scholarly journals Feasibility and Utility of Tele-Neurorehabilitation Service in India: Experience from a Quaternary Center

2018 ◽  
Vol 09 (04) ◽  
pp. 541-544 ◽  
Author(s):  
Meeka Khanna ◽  
Guru S. Gowda ◽  
Virupaksha Irappa Bagevadi ◽  
Anupam Gupta ◽  
Karishma Kulkarni ◽  
...  

ABSTRACT Background: Neurological rehabilitation service in developing countries like India is a great challenge in view of limited resources and manpower. Currently, neurological rehabilitation with a multidisciplinary team is limited to a few major cities in the country. Tele-neurorehabilitation (TNR) is considered as an alternative and innovative approach in health care. It connects the needy patients with the health-care providers with minimum inconvenience and yields cost-effective health care. Aim: The aim of this study was to study the socioclinical parameters, feasibility, and utility of TNR services in India. Methodology: A retrospective file review of TNR consultations provided through Telemedicine Center at a quaternary hospital-based research center in south India between August 2012 and January 2016. Results: A total of 37 consultations were provided to the patients belonging to four districts of Karnataka. The mean age of the patients was 34.7 (±19.5) years, 23 (62.1%) were aged between 19 and 60 years, and 31 (83.8%) were male. Thirty-one patients (83.8%) had central nervous system-related disorders such as stroke, cerebral palsy, and tubercular meningitis with sequelae or neuromuscular disorders such as Guillain–Barre Syndrome and Duchenne muscular dystrophy. Twelve patients (32.4%) were advised to consult higher centers in the vicinity, and the rest was referred to the district hospital. Conclusion: The findings suggest that TNR services are feasible, effective, and less resource intensive in delivering quality telemedicine care in India. More clinical studies are required to elucidate its full utility at different levels and in different parts of the country.

2004 ◽  
Vol 11 (8) ◽  
pp. 547-554 ◽  
Author(s):  
Dina Brooks ◽  
Audrey King ◽  
Mark Tonack ◽  
Helen Simson ◽  
Maria Gould ◽  
...  

OBJECTIVES:To identify user perspectives on the issues that impact the quality of the daily lives of ventilator-assisted individuals living in the community.METHODS:Semistructured interviews were held with 26 Canadian ventilator-assisted individuals (mean age 44±14 [SD] years, range 23 to 60 years; mean ventilator experience 18±13 years, range three to 53 years) whose disability from neuromuscular conditions necessitated assistance with activities of daily living. Participants described their daily life experiences and perceptions of the factors that limited or enhanced their quality. Interviews were tape-recorded, transcribed and analyzed for emergent codes and themes.RESULTS:Ventilator users characterized important issues in terms of personal successes and limitations, as well as dependencies on others for daily living. Personal support services, income security, health care and transportation were important positive contributors to their quality of life. Dependency on others was clearly a negative contributor. The ventilator was regarded as a form of assistive technology, similar to a wheelchair. Ventilator users perceived that ventilation was associated with a stigma and negative assumptions about disability, particularly if suctioning was required.CONCLUSIONS:The majority of participants considered home mechanical ventilation to be a positive benefit for independent living, enhancing their overall health. They were clear as to the issues of importance to them, and formulated recommendations for health care providers and policy makers that could improve the quality of their daily lives. Many of the issues identified in the present report are faced by the growing community of ventilator users.


Author(s):  
Ahmad Sadeghi ◽  
Hasan Jafari ◽  
Hossein Rouhani ◽  
Akram Zhianifard ◽  
Maryam Siavashi

Introduction: Job Satisfaction in Health care organizations is one of the important pillars of health promotion, due to the role they play in the prevention, care and treatment. The aim of this study was to determine the job satisfaction and its related factors in health workers in Esfarayen. Methods: This descriptive-analytical study was carried out on 140 health care workers in Esfarayen in 2017. Data was collected using Herzberg job satisfaction questionnaire, and data were analyzed using ANOVA and t-test in SPSS21 software. Results: The mean age of participant was 37 ± 8.34. Most of them were female (70%) and married (85.5%). The average of job satisfaction was 61.45 ± 7.65 (out of 100). The highest job satisfaction score was work ability (73.54 ± 1.08) and the lowest score belonged to supervision ( 49.15 ± 5.73). Among the demographic variables, Job satisfaction was significantly associated with Employment Status (P<0.05). Conclusion: Despite employees have job satisfaction, factors that increase job satisfaction of employees should be considered by the relevant authorities. Establishing suitable job standards, fair and reasonable salary, and the creation of facilities in the workplace can lead to improved employee satisfaction and, consequently, improved service quality.


PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165021
Author(s):  
Ruth Pulikottil-Jacob ◽  
Martin Connock ◽  
Ngianga-Bakwin Kandala ◽  
Hema Mistry ◽  
Amy Grove ◽  
...  

1996 ◽  
Vol 1 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Peter Littlejohns ◽  
Carol Dumelow ◽  
Sian Griffiths

Objectives: To help develop a means, based on the views of purchasers and providers of health care, of incorporating national research on clinical effectiveness into local professional advisory mechanisms in order to inform health care purchasing and contracting. Methods: Three geographically based multidisciplinary workshops attended by National Health Service (NHS) staff drawn from the principal purchaser and provider groups in one English region were organized around the discussion of three health care purchasing case studies: Coronary artery disease, diabetes and management of clinical depression in general practice. The proceedings were transcribed and analyzed using content analysis methods. Results: 95 people took part. There were major differences between the purchasers' and health care providers' views on the right balance between local and national information and advisory sources for purchasing. In general, providers wanted the provision of advice to purchasers to be local, in which their opinion was sought, either individually or collectively, acted on and the results fed back to them. In contrast, health authority purchasers considered that local professionals were only one source of professional advice, albeit an important one, to be utilized in coming to decisions. General practitioner fundholders as purchasers, however, preferred to rely on their own experiences and contacts with local providers in making purchasing decisions. Conclusions: Professional specialist advisory groups are necessary to inform the purchasing of health care, but should extend beyond advising on the placement of individual contracts. Involving health care providers in all short-term contracting is unlikely to be cost-effective given the time commitment required. The emphasis at purchaser/provider meetings should be on education: Providing an opportunity for purchasers and providers to develop closer relationships to discuss political imperatives and financial constraints; increasing communication and understanding of providers' and purchasers' roles; and providing an environment for professionals and purchasers to share their views on purchasing. As currently presented, elements of the national policies in the NHS advocating the use of both national evidence on clinical effectiveness and local professional advice are contradictory and should be clarified.


2020 ◽  
Vol 2020 ◽  
pp. 1-16
Author(s):  
Nguyen Thi Thu Thuong ◽  
Tran Quang Huy ◽  
Do Anh Tai ◽  
Tran Nhuan Kien

Background. In recent years, health insurance (HI) has been chosen by many low- and middle-income countries to obtain an important health policy target—universal health coverage. Vietnam has recently introduced the Revised Health Insurance Law, and the effects of the voluntary health insurance (VHI) and heavily subsidised health insurance (HSHI) programmes have not yet been analysed. Therefore, this study is aimed at examining the impact of these HI programmes on the utilisation of health care services and out-of-pocket health expenditure (OOP) in general and across different health care providers in particular. Methods. Using the two waves of Vietnam Household Living Standard Surveys 2014 and 2016 and the difference-in-difference method, the impacts of VHI and HSHI on health care utilisation and OOP in Vietnam were estimated. Results. For both the VHI and HSHI groups, we found that HI increased the probability of seeking outpatient care, the mean number of outpatient visits, the total number of visits, and the mean number of visits at the district level of health care providers in the last 12 months. However, there was no evidence that the HSHI programmes increased the mean number of inpatient visits and the number of visits at the provincial hospital. We also found that while the VHI programme reduced OOP for both outpatient and inpatient care, the HSHI scheme did not result in a reduction in OOP for hospitalisation, although HI lowered the total OOP. Similarly, we found that for both groups, HI reduced OOP when the insured visited district and provincial hospitals. However, the statistically significant impact was not demonstrated when the enrolees of HSHI programmes visited provincial hospitals. Conclusion. The study offers evidence that the Vietnamese HI scheme increased health care service utilisation and decreased OOP for the participants of the VHI and HSHI programmes. Therefore, the government should continue to consider improving the HI system as a strategy to achieve universal health coverage.


2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).


