scholarly journals Economic and financial crisis based on Troika’s intervention and potentially avoidable hospitalizations: an ecological study in Portugal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cristina Loureiro da Silva ◽  
João Victor Rocha ◽  
Rui Santana
Keyword(s):  
Financial Crisis ◽  
Health Management ◽  
Hypertensive Heart Disease ◽  
Foreign Assistance ◽  
Chronic Obstructive ◽  
Socioeconomic Variables ◽  
Avoidable Hospitalizations ◽  
Use Of Resources ◽  
Tract Infections ◽  
Economic And Financial Crisis

Abstract Background Hospitalisations for Ambulatory Care Sensitive Conditions (ACSC) cause harm to users and to health systems, as these events are potentially avoidable. In 2009, Portugal was hit by an economic and financial crisis and in 2011 it resorted to foreign assistance (“Memorandum of Understanding” (2011–2014)). The aim of this study was to analyse the association between the Troika intervention and hospitalisations for ACSC. Methods We analysed inpatient data of all public NHS hospitals of mainland Portugal from 2007 to 2016, and identified hospitalisations for ACSC (pneumonia, chronic obstructive pulmonary disease, hearth failure, hypertensive heart disease, urinary tract infections, diabetes), according to the AHRQ methodology. Rates of hospitalisations for ACSC, the rate of enrollment in the employment center and average monthly earnings were compared among the pre-crisis, crisis and post-crisis periods to see if there were differences. A Spearman’s correlation between socioeconomic variables and hospitalisations was performed. Results Among 8,160,762 admissions, 892,759 (10.94%) were classified as ACSC hospitalizations, for which 40% corresponded to pneumonia. The rates of total hospitalisations and hospitalisations for ACSC increased between 2007 and 2016, with the central and northern regions of the country presenting the highest rates. No correlations between socioeconomic variables and hospitalisation rates were found. Conclusions During the period of economic and financial crisis based on Troika’s intervention, there was an increase in potentially preventable hospitalisations in Portugal, with disparities between the municipalities. The high use of resources from ACSC hospitalisations and the consequences of the measures taken during the crisis are factors that health management must take into account.

Preliminary results from the COPE study using primary-care electronic health records and environmental modelling to examine COPD exacerbations

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696749 ◽  
Author(s):  
Maimoona Hashmi ◽  
Mark Wright ◽  
Kirin Sultana ◽  
Benjamin Barratt ◽  
Lia Chatzidiakou ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Management ◽  
Practice Research ◽  
Chronic Obstructive ◽  
Clinical Practice Research Datalink ◽  
Health Records ◽  
Preliminary Results ◽  
Copd Exacerbations ◽  
Electronic Health

BackgroundChronic Obstructive Airway Disease (COPD) is marked by often severely debilitating exacerbations. Efficient patient-centric research approaches are needed to better inform health management primary-care.AimThe ‘COPE study’ aims to develop a method of predicting COPD exacerbations utilising personal air quality sensors, environmental exposure modelling and electronic health records through the recruitment of patients from consenting GPs contributing to the Clinical Practice Research Datalink (CPRD).MethodThe study made use of Electronic Healthcare Records (EHR) from CPRD, an anonymised GP records database to screen and locate patients within GP practices in Central London. Personal air monitors were used to capture data on individual activities and environmental exposures. Output from the monitors were then linked with the EHR data to obtain information on COPD management, severity, comorbidities and exacerbations. Symptom changes not equating to full exacerbations were captured on diary cards. Linear regression was used to investigate the relationship between subject peak flow, symptoms, exacerbation events and exposure data.ResultsPreliminary results on the first 80 patients who have completed the study indicate variable susceptibility to environmental stressors in COPD patients. Some individuals appear highly susceptible to environmental stress and others appear to have unrelated triggers.ConclusionRecruiting patients through EHR for a study is feasible and allows easy collection of data for long term follow up. Portable environmental sensors could now be used to develop personalised models to predict risk of COPD exacerbations in susceptible individuals. Identification of direct links between participant health and activities would allow improved health management thus cost savings.

scholarly journals Chronic obstructive pulmonary disease in organized groups

2020 ◽  
Vol 98 (6) ◽  
pp. 36-39
Author(s):  
G. T. Tаshmetovа ◽  
I. V. Liverko
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Toxic Substances ◽  
Upper Respiratory Tract ◽  
Obstructive Pulmonary Disease ◽  
Smoking Exposure ◽  
Upper Respiratory ◽  
Tract Infections

The objective: to study the prevalence of chronic obstructive pulmonary disease (COPD) in adult organized groups, to assess the structure and risk factors of its development.Subjects and methods. 3,000 people of the organized population working at various enterprises in Tashkent aged 20 to 60 years (1,400 (46.7%) women and 1,600 (53.3%) men) underwent the contemporary pulmonological screening.Results. The active pulmonological screening aimed to detect COPD among organized groups has been justified; examination of 3,000 people allowed detecting 198 (6.6%) new patients additionally to 65 cases that were already known at the time of screening. The chances of developing COPD increase with the presence of risk factors such as smoking, exposure to toxic substances and chemicals, and recurrent upper respiratory tract infections.

scholarly journals Levofloxacin: the role and significance in the treatment of lower respiratory tract infections

