scholarly journals Depression and Physical Illnesses: an Update

1970 ◽  
Vol 40 (1) ◽  
pp. 53-58
Author(s):  
MA Mohit ◽  
MM Maruf ◽  
H Ahmed ◽  
MT Alam
Keyword(s):  
Respiratory Diseases ◽  
Recovery Process ◽  
Chronic Illnesses ◽  
Mental Illnesses ◽  
Medical Conditions ◽  
Treatment Regimens ◽  
Care Services ◽  
Primary Care Services ◽  
Almost All

Many chronic illnesses have a strong effect on an individual's mental and emotional status, and, in turn, undiagnosed mental disorders can affect a person's ability to cope with an illness and participate in the treatment and recovery process. Depression is the most common complication of almost all chronic or serious medical conditions. Major depression among persons experiencing chronic medical conditions like cardiovascular diseases, diabetes, respiratory diseases, obesity, cancer etc. increases the burden of their physical illness and somatic symptoms, causing increased functional impairment along with increased medical costs. Depression in long-term illnesses impairs ability for self -care and for maintenance of treatment regimens thus causing increased mortality. Yet, effective treatments, for depression exist. Many factors point to reasons that mental illnesses are not adequately addressed as evidenced by the literatures. Primary care services need to improve ways of identifying depression associated with particular chronic illnesses. we must develop new ways to understand the extent of this mental health problem, and optimal ways to evaluate manage and treat depression in patients with other co-morbid medical conditions. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9966 BMJ 2011; 40(1): 53-58

Hygrothermal Microclimate of Reconstructed Residential Building

2014 ◽  
Vol 1041 ◽  
pp. 307-310
Author(s):  
Mária Budiaková
Keyword(s):  
Relative Humidity ◽  
Questionnaire Survey ◽  
Respiratory Diseases ◽  
Natural Ventilation ◽  
Residential Building ◽  
Experimental Measurements ◽  
Air Humidity ◽  
Respiratory Problems ◽  
Almost All

The paper is oriented on the hygrothermal microclimate of residential interiors in reconstructed building. The questionnaire survey has showed significant increase in number of allergies, respiratory diseases and occurrence of fungi after reconstruction. In order to find causes, experimental measurements of hygrothermal microclimate were carried out. The long term high values of relative humidity were found out and the link with number of efficient natural ventilation was searched for. Ventilation once a day was usual, what was proved as insufficient. Dwellers were informed about right way and number of ventilation. Furthermore, measurements proved decrease of air humidity, but not sufficiently. It was proved that nobody was able to achieve recommended number of ventilation and almost all of them considered it annoying and unreal to sustain. The biggest problem was proved night 7 hour interval. Therefore allergic and respiratory problems were significant in the morning. In conclusions of paper is suggestion for solution of researched problem.

Electronic Patient Records (EPR), Library Services (LS) and Multidisciplinary Team (MDT) Meetings

2017 ◽  
pp. 179-197
Author(s):  
Shahid Muhammad ◽  
Malcolm Rigler ◽  
Meshia Adams
Keyword(s):  
Primary Care ◽  
Multidisciplinary Team ◽  
Library Services ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Long Term Conditions ◽  
Health Records ◽  
Care Services ◽  
Primary Care Services

Patients with Long-Term Conditions (LTCs) account for around 50% of General Practitioner (GP) appointments, 64% of outpatient appointments and 70% of hospital bed days. There needs to be a wider access to knowledge and understanding such as directories with information leaflets, documents, books on lifestyle, helpful contacts and sources to information that can support patients and the general public on the most important elements their health. This cannot be achieved just through patients accessing their health records in sole. The objective of this paper is to 1) highlight the importance of integrating General Practice (GP), Electronic Patient Records (EPR) with Library Services (LS) and 2) also explore why it would be advantageous to implement patient-centred Multidisciplinary Team (MDT) meetings in primary care for patients with Long-Term Conditions (LTCs). This article provides a UK glance and how primary care services can be improved, integrating for the better. Having access to Electronic Patient Records (EPR) alone will not help or encourage a patient to gain confidence and/ or understanding especially if patients are overwhelmed by their healthcare choices and Health Literacy (HL) complexities. Patients' whose first language is not English for example, approaching more methods to support HL is/ will be challenging. Library and Health Services partnerships should be initiated to allowing access to wider resources. In addition, patient-centred Multidisciplinary Team (MDT) meetings should be arranged at dedicated time points between a doctor and patient/ carer and these can take place in a private section within library setting involving wider participation in care plans. Given that more patients and the public will have opportunity to access their health records, a “Libraries and Health” partnership can help integrate primary healthcare better thus allowing all to access health-related literature, using books, leaflets and digital media in a comfortable environment in a setting that also has staff that can support with HL and technology. An EPR and MDT initiative should be supported with library and health partnerships; this needs to be encouraged.

