Az elhízás kezelése és megelőzése: táplálkozás, testmozgás, orvosi lehetőségek

Összefoglaló. Az elhízás és következményes megbetegedései fontos népegészségügyi problémát jelentenek hazánkban is. Kezelése komoly szakmai kihívás, ugyanakkor prevenciója eredményesebb lehet. Az elhízott betegekkel leggyakrabban találkozó háziorvosok, más szakorvosok és egészségügyi szakemberek részéről nagy igény van egy viszonylag rövid, áttekinthető, naprakész gyakorlatias útmutatóra. A különböző orvosszakmai társaságokban tevékenykedő, évtizedes szakmai tapasztalatokkal rendelkező szerzők összefoglalják tudományosan megalapozott, bizonyítékokon alapuló ismereteiket. Az elhízás kezelését lépcsőzetesen célszerű megkezdeni, előtte felmérve a beteg motivációját, általános állapotát, lehetőségeit. A szerzők leírják az energiaszükséglet meghatározásával, az étrenddel és a fizikai aktivitás megtervezésével kapcsolatos alapvető szempontokat. Felsorolják a hazánkban elérhető gyógyszereket és metabolikus sebészeti beavatkozásokat, az életmódi támogatás igényét. Az elhízás megelőzésében az élet első 1000 napjának táplálkozása, a későbbiekben a szülői minta a meghatározó. Sok kihasználatlan lehetősége van a háziorvosok, a lakóközösségek, az állami szervek koordinált együttműködésének, helyi kezdeményezéseknek. Az elhízás betegségként való meghatározása egyaránt igényel egészségpolitikai és kormányzati támogatást, az elhízottak ellátására szakosodott multidiszciplináris centrumok számának és kompetenciájának növelését. Orv Hetil. 2021; 162(9): 323–335. Summary. Obesity and related morbidities have a high public health impact in Hungary. The treatment is a challenge, but prevention seems more effective. General practitioners, other specialists and health care professionals who are treating obese persons require short, summarized, updated and practical guideline. Hungarian medical professionals of different scientific societies, having decennial practices, are summarizing their evidence-based knowledge. Obesity management requires step by step approach, evaluating previously the general health condition, motivation and options of the patients. The measurement of energy requirement, planning of diet and physical activities, available surgical methods and medications are described in detail with life style and mental support needed. The most important period in the prevention of obesity is the first 1000 days from conception. Other significant factors are the life style habits of the parents. Proper obesity prevention requires better coordination of primary health care, community and governmental activities. Obesity should be defined as morbidity, therefore stronger governmental support and more health-policy initiatives are needed, beside increasing number and developing of multidisciplinary centres. Orv Hetil. 2021; 162(9): 323–335.

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Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

Qualitative Health Research ◽

10.1177/1049732321998643 ◽

2021 ◽

pp. 104973232199864

Author(s):

Nabil Natafgi ◽

Olayinka Ladeji ◽

Yoon Duk Hong ◽

Jacqueline Caldwell ◽

C. Daniel Mullins

Keyword(s):

Health Care ◽

Health Care Delivery ◽

Health Care Professionals ◽

Care Delivery ◽

Lessons Learned ◽

Community Members ◽

Community Based ◽

Care Community ◽

Care Experience ◽

National Initiative

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

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How Women Evaluate Birth Challenges: Analysis of Web-Based Birth Stories (Preprint)

10.2196/preprints.12206 ◽

2018 ◽

Author(s):

