Grey nomads with diabetes: the experience of rural and remote diabetes educators in South Australia

2020 ◽  
Vol 26 (4) ◽  
pp. 300
Author(s):  
Anita De Bellis ◽  
Pauline Hill ◽  
Wendy Abigail ◽  
Jane Giles ◽  
Christine McCloud
Keyword(s):  
Glycaemic Control ◽  
Chronic Conditions ◽  
South Australia ◽  
Further Education ◽  
Older Age ◽  
Self Management ◽  
Age Group ◽  
Rural And Remote ◽  
Practice Recommendations ◽  
Diabetes Educators

The phenomenon of grey nomads travelling in rural and remote regions of Australia is on the increase, and as this cohort is an older age group, they are often travelling with chronic conditions, such as diabetes. Seven rural and remote diabetes educators were interviewed about their experiences of grey nomad travellers with diabetes, to whom they provided services. The findings revealed problems associated with grey nomads with diabetes, including maintenance of equipment, medications, self-management, glycaemic control and unpredictable events. The problems highlighted by the participants were exacerbated when travelling long distances for extended periods, often with changes to their usual regime of self-management. The isolation and remoteness of some areas was a factor for the travellers who were often not prepared and often turned to pharmacists for help. The participants were able to enhance the care and self-management of the travellers with diabetes and identified several pathways travellers may undertake if they needed services related to their diabetes. The diabetes educators’ capacity to provide services for travellers was stretched at times; however, this was viewed as positive in that it added diversity to their normal practice. Recommendations included a preparation checklist and information for travellers with diabetes and further education for pharmacists.

Self-management of chronic conditions in a rural and remote context

2015 ◽  
Vol 21 (1) ◽  
pp. 90 ◽  
Author(s):  
Adem Sav ◽  
Michelle A. King ◽  
Fiona Kelly ◽  
Sara S. McMillan ◽  
Elizabeth Kendall ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Urban Areas ◽  
Chronic Conditions ◽  
Health Care Services ◽  
Management Strategies ◽  
Lifestyle Changes ◽  
Self Management ◽  
Rural And Remote ◽  
North West

Living in a rural or remote environment presents unique challenges for people with chronic conditions, mainly those created by limited health-care services and the physical and emotional isolation. Yet, research on how people self-manage their chronic conditions in such locations is limited. This study aims to contribute to research and clinical practice by describing the ways in which a diverse group of rural and remote people with a range of chronic conditions, and their unpaid carers, self-manage their conditions. Using semi-structured in-depth interviews, data was collected from a sample of 32 participants, residing in one of two regions of Australia: Mount Isa/North West region of Queensland and the Northern Rivers area of New South Wales. Our findings suggest that although self-managing in a rural and remote context requires many of the lifestyle changes necessary in urban areas, the uniqueness of the rural lifestyle and the limited availability of health care results in, at times, creative forms of self-management. Health-care professionals and policy makers need to be cognisant of the ways in which rural and remote residents modify self-management strategies to suit their needs, and help them develop self-management plans tailored to the realities of their rural environment.

Chronic condition management and self-management in Aboriginal communities in South Australia: outcomes of a longitudinal study

2013 ◽  
Vol 37 (2) ◽  
pp. 246 ◽  
Author(s):  
Peter W. Harvey ◽  
John Petkov ◽  
Inge Kowanko ◽  
Yvonne Helps ◽  
Malcolm Battersby
Keyword(s):  
Health Status ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Aboriginal People ◽  
Systems Of Care ◽  
South Australia ◽  
Self Management ◽  
Care Planning ◽  
Aboriginal Communities ◽  
Structured Systems

