scholarly journals Effective Containment of a COVID-19 Subregional Outbreak in Italy Through Strict Quarantine and Rearrangement of Local Health Care Services

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Sara Tedeschi ◽  
Lorenzo Badia ◽  
Fabio Berveglieri ◽  
Rodolfo Ferrari ◽  
Simona Coladonato ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
World Health ◽  
Nasopharyngeal Swab ◽  
Local Health ◽  
Telephone Contact ◽  
Care Services ◽  
Local Health Care ◽  
Emilia Romagna Region ◽  
Health Organization

Abstract Background Since the beginning of the pandemic, the epidemiology of coronavirus disease 2019 (COVID-19) in Italy has been characterized by the occurrence of subnational outbreaks. The World Health Organization recommended building the capacity to rapidly control COVID-19 clusters of cases in order to avoid the spread of the disease. This study describes a subregional outbreak of COVID-19 that occurred in the Emilia Romagna region, Italy, and the intervention undertaken to successfully control it. Methods Cases of COVID-19 were defined by a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on nasopharyngeal swab. The outbreak involved the residential area of a small town, with ~10 500 inhabitants in an area of 9 km2. After the recognition of the outbreak, local health care authorities implemented strict quarantine and a rearrangement of health care services, consisting of closure of general practitioner outpatient clinics, telephone contact with all residents, activation of health care units to visit at-home patients with symptoms consistent with COVID-19, and a dedicated Infectious Diseases ambulatory unit at the nearest hospital. Results The outbreak lasted from February 24 to April 6, 2020, involving at least 170 people with a cumulative incidence of 160 cases/10 000 inhabitants; overall, 448 inhabitants of the municipality underwent at least 1 nasopharyngeal swab to detect SARS-CoV-2 (positivity rate, 38%). Ninety-three people presented symptoms before March 11 (pre-intervention period), and 77 presented symptoms during the postintervention period (March 11–April 6). Conclusions It was possible to control this COVID-19 outbreak by prompt recognition and implementation of a targeted local intervention.

scholarly journals Seminars in social psychiatry in Romania

1992 ◽  
Vol 16 (6) ◽  
pp. 340-342 ◽  
Author(s):  
Greg Wilkinson ◽  
Linda Gask ◽  
John Henderson
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Graduate Training ◽  
Training Programme ◽  
World Health ◽  
Psychiatric Training ◽  
Regional Office ◽  
Care Services ◽  
Post Graduate Training ◽  
Health Organization

For more than a decade there has been no opportunity for formal post-graduate training in psychiatry in Romania. In February 1992, as part of a World Health Organization (Regional Office for Europe) initiative, we travelled to Romania as WHO temporary advisers to give seminars on: (i) the role of primary health care services in providing mental health care; and (ii) the development of community-based services for the mentally ill and disabled. Our seminars were designed to complement the biological and clinical elements of a developing psychiatric training programme.

scholarly journals Maternal near miss morbidity in Colombia: variables related to opportune access to health care related to the number of inclusion criteria

2015 ◽  
Vol 62 (4) ◽  
pp. 553-558 ◽  
Author(s):  
José Luis Pérez-Olivo ◽  
Esther Liliana Cuevas ◽  
Sara García-Forero ◽  
Adalberto Campo-Arias
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Inclusion Criteria ◽  
Care Services ◽  
Timely Access ◽  
Health Organization

<p>Background. In Colombia, maternal near miss morbidity is<br />monitored in the health surveillance system. The National<br />Health Institute included a special report on cases that met<br />three or more World Health Organization criteria according to<br />the World Health Organization criteria.</p><p><br />Objective. To estimate the relationship between variables<br />related to opportune access to health care services in Colombia during 2013 depending on inclusion criteria –three or more– for maternal near miss morbidity.</p><p><br />Materials and methods. A cross-sectional analysis of the<br />national registry of obligatory notification on maternal near<br />miss morbidity was performed. Cases with three or more criteria were compared with those with one or two according to some variables related to the timely access of health care services.</p><p><br />Results. A total of 8 434 maternal near miss morbidity cases<br />were reported, women were aged between 12 and 51 years old<br />(M=26.4, SD=7.5). 961 (11.4%) lived in remote rural areas; 4<br />537 (53.8%) were uninsured under the health system, or they<br />were affiliated to either the subsidized or special health care<br />regime; 845 (10.0%) belonged to an ethnic minority; 3 696<br />(44.4%) were referred to a more complex service; 4 097 (49.2%) were admitted to the intensive care unit; and 3 975 (47.1%) met three or more of the inclusion criteria for maternal near miss morbidity. They were combined to meet three or more of the case inclusion criteria: intensive care unit admission (OR=5.58;IC95% 5.06-6.15); being uninsured or affiliated to the subsidized or special regime (OR=1.57; IC95% 1.42-1.74); and referral to a more complex service (OR=1.18; IC95% 1.07-1.31).</p><p><br />Conclusions. In Colombia, the timely access of health care<br />services is related to maternal near miss morbidity with three<br />or more inclusion criteria.</p>