Yasmine L Konheim-Kalkstein ◽

Talya Miron-Shatz ◽

Leah Jenny Israel

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Positive Emotions ◽

Fisher Exact Test ◽

Labor And Delivery ◽

Care Providers ◽

Birth Stories ◽

Care Community ◽

Emotional Appraisal

BACKGROUND Birth stories provide an intimate glimpse into women’s birth experiences in their own words. Understanding the emotions elicited in women by certain types of behaviors during labor and delivery could help those in the health care community provide better emotional care for women in labor. OBJECTIVE The aim of this study was to understand which supportive reactions and behaviors contributed to negative or positive emotions among women with regard to their labor and delivery experience. METHODS We sampled 10 women’s stories from a popular blog that described births that strayed from the plan. Overall, 90 challenging events that occurred during labor and delivery were identified. Each challenge had an emotionally positive, negative, or neutral evaluation by the woman. We classified supportive and unsupportive behaviors in response to these challenges and examined their association with the woman’s emotional appraisal of the challenges. RESULTS Overall, 4 types of behaviors were identified: informational inclusion, decisional inclusion (mostly by health care providers), practical support, and emotional support (mostly by partners). Supportive reactions were not associated with emotional appraisal; however, unsupportive reactions were associated with women appraising the challenge negatively (Fisher exact test, P=.02). CONCLUSIONS Although supportive behaviors did not elicit any particular emotion, unsupportive behaviors did cause women to view challenges negatively. It is worthwhile conducting a larger scale investigation to observe what happens when patients express their needs, particularly when challenges present themselves during labor, and health care professionals strive to cater to them.

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Involuntary automaticity: a work-system induced risk to safe health care

Health Services Management Research ◽

10.1258/095148405774518615 ◽

2005 ◽

Vol 18 (4) ◽

pp. 211-216 ◽

Cited By ~ 49

Author(s):

Brian Toft ◽

Hugo Mascie-Taylor

Keyword(s):

Health Care ◽

Patient Safety ◽

Health Care Professionals ◽

Health Care Organizations ◽

Negative Effects ◽

Care Community ◽

Work System ◽

Skilled Action ◽

Conscious Attention

Automaticity is the term given by psychologists to the skilled action that people develop through repeatedly practising the same activity, for example driving a car. Usually, automaticity is discussed in terms of the benefits it brings to people, such as the reduction in the degree of conscious attention a person needs to pay to such skilled activities. However, there is evidence to suggest that substantial costs may also be associated with such learned behaviour. Managing patient safety is a difficult task and one of the ways in which health-care professionals seek to accomplish it is through the use of verbal challenge-response protocols. However, it is argued in this paper that it is possible for the negative effects of automaticity to involuntarily capture those using such verbal checklist techniques and cause them to erroneously believe that the treatment that they are about to administer to a patient is safe when it is not. This phenomenon does not, however, seem to have been recognized by the health-care community nationally or internationally. We conclude that patient safety could be significantly improved worldwide if the organizational arrangements which appear to induce involuntary automaticity were to be robustly addressed by the management of all health-care organizations.

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Assessing Medical Students’ Knowledge of the Deaf Culture and Community in Puerto Rico: A Descriptive Study.

10.21203/rs.3.rs-27029/v1 ◽

2020 ◽

Author(s):

Andrea Lozano ◽

Michael Kung ◽

Lorena Rivera-González ◽

Yllen Hernández-Blanco ◽

Vicente Covas ◽

...

Keyword(s):

Health Care ◽

Puerto Rico ◽

Medical Students ◽

American Sign Language ◽

Health Care Access ◽

Health Care Professionals ◽

Descriptive Study ◽

Deaf Culture ◽

Medical Setting ◽

Care Community

Abstract Background: Effective communication between health care professionals and Deaf and Hard of Hearing (D&HH) patients remains a challenge. Literature regarding health professionals’ knowledge of the D&HH community and their barriers towards health care access is limited in Puerto Rico and suggests a need for research. Therefore, this descriptive study aims to evaluate future physician’s knowledge about the Deaf culture and community in a student cohort at San Juan Bautista School of Medicine (SJBSM).Methods: A survey utilized in a previous study by Hoang et al. was targeted to 230 medical students to evaluate their knowledge of (D&HH) patients. The survey consisted of three parts testing awareness, exposure, and knowledge of the Deaf community. Responses from the Knowledge section were graded using an answer key, and correct answers were added to create an overall continuous sum score per participant, with higher scores meaning higher knowledge. Participants also were asked to write in possible issues deaf patients may face when hospitalized, excluding communication problems. All data were recorded and used for descriptive analysis.Results: 158 (68%) medical students participated. 63% reported exposure to D&HH people, and 80% were aware of the Deaf culture. 21% of students answered to have attended an American Sign Language (ASL) class, and 86% expressed interest in taking an ASL class. The overall percentage of correct answers of all the medical classes evaluated was 39%, with increasing percent knowledge as medical student year increased. The most frequently listed problem by respondents that deaf patients may face when hospitalized was dealing with an emergency in the hospital, such as the fire alarm.Conclusion: Students from clinical years (MSIII & MSIV) showed a better understanding of the Deaf culture when compared to students in pre-clinical years (MSI & MSII). Nevertheless, knowledge was limited in all groups. The information generated is not only valuable for our school but the health-care community as well. The literature related to Deaf culture, particularly in the medical setting in Puerto Rico, is limited. Therefore, there exists a need to continue investigating ways to improve medical students’ education of the Deaf culture and community.

