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2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Guillaume Coindard ◽  
Michaël Acquadro ◽  
Raphaël Chaumont ◽  
Benoit Arnould ◽  
Philippe Boisnault ◽  
...  

Abstract Background Smoking cessation is a major public health issue. In France, primary care physicians (PCP) are the first contact points for tobacco management. The objective of this study was to understand how PCPs are involved in the management of smoking cessation: ownership, commitment, barriers. Methods A qualitative study was conducted using group and individual semi-structured techniques with PCPs. A thematic analysis of verbatim transcripts was performed to identify concepts and sub-concepts of interest. Saturation was evaluated retrospectively to ensure adequate sample size. Results A sample of 35 PCPs were interviewed, 31 in four focus groups and four in individual interviews. PCPs discussed their roles in the management of tobacco smoking cessation, including the different strategies they are using (e.g., Minimal Intervention Strategy, Motivational Interviewing), the multiple barriers encountered (e.g., lack of time, patients’ resistance to medical advice), the support resources and the treatment and intervention they prescribed (e.g. nicotine replacement therapy, supporting therapist). Conclusions This study provides a better understanding of the beliefs, attitudes, and behaviors of PCPs in managing smoking cessation. Guiding and encouraging patients toward smoking cessation remains a major objective of PCPs. While PCPs reported that progress has been made in recent years in terms of tools, technology and general awareness, they still face major barriers, some of which could be overcome by appropriate training.


2022 ◽  
Vol 10 (19) ◽  
pp. 52-58
Author(s):  
Elva J. Corona-Olivera

Depression is one of the main psychiatric disorders that prevails during childhood and adolescence. The causes are multifactorial, of which the following stand out: traumatic events, the social development environment, genetics and brain chemistry accompanied by some anatomical and functional alterations. The consequences can be serious in the long term and can even contribute to the problem if it is not identified and referred promptly or lead to suicide, once the diagnosis has not been effective. The treatment for depression is complex and includes drugs and cognitive-behavioral therapy. This article aims to help first contact physicians to diagnose in a timely manner to act in situations that may endanger the patient with this condition, and therefore refer to specialists.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Massimo Andreoni ◽  
Nicola Coppola ◽  
Antonio Craxì ◽  
Stefano Fagiuoli ◽  
Ivan Gardini ◽  
...  

Abstract Background It has been estimated that the incidence of chronic hepatitis C virus (HCV) will not decline over the next 10 years despite the improved efficacy of antiviral therapy because most patients remain undiagnosed and/or untreated. This study aimed to investigate the opinion of relevant target populations on the practicability, effectiveness and best modalities of the test-and-treat approach in the fight against HCV in Italy. Methods A survey was delivered to patients with HCV from the general population, patients from drug addiction services, hospital physicians and healthcare providers for drug addiction services. Results For both hospital clinicians and SerD HCPs, tolerability is shown as the most important feature of a suitable treatment. Time to treatment (the time from first contact to initiation of treatment) is deemed important to the success of the strategy by all actors. While a tolerable treatment was the main characteristic in a preferred care pathway for general patients, subjects from drug addiction services indicated that a complete Meet–Test–Treat pathway is delivered within the habitual care center as a main preference. This is also important for SerD HCPs who are a strong reference for their patients; hospital clinicians were less aware of the importance of the patient-HCP relationship in this process. Conclusion The health system is bound to implement suitable pathways to facilitate HCV eradication. A Meet–Test–Treat program within the drug addiction services may provide good compliance from subjects mainly concerned with virus transmission.