2017 ◽  
Vol 5 (2) ◽  
pp. 100-105 ◽  
Author(s):  
Reem Elmaghloub ◽  
Ashraf Elbahrawy ◽  
Gamal El Didamony ◽  
Ahmed Elwassief ◽  
Abdel-Gawad Saied Mohammad ◽  
...  

AbstractBackground and ObjectivesHealth Care Workers (HCWs) are at a high risk of needle stick injuries and HBV infection in Egypt; this problem is further aggravated by low Hepatitis B (HB) vaccination coverage. Limited data are available on the prevalence of HBV infection in Egyptian HCWs. In this study, we aimed to assess the HBV infection rate and genotypes among Egyptian HCWs.MethodsFive hundred and sixty-four (564) HCWs were included. Of them, 258 (45.74%) were health care providers and 306 (54.25%) were non-health care providers. All HCWs completed both the study questionnaires and provided a blood sample for HBV testing. Indeed, all HCWs were tested for Hepatitis B surface antigen (HBsAg) and antibody to Hepatitis B core antigen (anti-HBc), by enzyme-linked immunosorbent assay. HBVDNA was checked for HCWs who tested positive for HBsAg and/or anti-HBc, by nested Polymerase Chain Reaction (PCR). HBVDNA positive HCWs were further subjected to HBV genotyping.ResultsThe mean age of included HCWs was 33.0 ± 9.8 years, of whom 319 (56.56%) were males. The mean duration of health care work was 9.3 ± 6.7 years. The frequency of HBsAg and anti-HBc were 1.4%, and 24.5%, respectively. Old age and prolonged duration of health care work were significantly associated with anti-HBc seropositivity. Among 140 HCWs positive for HBsAg and/or anti-HBc, 14 (10 %) had positive HBVDNA by PCR. HBV/E (n= 7), HBV/D (n= 3) and co-infection with E and D (n= 4) genotypes were detected.ConclusionEgyptian HCWs have a significantly high rate of HBV exposure. The detection of HBV/E genotype among Egyptian HCWs suggests prevalent transmission of HBV/E among Egyptian populations.


Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ahmed Latif ◽  
◽  
Sobia Yaqub ◽  
Qudsia Anwar Dar ◽  
Umer Sultan Awan ◽  
...  

Objective: This study aims to determine level of stress, resilience and moral distress among health care providers during covid-19 pandemic. Methods: This is a cross-sectional study performed using an online questionnaire. Data was collected from Health Care Providers, working in various tertiary care hospitals of Lahore, using an online questionnaire. Perceived stress scale (PSS), Connor-Davidson Resilience Scale (CD-RISC 10) and Moral Distress Thermometer were used to determine level of stress, resilience and moral stress respectively among the HCPs. Scores on the PSS can range from 0 to 40 with scores of 0-13, 14-26 and 27-40 being considered as low, moderate and high stress respectively. The Moral Distress Thermometer has scores ranging from 0-10 with value of ≥4 considered high. Data was analyzed using SPSS version.23.Descriptive variables were reported as means and frequencies. Intergroup analysis was done using Chi square test with p<0.05 taken as significant. Results: A total of 278 (n=278) HCPs participated in study. According to the PSS (Perceived Stress Scale) scores, 5.03% (14) reported low, 86.69% (241) moderate and 8.27% (23) high stress levels. The mean stress score is 21.56+/-4.32. Providing patient care (mean = 2.28+/-1.15 SD) and transmitting infection to others (mean = 3.02+/-1.10 SD) were deemed major causes of stress. The mean CD-RISC score was 23.14+/-7.81 SD. Only 10.8% (30) had a score of ≥ 32. The mean Moral Distress score was 4.2+/-2.98 SD, with 53.2% (149) participants reporting high Moral distress (score ≥4). Conclusion: The high level of stress among HCPs during COVID-19 pandemic highlights the need of urgent measures to overcome this psychological issue which if left un-addressed can affect performance of HCPs. Key Words: Stress, Resilience, HCPs How to cite: Latif A., Yaqub S., Dar A.Q., Awan S.U., Farhat Hina., Khokhar A.M., Stress, Resilience and Moral Distress among Health care Providers during COVID-19 pandemic. Esculapio 2021;17 (01):79-82


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