Textbook of Post-ICU Medicine: The Legacy of Critical Care

2014 ◽  
Keyword(s):  
Recovery Process ◽  
Public Health Issue ◽  
Major Public Health Issue ◽  
Psychological Issues ◽  
Treatment Regimens ◽  
Clinical Syndromes ◽  
Stage Renal Disease ◽  
End Stage

Describing the major clinical syndromes affecting ICU survivors, this resource delineates established or postulated biological mechanisms of the post-acute recovery process, and discusses strategies for treatment and rehabilitation to promote recovery in the ICU and in the long term. Many ICU survivors suffer from a range of long-lasting physical and psychological issues such as end stage renal disease, congestive heart failure, cognitive impairment, neuromuscular weakness, and depression or anxiety, which affect their overall quality of life and ability to lead productive lives. This online work discusses the science of the recovery process and the innovative treatment regimens which are helping ICU survivors regain function as they heal following trauma or disease. This lingering burden or 'legacy' of critical illness is now recognized as a major public health issue, with major efforts underway to understand how it can be prevented, mitigated, or treated.

scholarly journals Evaluation of primary care services in Hungary

2020 ◽  
Author(s):  
Imre Rurik ◽  
Zoltán Jancsó ◽  
László Kalabay ◽  
Levente Lánczi ◽  
Lajos Mester ◽  
...  
Keyword(s):  
Primary Care ◽  
Service Level ◽  
Comprehensive Overview ◽  
Process Indicators ◽  
Community Orientation ◽  
Care Services ◽  
Primary Care Services ◽  
Burn Out ◽  
Gate Keeping ◽  
Almost All

Abstract Background. It is a major challenge to show what configurations of primary care(PC) is associated with better outcomes, in terms of quality, equity and costs. The QUALICOPC Study tried to analyse and compare them within 35 countries, using validated questionnaires filled by family physicians/general practitioners (GPs). This paper aims to provide data of the Hungarian-arm of the QUALICOPC Study; to compare some findings to that of other participating countries; to give a comprehensive overview about the recent Hungarian PC system. Methods. Altogether 222 questionnaires were completed by Hungarian GPs, delivered by fieldworkers, in a geographically representative distribution. Results . Financing are based mostly on capitation, with smaller additional compensatory elements and minor quality incentives. The gate-keeping function is weak, although by referrals, the preference of patients is mostly considered. Communication between PC and specialists is often insufficient. Variety of available devices and equipment’s are appropriate. Single handed practices were 87%. Appointment instead of queuing is a new option and become more popular, mainly among better educated and urban patients. GPs are involved in the management of almost all chronic condition of all generations. Half of them estimate their job as still interesting, burn-out symptoms were rarely found. Among the evaluated process indicators, access, continuity, comprehensiveness and coordination were rated as satisfactory, together with equity among health outcome indicators. Financing is not sufficient, therefore many GPs are involved in other earning activities. The increasing shortage of manpower is a major challenge. Conclusions. In the past 2 decades, there was visible improvement at service level and in economic circumstances. Cooperation and communication between different levels of health care provision should be improved, focusing better to community orientation and to preventive services. There is a need for specific primary care oriented guidelines to define the expected tasks of GPs.

scholarly journals Linezolid use for drug-resistant tuberculosis in Georgia: a retrospective cohort study

