scholarly journals The evaluation of anaemia in an older primary care population: retrospective population-based study

BJGP Open ◽  
2017 ◽  
Vol 1 (4) ◽  
pp. bjgpopen17X101157
Author(s):  
David McCartney ◽  
Brian Shine ◽  
Deborah Hay ◽  
Daniel S Lasserson
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Blood Count ◽  
Iron Status ◽  
World Health Organisation ◽  
Population Based ◽  
World Health ◽  
Full Blood Count ◽  
Mean Cell Volume ◽  
Normocytic Anaemia

BackgroundAnaemia is common in older people and the identification of potentially reversible haematinic deficiencies relies on appropriate investigation, often undertaken in primary care.AimTo determine the laboratory prevalence of anaemia, the types of anaemia observed, and the biochemical and haematological investigations undertaken to characterise any associated haematinic abnormality in older primary care patients.Design & settingA retrospective primary care based study of patients aged >65 years undergoing a full blood count in Oxfordshire, UK between 1 January 2012 and 31 December 2013.MethodConsecutive patients aged >65 years with a full blood count were identified retrospectively from a laboratory database. Patient demographics, number of blood tests and additional laboratory investigations requested were recorded. World Health Organisation (WHO) criteria were used to define anaemia.ResultsIn total 151 473 full blood counts from 53 890 participants were included: 29.6% of patients were anaemic. The majority had a normocytic anaemia (82.4%) and 46.0% of participants with anaemia had no additional investigations performed. The mean haemoglobin was lower in the anaemic group that underwent further investigation than those who did not (Hb 10.68 g/dl versus 11.24 g/dl, P<0.05): 33.2 % of patients with a microcytic anaemia (mean cell volume <80) did not have any markers of iron status measured.ConclusionA large proportion of older adults in primary care with a recent blood test are anaemic, the majority with a normocytic anaemia, with evidence of inadequate investigation. Those with lower haemoglobin are more likely to be further investigated. Further work is needed to understand the approach to anaemia in older adults in primary care.

scholarly journals Can Haematological Indices Predict Positive Findings at Endoscopy in Anaemic Patients?

2007 ◽  
Vol 89 (3) ◽  
pp. 221-225
Author(s):  
AMP Schizas ◽  
R Reid ◽  
ML George
Keyword(s):  
Cell Volume ◽  
Blood Cells ◽  
Blood Count ◽  
Haematological Parameters ◽  
Full Blood Count ◽  
Mean Cell Volume ◽  
Upper Gi ◽  
Significant Difference ◽  
Significant Pathology ◽  
Haematological Indices

INTRODUCTION Patients with anaemia are commonly referred for bidirectional endoscopy. The aim of this study was to determine if any haematological parameters could predict positive findings at endoscopy. PATIENTS AND METHODS A total of 209 patients had bidirectional endoscopies performed for anaemia between September 2002 and March 2004. The endoscopy reports, histology and full blood count results (haemoglobin [Hb], red blood cells [RBCs], packed cell volume [PCV], mean cell volume [MCV] and mean cell haemoglobin [MCH]) were then reviewed. Statistical analysis was performed using non-parametric tests. RESULTS Overall, 197 patients had successful bidirectional endoscopies with 12 requiring completion barium enema. In 48 (23%) of these patients, a cause of anaemia was found with 15 (7.2%) carcinomas detected (2 upper GI and 13 lower GI). There was a significant difference in haemoglobin (9.2 g/dl versus 10.1 g/dl; P = 0.0044), RBCs (3.56 × 1012/l versus 3.83 × 1012/l; P = 0.0325) and PCV (0.279 l/l versus 0.31 l/l; P = 0.0112) between patients with positive findings at endoscopy and those with a normal investigation. Cancer patients had significantly lower haemoglobin (8.65 g/dl versus 10.1 g/dl; P = 0.0103), RBCs (3.45 × 1012/l versus 3.83 × 1012/l; P = 0.0179) and PCV (0.27 l/l versus 0.31 l/l; P = 0.0298) compared with patients with normal endoscopies. There was no significant difference in the other haematological parameters between those found to have positive findings and those that had normal endoscopies. CONCLUSIONS Based on this study, the yield of bidirectional endoscopy is low, with haemoglobin and PCV being the most useful haematological indices of significant pathology. Ferritin and MCV did not predict the likelihood of finding a gastrointestinal cause for the anaemia.

scholarly journals Reticulocyte and Erythrocyte Hemoglobin Parameters for Iron Deficiency and Anemia Diagnostics in Patient Blood Management. A Narrative Review

2021 ◽  
Vol 10 (18) ◽  
pp. 4250
Author(s):  
Christian Hoenemann ◽  
Norbert Ostendorf ◽  
Alexander Zarbock ◽  
Dietrich Doll ◽  
Olaf Hagemann ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Loss ◽  
Blood Cells ◽  
Blood Count ◽  
Iron Status ◽  
Full Blood Count ◽  
Patient Blood Management ◽  
Acute Blood Loss ◽  
Blood Management ◽  
Main Factors

