scholarly journals To study the prescriptions of the bed-head tickets of inpatients of the selected depts. of JNIMS hospital about the appropriateness of the prescriptions in geriatric patients

2017 ◽  
Vol 6 (11) ◽  
pp. 2707
Author(s):  
Oinam Joychandra Singh ◽  
Surbala L. ◽  
S. Losica R. K.
Keyword(s):  
Old Age ◽  
Health Care Providers ◽  
Geriatric Patients ◽  
Age Group ◽  
Inappropriate Prescription ◽  
Care Providers ◽  
Start Criteria ◽  
Stopp Criteria ◽  
The Status ◽  
Inappropriate Prescriptions

Background: Polypharmacy is an increasing problem among the health care providers. This happened during the management of old age people with much comorbidity and weak functioning of the vital organs like heart, lungs and kidneys, etc. Over and above this, self-medication and adverse drug effects of using many drugs are the causes of polypharmacy. Age 65 years or above is considered as Geriatric.Methods: 550 case sheets or Bed head tickets of the inpatients of selected departments were examined for a period of three months. 434 bed head tickets having discharge slips with written prescriptions of 5 or more drugs were re-examined as it fulfilled the criteria of Polypharmacy or inappropriate prescriptions. Demographic data, clinical and drug history were recorded in the prepared data sheet. These data were studied as per guidelines of the tools-Beer’s criteria, STOPP criteria, START criteria, MAI criteria.Results: Accordingly, the reasons for polypharmacy and inappropriate prescriptions were elicited. The common drugs mostly prescribed are antibiotics and NSAIDs preparations. The status of polypharmacy or inappropriate prescription were more in the age group of 65-75 years and also mainly among the male geriatric patients. The maximum number of comorbidity was observed in the age group 65-75 years.Conclusions: As per the criteria of the tools, the number of overprescribing was 70 (19.15%), inappropriate prescription as 17 (4.6%). For prevention and decreasing the incidence of polypharmacy or inappropriate prescriptions, the tools (Beer’s criteria, STOPP criteria, START criteria, MAI criteria) are nowadays put forward to the prescriber as a guideline of good and appropriate prescription. Therefore, the present study can find out the status of prescription i.e. under-prescription, over-prescription, avoid prescription and inappropriate prescription. Hence, the study can draw the attention of the prescribers before and during prescribing drugs to the patients particularly old age patients.

scholarly journals Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide

2020 ◽  
Vol 16 (1) ◽  
pp. 79-87
Author(s):  
Meaghan Lunney ◽  
Aminu K. Bello ◽  
Adeera Levin ◽  
Helen Tam-Tham ◽  
Chandra Thomas ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Kidney Failure ◽  
Low Income Countries ◽  
Multidisciplinary Teams ◽  
Spiritual Support ◽  
Care Providers ◽  
The Status ◽  
Kidney Health

Background and objectivesPeople with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality.Design, setting, participants, & measurementsThe Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management.ResultsRespondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery.ConclusionsOverall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.

Systematic Review of Preventing Suicide in Old Age: 2005–2010

2011 ◽  
Vol 26 (S2) ◽  
pp. 2020-2020
Author(s):  
C.A. de Mendonça Lima ◽  
R.M. Rodrigues
Keyword(s):  
Health Care ◽  
Old Age ◽  
Health Care Providers ◽  
The Elderly ◽  
Educational Interventions ◽  
List Type ◽  
Care Providers ◽  
Individual Level ◽  
Survivors Of Suicide ◽  
Somatic Disorders

