scholarly journals Slow medicine: a philosophical conception for a humanized geriatric practice

2021 ◽  
Vol 15 ◽  
Author(s):  
Patrick Alexander Wachholz ◽  
José Carlos Aquino de Campos Velho
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Biomedical Model ◽  
Reflective Practices ◽  
Medical Resources ◽  
Windows Of Opportunity ◽  
Appropriate Care ◽  
Concept Of Health ◽  
Slow Medicine ◽  
Care Fragmentation

Expansion of the concept of health, care fragmentation, and technology overvaluation have fostered discussions about the limitations of the biomedical model. The post-COVID-19 era can be one of the largest and best windows of opportunity for implementation of interventions aimed at promoting health equity, particularly in geriatrics. The mission of Slow Medicine can be summarized in three keywords: measured, because it acts with moderation, gradually and without waste; respectful, because it seeks to preserve the dignity and values of each person; and equitable, because it is committed to ensuring access to appropriate care for all. Operationally, the Slow Medicine movement is known internationally for the “Doing more does not mean doing better” campaign, whose objective is essentially to reflect upon and try to engage physicians in reflective practices to avoid the overuse of medical resources, both diagnostically and therapeutically. In this article, we present a brief historical summary and the principles that guide the praxis of the Slow Medicine movement, and invite the reader to reflect on a “geriatrics without haste.”

Impact of Religion on Traditional Health Care Practices Among the Lepchas of Upper and Lower Lingthem of Upper Dzongu, Sikkim, India

2021 ◽  
pp. 2455328X2199571
Author(s):  
Manisha Thapa ◽  
Pinak Tarafdar
Keyword(s):  
Health Care ◽  
Cultural Practices ◽  
Traditional Health ◽  
Health Care Practices ◽  
Modern Health Care ◽  
Concept Of Health ◽  
Traditional Health Care ◽  
Primary Means ◽  
Care Practices ◽  
The Village

In all cultures and regions, the concept of health varies, based on the type of environment and prevalent sociocultural traditions. The present study is conducted among the Lepchas of the village of Lingthem divided into two sectors—Upper and Lower Lingthem, Upper Dzongu, North Sikkim. This population comprising Buddhist Lepchas residing away from the mainstream through poor infrastructural facilities still maintain ethnomedical health care practices without influence of major Indian healing systems. Living in the area of Dzongu exclusively inhabited by Lepchas revival of ancient cultural practices is evident among Lepchas of Lingthem. The structure of religious beliefs prevalent among the Lepchas, including traditional animistic as well as Buddhist practices, greatly influence forms of treatment sought for specific ailments. Even today, the use and maintenance of traditional health care with syncretized Buddhist religious belief among residents of Lingthem act as a vital source for understanding the influence of religion on traditional health care practices. Despite the presence of a few modern health care agencies, the traditional treatment of Bongthing (Lepcha shaman) and Buddhist monks remain widely popular as primary means of health care.

scholarly journals Scoping review of the World Health Organization’s underlying equity discourses: apparent ambiguities, inadequacy, and contradictions

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Michelle M. Amri ◽  
Geneviève Jessiman-Perreault ◽  
Arjumand Siddiqi ◽  
Patricia O’Campo ◽  
Theresa Enright ◽  
...  
Keyword(s):  
Health Equity ◽  
Capabilities Approach ◽  
World Health ◽  
Eligibility Criteria ◽  
Hand Search ◽  
Ovid Medline ◽  
Concept Of Health ◽  
Past Half Century ◽  
The World ◽  
Health Organization

