scholarly journals Ocular foreign bodies: evolution of professional roles and public costs in Quebec

2021 ◽  
Vol 83 (2) ◽  
pp. 9-15
Author(s):  
Benoit Tousignant ◽  
Drissa Moriba Coulibaly ◽  
Julie Brûlé ◽  
Jacques Gresset
Keyword(s):  
Health Insurance ◽  
Healthcare Costs ◽  
Foreign Bodies ◽  
Family Physicians ◽  
Significant Trend ◽  
Public Healthcare ◽  
Regression Slopes ◽  
Apparent Shift ◽  
Public Costs ◽  
Almost All

Purpose In 2003, Quebec optometrists were legally enabled to extract superficial ocular foreign bodies, with part of this service covered by the universal health insurance. This study analyses the evolution of roles for professionals managing this condition (optometrists, ophthalmologists, emergency physicians and family physicians) and the related public healthcare costs. Methods Data from the provincial health insurance were combined to demographic and annual healthcare workforce statistics. Across professions and sociosanitary regions, variations in annual rates of conditions treated were calculated, as well as variations in public healthcare costs. Linear regression slopes of these variations were used as indicators of linear trends. Results Between 2010 and 2016, the proportion of cases managed by optometrists increases from 32% to 44%, following a significant trend (p < 0.007). For family physicians, the proportion of cases managed decreases from 49% to 33%, following a significant trend (p < 0.0001). The increase in optometrists managing cases is visible in almost all sociosanitary regions, reaching +19%. A significant trend was observed for increasing healthcare costs for optometrists (p < 0.008) and ophthalmologists (p < 0.004) and for decreasing healthcare costs for family physicians (p < 0.001). In 2016, optometrists managed 44% of cases, representing 13% of related healthcare costs. Conclusion In Quebec, optometrists are now the professionals managing the largest proportion of superficial ocular foreign bodies, across the province. There is an apparent shift from the proportion of cases managed by family physicians, which have similarly decreased.

scholarly journals Evidence-Based Medicine in judicial decisions concerning right to healthcare

2016 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Eduardo Rocha Dias ◽  
Geraldo Bezerra da Silva Junior
Keyword(s):  
Health Insurance ◽  
Evidence Based Medicine ◽  
Private Health Insurance ◽  
Scientific Evidence ◽  
Federal Court ◽  
Public Healthcare ◽  
Evidence Based ◽  
Unified Health System ◽  
The Individual ◽  
Based Medicine

ABSTRACT Objective To analyze, from the examination of decisions issued by Brazilian courts, how Evidence-Based Medicine was applied and if it led to well-founded decisions, searching the best scientific knowledge. Methods The decisions made by the Federal Courts were searched, with no time limits, at the website of the Federal Court Council, using the expression “Evidence-Based Medicine”. With regard to decisions issued by the court of the State of São Paulo, the search was done at the webpage and applying the same terms and criterion as to time. Next, a qualitative analysis of the decisions was conducted for each action, to verify if the patient/plaintiff’s situation, as well as the efficacy or inefficacy of treatments or drugs addressed in existing protocols were considered before the court granted the provision claimed by the plaintiff. Results In less than one-third of the decisions there was an appropriate discussion about efficacy of the procedure sought in court, in comparison to other procedures available in clinical guidelines adopted by the Brazilian Unified Health System (Sistema Único de Saúde) or by private health insurance plans, considering the individual situation. The majority of the decisions involved private health insurance plans (n=13, 68%). Conclusion The number of decisions that did consider scientific evidence and the peculiarities of each patient was a concern. Further discussion on Evidence-Based Medicine in judgments involving public healthcare are required.