Anemia, iron deficiency and other hematinic deficiencies are a major cause of perioperative transfusion needs and are associated with increased morbidity and mortality. Anemia can be caused either by decreased production of hemoglobin or red blood cells or by increased consumption and blood loss. Decreased production can involve anything from erythropoietin or vitamin B12 insufficiency to absolute or functional lack of iron. Thus, to achieve the goal of patient blood management, anemia must be addressed by addressing its causes. The traditional parameters to diagnose anemia, despite offering elaborate options, are not ideally suited to giving a simple overview of the causes of anemia, e.g., iron status for erythropoiesis, especially during the acute phase of inflammation, acute blood loss or iron deficiency. Reticulocyte hemoglobin can thus help to uncover the cause of the anemia and to identify the main factors inhibiting erythropoiesis. Regardless of the cause of anemia, reticulocyte hemoglobin can also quickly track the success of therapy and, together with the regular full blood count it is measured alongside, help in clearing the patient for surgery.

scholarly journals Training primary care nurses to conduct alcohol screening and brief interventions in South Africa

Curationis ◽  
2006 ◽  
Vol 29 (2) ◽  
Author(s):  
K Peltzer ◽  
P Seoka ◽  
T Babor ◽  
I Obot
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Health Care Providers ◽  
World Health Organisation ◽  
Alcohol Screening ◽  
World Health ◽  
Rural Site ◽  
Urban Site ◽  
Care Providers ◽  
Screening And Brief Intervention

Although progress has been made in developing a scientific basis for alcohol screening and brief intervention (SBI), training packages are necessary for its widespread dissemination in primary care settings in developing societies. Using a training package developed by the World Health Organisation 121 nurses from one rural site (29 clinics in Vhembe District) and one urban site (3 clinics and 6 mobile clinics in Polokwane/ Seshego) in South Africa were compared before and after SBI training regarding knowledge and attitudes, and the subsequent practice of SBI in routine clinical practice. Although the training effects were at times moderate, all changes were in a direction more conducive to implementing SBI. Health care providers significantly increased in knowledge, confidence in SBI and higher self-efficacy in implementing SBI at followup after 9 months after receiving the training. When delivered in the context of a comprehensive SBI implementation programme, this training is effective in changing providers’ knowledge, attitudes, and practice of SBI for at-risk drinking.

scholarly journals EXPRESS: Stroke in India: a systematic review of the incidence, prevalence and case fatality

2021 ◽  
pp. 174749302110278
Author(s):  
Stephanie Patricia Jones ◽  
Kamran Baqai ◽  
Andrew Clegg ◽  
Rachel Georgiou ◽  
Cath Harris ◽  
...  
Keyword(s):  
Case Fatality ◽  
Population Data ◽  
World Health Organisation ◽  
Population Based ◽  
The State ◽  
World Health ◽  
Bibliographic Databases ◽  
Community Based ◽  
High Quality ◽  
Longitudinal Data Collection

Background: The burden of stroke is increasing in India; stroke is now the fourth leading cause of death and the fifth leading cause of disability. Previous research suggests that the incidence of stroke in India ranges between 105 and 152/100,000 people per year. However, there is a paucity of available data and a lack of uniform methods across published studies. Aim: To identify high-quality prospective studies reporting the epidemiology of stroke in India. Summary of review: A search strategy was modified from the Cochrane Stroke Strategy and adapted for a range of bibliographic databases from January 1997 to August 2020. From 7,717 identified records, nine studies were selected for inclusion; three population-based registries, a further three population-based registries also using community-based ascertainment and three community-based door-to-door surveys. Studies represented the four cities of Mumbai, Trivandrum, Ludhiana, Kolkata, the state of Punjab and 12 villages of Baruipur in the state of West Bengal. The total population denominator was 22,479,509 and 11,654 (mean 1,294 SD 1,710) people were identified with incident stroke. Crude incidence of stroke ranged from 108 to 172/100,000 people per year, crude prevalence from 26 to 757/100,000 people per year and one-month case fatality rates from 18% to 42%. Conclusions: Further high-quality evidence is needed across India to guide stroke policy and inform the development and organisation of stroke services. Future researchers should consider the World Health Organisation STEPwise approach to Surveillance (STEPS) framework, including longitudinal data collection, the inclusion of census population data and a combination of hospital-registry and comprehensive community ascertainment strategies to ensure complete stroke identification.

scholarly journals Age-Friendly Built Environment

Encyclopedia ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 781-791
Author(s):  
Hing-Wah Chau ◽  
Elmira Jamei
Keyword(s):  
Older Adults ◽  
Built Environment ◽  
Independent Living ◽  
Holistic Approach ◽  
World Health Organisation ◽  
Living Environment ◽  
World Health ◽  
Active Ageing ◽  
Outdoor Spaces ◽  
Wide Range

