scholarly journals International Travel With a Chronic Medical Illness – Health Risks, Practical Challenges and Evidence-Based Recommendations

2020 ◽  
Vol 9 (2) ◽  
pp. 44-59
Author(s):  
Milad Darrat ◽  
Gerard Thomas Flaherty
Keyword(s):  
Health Care Providers ◽  
Medical Condition ◽  
Travel Medicine ◽  
International Travel ◽  
Medical Illness ◽  
Evidence Based ◽  
Care Providers ◽  
Preventative Measures ◽  
Overseas Travel ◽  
Primary Care Practitioners

Introduction: Primary care practitioners and travel medicine physicians are primarily responsible for identifying individuals who may be unfit for overseas travel and consulting with them pre-travel. Pre-existing medical conditions such as cardiovascular disease, chronic respiratory conditions and diabetes mellitus (DM) have the potential to complicate travel journeys. A considerable percentage of travel-associated illness may be due to the decompensation of a pre-existing medical condition. This review seeks to address the challenges faced by travellers with each of these conditions, including recently updated and evidence-based practical approaches for travel with comorbidities. Methods: Sources for this review were identified through searches of PubMed/Google Scholar for materials published between 1st January 2000 and 31st December 2019, using combinations of search terms. Results: The volume of literature on travelling with a pre-existing condition exploded with more than 865 associated articles indexed on the PubMed alone as of March 2020. After screening titles, abstracts and, in some cases, the full text version of indexed articles, 121 articles were deemed relevant to the subject matter of this review. Conclusion: Rational approaches to pre-planning for travel with a medical condition will contribute to the prevention of problems while in transit as well as when at the travel destination. It is imperative for health care providers to be aware of the preventative measures and current recommendations that should be taken before and during travel to protect individuals with a chronic illness. Further research and studies should be directed to protect this vulnerable group of travellers.

The Interaction of Pulmonary Physiology and Swallowing: A Juggling Act for the Physician and Speech-Language Pathologist

2009 ◽  
Vol 18 (1) ◽  
pp. 34-40
Author(s):  
Karen J. Dikeman ◽  
Marta S. Kazandjian ◽  
Elbert Tun ◽  
Panina Niyazova ◽  
Tien-Tsai Tsai ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Condition ◽  
Team Approach ◽  
Care Providers ◽  
Geriatric Population ◽  
Pulmonary Physiology ◽  
Speech Language Pathologist ◽  
Ventilator Dependence ◽  
Clinical Case Studies ◽  
Single Disease Entity

Abstract Patients who are dependent upon tracheostomy and/or ventilator use present a particular challenge to health-care providers. The interaction of pulmonary physiology and deglutition is complex, as illustrated in the course of patients who are in the weaning process. Speech language pathologists (SLPs) should work closely with their physician colleagues to understand the influence of multiple medical co-morbidities on intervention. In traditional medicine, the clinician's objective is to connect a patient's many symptoms and complaints to a single disease entity. However, in caring for the ventilator dependent geriatric population, a symptom such as dysphagia typically results from the interplay of various, multi-organ symptoms, and conditions. This article strives to demonstrate the “juggling act” that the physician and SLP must balance between the patient's current medical condition, pulmonary dysfunction, and disordered swallowing. Clinical case studies illustrate the benefit of swallowing intervention on quality of life. While the care of patients with tracheostomy and ventilator dependence requires a team approach, with respiratory therapy and nursing vital members, this article emphasizes the roles of the SLP and physician.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

Translating Evidence-Based Interventions Into Practice

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 9S-19S ◽  
Author(s):  
Meera Viswanathan ◽  
Linda Lux ◽  
Kathleen N. Lohr ◽  
Tammeka Swinson Evans ◽  
Lucia Rojas Smith ◽  
...  
Keyword(s):  
Health Care Providers ◽  
System Integration ◽  
Pediatric Asthma ◽  
Evidence Based ◽  
Extensive Literature ◽  
Care Providers ◽  
Planning Period ◽  
Community Based ◽  
Asthma Morbidity ◽  
Effective Interventions

Pediatric asthma is a multifactorial disease, requiring complex, interrelated interventions addressing children, families, schools, and communities. The Merck Childhood Asthma Network, Inc. (MCAN) is a nonprofit organization that provides support to translate evidence-based interventions from research to practice. MCAN developed the rationale and vision for the program through a phased approach, including an extensive literature review, stakeholder engagement, and evaluation of funding gaps. The analysis pointed to the need to identify pediatric asthma interventions implemented in urban U.S. settings that have demonstrated efficacy and materials for replication and to translate the interventions into wider practice. In addition to this overall MCAN objective, specific goals included service and system integration through linkages among health care providers, schools, community-based organizations, patients, parents, and other caregivers. MCAN selected sites based on demonstrated ability to implement effective interventions and to address multiple contexts of pediatric asthma prevention and management. Selected MCAN program sites were mature institutions or organizations with significant infrastructure, existing funding, and the ability to provide services without requiring a lengthy planning period. Program sites were located in communities with high asthma morbidity and intended to integrate new elements into existing programs to create comprehensive care approaches.