scholarly journals The Relations between Disability and Environmental Factors: A Pilot Study in Iranian Older Adults

2016 ◽  
Vol 8 (12) ◽  
pp. 87 ◽  
Author(s):  
Mohammadreza Shahbazi ◽  
Mahshid Foroughan ◽  
Mahdi Rahgozar ◽  
Reza Salmanroghani
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Environmental Factors ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
World Health ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Care Services ◽  
Health Organization

<p><strong>OBJECTIVE: </strong>This study explored disability and its correlations with the environmental factors in a group of Iranian older adults.</p><p><strong>MATERIALS &amp; METHODS</strong><strong>:</strong> A cross sectional study was performed. One hundred participants receiving adult day care services in Kahrizak center in Iran were selected by using the complete enumeration method. The World Health Organization Disability Assessment Schedule 2 (WHODAS II) and the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaires were used to collect data.</p><p><strong>RESULTS:</strong> The mean score of disability was 20.61±13.66, and the scores were higher in women compared to men (P=0.001). Among the CHIEF-25 items‚ the most frequently perceived barrier by the participants was transportation followed by home design and unavailability of health care services. There was a significant association between the disability scores and the environmental factors (P&lt;0.001). Also, significant relationships were found between the disability and all the subscales investigated in the study (polices‚ physical/structural‚ attitude/support‚ services/assistance) (P&lt;0.001).<strong></strong></p><p><strong>CONCLUSION: </strong>Appropriate transportation‚ availability to health care services and removing physical/structural barriers should be taken in consideration.</p>

Part 5: Community Perception of Local Health Care Services

1991 ◽  
Vol 7 (5) ◽  
pp. 542-559 ◽  
Author(s):  
L. Gary Hart ◽  
Denise M. Lishner ◽  
Bruce A. Amundson
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Local Health ◽  
Community Perception ◽  
Care Services ◽  
Local Health Care

Mass-gathering Events: The Role of Advanced Nurse Practitioners in Reducing Referrals to Local Health Care Agencies

2016 ◽  
Vol 31 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Anthony E. Kemp
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Nurse Practitioners ◽  
Health Care Services ◽  
Local Health ◽  
Medical Team ◽  
Mass Gathering ◽  
Care Services ◽  
Local Health Care

AbstractIntroductionThe introduction of advanced practitioner roles has challenged the traditional boundaries of health care. While studies have been undertaken to understand the role of physicians in respect of mass-gathering medicine, the role of advanced nurse practitioners (ANPs) has not been investigated.ProblemDoes the presence of an ANP reduce the referral rates of patients presenting for medical care at mass-gathering events to external health care resources?MethodsA prospective observational study was undertaken to determine whether the presence of an ANP would reduce the patient referral rate to external health care services by first aiders and paramedics working within an event medical team. Patients identified as requiring referral were reviewed by an ANP as part of the on-site medical provision for four mass-gathering events in the south of England. Additionally, information was gathered identifying which patients would have been transported to hospital by ambulance compared to those actually transported following ANP review. Statistical analysis was undertaken for three key measures (referrals to all local health resources, referrals to hospital-based acute services, and transfers to hospital by ambulance).ResultsA rounded total of 842,000 people attended four mass-gathering events held over 14 days. Of these, 652 presented for medical care, many self-referring.Using a one-tailed Fisher’s Exact Test and Phi analysis, this study demonstrated statistically significant reductions in the overall referral of patients to all external health care resources (P<.001; φ=0.44), to the emergency department (ED; P<.001; φ=0.43), and a reduction in ambulance transport (P<.001; φ=0.42). Effect size analysis demonstrated a medium-sized effect evident for all of the above, which was also demonstrated in economic terms.The event medical team would have referred 105 (16.3%) of the 652 patient presentations to external health care services; 47 (7.2%) would have been transported by ambulance. In comparison, the ANP referred 23 patients (3.5%) with 11 (1.7%) being transported by ambulance. It also was noted that the first aiders and paramedics could be more selective in their referral habits that were focused primarily on the ED.ConclusionsAppropriately trained and experienced ANPs working within event medical teams have a positive impact on referral rates from mass-gathering events.KempAE. Mass-gathering events: the role of advanced nurse practitioners in reducing referrals to local health care agencies. Prehosp Disaster Med. 2016;31(1):58–63.