CAUSES OF CONFLICTS IN DENTAL PRACTICE, WAYS TO PREVENT AND RESOLVE THEM

2021 ◽  
Vol 67 (5) ◽  
pp. 7
Author(s):  
T.A. Luzgina ◽  
◽  
O.A. Tsyganova ◽  
Keyword(s):  
Rural Areas ◽  
Health Workers ◽  
Professional Activity ◽  
Public Healthcare ◽  
Material Base ◽  
Dental Practice ◽  
Conflict Communication ◽  
Conflict Situations ◽  
Almost All

Significance: the number of conflicts related to realization of the right to health and medical care especially in such specific branch of medicine as dentistry has recently been on the rise in Russia. Furthermore, among the main fields of social interaction, a large number of interpersonal conflicts does relate to professional activity. Subject of research: conflicts and conflict situations in dental practice. Purpose of work: to identify main groups of causes of conflict situations and conflicts in dental practice and suggest ways to prevent and resolve them. Material and methods: questionnaire survey of dentists with additional interview of the respondents, mathematical and statistical data analysis using the SPSS Statistics software (Pearson chi-square tests, Kruskal-Wallis tests). Results: The majority of the respondents (59.0%) say that they have never had any conflicts with the administration. The leading cause of disagreement is dissatisfaction with the material base and supplies (35%). The prevailing share of the dentists (61.5%) indicate that conflicts between them and a colleague / nurse have never occurred. The main cause of the conflict communication is insubordination or lack of subordination, especially in rural areas and public facilities. Doctors of public healthcare facilities and dentists working in rural areas were more often in conflict with a colleague or manager. Almost all health workers (98%) note that they have encountered conflict patients. The main cause of the conflict communication is long waiting for a dental appointment (33.3%). Out of all factors influencing the relationship, about half of the respondents (53.0%) mentioned the emotional state of the patient. Out of all behavior strategies in conflicts, the majority of dentists (44%) prefer cooperation. Conclusion: Almost all (98%) dentists came into conflict with the patient. The main causes of these conflicts included: long waiting times for admission (33.3%), irrational work of the registry, the administrator (23.1%) and complaints about the quality of services (22.2%). Medical workers with average work experience (10-29 years) were more likely to conflict with the patient about claims to the quality of treatment (31.3%).

scholarly journals Off to a good start after a cancer diagnosis: implementation of a time out consultation in primary care before cancer treatment decision

2019 ◽  
Vol 14 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Eveline A. Noteboom ◽  
Niek J. de Wit ◽  
Ingrid J. E. M. van Asseldonk ◽  
Monique C. A. M. Janssen ◽  
Wai Yee Lam-Wong ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Family Physicians ◽  
Treatment Decision ◽  
Added Value ◽  
Structured Interviews ◽  
Time Out ◽  
Almost All ◽  
Care Path

Abstract Purpose Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians’ and specialists’ strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a “time out consultation” (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM. Methods For patients with metastatic lung or gastro-intestinal cancer, a TOC was introduced in their care path in a southern region of The Netherlands, from April until October 2016. Uptake of a TOC was measured to reflect on facilitation of continuity of primary care. The added value for SDM and overall experiences were evaluated with questionnaires and semi-structured interviews among patients, family physicians, and specialists. Results Of the 40 patients who were offered a TOC, 31 (78%) had a TOC. Almost all patients, family physicians, and specialists expressed that they experienced added value for SDM. This includes a stimulating effect on reflection on choice (expressed by 83% of patients) and improved preparation for treatment decision (75% of patients). Overall added value of a TOC for SDM, only evaluated among family physicians and specialists, was experienced by 71% and 86% of these physicians, respectively. Conclusion and Implications for Cancer Survivors The first experiences with a TOC in primary care before cancer treatment decision suggest that it may help to keep the GP “in the loop” after a cancer diagnosis and that it may contribute to the SDM process, according to patients, family physicians, and specialists.

scholarly journals Nanotechnology in Battle against CoViD-19: The Prevention, Diagnosis, and Treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 2637-2645
Keyword(s):  
Detection Methods ◽  
Public Healthcare ◽  
The Novel ◽  
Healthcare Organizations ◽  
Dangerous Situation ◽  
Global Pandemic ◽  
Protection Devices ◽  
The Many ◽  
Novel Coronavirus ◽  
Almost All