Suicide is a typical phenomenon of the elderly and mainly among men. Besides the importance of suicide in terms of public health there is fewer interest to prevent suicide in old age. This can be explained by stigma, poor evaluation of the dimension of the problem and lack of politic will.Suicide prevention and the care of survivors of suicide depend on the mental health network of care. Interventions to reduce suicide can be made at individual level and at level of the development of policies and strategies. The detection of the persons at risk of suicide and the management of the suicide attempt are two main strategies to prevent suicide. Both received recently an important support from WHO with its publication mhGAP Intervention Guide which was conceived to be used in non-specialized health-care settings by health-care providers working at first- and second-level facilities. It includes guidance on evidence-based interventions to make the diagnosis and manage a number of priority conditions, including suicide.Our review of the literature pointed to the necessity to develop additional research to determine:•the role of somatic disorders as precipitant factor;•the role on suicide of the pre-morbid personality, cognitive functioning, social support and recent and chronic stressing events;•the participation of normal and pathological ageing on the expression of the suicide behavior;•the biological markers of suicide in old age;•the potential impact on suicide rates of educational interventions for the general public and for caregivers.

Unprofessional Practice? The Status and Power of Sport Physicians

2006 ◽  
Vol 23 (4) ◽  
pp. 376-395 ◽  
Author(s):  
Dominic Malcolm
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Sports Medicine ◽  
Rugby Union ◽  
Care Providers ◽  
The Status ◽  
Limited Power ◽  
Peculiar Character ◽  
Using Data ◽  
Workplace Setting

In this article I examine the role and working practice of rugby union club doctors in England. While medicine is widely perceived to be one of the most powerful professions in Western societies, sociologists of sport have argued that sport clinicians often wield relatively limited power over their athlete-patients. In this article I therefore attempt to shed further light on the “peculiar” character of sports medicine. Using data drawn from interviews and questionnaires, I argue that this phenomenon can be understood only by looking at the structure of the sports medicine profession, the specificities of the rugby club as a workplace setting, and the relationships club doctors have with clients (coaches and athletes) and other health care providers (physiotherapists).

scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

scholarly journals Cervix Uteri Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Countries From Different Regions in the World

2022 ◽  
Vol 29 ◽  
pp. 107327482110686
Author(s):  
Najla A. Lakkis ◽  
Mona H. Osman ◽  
Reem M. Abdallah
Keyword(s):  
Middle East ◽  
Incidence Rate ◽  
Health Care Providers ◽  
Sexual Behaviors ◽  
Temporal Trends ◽  
Cervix Uteri ◽  
Age Group ◽  
Care Providers ◽  
Annual Percent Change ◽  
Western Asia

Background Invasive cervix uteri cancer is the fourth most common malignancy in women globally. This study investigates the incidence and trends of cervix uteri cancer in Lebanon, a country in the Middle East, and compares these rates to regional and global ones. Methods Data on cervix uteri were obtained from the Lebanese national cancer registry for the currently available years 2005 to 2016. The calculated age-standardized incidence and age-specific rates were expressed as per 100,000 population. Results From 2005 to 2016, cervix uteri cancer was the tenth most common cancer among women. Its age-standardized incidence rate fluctuated narrowly between 3.5 and 5.7 per 100,000, with the lowest rate in 2013 and the highest rate in 2012. The age-specific incidence rate had 2 peaks, the highest peak at age group 70–74 years and the second at age group 50–59 years. The annual percent change (+.05%) showed a non-statistically significant trend of increase. The age-standardized incidence rate of cervix uteri cancer in Lebanon was comparable to that of the Western Asia region that has the lowest incidence rate worldwide. The rate was intermediate as compared to other countries in the Middle East and North Africa Region and relatively similar to the ones in Australia, North America, and some Western European countries. Conclusion The incidence rates of invasive cervix uteri are low in Lebanon. This could be attributed to the low prevalence of human papilloma virus infection and other sexually transmitted infections among Lebanese women, and the opportunistic screening practices. It is important to adopt a comprehensive approach to decrease the potential burden of cervix uteri, especially with the rising patterns of risky sexual behaviors. This includes improving awareness, enhancing access to preventive services, developing clinical guidelines, and training health care providers on these guidelines.

scholarly journals Kawasaki Disease Hospitalization: Outcomes in Two Tertiary Care Hospitals in Bangladesh

