scholarly journals Innovative Clinical-Organizational Model to Ensure Appropriateness and Quality in the Management of Medical Cannabis: An Italian Regional Case

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1425
Author(s):  
Eleonora Russo ◽  
Clara Cannas ◽  
Maria Susanna Rivetti ◽  
Carla Villa ◽  
Barbara Rebesco
Keyword(s):  
Health Care ◽  
Health Facilities ◽  
Standards Of Care ◽  
Main Role ◽  
Local Health ◽  
Medical Cannabis ◽  
Organizational Model ◽  
Technical Standards ◽  
High Standards ◽  
Set Up

This work focuses on the clinical-organizational model implemented in an Italian region (Liguria) to streamline the access procedures to galenic cannabis preparations. The competent local health care authority that takes care of tracing a virtuous path to obtain common, uniform and shared protocols and ensure high standards of care is A.Li.Sa. (Azienda Ligure Sanitaria), a public organization with the function of coordination, direction and governance of the health care in the regional hospitals and health facilities. To this purpose, different working groups and a board meeting have been set up with the main role to define and develop technical standards to be applied to the prescription, preparation and dispensing of pharmaceutical forms based on therapeutic cannabis. In particular, the galenic preparations provided by the Italian Ministry of Health, described in detail in the regional standard operating protocols, are described and discussed. Moreover, the most significant data monitored from 2018 to 2020 and collected by hospitals and the evaluation of those derived from local pharmacies and health facilities are presented, discussed and compared in regards to their adherence and coherence with the Italian Institute of Health (ISS) data.

The Treatment of Craniosynostosis: An Ethical Perspective

1998 ◽  
Vol 35 (3) ◽  
pp. 212-214 ◽  
Author(s):  
Christopher Ward
Keyword(s):  
Health Care ◽  
Informed Choice ◽  
Standards Of Care ◽  
Ethical Perspective ◽  
Ethical Imperative ◽  
Moral Framework ◽  
Maximum Benefit ◽  
High Standards ◽  
The Right ◽  
Relationship Of

The parents of children with craniofacial deformity have expectations that cannot always be reasonably met in a world of clinical uncertainty. In order to bridge the “reality gap,” the members of the cranofacial team must be open and honest in discussing the known harms and benefits of a proposed treatment, so that a relationship of trust evolves between the health care professional and the patient/parent. It is only through this trust that a truthful implementation of consent, within its moral framework, can be achieved. This, in turn, requires an analysis of the outcomes of the various options for treatment as well as evidence that the cranofacial team is able to provide high standards of care. All this leads to the ethical imperative of respecting the right of parents to make an informed choice and allowing them to see that their child is treated in a way that provides maximum benefit and minimum harm.

scholarly journals Needs assessment and staff education to effect long-term change in emergency medicine in rural Nepal

CJEM ◽  
2004 ◽  
Vol 6 (04) ◽  
pp. 266-270
Author(s):  
Valerie F. Krym ◽  
Russell D. MacDonald
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Needs Assessment ◽  
Care Staff ◽  
Standards Of Care ◽  
Health Care Staff ◽  
Local Health ◽  
Staff Education ◽  
Local Health Care

ABSTRACT Medical work in developing countries is challenging and rewarding. To make a lasting impact on the local community, a health care worker must be willing to listen to the needs of the people. The long-term impact of a needs assessment and staff education on emergency medicine at a rural hospital in Nepal is presented. The Scheer Memorial Hospital is a 102-bed non-governmental, not-for-profit hospital in Banepa, Nepal. Nepalese and ex-patriot health care professionals staff the hospital. Medical supplies are obtained from local manufacturers or as donations from foreign organizations. The hospital waives fees for those who cannot afford care. Two academic emergency physicians with expertise in international health undertook a needs assessment to assist in planning for long-term health care goals related to emergency medicine. The assessment focused on health care planning and education of the local health care staff. Based on interviews and objective assessments, a plan was developed and implemented to address 4 key areas: physical plant, equipment, staff training and essential tasks. Sustainable positive change was accomplished by acknowledging local customs and standards of care, meeting the needs of local health care staff and using available resources.

scholarly journals Bilio-pancreatic endoscopy during COVID-19 pandemic

2020 ◽  
Vol 13 ◽  
pp. 175628482093518
Author(s):  
Vincenzo Bove ◽  
Tommaso Schepis ◽  
Ivo Boškoski ◽  
Rosario Landi ◽  
Beatrice Orlandini ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Physical Distance ◽  
Health Care Facilities ◽  
Standards Of Care ◽  
Unknown Etiology ◽  
Care Providers ◽  
The Public ◽  
Frequent Exchange ◽  
High Standards

