Lonkan tekonivelleikkauksen jälkeinen fysioterapeuttinen ohjaus fysioterapeuttien kuvaamana

Lonkan tekonivelleikkausten sekä leikkauksen jälkeistä fysioterapiaa tarvitsevien määrä kasvaa väestön ikääntyessä. Kuntoutumisen kannalta fysioterapeuttinen ohjaus on tärkeää. Tämän tutkimuksen tarkoituksena oli tarkastella fysioterapeuttien käsityksiä lonkan tekonivelleikkauksen jälkeisestä fysioterapeuttisesta ohjauksesta. Laadullisen tutkimuksen aineistona oli fysioterapeuttisten ohjaustilanteiden (n=7) kuvanauhojen pohjalta tehdyt recall-haastattelut. Aineiston fenomenografisessa analyysissä muodostettiin kolme hierarkkista kuvauskategoriaa, jotka olivat suppeammasta laajempaan: asiantuntijalähtöinen fysioterapeuttinen ohjaus, potilaan yksilöllisyyttä arvostava fysioterapeuttinen ohjaus sekä fysioterapeuttinen ohjaus osana potilaan kuntoutumista. Nämä kategoriat sisälsivät kuusi ohjaustilanteita kuvaavaa teemaa ja niiden variaatiot: potilaan osallistuminen, kehollinen ohjaus, eettisyys ohjaussuhteessa, fysioterapeutin asiantuntijuus, yhteistyö ja terveydenhuoltojärjestelmän eettisyys. Fysioterapeuttisen ohjauksen onnistumisen kannalta kriittiset tekijät fysioterapeuttien ohjauskäsityksissä olivat potilaskeskeisyys, moniammatillinen yhteistyö ja kuntoutumisprosessin jatkuvuus. Abstract Physiotherapists’ perceptions of patient counseling after total hip arthroplasty (THA) The number of total hip arthroplasties is growing due to the fact that THA is a cost-effective procedure moving people quickly from poor to good functional capacity. The aim of the qualitative study was to explore physiotherapists’ perceptions of post-operative patient counseling. The data of this study consisted of seven physiotherapy situations with inpatients in hospital setting. Data were collected by open recall-interviews based on videotapes of patient counseling situations. The data were analyzed according to phenomenographic approach, which revealed three hierarchical categories: therapist-centered patient counseling, patient counseling which values patient’ individuality and patient counseling as part of individual rehabilitation process. Six themes that varied hierarchically in three categories describing different ways of understanding patient counseling were found: patients’ active participation, counseling for movement awareness, ethical counseling relationship, physiotherapy expertise, cooperation, and ethicality of national health care system. The critical variation between categories manifested as patient-centeredness, multiprofessional cooperation and the continuity of rehabilitation process.

Tasks, shortcomings and reservations in the process of reforming the specialized dermatovenereological sector of health care

Objective — to draw the attention of the Ukrainian health care management, the National Health Care Service (NHCS) and dermatovenereologists to urgent issues of reforming the industry, identifying shortcomings in the reform and presenting the views of experienced professionals on correcting organizational measures.Official statistics was used based on the materials of leading specialists of Kharkiv Research Institute of Dermatology and Venereology, scientific and practical institutions of Ukraine, the forecast of «GlobalData» analytical and statistical company on the trend of syphilis in the world, the results of discussion of current reform issues with leading specialists in dermatovenereology.The interpretation of the modern epidemiological panorama of skin and venereological pathology, the current state of organizational and material support of dermato-venereology institutions are presented. Some specific shortcomings and miscalculations in the process of reforming are revealed from the point of view of experienced specialists in the field, the authors’ vision of ways to improve the organization and activity of the dermatovenereological service of the country is presented.The need for correction in the process of reforming the specialized dermatovenereological service by resolving the urgent issue of organization in the areas of round-the-clock bed stock within reasonably adjusted limits and their financial and material support is substantiated. Calculations of the needs of round-the-clock inpatient beds in the regions should be carried out in the NHCS with the participation of the leadership of the Ukrainian Association of Dermatovenereologists and Cosmetologists (UADVC). The reforming of the dermatovenereology service should become a truly effective compo­nent of the generally progressive system of health care reform, taking into account the international medical and statistical forecasts.