scholarly journals Continuity of care is associated with satisfaction with local health care services

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Lautamatti ◽  
M. Sumanen ◽  
R. Raivio ◽  
K. J. Mattila
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Local Health ◽  
Care Services ◽  
Local Health Care

Medical Technology and Developing Countries: The Case of Brazil

1986 ◽  
Vol 16 (3) ◽  
pp. 363-373 ◽  
Author(s):  
H. David Banta
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Health Care Services ◽  
Medical Technology ◽  
Developed Countries ◽  
World Health ◽  
Care Services ◽  
Use Of Technology ◽  
The Government ◽  
Health Organization

Developing countries, faced with severe resource limitations, are trying to develop modern health care services that deliver sensible medical technologies. Because of their lack of development, these countries must import much technology, while often lacking the expertise to make wise choices. In this article, the case of Brazil is examined. Brazil has shared many of the problems of other developing countries, including inadequate access of the population to health services, maldistribution and excessive use of technology, a relatively weak national industry for production of drugs and medical devices, a weak policy structure for dealing with medical technology, and little tradition of using research or policy analysis as a guide to action. Since the election in 1985 that returned Brazil to democratic rule, the government has taken active steps to address many of these problems. The example of Brazil is important for all of the developing world to examine and follow, where applicable. In addition, North American and European aid programs could play a much more constructive role in helping less developed countries develop their health care services. International organizations such as the World Health Organization must also be active in assisting such countries to improve their decisions concerning medical technology.

scholarly journals A study on disease burden and treatment among patients attending teleconsultation during lockdown period

2021 ◽  
Vol 10 (4) ◽  
pp. 434
Author(s):  
Mounika Yedlapalli ◽  
Sai Pasupula Kiran ◽  
Sravani Potti ◽  
Devikala A. ◽  
Chandrakala Kambar
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Disease Burden ◽  
Medical Officer ◽  
Vital Role ◽  
World Health ◽  
Care Services ◽  
Disease Pattern ◽  
The Government ◽  
Health Organization

Background: Covid-19 has been announced as a pandemic by the World Health Organization. To maintain social distancing effectively, the Government of India announced a complete lockdown on March 25th, 2020. As there are no proper transport facilities for patients who need health care services, the Government of Andhra Pradesh started 104 sevakendram as a helpline. Medical services were also provided by this 104 sevakendram through teleconsultation with doctors. The aim and objectives of the study were to study the disease pattern and treatment given to patients attending teleconsultations, to analyze the disease burden among the patients attending teleconsultation, to study the treatment given to the patients attending teleconsultation.Methods: It is a retrospective, observational, and analytical study. After prior IEC clearance and permission from teleconsultation authority, we did the study at Dr.YSR Aarogyasri health care trust, Guntur. Data regarding all calls connected to 104 was collected. Detailed information of the calls related to the Medical officer about the age, gender, disease pattern, and treatment given to the patient was collected. Statistical analysis was done using MS excel software.Results: On average, 104 sevakendram received two hundred valid teleconsultations per day. Most of the calls are related to anxiety and these calls constitute twenty four percent. Treatment given was according to probable diagnosis, mostly symptomatic and continuation of the same treatment.Conclusions: 104 sevakendram has played a vital role in meeting the medical and health requirements of the people suffering from different diseases during the lockdown period. 

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