Author(s):  
Marek A. Motyka ◽  
Ahmed Al-Imam

Drug use is a behaviour frequently seen among adolescents. The World Drug Report draws attention to the increase in this phenomenon. The studies were undertaken to look for determinants that promote drug use and those that protect against reckless activities. It seems important to determine the causes of drug initiation. The presented study aimed to identify the determinants favouring first contact with drugs among adolescents. Eighteen respondents participated in the study. Purposive sampling was used and data were collected using categorized interviews. The exploratory nature of the interviews focused on obtaining information on three areas: family life, peer influences and the role of mass culture products. Education, financial background, and inquiries about life plans, dreams, and their realization were also recorded. The analysis of empirical data made it possible to establish interesting factors conducive to the respondents’ first contact with drugs both in the family environment, peer environment, but also related to popular culture, lifestyle, the influence of significant others, as well as to the dangers of the Internet. Established causes of drug initiations are indicated. The obtained results can be used in designing preventive interventions among adolescents. They can also be the basis for planning further studies with this group.  


2022 ◽  
Vol 21 (1) ◽  
pp. 116-139
Author(s):  
Manuel de Jesús Hernández Ramírez ◽  
Erika Yovana González Martín ◽  
Ashlye Melannie Fuentes Rodríguez ◽  
Suleika Alelí Carranza López ◽  
Violeta Compeán Padilla ◽  
...  

Introduction: Death is a complex phenomenon, nurses in training may face the process of dying and death of people, which can generate diverse situations that represent their lived experiences. Objective: To understand the lived experience of the first contact with death during clinical practicum of nursing students at a public university.Methodology: Qualitative study with phenomenological approach. It was conducted from October 2020 to February 2021. Selection of participants by intentional sampling with information saturation with seven participants. Data collection through phenomenological interview; participants gave informed consent. The analysis was carried out through the three phases of Max Van Manen's hermeneutic phenomenological method (description, interpretation, description plus interpretation). Results: The students refer to having been faced with the phenomenon in a state of helplessness, blockage, uncertainty, and fear; as well as facing death in a professional and reflective manner in order to provide quality care. Discussion: Death is a natural process; however, the first experiences are diverse and can produce in the students a set of emotions that condition their capacity to act, the way of adapting and observing the needs that arise during this experience. Conclusion: The experiences of nursing students show that they have difficulties in facing death, but it was not an impediment to provide the necessary care; it is considered that a deeper preparation on the process of dying can be favorable for their performance as professionals. Introducción: La muerte es un fenómeno complejo, las enfermeras en formación pueden enfrentarse al proceso de morir y muerte de personas, lo que puede generar diversas situaciones que representan sus experiencias vividas. Objetivo: Comprender la experiencia vivida ante el primer contacto con la muerte durante prácticas clínicas de estudiantes de enfermería de una universidad pública.Metodología: Estudio cualitativo con enfoque fenomenológico. Se llevó a cabo de octubre del 2020 a febrero del 2021. Selección de participantes por muestreo intencional con saturación de información con siete participantes. Recolección de datos a través de entrevista fenomenológica; los participantes emitieron su consentimiento informado. El análisis se llevó a cabo por las tres fases del método fenomenológico hermenéutico de Max Van Manen (descripción, interpretación, descripción más interpretación). Resultados: Los estudiantes refieren haber estado frente al fenómeno en un estado de impotencia, bloqueo, incertidumbre y miedo; así como afrontaron la muerte de manera profesional y reflexiva para brindar cuidado de calidad. Discusión: La muerte es un proceso natural, sin embargo, las primeras experiencias son diversas y pueden producir en los estudiantes un conjunto de emociones que condicionan su capacidad de actuar, el modo de adaptarse y observar las necesidades surgidas durante esta experiencia. Conclusión: Las experiencias de los estudiantes de enfermería demuestran que tienen dificultades para afrontar la muerte, pero no fue un impedimento para brindar los cuidados necesarios; se considera que una preparación más profunda sobre el proceso de morir puede ser favorable para su actuar como profesional.


