scholarly journals Challenges and opportunities for the future Clinical Nutrition Committee in Tartu University Hospitals

2020 ◽  
Vol 28 (2) ◽  
Author(s):  
Liidia Kiisk

Patients of health care and welfare institutions have several accompanying diseases; therefore, the nutritional counsellors’ or dietary nurses’ competence is often insufficient for administering a special diet, but the help of clinical dietologists and physicians of different specialities is necessary. In elaboration of clinical nutrition therapy strategies, their consistent development and coordination, an interdisciplinary clinical nutrition team can be helpful. Raising the nutritional awareness of the staff of structural units of medical and welfare institutions in helps them make rational choices in different disease cases, guaranteeing the patient’s wellbeing and a health care service with maximum benefit and minimum risk for the patient’s health. Physicians and other specialists of Tartu University Hospital (nurses, speech therapists, pharmacists, nutrition counsellors, diabetes nurses) have contributed comprehensively to chronic patients’ individual counselling during hospital treatment and supporting of outpatients’ nutritional treatment. In 2018, an initiative group of physicians of the hospital presented to the hospital’s Executive Board the need for establishing a broad-based expert group of clinical nutrition. With the Executive Board’s decision, a clinical nutrition committee was founded for rendering the nutrition treatment service.

2017 ◽  
Vol 54 (4) ◽  
pp. 445-465 ◽  
Author(s):  
Gesine Sturm ◽  
Zohra Guerraoui ◽  
Sylvie Bonnet ◽  
Françoise Gouzvinski ◽  
Jean-Philippe Raynaud

This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations.


2018 ◽  
Vol 24 (2) ◽  
pp. 188-207 ◽  
Author(s):  
Jari Stenvall ◽  
Tony Kinder ◽  
Paivikki Kuoppakangas ◽  
Ilpo Laitinen

All successful public service innovations require learning and just as importantly and often more deeply, unlearning. This research investigates the unlearning of health professionals focusing on the issue of why and how unlearning happens at an individual level for health care professions in the transition from product logic to service-dominant logic at Tampere University Hospital in Finland. We applied a qualitative single case study method, a problem-centred unlearning framework with a narrative approach, which facilitates understanding of how the informants perceived the service transition process. We identified three distinct unlearning narratives, and we recognised barriers and enablers to unlearning in the health care service culture and context and suggest ways in which these might be overcome. Results of the study shows that deep and radical change in public health care services is possible, by applying distributed leadership and allowing individual actors time for reflections, mind-wandering, listening and learning from users and discourse between professionals.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 380-384
Author(s):  
Priyanka Paul Madhu ◽  
Yojana Patil ◽  
Aishwarya Rajesh Shinde ◽  
Sangeeta Kumar ◽  
Pratik Phansopkar

disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declared the agent as the (SARS-CoV-2) the severe acute respiratory syndrome and the World Health Organization had activated significant surveillance to prevent the spread of this infection across the world. Taking into the account about the rigorousness of COVID-19, and in the spark of the enormous dedication of several dental associations, it is essential to be enlightened with the recommendations to supervise dental patients and prevent any of education to the dental graduates due to institutional closure. One of the approaching expertise that combines technology, communications and health care facilities are to refine patient care, it’s at the cutting edge of the present technological switch in medicine and applied sciences. Dentistry has been improved by cloud technology which has refined and implemented various methods to upgrade electronic health record system, educational projects, social network and patient communication. Technology has immensely saved the world. Economically and has created an institutional task force to uplift the health care service during the COVID 19 pandemic crisis. Hence, the pandemic has struck an awakening of the practice of informatics in a health care facility which should be implemented and updated at the highest priority.


Author(s):  
Sean G. Sullivan

Impulse control disorders (ICDs) and conditions with impulse control features provide a challenge in terms of identification, treatment, and follow-up when mental health specialists are in short supply. Medical settings, in particular the largest, primary health care, provide an opportunity to address many impulse-affected conditions currently poorly assessed and treated in health care settings. Barriers to intervention for ICDs in primary health care are time constraints; understanding of the etiology, symptoms, and appropriate interventions; the health and social costs; and prioritizing of training in and treatment of conditions perceived as more serious or appropriate to a primary health care service. These barriers may possibly be overcome in primary care settings, and in this chapter, a model to address problem gambling is described.


2015 ◽  
Vol 10 (2) ◽  
pp. 61-63 ◽  
Author(s):  
Caroline Voogd ◽  
Madeleine Murphy ◽  
Sophie Gardner

2020 ◽  
pp. 1-10
Author(s):  
Jeremy S. Ruthberg ◽  
Chandruganesh Rasendran ◽  
Armine Kocharyan ◽  
Sarah E. Mowry ◽  
Todd D. Otteson

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p <  0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.


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