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(P1-53) Effectiveness of “Understanding Disasters” Training Among Health Care Professionals and Responders in China

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11003852 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s115-s116

Author(s):

C.L.Y. Lin ◽

K. Hung ◽

E.Y.Y. Chan ◽

P.P.Y. Lee

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Essential Role ◽

Response Rate ◽

Human Impacts ◽

Health Impact ◽

Technical Knowledge ◽

Demographic Information ◽

Training Materials ◽

Disaster Knowledge

BackgroundKnowledge about disasters plays an essential role in managing and responding to disasters and emergencies, especially among a group of health care professionals who are actively or will potentially be involved in disaster and emergency settings. A set of training materials that aims to enhance understanding of disasters and their impact of health has been developed. This project aims to examine the effectiveness of the disaster knowledge training to improve technical knowledge and perceptions of health impact of disasters in health care professionals and responders.Methods“Understanding Disasters” training was provided to 300 health care professionals during May to October. Each of the participated attendees filled a pre- and immediate post-training survey that contains socio-demographic information and 20 items measuring various knowledge of disasters.Results287 individuals completed the questionnaires (95% response rate). Findings demonstrated that training may effectively enhance one's knowledge about disasters, especially by clarifying the myths and misunderstandings towards disasters. Respondents demonstrated an enhancement of knowledge in 70% of the questions (14/20). Of note, while the whole sample exhibited an enhancement in knowledge, non-clinical staff appeared to have more statistical significant gained in knowledge than clinical based trainee.ImplicationAlthough disasters cannot be controlled, human impacts of disaster can be mitigated if appropriate training might be offer. This study demonstrates that training program might be useful to enhance better understanding of health impact of disasters.

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Immersive Virtual Reality in Health Care: Systematic Review of Technology and Disease States

JMIR Biomedical Engineering ◽

10.2196/15025 ◽

2019 ◽

Vol 4 (1) ◽

pp. e15025 ◽

Cited By ~ 2

Author(s):

Aaron J Snoswell ◽

Centaine L Snoswell

Keyword(s):

Systematic Review ◽

Health Care ◽

Virtual Reality ◽

Health Care Professionals ◽

Acute Treatment ◽

Feasibility Studies ◽

Health Condition ◽

Health Conditions ◽

Immersive Virtual Reality ◽

Technical Specifications

Background Immersive virtual reality (IVR) presents new possibilities for application in health care. Health care professionals can now immerse their patients in environments to achieve exposure to a specific scene or experience, evoke targeted emotional responses, inspire, or distract from an experience occurring in reality. Objective This review aimed to identify patient-focused applications for head-mounted IVR for acute treatment of health conditions and determine the technical specifications of the systems used. Methods A systematic review was conducted by searching medical and engineering peer-reviewed literature databases in 2018. The databases included PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Association for Computing Machinery, Institute of Electrical and Electronics Engineers, Scopus, and Web of Science. Search terms relating to health and IVR were used. To be included, studies had to investigate the effectiveness of IVR for acute treatment of a specific health condition. IVR was defined as a head-mounted platform that provides virtual and auditory immersion for the participant and includes a minimum of 3 degrees of orientation tracking. Once identified, data were extracted from articles and aggregated in a narrative review format. Results A total of 58 studies were conducted in 19 countries. The studies reported IVR use for 5 main clinical areas: neurological and development (n=10), pain reduction through distraction (n=20), exposure therapy for phobias (n=9), psychological applications (n=14), and others (n=5). Studies were primarily feasibility studies exploring systems and general user acceptance (n=29) and efficacy studies testing clinical effect (n=28). Conclusions IVR has a promising future in health care, both in research and commercial realms. As many of the studies examined are still exploring the feasibility of IVR for acute treatment of health conditions, evidence for the effectiveness of IVR is still developing.