2018 ◽  
Vol 43 (3) ◽  
pp. 143-148
Author(s):  
Nurun Nahar Fatema Begum ◽  
Abdul Ali Mia ◽  
Mamun Mostafi ◽  
Khaleda Akhter ◽  
Mahbuba Sultana ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Health Care Providers ◽  
Disease Incidence ◽  
Tertiary Care ◽  
Cervical Lymphadenopathy ◽  
Military Hospital ◽  
Age Group ◽  
Care Providers

Kawasaki disease (KD) is an acute self-limiting inflammatory disease associated with vasculities, affecting predominantly medium sized vessels and encountered these cases infrequently in clinical practice. The most concerning complication is coronary artery aneurysm (CAA) leading to myocardial infarction or sudden death. Fever is the essential feature. Kawasaki disease is invariably associated with an inflammatory process with elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count. Early recognition and treatment with IVIG (Intravenous venous immunoglobulin), and Aspirin showed highest protection against development of coronary artery disease. Incidence of KD is more in East Asia or in Asian ancestry living in other countries. The reason for high incidence in developing country is still unknown. Recently a significant number of cases attended in day to day practice which led conducting this study to assess the pattern of presentation, management and outcome after treatment and to aware the health care providers about the nature of the disease. This observational study conducted during September 2014 to March 2016. All the cases reported to the department of paediatric echocardiography for coronary artery analysis and suspected as KD were included in the study. History, clinical examination and investigation reports were analyzed from records. Age, gender, clinical feature, management, follow-up, echocardiography findings and outcome were analyzed. Data were collected from records of Echocardiography Department and Paediatric Cardiology Department of Lab Aid Cardiac Hospital and Combined Military Hospital, Dhaka. Among 27 cases, 16 were male (49.25%) and 11 were female (40.75%). Age distribution showed 8 (29.63%) were under one year of age, 13(48.14%) were in 1-5 years age group, 6 (22.23%) were in more than 5 years age group. All 27 cases were presented with fever, strawberry tongue, conjunctivitis, skin rash with peeling. Raised ESR, CRP and neutrophilic leukocytosis were found in all 27 cases. Cervical lymphadenopathy was found in 15 (55.52%) cases. Coronary artery changes were observed in 24 cases (88.89%). IVIG was given in 25 (92.60%) cases and Aspirin was given in 27 cases. Complete cure was achieved in 25 (92.59%) cases and one case died from thrombo-embolic event of radial artery and amputation of hand. The outcome of KD depends on the severity of coronary artery involvement. Patients with aneurysm larger than 08 mm are at highest risk of myocardial infarction. Less than 08 mm aneurismal dilatation regress with time. In this series outcome was excellent due to timely diagnosis and proper intervention.

Association between Social Media Use and Depressive Symptoms: A Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Hee Yun Lee ◽  
Yan Luo ◽  
Cho Rong Won ◽  
Jiyoung Lee ◽  
Jeongwon Baik
Keyword(s):  
Social Media ◽  
Depressive Symptoms ◽  
Social Comparison ◽  
Health Care Providers ◽  
Age Groups ◽  
Social Networking Site ◽  
Age Group ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Health Purpose

BACKGROUND The use of social media or social networking site (SNS) is increasing across all age groups, and one of the primary motives of using SNS is to seek health-related information. Previous research shows inconclusive results regarding the effect of SNS use on depression, as social comparison that individuals experience while using SNS increases the likelihood of depression. But other argues the beneficial use of SNS in managing mental health. OBJECTIVE Our study aims to explore the relationship between SNS use for health purpose and depression across the four age groups (18-34 years old, 35-49 years old, 50-64 years old, and above 65 years old). METHODS A sample of 6,789 adults aged 18 and older was extracted from a 2017 and 2018 Health Information National Trends Survey (HINTS). Univariate and bivariate analyses to examine the association between each variable and four age groups were conducted. Multiple linear regression analyses to predict depression level among participants with use of SNS for health purpose were conducted. RESULTS SNS use for health purpose and depression were positively associated for all age groups with strongest association among the youngest group (=.113, P<.001). Income and self-reported health status indicated an inverse relationship for all age groups, while race and marital status differed by age group. Gender and frequency of visiting health care providers predicted higher level of depression depending on age group, such as positive association among 35-49 years old group (=.076, P<.05; =.077, P<.05, respectively). CONCLUSIONS Overall, SNS users may be susceptible to social comparison. Age-tailored interventions educating on healthy SNS use along with identifying individuals with existing depressive symptoms through assessment of SNS use pattern are needed.