Age-friendly built environments have been promoted by the World Health Organisation (WHO, Geneva, Switzerland) under the Global Age-friendly Cities (AFC) movement in which three domains are related to the built environment. These are: housing, transportation, outdoor spaces and public buildings. The aim is to foster active ageing by optimising opportunities for older adults to maximise their independent living ability and participate in their communities to enhance their quality of life and wellbeing. An age-friendly built environment is inclusive, accessible, respects individual needs and addresses the wide range of capacities across the course of life. Age-friendly housing promotes ageing in familiar surroundings and maintains social connections at the neighbourhood and community levels. Both age-friendly housing and buildings provide barrier-free provisions to minimise the needs for subsequent adaptations. Age-friendly public and outdoor spaces encourage older adults to spend time outside and engage with others against isolation and loneliness. Age-friendly public transport enables older adults to get around and enhances their mobility. For achieving an age-friendly living environment, a holistic approach is required to enable independent living, inclusion and active participation of older adults in society. The eight domains of the AFC movement are not mutually exclusive but overlap and support with one another.

scholarly journals Comunicação em Saúde: Evitar o Contágio da Doença por Vírus Ébola nos PALOP – Metodologia KISS & KEYWORDS

2015 ◽  
Vol 28 (2) ◽  
pp. 141
Author(s):  
Isabel De Santiago ◽  
José Pereira Miguel ◽  
Francisco Antunes
Keyword(s):  
Health Communication ◽  
Ebola Virus ◽  
Virus Disease ◽  
World Health Organisation ◽  
Population Based ◽  
World Health ◽  
African Countries ◽  
Communication Plan ◽  
Sao Tome And Principe ◽  
The Individual

In this work, Health Communication is considered as an important discipline in medicine and health sciences for his role as true determinant of health. We highlight their contribution to health promotion and disease prevention. Thus, the Health Communication Plan (PCS): Preventing the spread of Ebola virus disease in the Portuguese Speaking African Countries - KISS &amp; KEYWORDS methodology is a tool that aims to minimize the risk of infection by Ebola virus in the Portuguese Speaking African Countries and also train for a general<br />improvement of health conditions of the local populations. In the PCS design are especially considered the social and cultural contexts of the target populations, especially the customs, traditions and religion. Health Communication is considered as an Essential Function of Public Health and its main is to provide a population-based approach. The target of communication actions are population groups in addition to the individual communication, target-audiences are people without access to the media, in Guinea Bissau, Cape Verde and Sao Tome and Principe. Under the communication plan uses the methodology, models and practices both by media professionals as health. A proximity approach and cultural mediation, previously identified key facts, are defined objectives; outlines to the Plan in concrete and its implementation methodology (target-audience and following intervention, materials to be used and key-messages and partners to mobilize) following the World Health Organisation standards.

Haematology

2010 ◽  
pp. 211-308 ◽  
Keyword(s):  
Platelet Count ◽  
Blood Cell ◽  
Cell Morphology ◽  
Blood Count ◽  
Iron Status ◽  
Blood Film ◽  
Full Blood Count ◽  
Red Cell ◽  
Cell Parameters ◽  
Blood Cell Morphology

Full blood count 212 Red cell parameters 214 White cells 216 Platelet count 217 Peripheral blood film 218 Red cell morphology 219 Parasites on the blood film & marrow 222 White blood cell morphology 224 Assessment of iron status 226 Assessment of vitamin B12...

scholarly journals Optimising laboratory monitoring of chronic conditions in primary care: a quality improvement framework

2019 ◽  
Vol 8 (1) ◽  
pp. e000349 ◽  
Author(s):  
Darunee Whiting ◽  
Richard Croker ◽  
Jessica Watson ◽  
Andy Brogan ◽  
Alex J Walker ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Chronic Disease ◽  
Liver Function ◽  
Chronic Conditions ◽  
Blood Count ◽  
Full Blood Count ◽  
Similar Amount ◽  
Blood Tests ◽  
Ordering Systems

Monitoring of chronic conditions accounts for a significant proportion of blood testing in UK primary care; not all of this is based on evidence or guidelines. National benchmarking shows significant variation in testing rates for common blood tests. This project set out to standardise the blood tests used for monitoring of chronic conditions in primary care across North Devon, and to measure and reduce the harms of unwarranted testing. Chronic disease test groups were developed in line with current guidelines and implemented using one-click electronic test ordering systems. The main difference from previous general practitioner practice algorithms was removing the requirement for full blood count and liver function test monitoring for many conditions. Baseline harms of testing were measured and included significant costs, workload and patient anxiety. By defining the scale of the problem, we were able to leverage change across several cycles of quality improvement, using a pathology optimisation forum for peer-led improvement, and developing a framework focusing on what matters to patients. Overall primary care testing rates in North Devon fell by 14% for full blood count testing and 22% for liver function tests, but without a reduction in the number of tests showing possible significant pathology. We estimate that this has reduced testing costs by £200 000 across a population of around 180 000 people and has reduced downstream referral costs by a similar amount. Introduction of simple chronic disease test groups into primary care electronic ordering systems, when used alongside engagement with clinicians, leads to both quality improvement and reduction in system costs.

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