scholarly journals Tele-sleep Medicine: An Opportunity in a Crisis

Author(s):  
Nagarajan Ramakrishnan ◽  
Pon Thelac ◽  
Nileena Mana

The countrywide lockdown in India has necessitated healthcare providers consider alternate options for providing care during the COVID-19 pandemic. While there has been a tremendous focus in coping with emergency and inpatient care for COVID-19 related illness, there is also an increasing need to address management of non-communicable disease. The pandemic and the associated lockdown have witnessed the onset or worsening of sleep disorders often related to changing lifestyle, including inactivity, fear of the disease, and generalised anxiety caused by the uncertainty of the future. We propose the term ‘Lockdown Sleep Syndrome’ to describe this grouping of signs and symptoms. The wide coverage and extensive use of smartphones and more importantly, the appropriately timed Telemedicine Practice Guidelines from the Government of India, have made telehealth an attractive option, particularly in specialities such as Sleep Medicine which involves minimal physical examination. The experience of restricting personal visits to the clinic and promoting teleconsultation during the initial fifty days of lockdown is described. It was observed that two thirds of consultations shifted to a telehealth platform, and this was effective in giving satisfactory care and valid prescriptions, including to those outside the city of Chennai. Telemedicine not only helped provide uncompromised care to existing patients but also helped in identifying and managing the onset of new sleep problems with a pattern of signs and symptoms which are described as “Lockdown Sleep Syndrome”.

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029562 ◽  
Author(s):  
Lal B Rawal ◽  
Kie Kanda ◽  
Tuhin Biswas ◽  
Md. Imtiaz Tanim ◽  
Prakash Poudel ◽  
...  

ObjectiveTo explore healthcare providers’ perspective on non-communicable disease (NCD) prevention and management services provided through the NCD corners in Bangladesh and to examine challenges and opportunities for strengthening NCD services delivery at the primary healthcare level.DesignWe used a grounded theory approach involving in-depth qualitative interviews with healthcare providers. We also used a health facility observation checklist to assess the NCD corners’ service readiness. Furthermore, a stakeholder meeting with participants from the government, non-government organisations (NGOs), private sector, universities and news media was conducted.SettingTwelve subdistrict health facilities, locally known as upazila health complex (UHC), across four administrative divisions.ParticipantsParticipants for the in-depth qualitative interviews were health service providers, namely upazila health and family planning officers (n=4), resident medical officers (n=6), medical doctors (n=4) and civil surgeons (n=1). Participants for the stakeholder meeting were health policy makers, health programme managers, researchers, academicians, NGO workers, private health practitioners and news media reporters.ResultsParticipants reported that diabetes, hypertension and chronic obstructive pulmonary disease were the major NCD-related problems. All participants acknowledged the governments’ initiative to establish the NCD corners to support NCD service delivery. Participants thought the NCD corners have contributed substantially to increase NCD awareness, deliver NCD care and provide referral services. However, participants identified challenges including lack of specific guidelines and standard operating procedures; lack of trained human resources; inadequate laboratory facilities, logistics and medications; and poor recording and reporting systems.ConclusionThe initiative taken by the Government of Bangladesh to set up the NCD corners at the primary healthcare level is appreciative. However, the NCD corners are still at nascent stage to provide prevention and management services for common NCDs. These findings need to be taken into consideration while expanding the NCD corners in other UHCs throughout the country.


2018 ◽  
Vol 10 (10) ◽  
pp. 123 ◽  
Author(s):  
Melkamu D. Kassa ◽  
Jeanne Grace

Introduction: Physical exercise is recognized as one component of non-communicable disease prevention, but little attention has been devoted to integrating physical exercise into the Ethiopian healthcare system, with the barriers to its inclusion being unclear. Objectives: The present study explores the bottlenecks to integrate physical exercise into the Ethiopian healthcare system to treat non-communicable disease. Design: A mixed method sequential explanatory design. Setting: Public referral hospitals in Ethiopia. Methodology: Data was collected in two phases among 312 (195 males and 117 females) healthcare professionals. The participants were selected proportionately and randomly from 13 public referral hospitals. Results: Lack of: national coordination to promote physical exercise (t (311) = 69.20, p < .0005), trained physical exercise professionals (t (311) = 14.42, p < .0005); physical exercise guidelines (t (311) = 33.25, p < .0005); training how to prescribe physical exercise by healthcare providers (t (311) = 62.94, p < .0005); information on the health benefits of physical exercise to give to their patients (t (311) = 65.62, p < .0005); and built environment that encourages physical exercise participation (t (311) = 59.64, p < .0005) were identified as barriers. Additionally, built environment, policy, healthcare professionals' lifestyle, demography of healthcare professionals, health information coverage of physical exercise and the hospital physical building were also identified as barriers. Conclusions: Physical exercise appears marginalized from the Ethiopian healthcare system. Healthcare organizations and policy makers could take the cited barriers into consideration to plan, design and integrate physical exercise into the healthcare system to prevent NCDs in Ethiopia.