Abstract Background and objective Given the heightened rhetorical prominence the World Health Organization has afforded to equity in the past half-century, it is important to better understand how equity has been referred to and its conceptual underpinning, which may have broader global implications. Eligibility criteria Articles were included if they met inclusion criteria — chiefly the explicit discussion of the WHO’s concept of health equity, for example in terms of conceptualization and/or definitions. Articles which mentioned health equity in the context of WHO’s programs, policies, and so on, but did not discuss its conceptualization or definition were excluded. Sources of evidence We focused on peer-reviewed literature by scanning Ovid MEDLINE and SCOPUS databases, and supplementing by hand-search. Results Results demonstrate the WHO has held — and continues to hold — ambiguous, inadequate, and contradictory views of equity that are rooted in different theories of social justice. Conclusions Moving forward, the WHO should revaluate its conceptualization of equity and normative position, and align its work with Amartya Sen’s Capabilities Approach, as it best encapsulates the broader views of the organization. Further empirical research is needed to assess the WHO interpretations and approaches to equity.

Accountability for Rationing — Theory into Practice

2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Systems ◽  
The Public ◽  
Modern Health Care ◽  
Concept Of Health ◽  
Care Systems ◽  
Health Need

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.

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.

Primary Health Care Models Addressing Health Equity for Immigrants: A Systematic Scoping Review

2016 ◽  
Vol 20 (1) ◽  
pp. 214-230 ◽  
Author(s):  
Ricardo Batista ◽  
Kevin Pottie ◽  
Louise Bouchard ◽  
Edward Ng ◽  
Peter Tanuseputro ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Equity ◽  
Scoping Review ◽  
Primary Health ◽  
Health Care Models ◽  
Care Models

scholarly journals Towards Health Equity in a National Autism Strategy: A Lens on Disparities, Barriers, and Solutions

2021 ◽  
Vol 1 (1) ◽  
pp. 62-72
Author(s):  
Kaela Scott ◽  
Megan Krasnodembski ◽  
Shivajan Sivapalan ◽  
Bonnie Brayton ◽  
Neil Belanger ◽  
...  
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Panel Discussion ◽  
Determinants Of Health ◽  
The Public ◽  
Autistic People ◽  
People First ◽  
The Government ◽  
Services And Supports

Health equity allows people to reach their full health potential and access and receive care that is fair and suitable to them and their needs regardless of where they live, what they have, or who they are. To achieve health equity, equity in healthcare focuses on the role of the health system to provide timely and appropriate care. When viewed in the context of a National Autism Strategy, this extends to ensuring access to the resources that each Autistic person requires to meet their health needs, such as an autism diagnosis, services, and supports. Based on the equity panel discussion held at the Canadian Autism Leadership Summit 2020, this article reflects on the current disparities and barriers to achieving health equity in a National Autism Strategy, and outlines ways to address them. Disparities to equitable care within the autism community extend from the level of support needs of an individual to how those intersect with several key determinants of health including: geography, culture, gender, and socioeconomic status. Notably, barriers arise due to a “lack of” theme, including lack of awareness, knowledge, access, and voice. Four reoccurring ideas were identified for how to address inequities in health care for Autistic people. First, allocate resources for regional or in-community endeavours; second, improve Autistic representation and connection; third, establish a community of allies to advocate and collaborate; and fourth, establish leadership within the community and government to make disability a priority for Canada. To achieve equity in health care in a National Autism Strategy, we need to look at the intersectionality of autism with the key determinants of health. Moreover, to effectively engage with the government, health professionals, and the public, the autism community should strive to find a unified and diverse voice. And finally, conversation must turn to action. 

scholarly journals 'I just hope they take it seriously': homeless men talk about their health care

2020 ◽  
Vol 44 (5) ◽  
pp. 748
Author(s):  
Nancy Sturman ◽  
Don Matheson
Keyword(s):  
Health Care ◽  
Psychological Distress ◽  
Health Outcomes ◽  
Health System ◽  
Social Issues ◽  
Healthcare Systems ◽  
Poor Health ◽  
Homeless Men ◽  
Life Threatening ◽  
Care Fragmentation