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Genetic Modification and Adverse Societal Effects

Ethics & Medics ◽

10.5840/em20184335 ◽

2018 ◽

Vol 43 (3) ◽

pp. 2-4

Author(s):

Phil Cerroni ◽

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Patient Autonomy ◽

Hippocratic Oath ◽

Human Beings ◽

Care Community ◽

Do No Harm ◽

Genetic Technologies ◽

Physical Abilities

Emerging genetic technologies challenge the relevance of terms the health care community has relied on for centuries. Since the Hippocratic Oath inspired the principle “First, do no harm,” health care professionals have affirmed the curative role of medicine, despite disagreement over concepts like patient autonomy, benefit, and dignity. Before the advent of genetic engineering, man’s ability to improve his cognitive and physical abilities beyond human beings’ species-typical capacities was outside the realm of possibility. This is no longer the case, and our existing vocabulary, which centers on developing and providing cures, does not describe the possibilities introduced by emerging genetic technologies.

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Let’s save our nurses and doctors!

Orvosi Hetilap ◽

10.1556/oh.2014.29956 ◽

2014 ◽

Vol 155 (52) ◽

pp. 2082-2092 ◽

Cited By ~ 1

Author(s):

András Guseo ◽

Annamária Hertelendi

Keyword(s):

Health Care ◽

Body Mass Index ◽

Body Mass ◽

Health Care Professionals ◽

Health Condition ◽

The Body ◽

University Hospital ◽

Cancer Death ◽

Hospital Employees ◽

Department Directors

Introduction: Several studies have shown that healthcare service is a dangerous workplace, but the reasons have been remained unexplained. Aim: The aim of the authors was to obtain data on the health condition of health care professionals and identify the underlying risk factors for the increased morbidity. Method: Health care data obtained from 276 bedside nurses in 2004 and 1250 hospital employees in 2009 were analysed. In addition, the fate of department directors of Szent György University Hospital in Székesfehérvár between 1979 and 2010 was recorded and the data were compared to those obtained from a smaller hospital in Budapest during the same time period. Results: The body mass index of bedside nurses between the age of 30–35 years reached the upper limit of normal (which occurred 5–10 years earlier as compared to the average population) and then it increased continuously above the average value. In hospital employees the increase of body mass index was accompanied by an increase in the frequency of chronic diseases such as hypertension, allergy, thyroid dysfunction, rheumatologic diseases, diabetes, peptic ulcer, cancer and depression. When the cause of death of the department directors who died between 1979 and 2010 was analyzed the authors found that cancer death occurred in 77% and 82% of department directors in Székesfehérvár and Budapest hospitals, respectively, while cancer death rate in 2011 was 25.4% in Hungary. Conclusions: The authors propose that continuous psychological stress, night shifts, nonstop standby and surcharge may all suppress the activity of the immune system. This proposal seems to be supported by novel psycho-neuro-immunological research data. The solution could be early prevention using stress control. Orv. Hetil., 2014, 155(52), 2082–2092.