Common Rheumatic Diseases in the Elderly

2018 ◽  
Author(s):  
Nisha J. Manek ◽  
George Muñoz
Keyword(s):  
Health Care Providers ◽  
Rheumatic Diseases ◽  
Multidisciplinary Approach ◽  
Geriatric Patients ◽  
The Elderly ◽  
Evidence Base ◽  
Care Providers ◽  
Comorbid Conditions ◽  
Integrative Therapies ◽  
Perfect Storm

With increasing longevity, the prevalence and impact of rheumatic diseases are projected to rise dramatically in the coming decades. Common rheumatic diseases such as osteoarthritis typically arise among the elderly. For diseases such as rheumatoid arthritis and gout, patients diagnosed at earlier ages carry the burden into their later years. Gout is associated both with comorbid conditions whose prevalence rises with age as well as with medications commonly prescribed in older people. These factors, along with the unique challenges associated with optimal diagnosis and treatment of arthritides in the elderly, suggest we can expect a “perfect storm” of health challenges for older patients and their health care providers. The chapter reviews the most common rheumatic diseases in geriatric patients and the evidence base for complementary and integrative therapies. In most cases, a multidisciplinary approach is beneficial.

A Systematic Review of Studies of the STOPP/START 2015 and American Geriatric Society Beers 2015 Criteria in Patients ≥ 65 Years

2019 ◽  
Vol 12 (2) ◽  
pp. 121-154 ◽  
Author(s):  
Roger E. Thomas ◽  
Bennett C. Thomas
Keyword(s):  
Data Availability ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Start Criteria ◽  
Hospitalised Patients ◽  
Stopp Criteria ◽  
Prescribing Omissions ◽  
Changes Over Time ◽  
Community Patients ◽  
Inappropriate Prescriptions

Background: Polypharmacy remains problematic for individuals ≥65. Objective: To summarise the percentages of patients meeting 2015 STOPP criteria for Potentially Inappropriate Prescriptions (PIPs), 2015 Beers criteria for Potentially Inappropriate Medications (PIMs), and START criteria Potential Prescribing Omissions (PPOs). Methods: Searches conducted on 2 January 2019 in Medline, Embase, and PubMed identified 562 studies and 62 studies were retained for review. Data were abstracted independently. Results: 62 studies (n=1,854,698) included two RCTs and 60 non-randomised studies. For thirty STOPP/START studies (n=1,245,974) average percentages for ≥1 PIP weighted by study size were 42.8% for 1,242,010 community patients and 51.8% for 3,964 hospitalised patients. For nineteen Beers studies (n = 595,811) the average percentages for ≥1 PIM were 58% for 593,389 community patients and 55.5% for 2,422 hospitalised patients. For thirteen studies (n=12,913) assessing both STOPP/START and Beers criteria the average percentages for ≥1 STOPP PIP were 33.9% and Beers PIMs 46.8% for 8,238 community patients, and for ≥ 1 STOPP PIP were 42.4% and for ≥1 Beers PIM 60.5% for 4,675 hospitalised patients. Only ten studies assessed changes over time and eight found positive changes. Conclusions: PIP/PIM/PPO rates are high in community and hospitalised patients in many countries. RCTs are needed for interventions to: reduce new/existing PIPs/PIMs/PPO prescriptions, reduce prescriptions causing adverse effects, and enable regulatory authorities to monitor and reduce inappropriate prescriptions in real time. Substantial differences between Beers and STOPP/START assessments need to be investigated whether they are due to the criteria, differential medication availability between countries, or data availability to assess the criteria.

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