Objectives. This paper describes the longitudinal component of a larger mixed methods study into the processes and outcomes of chronic condition management and self-management strategies implemented in three Aboriginal communities in South Australia. The study was designed to document the connection between the application of structured systems of care for Aboriginal people and their longer-term health status. Methods. The study concentrated on three diverse Aboriginal communities in South Australia; the Port Lincoln Aboriginal Health Service, the Riverland community, and Nunkuwarrin Yunti Aboriginal Health Service in the Adelaide metropolitan area. Repeated-measure clinical data were collected for individual participants using a range of clinical indicators for diabetes (type 1 and 2) and related chronic conditions. Clinical data were analysed using random effects modelling techniques with changes in key clinical indicators being modelled at both the individual and group levels. Results. Where care planning has been in place longer than in other sites overall improvements were noted in BMI, cholesterol (high density and low density lipids) and HbA1c. These results indicate that for Aboriginal patients with complex chronic conditions, participation in and adherence to structured care planning and self-management strategies can contribute to improved overall health status and health outcomes. Conclusions. The outcomes reported here represent an initial and important step in quantifying the health benefits that can accrue for Aboriginal people living with complex chronic conditions such as diabetes, heart disease and respiratory disease. The study highlights the benefits of developing long-term working relationships with Aboriginal communities as a basis for conducting effective collaborative health research programs. What is known about the topic? Chronic condition management and self-management programs have been available to Aboriginal people in a range of forms for some time. We know that some groups of patients are keen to engage with care planning and self-management protocols and we have anecdotal evidence of this engagement leading to improved quality of life and health outcomes for Aboriginal people. What does this paper add? This paper provides early evidence of sustained improvement over time for a cohort of Aboriginal people who are learning to deal with a range of chronic illnesses through accessing structured systems of support and care. What are the implications for practitioners? This longitudinal evidence of improved outcomes for Aboriginal people is encouraging and should lead on to more definitive studies of outcomes accruing for people engaged in structured systems of care. Not only does this finding have implications for the overall management of chronic illness in Aboriginal communities, but it points the way to how health services might best invest their resources and efforts to improve the health status of people with chronic conditions and, in the process, close the gap between the life expectancy of Aboriginal people and that of other community groups in Australia.

Optimization of the care model for elderly in Poland

Physiotherapy ◽  
2013 ◽  
Vol 21 (4) ◽  
Author(s):  
Felicja Lwow ◽  
Małgorzata Korzeniowska ◽  
Joanna Dadacz ◽  
Ewa Hladik ◽  
Agata Łukojko ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Institutional Care ◽  
Developed Countries ◽  
Social Aspect ◽  
Age Group ◽  
Care Needs ◽  
Optimal Health ◽  
Health Care Models ◽  
The Individual

AbstractThe demographic situation of Poland as well as other developed countries shows a growing number of people at retirement age. According to the data from GUS (Central Statistical Office), their number reached 6.5 mln in Poland in 2011, and the prognosis for shows 8,3 mln by the year 2035. The consequence of this fact is a necessity of including the specificity of this age group in the functioning of Polish health care as well as in preventive medicine and health promotion. Unifying the health needs of this age group would be disadvantageous due to the diversification of physical efficiency level in the psychosomatic and social aspect. Nevertheless, the key problem is to distinguish the optimal health care models which include not only chronic conditions and dysfunctions but also the quality of life and socially independent life style that guarantee the lack of isolation and social exclusion. Distinguishing the four action models, namely people considered as healthy by the system, autonomously functioning people with chronic conditions, and people who need other people or institutional care to function in a society, seems to cover the individual needs of this group. Concluding, the National Health Care needs to work out some proceeding algorithms for these models. The optimal program adjustment for the needs of the target group would most certainly improve the effectiveness of the Health Care.

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

COVID-19 Epigenetics and Implications for Public Health

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Verda Tunalıgil ◽  
Gülsen Meral ◽  
Ahmet Katı ◽  
Dhrubajyoti Chattopadhyay ◽  
Amit Kumar Mandal
Keyword(s):  
Chronic Conditions ◽  
Empirical Investigation ◽  
Age Groups ◽  
Infectious Agent ◽  
Well Being ◽  
Epigenetic Mechanisms ◽  
Age Group ◽  
Epigenetic Changes ◽  
Patient Groups ◽  
Epigenetic Processes

Abstract:: Epigenetic changes in COVID-19 host, a pandemic-causing infectious agent that globally incapacitated communities in varying complexities and capacities are discussed, proposing an analogy that epigenetic processes contribute to disease severity and elevate the risk for death from infection. Percentages of hospitalization, with and without intensive care, in the presence of diseases with increased ACE2 expression, were compared, based on the best available data. Further analysis compared two different age groups, 19-64 and ≥65 years of age. The COVID-19 disease is observed to be the most severe in the 65-and-higher-age group with preexisting chronic conditions. This observational study is a non-experimental empirical investigation of the outcomes of COVID-19 in different patient groups. Results are promising for conducting clinical trials with intervention groups. To ultimately succeed in disease prevention, researchers and clinicians must integrate epigenetic mechanisms to generate valid prescriptions for global well-being.

