◽  
Sergey Shkitin ◽  
Maxim Efimov ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Bronchial Asthma ◽  
Medical Practice ◽  
Adverse Outcomes ◽  
Expert Assessment ◽  
Medical Treatments ◽  
General Medical Practice ◽  
The Future ◽  
Quality Of Medical Care

The purpose of the study is to identify typical problems in medical treatment of patients with bronchial asthma and to assess how it effects the future course of the disease. Experts in «general medical practice», «pulmonology», «therapy» conducted an examination. On the basis of the expert examinations, typical problems in medical treatments have been identified and classified. The most significant violations affecting the course of the disease and the formation of adverse outcomes in bronchial asthma have been identified. The results of the study can be used to develop a methodology for assessing the quality of medical care and predicting the future course of the disease in patients with bronchial asthma.

scholarly journals A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial

2015 ◽  
Vol 19 (88) ◽  
pp. 1-118 ◽  
Author(s):  
Janesh K Gupta ◽  
Jane P Daniels ◽  
Lee J Middleton ◽  
Helen M Pattison ◽  
Gail Prileszky ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Medical Treatment ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Randomised Trial ◽  
Clinical Effectiveness ◽  
Health Technology ◽  
Medical Treatments

BackgroundHeavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment is limited.ObjectivesTo assess the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena®, Bayer) compared with usual medical treatment, with exploration of women’s perspectives on treatment.DesignA pragmatic, multicentre randomised trial with an economic evaluation and a longitudinal qualitative study.SettingWomen who presented in primary care.ParticipantsA total of 571 women with HMB. A purposeful sample of 27 women who were randomised or ineligible owing to treatment preference participated in semistructured face-to-face interviews around 2 and 12 months after commencing treatment.InterventionsLNG-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined oestrogen–progestogen or progesterone alone). Women could subsequently swap or cease their allocated treatment.Outcome measuresThe primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) assessed over a 2-year period and then again at 5 years. Secondary outcomes included general quality of life (QoL), sexual activity, surgical intervention and safety. Data were analysed using iterative constant comparison. A state transition model-based cost–utility analysis was undertaken alongside the randomised trial. Quality-adjusted life-years (QALYs) were derived from the European Quality of Life-5 Dimensions (EQ-5D) and the Short Form questionnaire-6 Dimensions (SF-6D). The intention-to-treat analyses were reported as cost per QALY gained. Uncertainty was explored by conducting both deterministic and probabilistic sensitivity analyses.ResultsThe MMAS total scores improved significantly in both groups at all time points, but were significantly greater for the LNG-IUS than for usual treatment [mean difference over 2 years was 13.4 points, 95% confidence interval (CI) 9.9 to 16.9 points;p < 0.001]. However, this difference between groups was reduced and no longer significant by 5 years (mean difference in scores 3.9 points, 95% CI –0.6 to 8.3 points;p = 0.09). By 5 years, only 47% of women had a LNG-IUS in place and 15% were still taking usual medical treatment. Five-year surgery rates were low, at 20%, and were similar, irrespective of initial treatments. There were no significant differences in serious adverse events between groups. Using the EQ-5D, at 2 years, the relative cost-effectiveness of the LNG-IUS compared with usual medical treatment was £1600 per QALY, which by 5 years was reduced to £114 per QALY. Using the SF-6D, usual medical treatment dominates the LNG-IUS. The qualitative findings show that women’s experiences and expectations of medical treatments for HMB vary considerably and change over time. Women had high expectations of a prompt effect from medical treatments.ConclusionsThe LNG-IUS, compared with usual medical therapies, resulted in greater improvement over 2 years in women’s assessments of the effect of HMB on their daily routine, including work, social and family life, and psychological and physical well-being. At 5 years, the differences were no longer significant. A similar low proportion of women required surgical intervention in both groups. The LNG-IUS is cost-effective in both the short and medium term, using the method generally recommended by the National Institute for Health and Care Excellence. Using the alternative measures to value QoL will have a considerable impact on cost-effectiveness decisions. It will be important to explore the clinical and health-care trajectories of the ECLIPSE (clinical effectiveness and cost-effectiveness of levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia) trial participants to 10 years, by which time half of the cohort will have reached menopause.Trial registrationCurrent Controlled Trials ISRCTN86566246.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 88. See the NIHR Journals Library website for further project information

Outcome and quality of life after central pulmonary embolism: surgical embolectomy versus medical treatment

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
A Kadner ◽  
F Recher ◽  
FF Immer ◽  
J Schmidli ◽  
H Tevaearai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Embolism ◽  
Medical Treatment ◽  
Surgical Embolectomy

An experience of performing spirometry by trained general practitioners

2020 ◽  
pp. 34-36
Author(s):  
M. A. Pokhaznikova ◽  
E. A. Andreeva ◽  
O. Yu. Kuznetsova
Keyword(s):  
General Practitioners ◽  
Quality Criteria ◽  
Poor Quality ◽  
Male Gender ◽  
Study Research ◽  
The Poor ◽  
Quality Of Research ◽  
Forced Expiratory Maneuver ◽  
Maximal Effort

The article discusses the experience of teaching and conducting spirometry of general practitioners as part of the RESPECT study (RESearch on the PrEvalence and the diagnosis of COPD and its Tobacco-related aetiology). A total of 33 trained in spirometry general practitioners performed a study of 3119 patients. Quality criteria met 84.1% of spirometric studies. The analysis of the most common mistakes made by doctors during the forced expiratory maneuver is included. The most frequent errors were expiration exhalation of less than 6s (54%), non-maximal effort throughout the test and lack of reproducibility (11.3%). Independent predictors of poor spirogram quality were male gender, obstruction (FEV1 /FVC<0.7), and the center where the study was performed. The number of good-quality spirograms ranged from 96.1% (95% CI 83.2–110.4) to 59.8% (95% CI 49.6–71.4) depending on the center. Subsequently, an analysis of the reasons behind the poor quality of research in individual centers was conducted and the identified shortcomings were eliminated. The poor quality of the spirograms was associated either with the errors of the doctors who undertook the study or with the technical malfunctions of the spirometer.