2017 ◽  
Vol 94 (11) ◽  
pp. 851-860
Author(s):  
Aleksandr I. Sinopal’nikov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Nosocomial Pneumonia ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Minimal Risk ◽  
High Concentration ◽  
Obstructive Pulmonary Disease ◽  
Atypical Pathogens ◽  
Tract Infections

The advent of the first «respiratory» fluoroquinolone in the late 1990s gave rise to a dramatic growth in popularity ofantibiotics of this class. Levofloxacin like other fluoroquinolones is highly active with respect to Gram-positive, Gram-negative, and atypical pathogens including penicillin-resistant strains of Streptococcus pneumoniae. It is recommended for the treatment of community-acquired pneumonia, nosocomial pneumonia, and exacerbations of chronic obstructive pulmonary disease. Levofloxacin is safe and characterized by high bioavailability and high concentration at the site of inflammation. Therapy with its high doses (750 and 1000 mg/day) during 5 days improves the outcome of the treatment due to improved compliance and minimal risk of development of drug resistance. nosocomial pneumonia, exacerbations of chronic obstructive pulmonary disease.

scholarly journals Optimising experimental research in respiratory diseases: an ERS statement

2018 ◽  
Vol 51 (5) ◽  
pp. 1702133 ◽  
Author(s):  
Philippe Bonniaud ◽  
Aurélie Fabre ◽  
Nelly Frossard ◽  
Christophe Guignabert ◽  
Mark Inman ◽  
...  
Keyword(s):  
Experimental Research ◽  
Task Force ◽  
Ex Vivo ◽  
Experimental Models ◽  
Chronic Obstructive ◽  
Ethical Perspective ◽  
Validity Of Results ◽  
Use Of Resources ◽  
Research Recommendations

Experimental models are critical for the understanding of lung health and disease and are indispensable for drug development. However, the pathogenetic and clinical relevance of the models is often unclear. Further, the use of animals in biomedical research is controversial from an ethical perspective.The objective of this task force was to issue a statement with research recommendations about lung disease models by facilitating in-depth discussions between respiratory scientists, and to provide an overview of the literature on the available models. Focus was put on their specific benefits and limitations. This will result in more efficient use of resources and greater reduction in the numbers of animals employed, thereby enhancing the ethical standards and translational capacity of experimental research.The task force statement addresses general issues of experimental research (ethics, species, sex, age,ex vivoandin vitromodels, gene editing). The statement also includes research recommendations on modelling asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, lung infections, acute lung injury and pulmonary hypertension.The task force stressed the importance of using multiple models to strengthen validity of results, the need to increase the availability of human tissues and the importance of standard operating procedures and data quality.

Euro-Atlantic Relations in the XXI Century: Problems and Scenarios

2015 ◽  
Vol 59 (11) ◽  
pp. 31-37
Author(s):  
N. Arbatova
Keyword(s):  
Foreign Policy ◽  
Financial Crisis ◽  
The United States ◽  
Defense Spending ◽  
Main Question ◽  
The Us ◽  
The World ◽  
World Economic ◽  
The Impact ◽  
Economic And Financial Crisis

The Euro-Atlantic relations after the end of the Cold war have been strongly influenced by the impact of three interrelated crises: the existential crisis of NATO, the world economic and financial crisis, and the crisis in the Russia-West relations. The end of bipolarity has changed the threat environment and revealed how different alliance members formulate their threat perception and foreign policy interests. Europe stopped to be the US foreign policy priority. The US pivot to Asia has raised European concerns about American commitments to collective defense. The removal of the threat of a global conflict resulted in the EU initiatives aimed at promoting integration in the field of common security and defense policy (CSDP). Even though the US has officially welcomed a stronger European pillar in NATO, it has become concerned about new approaches that could divide transatlantic partnership and take resources away from military cooperation. At the same time the unilateralist preferences of the Bush administration generated deep political divisions between the United States and the European Union. The world economic and financial crisis contributed to a dangerous gulf between American and European defense spending. The US has complained about the tendency of the alliance’s European members to skimp on defense spending and take advantage of America’s security shield to free ride. In the absence of a clear external threat NATO tried to draft new missions, which were found in NATO’s expansion to the post-Communist space and Alliance’s out of area operations. But these new missions could not answer the main question about NATO’s post-bipolar identity. Moreover, the Kosovo operation of NATO in 1999 fueled Russia’s concerns about NATO’s intentions in the post-Soviet space. The creeping crisis in the Russia-West relations resulted in the Caucasus and Ukrainian conflicts that provided kind of glue to transatlantic relations but did not return them to the old pattern. There can be several representing possible futures lying ahead. But under any scenario EU will be faced with a necessity to shoulder more of the burden of their own security.

Crisis and European Union: Political Aspects

2012 ◽  
pp. 33-42
Author(s):  
N. Arbatova
Keyword(s):  
European Union ◽  
Financial Crisis ◽  
Focal Point ◽  
The European Union ◽  
The World ◽  
The Future ◽  
Systemic Crisis ◽  
World Economic ◽  
The Eu ◽  
Economic And Financial Crisis

The focal point of the article is the future of the European Union that has been challenged by the deepest systemic crisis in its history. The world economic and financial crisis became merely a catalyst for those problems that had existed earlier and had not been addressed properly by the EU leadership. The author argues that the EU crisis can be overcome only by new common efforts of its member-states and new integrationist projects.

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