scholarly journals Management of the patient with chronic obstructive airway disease (COPD) in a primary health care context

2019 ◽  
Vol 61 (5) ◽  
pp. 10-14
Author(s):  
I. Govender ◽  
H. I. Okonta ◽  
S. Rangiah ◽  
D. Nzaumvila

This paper describes the incidence of chronic obstructive airway disease (COPD), the risk factors, staging, investigations and management of COPD. The differential diagnosis for COPD is also presented as COPD can be confused with other clinical conditions. This paper is presented in practical terms for the clinician working in a primary health care context.

Curationis ◽  
1978 ◽  
Vol 1 (3) ◽  
Author(s):  
J.V. Larsen

It has recently been demonstrated that about 56 percent of patients delivering in a rural obstetric unit had significant risk factors, and that 85 percent of these could have been detected by meticulous antenatal screening before the onset of labour. These figures show that the average rural obstetric unit in South Africa is dealing with a large percentage of high risk patients. In this work, it is hampered by: 1. Communications problems: i.e. bad roads, long distances. and unpredictable telephones. 2. A serious shortage of medical staff resulting in primary obstetric care being delivered by midwives with minimal medical supervision.


Author(s):  
Hashim Mohamed

AbstractIntroductionPostnatal Depression (PND) is a major health problem affecting mother, her child and family.  Its prevalence and associated risk factors among South Asian mothers (SAM) living  in Qatar remain unknown. The objectives of this study were to estimate the prevalence of PND among (SEAM) in Qatar and to correlate risk factors contributing to the development of PND.Materials and methodsA total of (285 ) (SAM)females who were six months  postpartum were interviewed as  part of a prospective study conducted in primary health care centers in Qatar.  PND symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Descriptive statistics were used for summarizing the study and outcome variables. The χ2 test and ORs with 95% confidence intervals (CIs) were used for observation and quantifying the association between different variables. Multivariate binary logistic regression was used to identify the independent associated factors of PPD. P≤0.05 was considered significant. Variables included were age , occupation, education level ,previous psychiatric history ,comorbidities , ,history of depression during current  pregnancy, history of anxiety during current pregnancy, number of previous pregnancies, strong social support, husband support, marital problem before pregnancy and ongoing marital problems during current pregnancy.Results The prevalence of postnatal depression among 285 respondents was 33.2% .several psychosocial risk factors were significantly associated with postnatal depression and, after multiple regression analysis, a history of depressive illness ,anxiety ,marital problems before delivery ,a history of diabetes and asthma ,history of congenital malformations ,and lack of mother support.Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95), but marginally indicative of the risk of depressive symptoms.ConclusionThis study showed a high rate of depressive symptoms among(SAM) six months Postpartum . Future screening protocols  must be employed at primary care level and hospital based clinics in Qatar to detect and treat post natal depression.Keywords: postnatal  depression,  South Asians, primary health care ,Doha, EPDS  


2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.


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