Author(s):  
K.A. Gertseva ◽  
E.V. Kiseleva ◽  
D.V. Dubov ◽  
A.V. Rudnaya ◽  
Y.R. Gorchkova

Целью исследований стало изучение результатов диспансеризации поголовья собак и установление степени распространения незаразной патологии у безнадзорных собак в условиях приютов г. Рязани. Объектами исследования являлись собаки, принадлежащие приютам МУП Городская служба по контролю за безнадзорными животными . Проблема безнадзорных собак является сложной и многогранной, требующей глубокого комплексного подхода. В ней можно выделить множество составляющих. Это и санитарно-эпидемиологическая опасность популяции безнадзорных животных в городской среде, и опасность агрессивных собачьих стай, и вопрос перепроизводства домашних питомцев (безответственные владельцы выбрасывают ненужных им щенков, тем самым пополняя ряды бродячих животных), и т.п.. В настоящее время на территории города Рязани осуществляет свою деятельность муниципальное бюджетное учреждение Городская служба по контролю за безнадзорными животными . Одной из задач этой службы, а также частных современных приютов для безнадзорных животных, является оказание своевременной ветеринарной помощи с последующей адаптацией, поиск и определение собак на постоянное место жительства в ответственные семьи. Собаки, помимо обязательного проведения лечебно-профилактических мероприятий в отношении заразных инфекционных и паразитарных болезней, нуждаются также и в терапии незаразных патологий. Поэтому оценка распространения незаразной патологии является актуальной задачей для понимания объема необходимой терапии и профилактики обнаруженных болезней у безнадзорных собак, т.к. здоровая собака будет иметь больше шансов на приобретение нового хозяина. Авторами проведена диспансеризация поголовья безнадзорных собак в условиях приютов. Изучена ветеринарная и зоотехническая документация, дан анализ условиям содержания и кормления животных, выявлены основные факторы риска развития незаразной патологии у безнадзорных собак. Выяснили, что численность клинически здоровых животных в условиях приюта МУП Городская служба по контролю за безнадзорными животными составила 84,9 от общего поголовья. Показатели зоогигиенических параметров в приютах соответствовали установленным инструкцией нормам. К основным факторами риска развития незаразной патологии у безнадзорных собак следует отнести несбалансированное кормление, наличие ранговой иерархии в вольерах. Установили, что наиболее частой незаразной патологией безнадзорных собак являются болезни пищеварительной системы, которая составляет 47,8. Своевременное обнаружение и лечение незаразной патологии у безнадзорных собак в быстрые сроки позволит им стать клинически здоровыми, что значительно повышает шансы на приобретение нового хозяина.The aim of the research was to study the results of medical examination of the number of dogs and to establish the degree of spread of non-infectious diseases in neglected dogs in the shelters of Ryazan. The objects of the study were dogs belonging to the shelters of the MUP City service for the control of neglected animals. The problem of stray dogs - is complex and multifaceted, requiring a deep integrated approach. There are many components. This-and sanitary-epidemiological danger of the population of neglected animals in the urban environment, and the danger of aggressive canine flocks, and the issue of overproduction of Pets (irresponsible owners throw out their unwanted puppies, thereby replenishing the ranks of stray animals). Currently in the city of Ryazan carries out its activities municipal budget institution City service for the control of stray animals. One of the objectives of the service, as well as private modern shelters for stray animals is the provision of timely veterinary assistance and then adapt, search and identification of dogs in permanent residence in a responsible family. In addition to the compulsory treatment and preventive measures against communicable infectious and parasitic diseases, dogs also need therapy for non-communicable pathologies. Therefore, the assessment of spread of non-communicable disease is an urgent task for understanding the extent of the necessary therapy and prevention of diseases discovered among street dogs, because a healthy dog will have large chances of acquiring a new host. A medical examination of the number of stray dogs in shelters. The veterinary and zootechnical documentation is studied, the analysis of conditions of the maintenance and feeding of animals is given, the main risk factors of development of non-contagious pathology at neglected dogs are revealed. The leading non-infectious diseases of the livestock of the studied dogs are established.


2020 ◽  
Vol 2 (1) ◽  
pp. 30
Author(s):  
Amelia Ade Anggraini ◽  
Vevi Suryenti Putri ◽  
Zuli Nuranti

Hypertension is a non-communicable disease which is an important health problem throughout the world because its prevalence is quite high and continues to increase and its relationship with cardiovascular disease, stroke, retinopathy, and kidney failure. Based on the assessment conducted through interviews, observations, and distribution of questionnaires obtained data in RT 10 Kelurahan Murni with a total of 47 families and 172 inhabitants of the population of 39 elderly obtained hypertension percentage of 38.7% and 50% of the community if sick only take medication from shop. Counseling activities carried out for 45 minutes with the stages of directing participants to the place to be counseling, opening which was delivered by the moderator, delivering counseling material delivered by the presenter, demonstrating how to make a decoction of celery leaves, evaluating the extension participants, distributing leaflets to participants and documenting activities. The results of counseling 80,56% of participants were able to explain the understanding of hypertension, mention the causes of hypertension, 77,78% mention the signs and symptoms of hypertension, 77,7% explain the prevention of hypertension, 83,33% mention foods that are allowed, 86,11% mention foods that are not allowed, 86,11% can make herbal ingredients using celery leaves.