2020 ◽  
Vol 24 (4) ◽  
pp. 436-443 ◽  
Author(s):  
L. Mikiashvili ◽  
M. Kipiani ◽  
M. C. Schechter ◽  
Z. Avaliani ◽  
N. Kiria ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Retrospective Cohort ◽  
Drug Resistant ◽  
Treatment Regimens ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Country Of Georgia ◽  
Almost All ◽  
Culture Conversion

SETTING: Data on the long-term use of linezolid (LZD) in the treatment of drug-resistant pulmonary tuberculosis (DR-PTB) are limited.OBJECTIVE: To assess safety, tolerability and efficacy of LZD-containing regimens for the treatment of DR-PTB in the country of Georgia.DESIGN: A retrospective study was conducted among DR-PTB patients receiving LZD 600 mg/day as part of newly implemented regimens (bedaquiline or delamanid, repurposed and second-line drugs) from July 2014 to October 2015 in programmatic conditions and following WHO recommendations.RESULTS: One hundred mostly male (82%) patients with a median age of 33 years received LZD. Most patients (77%) had previously been treated for TB; 57% had extensively drug-resistant TB. The median duration of LZD use was 503 days (interquartile range 355–616). LZD-associated adverse events occurred in 12 patients, leading to discontinuation in 4 (2 each due to peripheral neuropathy and cytopenias), and dose reduction to 300 mg/day in 6 cases (4 due to peripheral neuropathy and 2 for cytopenias). Almost all patients (95%) achieved culture conversion and 79% had a successful treatment outcomes.CONCLUSION: Treatment regimens including lengthy LZD use showed fairly good safety and tolerability and were associated with high rates of culture conversion and favorable outcomes.

scholarly journals Psychiatry Residents' Perceptions and Reported Practices in Providing Primary Care

2017 ◽  
Vol 9 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Lisa M. Wehr ◽  
Erik R. Vanderlip ◽  
Patrick H. Gibbons ◽  
Jess G. Fiedorowicz
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Psychiatry Residents ◽  
Medical Conditions ◽  
Residency Programs ◽  
Care Services ◽  
Preventive Counseling ◽  
Primary Care Services ◽  
Primary Care Specialty ◽  
Improve Health

ABSTRACT Background Patients with psychiatric disorders have higher rates of chronic medical conditions and decreased life expectancy. Integrating medical and psychiatric care is likely to improve health outcomes for these patients. Objective This study examined what proportion of psychiatry residents viewed psychiatry as a primary care specialty, how important they felt it was to provide primary care to patients, and how this perception altered self-reported comfort and practice patterns in providing screening and treatment for select general medical conditions. Methods An online survey was sent to current psychiatry residents of US residency programs. Results A total of 268 residents from 40 programs completed the survey (25% response rate), with 55% (147 of 265) of respondents considering psychiatry to be a primary care specialty. Residents who held this opinion gave higher ratings for the importance of providing preventive counseling and reported counseling a higher percentage of patients on a variety of topics. They also reported screening more patients for several medical conditions. Residents who considered psychiatry to be primary care did not report greater comfort with treating these conditions, with the exception of dyslipidemia. The most commonly cited barrier to integrating primary care services was lack of time. Conclusions Residents' perceptions of psychiatry as a primary care field appears to be associated with a higher reported likelihood of counseling about, and screening for, medical conditions in their patients.

scholarly journals Evaluation of primary care services in Hungary: a comprehensive description of provision, professional competences, cooperation, financing, and infrastructure, based on the findings of the Hungarian-arm of the QUALICOPC study

2021 ◽  
Vol 22 ◽  
Author(s):  
Imre Rurik ◽  
Anna Nánási ◽  
Zoltán Jancsó ◽  
László Kalabay ◽  
Levente István Lánczi ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Financial Incentives ◽  
Descriptive Analysis ◽  
Health Care Provision ◽  
Care Provision ◽  
Process Indicators ◽  
Care Services ◽  
Primary Care Services ◽  
Almost All