2022 ◽  
pp. 419-432
Author(s):  
Daniela Rojatz ◽  
Peter Nowak ◽  
Ottomar Bahrs ◽  
Jürgen M. Pelikan

AbstractPrimary care is understood as the first contact point to medical care. It operates at the interface between the social and the health systems, between the patient with his or her family and the professional environment, and refers to the local population, while primary health care, following WHO, is defined as a whole-of-society approach envisioned to contribute to universal health coverage and equality. This chapter is dedicated primarily to the application of salutogenesis in primary care. Since primary care services are a complex of strongly interrelated professional practice, research, and supporting policy, applying salutogenesis in primary care comprehensively should introduce salutogenesis in all these fields simultaneously.This chapter examines how salutogenesis is addressed and discussed in policy, research, and practice of primary care and discusses the application of salutogenesis as an orientation, a model, and the construct of ‘sense of coherence’. Thus, it contributes to supporting the application of salutogenesis in primary care and provides an outlook on further research needs.


2021 ◽  
Vol 16 (4) ◽  
pp. 628-665
Author(s):  
Jian Zhou ◽  
◽  
Xiaohui Lu ◽  
Liang Ye ◽  
Yu Shao ◽  
...  

This study evaluates COVID-19 prevention and control policies. Based on the simulation, we compare the effects of two major policies: contact restriction and active treatment. Through regression and cluster analysis, we classified 169 countries and regions in the world into 10 groups, among which five groups accounted for the major proportion: the ones with the labels “CHN (China) mode,” “SE (South Europe) mode,” “ENE-SSA (East & North Europe and Sub-Saharan Africa) mode,” “US (United States) mode,” and “DEU (Germany) mode”). Differences in the effects of the prevention and control of COVID-19 in typical countries in each mode are comprehensively investigated. The conclusions of this study can be summarized as follows: First, contact restriction outperforms active treatment in curbing the spread of COVID-19. Second, “CHN mode” ranks the highest level of epidemic control and emphasizes epidemic prevention and control more than economic stimulus, which is the opposite of the “US mode”. Regression analysis reveals that the differences in epidemics worldwide are caused by policy differences among modes.


2021 ◽  
Author(s):  
Joana Figueiredo ◽  
Rita B Santos ◽  
Leonor Guerra-Guimaraes ◽  
Celine Leclerq ◽  
Jenny Renaut ◽  
...  

Plant apoplast is the first hub of plant-pathogen communication where pathogen effectors are recognized by plant defensive proteins and cell receptors and several signal transduction pathways are activated. As a result of this first contact, the host triggers a defence response that involves the modulation of several extra and intracellular proteins. In grapevine-pathogen interactions, little is known about the communication between cells and apoplast. Also, the role of apoplastic proteins in response to pathogens still remains a blackbox. In this study we focused on the first 6 hours after Plasmopara viticola inoculation to evaluate grapevine proteome modulation in the apoplastic fluid (APF) and whole leaf tissue. Plasmopara viticola proteome was also assessed enabling a deeper understanding of plant and pathogen communication. Our results showed that oomycete recognition, plant cell wall modifications, ROS signalling and disruption of oomycete structures are triggered in Regent after P. viticola inoculation. Our results highlight a strict relation between the apoplastic pathways modulated and the proteins identified in the whole leaf proteome. On the other hand, P. viticola proteins related to growth/morphogenesis and virulence mechanisms were the most predominant. This pioneer study highlights the early dynamics of extra and intracellular communication in grapevine defence activation that leads to the successful establishment of an incompatible interaction.


2021 ◽  
Author(s):  
Felix Nicolaus ◽  
Fatima Ibrahimi ◽  
Anne den Besten ◽  
Gunnar von Heijne

During SecYEG-mediated cotranslational insertion of membrane proteins, transmembrane helices (TMHs) first make contact with the membrane when their N-terminal end is ~45 residues away from the peptidyl transferase center. However, we recently uncovered instances where the first contact is delayed by up to ~10 residues. Here, we recapitulate these effects using a model TMH fused to two short segments from the BtuC protein: a positively charged loop and a re-entrant loop. We show that the critical residues are two Arg residues in the positively charged loop and four hydrophobic residues in the re-entrant loop. Thus, both electrostatic and hydrophobic interactions involving sequence elements that are not part of a TMH can impact the way the latter behaves during membrane insertion.


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