On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology detected in Wuhan (Hubei Province of China). In January 2020, a new coronavirus named SARS-CoV2 was isolated and, since that time, SARS-CoV2 related disease (COVID-19) rapidly spread all over the world becoming pandemic in March 2020. The COVID-19 outbreak dramatically affected the public-health and the health-care facilities organization. Bilio-pancreatic endoscopy is considered a high-risk procedure for cross-contamination and, even though it is not directly involved in COVID-19 diagnosis and management, its reorganization is crucial to guarantee high standards of care minimizing the risk of SARS-CoV2 transmission among patients and health-care providers. Bilio-pancreatic endoscopic procedures often require a short physical distance between the endoscopist and the patient for a long period of time, a frequent exchange of devices, the involvement of a large number of personnel, the use of complex endoscopes difficult to reprocess. On this basis, endoscopic units should take precautions with adjusted management of bilio-pancreatic endoscopy. The aim of this article is to discuss the approach to bilio-pancreatic endoscopy in the COVID-19 era with focus on diagnostic algorithms, indications, management of the endoscopic room, proper use of Personal Protective Equipment and correct reprocessing of instrumentation.

scholarly journals Some aspects of primary healthcare in a rural part of Zaire

Afrika Focus ◽  
1985 ◽  
Vol 1 (1-2) ◽  
Author(s):  
Antoon De Schryver
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Whooping Cough ◽  
Respiratory Infections ◽  
Health Problems ◽  
Positive Influence ◽  
Local Health ◽  
Oral Rehydration ◽  
Primary Health ◽  
Set Up

Primary health care during the period 1980-1982 in the sector of Kasongo-Lunda, Zaire is considered. Health infrastructure and main health problems are discussed. These problems were mainly diarrheas, respiratory infections, malaria, tuberculosis, whooping cough, measles, malnutrition and wormrelated diseases. A vaccination programme against diphteria, tetanus, whooping cough, poliomyelitis, measles and tuberculosis was set up and adapted to W.H.O. recommendations in 1981. The incidence of measles and whooping cough declined dramatically during the period 1978-1982. Diarrhea was treated with oral rehydration. About 16% of the children under five years of age suffered from malnutrition, mostly related to worm diseases ; therefore, a suppressive dose of antihelminthics was given every three months. These results show that local health centers, concerned with everyday health problems of the population, can have a strong positive influence upon the general health situation of a rural population. KEYWORDS : primary health care, expanded programme of immunisation, measles, whooping cough, diarrhea, tuberculosis, malnutrition, wormdiseases 

Health Practices and Indices of a Poor Urban Population in Indonesia Part I: Patterns of Health Service Utilization

1994 ◽  
Vol 7 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Katherine Kaye ◽  
Michael K Novell
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Urban Poverty ◽  
Health Care Service ◽  
Standards Of Care ◽  
Local Health ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

This first section in a two-part study of health indices and practices among residents living in a Jakarta slum describes the use of public and private primary health care services in relation to socioeconomic and health status. As problems associated with urban poverty rapidly increase in developing countries, it is important to study the ethnic and economic diversity which exists in slums and shanty towns: results of such studies should inform the development of effective strategies for outreach and service delivery. Through a survey of 690 mothers and 593 children, we found that 1) poorer residents were more likely than relatively affluent ones to rely on local government clinics ( posyandus) for primary health care; 2) regular posyanduusers were more likely than non-users to be fully immunized and to use ORT correctly; 3) delivery in hospital w as common among all residents, but especially among the more affluent; and 4) prevalence of contraception was high and not associated with socio-economic status or type of primary health care service used. Strengthening primary health care services at the government's local health posts could benefit all groups in the community if wealthier residents participated more in the posyandus. Standards of care in the private sector should also be improved. Asia Pac J Public Health 1994;7(3):178-82.

scholarly journals THE STUDY OF AVAILABILITY OF DRUGS’ CIRCULATION FOR DIFFERENT CONTINGENTS OF PATIENTS AT THE LEVEL OF PRIMARY MEDICAL AND SANITARY ASSISTANCE

2020 ◽  
pp. 87-94
Author(s):  
S. I. Zbrozhek
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Family Medicine ◽  
Discrete Series ◽  
Regional Level ◽  
Health Facilities ◽  
Outpatient Clinics ◽  
Local Health ◽  
Primary Health