ObjectiveMen who experience homelessness in Australia often have complex health and social issues, including the trimorbidity of concurrent mental illness, substance use disorders and physical health conditions. These men tend to have poor health outcomes, and present challenges to healthcare systems. To improve system responsiveness and patient outcomes, the perspectives of marginalised groups need to be understood. MethodsFive focus groups were conducted with 20 men in a homeless men’s hostel, exploring their experiences of seeking and receiving health care, and views about improving these. An inductive thematic analysis was undertaken. ResultsSeveral participants expressed gratitude for care provided for life-threatening physical illness and trauma. However, negative experiences of health system responses were more frequently reported. Four emerging themes all made securing effective ‘tickets of entry’ to health care more difficult: dismissive care, care fragmentation, inconsistent medical management of pain and inadequate acknowledgement of psychological distress. ConclusionsImprovements are needed in care integration and the de-escalation of potentially confrontational interactions. Effective, safe and compassionate system responses to presentations of psychological distress and pain should be collaboratively developed. Some current responses may entrench stigma, further traumatising vulnerable patients. What is known about the topic?Men who experience homelessness have poor health outcomes and present challenges to healthcare systems. What does this paper add?This paper describes healthcare experiences and insights of men who are experiencing homelessness in Australia. These men reported experiencing dismissive care, care fragmentation, inconsistent, inadequate and/or unsafe prescribing for pain and inconsistent and/or ineffective responses to psychological distress. What are the implications for practitioners?Changes are needed in health system responses, informed by the experiences and insights of marginalised people, to break cycles of trauma and exclusion.

scholarly journals Economic theory meets clinical practice: moral hazard

2019 ◽  
Vol 4 ◽  
Author(s):  
Olga Vasylyeva
Keyword(s):  
Health Care ◽  
Economic Theory ◽  
Clinical Practice ◽  
Moral Hazard ◽  
Real Life ◽  
Medical Services ◽  
Health Care Economics ◽  
Services Utilization ◽  
Field Of Vision ◽  
Concept Of Health

Economic theory must be tested by reality to prove that the goal is achievable and reproducible. However, health care economics do not always theorize based on modern-day medical practice, which results in detachment of some economic recommendations from real-life medicine. The theory of “moral hazard” assumes that patients will utilize more medical services if they transfer the risk of cost to insurances. In this article, we will revisit the understanding of appropriate avoidance of medical services and incorporate no-show rate, avoidance of care, and nonadherence into the concept of health services utilization. The primary goal of this interdisciplinary commentary is to bridge economic theory with clinical practice. It is written from the perspective of a clinical practitioner, who applies realities of everyday medicine to economic reasoning. The author hopes that this abstract will extend the field of vision of health care economics.   

Technology assessment, priority setting and appropriate care in Dutch health care

2004 ◽  
Vol 20 (4) ◽  
pp. 564-564 ◽  
Author(s):  
Marc Berg ◽  
Tom van der Grinten ◽  
Niek Klazinga
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Comparative Analysis ◽  
Priority Setting ◽  
Technology Assessment ◽  
Economic Evaluations ◽  
Technol Assess Health ◽  
Appropriate Care ◽  
Dutch Health ◽  
Dutch Health Care

References 8, 29, and 32 are incorrect as they appear in the article entitled “Technology assessment, priority setting, and appropriate care in Dutch health care,” by Marc Berg, Tom van der Grinten, and Niek Klazinga (Int J Technol Assess Health Care. 2004;20[1]:35-43). They should appear as follows: 8. Burgers JS, Bailey JV, Klazinga NS, et al. Inside guidelines: comparative analysis of recommendations and evidence in diabetes guidelines from 13 countries. Diabetes Care 2002;11:1933-1939.29. Zwart-van Rijkom JE, Leufkens HG, Busschbach JJ, et al. Differences in attitudes, knowledge and use of economic evaluations in decision-making in The Netherlands. The Dutch results from the EUROMET Project. Pharmacoeconomics 2000;2:149-160.32. Van der Grinten TED. Hervorming van de gezondheidszorg. Zal het deze keer wel lukken? Beleid & Maatschappij 2002;3:172-176.

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