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Psychological Distress and Coping Strategies among Nurses during the COVID-19 Pandemic: A Cross-Sectional Online Survey

The Open Nursing Journal ◽

10.2174/1874434602115010262 ◽

2021 ◽

Vol 15 (1) ◽

pp. 262-272

Author(s):

Eman K. Alnazly ◽

Anees A. Hjazeen

Keyword(s):

Health Care ◽

Psychological Distress ◽

Coping Strategies ◽

Health Care Professionals ◽

Online Survey ◽

Coping Styles ◽

Careful Study ◽

Cross Sectional ◽

Care Community ◽

Fear And Anxiety

Background: The emergence of COVID-19 has a significant impact on nurse’s overall health. The severity and magnitude of the COVID-19 pandemic means it is extremely likely that health-care professionals will experience psychological distress as a result of their direct contact with patients who have contracted the infection. Objectives: This study aimed to evaluate levels of psychological distress among nurses during the COVID-19 pandemic, determine the associated factors, and identify nurses’ coping strategies. Methods: This study is a cross-sectional design. Overall, 130 nurses answered online questionnaires. The questionnaires measured sociodemographic characteristics, Fear of COVID-19 Scale, the Depression, Anxiety, and Stress Scale, and the Brief Coping Inventory. Results: Nurses have a moderate level of fear (mean score: 24.34 ± 13.43) and depression (43.8% of the sample), and severe anxiety (73.8%) and stress (45.4%). Anxiety and fear were positively correlated (r = .675, p < .001). Independent t-tests revealed that female nurses had higher psychological distress and fear than male nurses (p = 0.015 and p = 0.038, respectively). Nurses who cared for patients who had tested positive for coronavirus disease 2019 and those who had a friend or family member who had tested positive had higher fear and psychological distress than their respective counterparts (p < .001 and p = .010, respectively). Working more hours was moderately correlated with fear and anxiety (p = 0.016). Nurses were found to generally adopt maladaptive coping styles. Conclusion: Through careful study of the factors determined through this research to be associated with psychological distress among nurses, the health-care community can better prepare to mitigate nurses’ emotional and psychological toll in future pandemic situations. Working with patients who have tested positive for COVID-2019 causes psychological distress for nurses.

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Best practices from changing diabetes® in children India

Journal of Social Health and Diabetes ◽

10.4103/2321-0656.187994 ◽

2016 ◽

Vol 04 (02) ◽

pp. 137-140

Author(s):

K. Prasanna Kumar ◽

Nalini Shah ◽

Vijay Viswanathan ◽

Archana Sarda ◽

Shuchy Chugh ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Psychosocial Support ◽

Care Delivery ◽

Diabetes Education ◽

Health Condition ◽

Undiagnosed Diabetes ◽

Common Chronic Disease ◽

The Right

AbstractIt is estimated that India alone has 70,200 cases of T1DM, with an annual increase rate of 3–5%.2 Despite being the most common chronic disease in children and adolescents, T1DM does not receive the attention it requires. Many children die of undiagnosed diabetes or shortly after diagnosis because of poor blood sugar control. Everyone with type 1 diabetes requires insulin from the beginning.3 Continuous management, comorbidities, and chronic complications place a heavy psychological and economic burden on the whole family. Challenges in India are at many levels, right from diagnosis, health-care delivery, availability of trained physicians, infrastructure, insulin, and monitoring and providing psychosocial support. The Changing Diabetes® in Children (CDIC) Programme is a part of Novo Nordisk's Access to Diabetes Care strategy and builds on the undefined cornerstones in the right to health. With an aim to improve the health condition and quality of life of the children with diabetes, this program was started in 2009. Globally, the program is operational in nine underdeveloped and developing countries including India and there are a total of >14,000 children under the care of the CDiC Programme. This global program was launched in India in 2011 by late former President Dr. APJ Abdul Kalam through Novo Nordisk Education Foundation. It has a pan-India footprint with 21 established centers in government hospitals and specialized clinics and >4000 registered children. Apart from providing essential care which includes free doctor consultations, providing insulin, and monitoring insulin, CDiC is also working in other key areas in type 1 management, namely, (1) diabetes education–with specially designed diabetes education tools, for children, parents, siblings, and other caregivers, (2) awareness and capacity building–advertorial series for general public and special accredited trainings for doctors and other health-care professionals, and (3) communication for all stakeholders–periodic CDiC newsletters and Mishti Guardian.

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