KUALITAS HIDUP PASIEN STROKE DI POLIKLINIK RAWAT JALAN RUMAH SAKIT SWASTA YOGYAKARTA

2019 ◽  
Vol 7 (3) ◽  
pp. 232-237
Author(s):  
Hana Larasati ◽  
Theresia Titin Marlina
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Hemorrhagic Stroke ◽  
Poor Quality ◽  
Social Dimension ◽  
Stroke Patients ◽  
Sampling System ◽  
Post Stroke ◽  
Psychological Dimension

Background: stroke is a disorder of nervous system function that occurs suddenly and is caused by brain bleeding disorders that can affect the quality of life physical dimensions, social dimensions, psychological dimensions, environmental dimensions. Based on the result of Lumbu study (2015) the number of samples were 71 people collected data using the (WHOQOL-BREF). There were 56 people (78,9%) had the poor quality of life of post stroke. The mean of post-stroke quality of life domain was physical domain (45,27%), psychological domain (49,87%), social relations domain (48,15%) and environmental domain (50.01%). Objective: the purpose of the study was know the quality of life of the stroke patients in Outpatient Polyclinic of Private Hospital in Yogyakarta. Methods: used descriptive quantitative by using questionnaire test of purposive sampling system based on patients who have been affected of ischemic or hemorrhagic stroke before, number 30 respondents. Result: quality of life of stroke patient of medium physical dimension (67%), psychological dimension (71%), social dimension (67%), dimension good environment (63%). Conclusion: the quality of life of stroke patients of physical dimension, psychological dimension, and moderate social dimension, while the quality of life of stroke patients were good environmental dimension.   Keywords: Hemorrhagic stroke, ischemic stroke, quality of life

YEAR 2020: ON THE REMAINING REPRODUCTIVE THREATS AND THEIR NEUTRALIZATION ON THE WAYS TO IMPROVE STRATEGIC PLANNING AND INDUSTRIAL POLICY, THE DEPLOYMENT OF THE NATIONAL INNOVATION SYSTEM AND ITS SECTORAL AND REGIONAL SUBSYSTEMS

2020 ◽  
pp. 3-53
Author(s):  
Yu.B. Vinslav
Keyword(s):  
Strategic Planning ◽  
Industrial Policy ◽  
Innovation System ◽  
Poor Quality ◽  
National Innovation System ◽  
State Regulation ◽  
Industrial Complex ◽  
The Past ◽  
Technological Modernization

The article analyzes the main indicators of the evolution of the domestic economy and its industrial complex in the past year (in January — November 2019). It Identifies trends in this evolution, including negative trends that determine the preservation of reproductive threats in 2020: sluggishness, instability and low quality of economic growth. The main reasons for the fact that the objective resource capabilities of the macro level were clearly not used enough to effectively solve the urgent problems of technological modernization of the economy and increase people’s welfare are established. The main reason is the poor quality of public administration, including imperfect strategic planning and industrial policy; there is still no modern national innovation system in the country. Accordingly, recommendations for improving the quality of state regulation in its specified components are justified. The recommended measures, according to the author, will help the economy to move to a trajectory of rapid, sustainable and high-quality growth.

Gender and Regional Differences in the Life Expectancy in Russia

2020 ◽  
Vol 27 (1) ◽  
pp. 106-120 ◽  
Author(s):  
L. A. Rodionova ◽  
E. D. Kopnova
Keyword(s):  
Drinking Water ◽  
Alcohol Consumption ◽  
Life Expectancy ◽  
Gender Gap ◽  
Poor Quality ◽  
Living Conditions ◽  
Regional Differentiation ◽  
Russian Regions ◽  
Poor Nutrition

The relevance of the chosen topic is closely related to the development of a system for monitoring the implementation of the May Presidential Decree (2018) to increase life expectancy and improve the quality of life of the population. It has been stated that despite the positive dynamics of life expectancy over the past decade, Russia still has a huge regional differentiation (16,6 years for women, 18,2 years for men in 2016) and an average gender gap - 10,6 years. The choice of factors affecting the gender gap in life expectancy in Russian regions is supported by a conclusion most common in foreign studies that climatic conditions, living conditions, the quality of food and drinking water, alcohol consumption are essential components of public health and life expectancy.The article provides an overview of studies on assessment factors of life expectancy, presents the authors’ approach to identifying gender gaps in life expectancy, living conditions, and lifestyle affecting the indicator of life expectancy. The paper presents the results of a comparative analysis of gender gap in life expectancy in Russia and foreign countries. The paper studies the correlation between living conditions and lifestyle, and life expectancy.Classification of the regions by the life expectancy at birth for men and women is an important component of this study. The authors used Rosstat data for 2016 and the k-means method to select three clusters of Russian regions taking into account gender, living conditions and lifestyle. The paper identifies similar health problems of the regions that are associated with alcohol consumption, poor nutrition and poor quality of drinking water, poor housing and living conditions. The lowest life expectancy rates for men and women are recorded in regions of the 1st cluster (Jewish Autonomous Region, Republic of Tuva, Chukotka Autonomous Area). High mortality rates are a result of external causes. There is a poor quality of drinking water and poor nutrition, excessive alcohol consumption, and inadequate housing conditions.Based on the obtained results were determined possible reserves for reducing the gender and regional differentiation of life expectancy.

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