Weight Bias and Psychosocial Implications for Acute Care of Patients With Obesity

2017 ◽  
Vol 28 (3) ◽  
pp. 254-262 ◽  
Author(s):  
Rachel Smigelski-Theiss ◽  
Malisa Gampong ◽  
Jill Kurasaki
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Health Care Providers ◽  
Physical Environment ◽  
Medical Condition ◽  
Weight Bias ◽  
Care Providers ◽  
Optimal Care ◽  
Childhood Experiences ◽  
Appropriate Care

Obesity is a complex medical condition that has psychosocial and physiological implications for those suffering from the disease. Factors contributing to obesity such as depression, childhood experiences, and the physical environment should be recognized and addressed. Weight bias and stigmatization by health care providers and bedside clinicians negatively affect patients with obesity, hindering those patients from receiving appropriate care. To provide optimal care of patients with obesity or adiposity, health care providers must understand the physiological needs and requirements of this population while recognizing and addressing their own biases. The authors describe psychosocial and environmental factors that contribute to obesity, discuss health care providers’ weight biases, and highlight implications for acute care of patients suffering from obesity.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

scholarly journals Faktor-Faktor yang Mempengaruhi Self-care Behavior pada Klien dengan Hipertensi di Komunitas

2020 ◽  
Vol 11 ◽  
pp. 37
Author(s):  
Wimar Anugrah Romadhon ◽  
Bernadetta Germia Aridamayanti ◽  
Anggi Hanafiah Syanif ◽  
Gevi Melliya Sari
Keyword(s):  
Health Care Providers ◽  
Self Efficacy ◽  
Self Care ◽  
Google Scholar ◽  
Evidence Based ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Salt Diet ◽  
Low Salt ◽  
Care Behavior

Background: self-care behavior is an important thing that needs to be considered by clients with hypertension which consists of several components, namely the use of drugs, low-salt diet, physical activity, smoking, weight management and alcohol consumption. Purpose: to show the factors that influence self-care behavior in clients with hypertension. Method: the database used to identify suitable articles obtained from Scopus, ProQuest and Google Scholar, limited to the last 5 years of publication from 2014 to 2019, English, and fulltext articles. The literature review used the keyword "Self-care behavior, Hypertension". In searching articles used "AND". Only 12 articles met the inclusion criteria. This review was from 12 of these articles. Results: self-care behavior in hypertensive clients were influenced by several factors, namely family support, self-efficacy, knowledge, and spirituality. Conclusion: factors related to self-care behavior and pathways can help health care providers develop and design evidence-based interventions for clients with hypertension. Recommendation: Community nurses understand the factors that influence self-care behavior in hypertensive clients in the community so they are able to provide appropriate nursing care. Keywords: factors of self-care behavior; hypertension; community ABSTRAK Latar belakang: self-care behavior merupakan hal penting yang perlu diperhatikan oleh klien dengan hipertensi yang terdiri dari beberapa komponen yaitu penggunaan obat-obatan, diet rendah garam, aktifitas fisik, merokok, manajemen berat badan dan konsumsi alkohol. Tujuan: untuk melihat adanya faktor-faktor yang mempengaruhi self-care behavior pada klien dengan hipertensi. Metode: database digunakan untuk mengidentifikasi artikel yang sesuai diperoleh dari Scopus, ProQuest dan Google Scholar terbatas untuk publikasi 5 tahun terakhir dari 2014 hingga 2019, bahasa inggris, dan fulltex article. Tinjauan literatur menggunakan kata kunci “factors of self-care behavior, Hypertension”. Dalam pencarian artikel menggunakan "AND". Hanya 12 artikel yang memenuhi kriteria inklusi. Ulasan ini berasal dari 12 artikel tersebut. Hasil: self-care behavior pada klien hipertensi dipengaruhi oleh beberapa faktor yaitu dukungan keluarga, self-efficacy, faktor personal, dan spiritualitas. Simpulan: faktor-faktor yang terkait dengan self-care behavior dan jalurnya dapat membantu penyedia layanan kesehatan mengembangkan dan mendesain intervensi bebasis bukti pada klien dengan hipertensi. Saran: Perawat komunitas memahami faktor-faktor yang mempengaruhi self-care behavior pada klien hipertensi di komunitas sehingga mampu memberikan asuhan keperawatan yang tepat. Kata kunci: factors of self-care behavior; hypertension; community

Infection risk and prophylaxis in patients with lymphoid cancer

Blood ◽  
2021 ◽  
Author(s):  
Nancy Law ◽  
Randy A. Taplitz
Keyword(s):  
Risk Factors ◽  
Health Care Providers ◽  
Treatment Approach ◽  
Antimicrobial Prophylaxis ◽  
Cancer Therapeutics ◽  
Infection Risk ◽  
Evidence Based ◽  
Care Providers ◽  
Additional Risk ◽  
Common Cause

Infections are a common cause of morbidity and mortality in patients with lymphoid cancer. With evolving cancer therapeutics, including new targeted and immunotherapies, clinicians need to be aware of additional risk factors and infections that may arise in patients treated with these agents. This "How I Treat" article will highlight fundamental issues including risk factors for infection, infectious diseases screenings and antimicrobial prophylaxis recommendations in patients with lymphoid cancers. We present 4 scenarios of patients with lymphoid cancers with varied infections and describe a treatment approach based on a combination of evidence-based data and experience, as there are limitations in objective infection data especially with newer agents. The goal of this discussion is to provide a framework for institutions and health care providers to develop their own approach in preventing and treating infections in patients with lymphoid cancer.

Depression in Medical Patients

2017 ◽  
pp. 146-159
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care Providers ◽  
Health Personnel ◽  
Time Constraints ◽  
Depression Treatment ◽  
Evidence Based ◽  
Medical Patients ◽  
Care Providers ◽  
Different Levels

Depression treatment that is coordinated with care for comorbid chronic conditions improves control of both the depression and the chronic medical disease. Interpersonal counseling (IPC) and briefer forms of IPT for depression have been introduced in medical practice and primary care to accommodate providers’ time constraints and different levels of training of mental health care providers. IPC is best used with patients who have low levels of depressive symptoms, or distress, and where more highly trained therapists are not available but health personnel are interested in providing counseling. There is high interest in developing briefer approaches for depression treatment in medical patients, a wealth of evidence-based choices, and much work to be done. A case example is given of a college student with comorbid depression and diabetes.

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