User-Centered Design Enhances Usability of an mHealth System for Users with Dexterity Impairments (Preprint)

2020 ◽  
Author(s):  
Kuntal Chowdhary ◽  
Daihua Xie Yu ◽  
Gede Pramana ◽  
Andrea Fairman ◽  
Brad Edward Dicianno ◽  
...  
Keyword(s):  
User Interface ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Independent Living ◽  
Health Interventions ◽  
Self Management ◽  
User Centered Design ◽  
Entire Study ◽  
Efficiency And Effectiveness ◽  
User Centered

BACKGROUND Mobile health (mHealth) systems have been shown to be useful in supporting self-management by promoting adherence to schedules and longitudinal health interventions, especially in people with disabilities (PwD). The Interactive Mobile Health and Rehabilitation (iMHere) System was developed to empower PwD and those with chronic conditions with supports needed for self-management and independent living. Since the first iteration of the iMHere 1.0 app, several studies have evaluated accessibility and usability of the system. Potential opportunities to improve and simplify the user interface (UI) were identified, and the iMHere modules were redesigned accordingly. OBJECTIVE The aim of this study was to evaluate the usability of the redesigned modules within iMHere 1.0. METHODS This study evaluated the original and redesigned MyMeds and SkinCare modules. To assess the participants’ dexterity levels, the Purdue Pegboard Test (PPBT) was administered. Participants were then asked to perform a set of tasks using both the original and redesigned MyMeds and SkinCare modules to assess efficiency and effectiveness. Usability was measured using the Telehealth Usability Questionnaire (TUQ) to evaluate 10 new accessibility features that were added to the redesigned app. Participants were also asked which version they preferred. RESULTS Twenty-four participants with disabilities and varied degrees of dexterity impairments completed the entire study protocol. Participants displayed improved efficiency and effectiveness of use when using the redesigned modules, as compared to the original modules. Participants also reported improved usability and preferred the redesigned modules. CONCLUSIONS This study demonstrated that the iMHere System became more efficient, effective, and usable for individuals with dexterity impairments after redesigning it according to user-centered principles.

scholarly journals CT density of cervical thymus, in comparison with mediastinal thymus

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Anitha Sen ◽  
Jiji Valsalamony ◽  
Jubie Raj
Keyword(s):  
Young Adults ◽  
Soft Tissue ◽  
Older Age ◽  
List Type ◽  
Age Group ◽  
Positive Correlation ◽  
Children And Young Adults ◽  
Criteria For Diagnosis ◽  
Ct Density ◽  
Moderate Positive Correlation

Abstract Objectives Cervical component of thymus is noted more in children and young adults than in older age group. CT texture (lobules of soft tissue interspersed with fat), similarity with CT density of mediastinal thymus and continuity with mediastinal thymus on sagittal/coronal images, are given as the criteria for diagnosis of the cervical thymus. But CT densities of cervical and mediastinal components of the thymus may vary. The purpose of our study was to compare CT densities of cervical and mediastinal parts of the thymus, in cases where ultrasonography correlation was available. Methods We retrospectively identified 22 patients who had undergone CT between May 2015 and May 2017 and in whom ultrasonography (USG) correlation was available. CT densities of cervical and mediastinal components of thymus were measured. Results CT density of cervical thymus is lower than the CT density of mediastinal thymus by ~ 25 HU. There is a moderate positive correlation between CT densities of cervical and mediastinal parts of the thymus. CT densities of both cervical and mediastinal thymus were found to reduce with age, but the reduction was statistically significant only in the cervical thymus in this study. Conclusions CT densities of cervical and mediastinal components of the thymus may vary, with CT density of cervical thymus being lower. There is a positive correlation between CT densities of cervical and mediastinal parts of the thymus. CT density of cervical thymus reduces with age. Understanding these may help avoid confusion on CT and avoid the need for correlative USG, saving time and effort.

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

scholarly journals Early CT features of COVID-19 pneumonia, association with patients’ age and duration of presenting complaint

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Reem M. EL Kady ◽  
Hosam A. Hassan ◽  
Tareef S. Daqqaq ◽  
Rania Makboul ◽  
Hanan Mosleh Ibrahim
Keyword(s):  
Pleural Effusion ◽  
Ground Glass Opacity ◽  
Ct Imaging ◽  
Older Age ◽  
Ground Glass ◽  
Imaging Features ◽  
Age Group ◽  
Patient Age ◽  
Atypical Features ◽  
Patient Âgé

Abstract Background Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients’ age. Results The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group (≥ 50 years old) and increased duration of presenting complaint (≥ 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age. Conclusion The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.

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