Abstract Background: Primary health care provision in terms of quality, equity, and costs are different by countries. The Quality and Costs of Primary Care (QUALICOPC) study evaluated these domains and parameters in 35 countries, using uniformized method with validated questionnaires filled out by family physicians/general practitioners (GPs). This paper aims to provide data of the Hungarian-arm of the QUALICOPC study and to give an overview about the recent Hungarian primary care (PC) system. Methods: The questionnaires were completed in 222 Hungarian GP practices, delivered by fieldworkers, in a geographically representative distribution. Descriptive analysis was performed on the data. Findings: Financing is based mostly on capitation, with additional compensatory elements and minor financial incentives. The gate-keeping function is weak. The communication between GPs and specialists is often insufficient. The number of available devices and equipment are appropriate. Single-handed practices are predominant. Appointment instead of queuing is a new option and is becoming more popular, mainly among better-educated and urban patients. GPs are involved in the management of almost all chronic condition of all generations. Despite the burden of administrative tasks, half of the GPs estimate their job as still interesting, burn-out symptoms were rarely found. Among the evaluated process indicators, access, continuity, comprehensiveness, and coordination were rated as satisfactory, together with equity among health outcome indicators. Financing is insufficient; therefore, many GPs are involved in additional income-generating activities. The old age of the GPs and the lack of the younger GPs generation contributes to a shortage in manpower. Cooperation and communication between different levels of health care provision should be improved, focusing better on community orientation and on preventive services. Financing needs continuous improvement and appropriate incentives should be implemented. There is a need for specific PC-oriented guidelines to define properly the tasks and competences of GPs.

De-professionalism as defined by services deemed unconventional, under-performing or ineffectual

2020 ◽  
pp. 121-142
Author(s):  
Nigel Malin
Keyword(s):  
Primary Care ◽  
Critical Care ◽  
Chronic Illness ◽  
Social Care ◽  
Public Spending ◽  
Care Services ◽  
Primary Care Services ◽  
Health And Social Care ◽  
Under Performing

This chapter discusses reports that some hospitals and primary care services are ‘under-performing’ due to a lack of health and social care professionals, particularly in areas like critical care, long-term and chronic illness. Similarly, in schools there are continuing claims that core funding remains a serious issue, that they are struggling to get and keep enough teachers, and standards are threatened as a result. Austerity is an extension of the neo-liberal logic to characterise any form of public spending as ‘unproductive’.

Polypharmacy perspectives in general practice environments

2019 ◽  
Vol 30 (7) ◽  
pp. 342-347
Author(s):  
Gerri Kaufman
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Continuing Professional Development ◽  
Adverse Outcomes ◽  
Practice Nurses ◽  
Care Services ◽  
Primary Care Services ◽  
Medication Reviews ◽  
Funding Cuts

Practice nurses need to keep up-to-date with the latest prescribing guidelines, especially for patients taking multiple medications. Gerri Kaufman discusses some of the challenges facing polypharmacy and considers the roles of deprescription and medicines reviews Polypharmacy refers to the use of multiple medicines. A combination of medicines can be appropriate and beneficial for the patient; however, polypharmacy can also be problematic where the risk of harm outweighs the benefits of treatment. Polypharmacy is associated with increasing age, the presence of multi-morbidities, a culture of single condition guideline-based prescribing, obesity and lower wealth. Managing polypharmacy is a challenge for prescribers working in general practice and primary care. Polypharmacy is associated with adverse outcomes, including adverse drug reactions, falls, increased length of stay in hospital, and mortality. Vigilance around the safer aspects of prescribing, undertaking structured medication reviews and deprescribing are considered important in addressing issues with polypharmacy, and enhancing the management of patients on multiple medicines. Comprehensive guidance is available on the medication review process and deprescribing; however, the process is time-consuming, complex and requires investment. The NHS Long Term Plan put forward proposals to increase investment in primary care services, which include addressing medication safety. Workforce shortages and funding cuts for continuing professional development are both perceived as barriers to its implementation. Both individual prescribers and the systems in which they work are accountable for improving safe medicine use in polypharmacy.

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