2019 ◽  
pp. 32-42
Author(s):  
Kristiawan P.A. Nugroho ◽  
Theresia P.E. Sanubari ◽  
Jein Mayasari Rumondor

Hipertensi merupakan Penyakit Tidak Menular (PTM) yang merupakan masalah utama dalam kesehatan masyarakat di Indonesia maupun dunia. Data ProÞ l Kesehatan Kota Salatiga 2014 menyatakan bahwa PTM yang banyak ditemukan di Kota Salatiga adalah hipertensi yaitu sebanyak 62%. Data penderita hipertensi di Puskesmas Sidorejo Lor selama 2 tahun terakhir tercatat sebanyak 319 kasus (2016) dan sebanyak 256 kasus sampa i dengan pertengahan tahun 2017. Tujuan penelitian adalah untuk mengetahui gambaran faktor-faktor yang mempengaruhi perilaku makan penderita hipertensi di wilayah kerja Puskesmas Sidorejo Lor. Metode penelitian menggunakan metode survei observasional dengan pengambilan data yang berupa kuisioner dengan menggunakan jenis penelitian deskriptif kuantitatif. Data yang diperoleh dianalisis menggunakan analisis univariat dan bivariat atau uji korelasi. Kata kunci : perilaku makan, hipertensi, faktor risiko Hypertension is a non-communicable disease (PTM) which is a major problem in public health in Indonesia and the world. Data health proÞ le of the city of Salatiga in 2014 states that non-communicable disease are commonly found in the city of Salatiga is hypertension as much as 62 percent. Data of hypertension patients at Puskesmas Sidorejo Lor during the last 2 years were recorded as many as 319 cases in 2016 dan as many as 256 cases until mid 2017. The purpose of this study was to determine the description of factors that inß uence feeding behavior of hypertension patients in the work area of Puskesmas Sidorejo Lor. This research method using observational survey method with taking data in the form of interviews and questionnaires using quantitative deskriptive research type. The data obtained were analyzed using univariate and bivariate analysis or correlation test. Key Words : eating behavior, hypertension, risk factors


2017 ◽  
Vol 41 (2) ◽  
pp. 207 ◽  
Author(s):  
Yodi Christiani ◽  
Paul Dugdale ◽  
Meredith Tavener ◽  
Julie E. Byles

Objective The aim of the present study was to examine non-communicable disease (NCD) policy formation and implementation in Indonesia. Methods Interviews were conducted with 13 Indonesian health policy workers. The processes and issues relating to NCD policy formation were mapped, exploring the interactions between policy makers, technical/implementation bodies, alliances across various levels and the mobilisation of non-policy actors. Results Problems in NCD policy formation include insufficient political interest in NCD control, disconnected policies and difficulty in multisectoral coordination. These problems are well illustrated in relation to tobacco control, but also apply to other control efforts. Nevertheless, participants were optimistic that there are plentiful opportunities for improving NCD control policies given growing global attention to NCD, increases in the national health budget and the growing body of Indonesia-relevant NCD-related research. Conclusion Indonesia’s success in the creation and implementation of NCD policy will be dependent on high-level governmental leadership, including support from the President, the Health Minister and coordinating ministries. What is known about the topic? The burden of NCD in Indonesia has increased gradually. Nationally, NCD-related mortality accounted for 65% of deaths in 2010. Indonesia is also a country with the highest burden of tobacco smoking in the world. However, the government has not instituted sufficient policy action to tackle NCDs, including tobacco control. What does this paper add? This paper deepens our understanding of current NCD control policy formation in Indonesia, including the possible underlying reason why Indonesia has weak tobacco control policies. It describes the gaps in the current policies, the actors involved in policy formation, the challenges in policy formation and implementation and potential opportunities for improving NCD control. What are the implications for practitioners? An effective NCD control program requires strong collaboration, including between government and health professionals. Health professionals can actively engage in policy formation, for example through knowledge production.


2019 ◽  
Vol 11 (1) ◽  
pp. 8-19
Author(s):  
Crystal Jelita Lumban Tobing

 KPPN Medan II is one of the government organization units at the Ministry of Finance. Where leaders and employees who work at KPPN Medan II always carry out official trips between cities and outside the city. With these conditions, making SPPD documents experiencing the intensity of official travel activities carried out by employees of KPPN Medan II can be said frequently. So that in making SPPD in KPPN Medan II is still using the manual method that is recording through Microsoft Word which in the sense is less effective and efficient. In naming employees who get official assignments, officers manually entering employee data that receives official travel letters are prone to being lost because data is manually written. The web-based SPPD application is built by applying this prototyping method which is expected to facilitate SPPD KPPN Medan II management officers in making SPPD that is effective, efficient, accurate, time-saving, and not prone to losing SPPD data of KPPN Medan II employees who will has made official trips due to the existence of a special database to accommodate all SPPD files.


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