People worldwide are experiencing the most dangerous situation concerning the novel severe acute respiratory syndrome known as coronavirus-2 (SARS-CoV-2), commonly referred to as the novel coronavirus disease-2019 (CoViD-19). Since late December 2019, an epidemic of coronavirus disease 2019 (CoViD-19) occurred in Wuhan, China, and rapidly spread to almost all parts of China. With the growing global burden of the CoViD-19 pandemic, scientists, researchers, and healthcare-related organizations constantly work for a viable vaccine or therapeutics, scalable detection methods, personal protection devices, and novel effective medical solutions. Nanotechnology has recently considerably addressed the many clinical and public healthcare issues that have emerged from the CoViD-19 pandemic. The main focus of this current review article is to explore the possibility and potential of nanotechnology to combat this global pandemic and ongoing mitigation techniques and strategies. Furthermore, novel nanotechnology-based products are currently being developed for the prevention, diagnostic, treatment of CoViD-19, which various researchers or healthcare organizations invent.

scholarly journals Natural regime of streamflow trends in Macedonia

Geografie ◽  
2018 ◽  
Vol 123 (1) ◽  
pp. 1-20
Author(s):  
Ivan Radevski ◽  
Svemir Gorin ◽  
Milena Taleska ◽  
Olgica Dimitrovska
Keyword(s):  
Significant Trend ◽  
Southern Europe ◽  
Significance Level ◽  
Seasonal Trends ◽  
Sen’S Slope ◽  
Single Positive ◽  
Almost All ◽  
Positive Significant Trend ◽  
Streamflow Trend ◽  
Streamflow Trends

This study investigates the annual and seasonal trends of minimum, mean and maximum streamflow, analyzed on 13 gauges/streams with natural regime, predominantly mountainous and homogeneously distributed in the studied area. The varying period of at least 40 years is used in the analysis. After the pre-whitening TFPW method was applied, the Mann-Kendall and Sen’s slope tests were used for trend testing. The analysis detects significant decreasing trends in the country (according to a = 0.1 significance level). In general, the streamflow shows levels of decrease in almost all streams with lower or higher magnitude (from 0.1 to 0.01). The results provide a unique assessment of streamflow trends in the country and the current findings are consistent with those in other regions of Europe, especially in Southern Europe. Significant trends of decrease have been found in each of the 13 streamflow gauges throughout Macedonia without a single positive significant trend. The test confirmed the general decreasing streamflow trend in the country; even the stations without any significant decreasing results are generally heading downward.

Obamacare repeal would roil US insurance markets

2017 ◽  
Keyword(s):  
Health Insurance ◽  
Healthcare Costs ◽  
Health Insurance Scheme ◽  
Insurance Markets ◽  
Lower Income ◽  
Donald Trump ◽  
Insurance Scheme ◽  
Content Type ◽  
The Future

Significance Republican lawmakers and President Donald Trump are seeking to coordinate efforts to repeal former President Barack Obama's signature legislation, which has been a locus of conservative opposition since 2009, and devise a health insurance scheme more to their liking. Impacts Democratic divisions over the future of the ACA are only likely to emerge if Republicans engage with the Senate minority. Healthcare costs are likely to eat into the income of and shape spending by lower-income households. Democrats could try to embarrass Ryan if frustrated House Republicans try to vacate his speakership.

scholarly journals Risiko Impfen?

2019 ◽  
Vol 144 (04) ◽  
pp. 254-261
Author(s):  
Frank Kowalzik ◽  
Fred Zepp
Keyword(s):  
Political Institutions ◽  
Disease Risk ◽  
Family Physicians ◽  
Subjective Perception ◽  
Decision Confidence ◽  
Individual Perception ◽  
Vaccination Recommendations ◽  
Vaccination Decision ◽  
Almost All ◽  
Individual Disease

AbstractSkepticism about vaccination is not new, but the perception of vaccine-related risks has changed in recent decades. In addition to aspects such as knowledge about vaccines, trust in medical care structures and political institutions, socio-economic, cultural and religious views also play an important role. These factors differ significantly worldwide and regionally. In almost all surveys, confidence in vaccines and/or the healthcare system is identified as essential for a positive vaccination decision. Confidence in vaccines correlates with the assessment of the specific individual disease risk and the potential side effects of the vaccines. Subjective perception of risk seldom corresponds to objectively measurable facts. Rather, it is distorted by individual perception in both directions (underestimation and overestimation). Transparent, science-based communication is helpful in promoting and maintaining trust in healthcare. Pediatricians and family physicians are the most important confidants for parents on questions about health care and vaccination recommendations.

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