COVID-19 Vaccines and Vaccination Report: The Nigeria Perspective

COVID-19 vaccine like other vaccines is developed to produce acquired immunity against the virus which causes coronavirus disease. The spread of the virus led to quick study by various science laboratories all over the world on the preventive role and the mortality rate reduction potential of covid vaccines. Celebration has been witnessed in different part of the world for the role the vaccines played against various cases arising from coronavirus infection. This review focused on the adverse event of coronavirus vaccines with perspective to the Nigerian populace. The type of vaccines approved for use by the WHO include; viral vector vaccines which has the Oxford-Astrazenca in its class, RNA vaccines, whole virus vaccines (having the Sinopharm, and Sinovac in it class), and protein subunit vaccines (with Novavax COVID-19 vaccines and (ESI, 2021), EpiVacCorona in it class). In Nigeria, about 8,439 mild adverse reactions have been reported by the National Health Care Development Agency (NPHCDA), following the administration of the first doses of the Oxford-AstraZeneca COVID-19 vaccine. The report showed that out of over a million persons who received the vaccine, 8,439 persons showed mild adverse effects, while 52 persons suffered moderate to severe adverse events on receiving the jab. Generally, the vaccine has proven to be effective in combating and limiting infection and spread of covid-19 among the citizenry.

COVID-19 Pandemic Impact on the National Health Care Surveys

While underscoring the need for timely, nationally representative data in ambulatory, hospital, and long-term-care settings, the COVID-19 pandemic posed many challenges to traditional methods and mechanisms of data collection. To continue generating data from health care and long-term-care providers and establishments in the midst of the COVID-19 pandemic, the National Center for Health Statistics had to modify survey operations for several of its provider-based National Health Care Surveys, including quickly adding survey questions that captured the experiences of providing care during the pandemic. With the aim of providing information that may be useful to other health care data collection systems, this article presents some key challenges that affected data collection activities for these national provider surveys, as well as the measures taken to minimize the disruption in data collection and to optimize the likelihood of disseminating quality data in a timely manner. (Am J Public Health. 2021;111(12):2141–2148. https://doi.org/10.2105/AJPH.2021.306514 )

Incorporating Public Values Through Multiple Accountability: A Case Study on Quality Regulation of Emergency Care in the Netherlands by an Independent Regulatory Agency

In this paper, we explore how multiple accountability (MA) can enable an independent regulatory agency to deal with multiple conflicting public values in a complex and politically salient decision-making process. We examined the decision-making process of the Dutch National Health Care Institute on quality regulation of emergency care in the Netherlands. Using insights derived from ethnography, document analysis, and interviews, we show that MA resulted from strategic interactions between the Institute’s vertical and horizontal accountability forums. We argue that MA impeded efficiency but also enabled the Institute to deal with multiple conflicting public values.

The proteomics analysis of the effects of Zhishi Rhubarb soup on ischaemic stroke

Background Stroke has always been a major threat worldwide but is most severe in China, with 2.5 million new stroke cases each year and 7.5 million stroke survivors, placing a heavy burden on the social and national health care systems. Zhishi Rhubarb Soup (ZRS) is a traditional Chinese medicine (TCM) that has been used clinically for many years in China. To explore the potential mechanism of ZRS in the treatment of stroke, liquid chromatography with mass spectrometry (LC–MS) was performed. Methods In this study, a quantitative proteomic method with LC–MS was used to analyse the proteomic differences between MACO samples treated with ZRS and those without ZRS treatment. Results Liquid chromatography with mass spectrometry (LC–MS) analysis led to the identification of 35,006 peptides, with 5160.0 proteins identified and 4094.0 quantified. Significantly differentially expressed proteins were identified through data analysis, and the difference was found to be more than 1.2 times (P < 0.05). The Gene Ontology (GO) analysis provided a summary of the dysregulated protein expression in the biological process (BP), cell component (CC), and molecular function (MF) categories. Proteins related to brain repair, including BDNF, IL-10, IL-6, and TGF-β, were found to change significantly, partially demonstrating the effectiveness of ZRS to attenuate tissue injury. Conclusion In this study, LC–MS/MS was performed to assess the effects of ZRS on differentially expressed proteins in rats with cerebral infarction. These promising results could help to improve the understanding of the effects of drugs on stroke.

Structuring complexity? A systemic perspective on the implementation of a disease management programme for type II diabetes care in Denmark

Chronic diseases are major causes of death and reduction in the quality of life worldwide, and their prevalence is expected to rise due to changing demographics. Disease management programmes (DMPs) have been presented as a policy response to challenges of care coordination for such chronic diseases. This paper investigates the implementation of DMPs in a National Health Care system in the Nordic region using type II diabetes as an example. DMPs are detailed descriptions of the sequence and responsibilities for diagnostic, treatment, rehabilitation and prevention procedures. The paper applies a systemic implementation perspective to provide detailed analysis of implementation progress, issues and concerns. The implementation analysis shows that the framework of DMP has facilitated the development of new practices and attention to the roles that each of the stakeholders are playing within the service delivery. Many new initiatives contribute to improved coordination and overall management of the Type 2 diabetes (T2DB) population. Yet, there are also several cross-cutting challenges that are affecting the implementation process.