Introduction. In the context of the coronavirus pandemic, the urgency of the development of primary health care in the light of the organization of access to medicines for different categories of patients at the primary level is becoming one of the main directions of reforming and developing the health care system in Ukraine. Its goal is to improve the quality and efficiency of medical care, increase the availability of medicines, and preserve and promote human health. Materials and methods. Grouped outpatient clinics of general practice of family medicine on the example of Kharkiv region according to certain features according to the Sturgess formula with the subsequent construction of discrete series of variations and the distribution polygon. Results. The conducted content analysis of the districts of the region allowed to determine the quantitative indicators of outpatient clinics of general practice of family medicine in the study period and to distribute them by groups. Discussion. Conducted the study concerning the organization of accessibility of circulation of medicines for the population through primary health care according to the current legislation by outpatient clinics of general practice of family medicine. The latter, within their competence based on family medicine, provide a set of preventive measures to prevent and reduce morbidity, disability and mortality, early detection of diseases, are responsible for creating a regulatory range of drugs and more. In turn, the study found that most health facilities are located in nine districts at the regional level, which are included in three groups. Conclusions. The study showed a tendency to increase the outpatient clinics of general practice of family medicine in nine districts of the regional level. Placed an emphasis on the need for further research on the areas of the regions to establish a correlation between the population living permanently in the area and the number of local health facilities.

Covid-19 and its financial effects on the dental fraternity and health-care workers: A literature review

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 628-631
Author(s):  
Devangi Agrawal ◽  
Namisha Khara ◽  
Bhushan Mundada ◽  
Nitin Bhola ◽  
Rajiv Borle
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Care Providers ◽  
Dental Procedures ◽  
Care Workers ◽  
Dental Practices ◽  
Precautionary Measures ◽  
The Government ◽  
Set Up

In the wake of the current outbreak of novel Covid-19, which is now declared as a 'pandemic' by the WHO, people around the globe have been dealing with a lot of difficulties. This virus had come into light in December 2019 and since then has only grown exponentially. Amongst the most affected are the ones who have been working extremely hard to eradicate it, which includes the hospitals, dental fraternity and the health-care workers. These people are financially burdened due to limited practise. In the case of dentistry, to avoid the spread of the virus, only emergency treatments are being approved, and the rest of the standard procedures have been put on hold. In some cases, as the number of covid cases is rising, many countries are even trying to eliminate the emergency dental procedures to divert the finances towards the treatment of covid suffering patients. What we need to realise is that this is probably not the last time that we are facing such a situation. Instead of going down, we should set up guidelines with appropriate precautionary measures together with the use of standardised PPEs. The government should also establish specific policies to support dental practices and other health-care providers. Together, we can fight this pandemic and come out stronger.

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
South African ◽  
Access To Health Care ◽  
Health Facilities ◽  
Hiv Positive ◽  
The South ◽  
Hiv Positive Women ◽  
Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

scholarly journals Health care network for chronic conditions: an intervention and evaluation in the health system

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C S Cardoso ◽  
N R Baldoni ◽  
C F Melo ◽  
L O Rezende ◽  
K Noronha ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Chronic Conditions ◽  
Panel Study ◽  
Health Indicators ◽  
Institutional Capacity ◽  
Local Health ◽  
Care Network ◽  
Health Care Network

Abstract Background Health assessments are necessary for the (re) formulation of effective public policies and to guarantee the quality of care offered. This study aim to evaluate the perception of health professionals concerning the institutional capacity of the health system to care for Chronic Conditions (CC) after intervention in a medium-sized municipality in Minas Gerais, Brazil. Methods It is a panel study with evaluation before, during and after an intervention in the health system with a focus on three CC, i.e., i) diabetes; ii) hypertension; and iii) pregnant women. Health care professionals from primary and specialized care units were interviewed using the Assessment of Chronic Illness Care (ACIC) scale, which was applied in nine focal groups organized by health care unit. Results A total of 240 professionals participated of this evaluation, being 94, 63 and 82 participants in 2013, 2015 and 2018 respectively. The ACIC scores showed an positive evolution in the capacity of the health system to care for CC over the years. In the first wave the global score was 5.40 (basic capacity), while in the third wave the score was 9.38 (optimal capacity), with a significant increase in the scores (p < 0.01). Conclusions An important gain in the institutional capacity of the municipality was evidenced for the care of chronic conditions after intervention in the health system. Such an enhancement of the health system to operate in the CC might be sustainable over the time. Furthermore, its impact may directly reflect on the health indicators of the population. Key messages The results showed a strengthening of the local health system. These findings can subsidize other municipalities with a similar reality in the organization of the health care network and, consequently improve the care provided to chronic conditions.

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