The Reception of Exiles in Rural France: National Guidelines and Local Variations of a Dispersion Policy

2020 ◽  
Vol 36 (2-3) ◽  
Author(s):  
William Berthomière ◽  
Julie Fromentin ◽  
David Lessault ◽  
Bénédicte Michalon ◽  
Sarah Przybyl
Keyword(s):  
National Guidelines ◽  
Rural France

Attitudes, Beliefs, and Practices Regarding Asthma Care Among Providers and Adult Asthmatics in Imperial County

2003 ◽  
Vol 1 (2) ◽  
pp. 88-100
Author(s):  
Paula Kriner ◽  
Yolanda Bernal
Keyword(s):  
Focus Groups ◽  
Cultural Beliefs ◽  
National Guidelines ◽  
Medical Practitioners ◽  
Beliefs And Practices ◽  
Attitudes And Practices ◽  
Hospitalization Rates ◽  
Adult Asthmatic ◽  
Asthma Hospitalization ◽  
Survey Results

Asthma is a major cause of morbidity in children and adults. Imperial County has reported among the highest asthma hospitalization rates in the state. Factors such as poverty, access to care, poor selfmanagement skills, and ethnocultural beliefs may influence asthma exacerbations. Provider and adult asthmatic attitudes, beliefs, and practices regarding asthma were examined using a mixed-methods approach: a survey to evaluate provider conformance with national guidelines, and focus groups targeting medical practitioners and adult asthmatics. Half of all providers who treat asthmatics completed a self-administered survey about asthma diagnosis; clinical monitoring of patients; treatment; patient education; and practice guidelines. Provider focus groups further explored survey results. Adult asthmatics participated in Spanishlanguage focus groups exploring cultural beliefs, attitudes, and practices. El asma es la mayor causa de morbilidad entre niños y adultos. El Condado de Imperial ha reportado las tazas más altas de hospitalización a causa de asma en el estado. Factores como la pobreza, acceso a cuidado médico, falta de experiencia sobre como manejar la enfermedad, y creencias étnicas y culturales pueden tener una influencia en las exacerbaciones del asma. Las actitudes, creencias, y prácticas de proveedores de atención médica y adultos concerniente al asma fueron examinadas utilizando varios métodos: una encuesta con el fin de evaluar el nivel de conformidad de los proveedores según las pautas establecidas a nivel nacional, y grupos foco con médicos y adultos con asma. La mitad de los proveedores que proveen atención a asmáticos completaron una encuesta acerca del diagnosis de asma; el monitoreo clínico de los pacientes; administración de tratamiento; educación a los pacientes; y pautas establecidas para proveer atención a pacientes con asma. Los grupos foco con los proveedores exploraron aun más los resultados de las encuestas. Los adultos con asma participaron en grupos foco dirigidos en español para explorar más a fondo las creencias culturales, actitudes y prácticas.

INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

2018 ◽  
pp. 184-195
Author(s):  
Minh Son Pham ◽  
Vu Quoc Huy Nguyen ◽  
Dinh Vinh Tran
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Growth Potential ◽  
National Guidelines ◽  
Intrauterine Growth ◽  
No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

СОХРАНЕНИЕ ПРИВЕРЖЕННОСТИ К ТЕРАПИИ КАК ГАРАНТИЯ ЭФФЕКТИВНОСТИ СЛИТ

2019 ◽  
Author(s):  
K.S. Pavlova ◽  
D.S. Mdinaradze
Keyword(s):  
Allergic Diseases ◽  
Atopic Asthma ◽  
National Guidelines ◽  
Allergen Specific Immunotherapy ◽  
Dose Dependent ◽  
Methods Of Treatment ◽  
Choice Of Therapy ◽  
Dose Dependent Effect ◽  
Reduced Adherence

По данным ВОЗ, рекомендации врача выполняют не более 50 пациентов. В конечном итоге это приводит к снижению или отсутствию эффекта от назначаемого лечения. В связи с этим во всех последних международных и национальных руководствах говорится о необходимости учета предпочтений пациента при выборе терапии. Аллерген-специфическая иммунотерапия (АСИТ) является одним из основных методов лечения аллергических заболеваний, таких как аллергический ринит, конъюнктивит и атопическая бронхиальная астма, обладает болезнь-модифицирующими свойствами и долгосрочным эффектом после окончания лечения. АСИТ относится к профилактическому и продолжительному методу (рекомендовано на протяжении не менее 3 лет), что часто является причиной снижения приверженности к терапии. В различных исследованиях подтвержден зависимый от дозы аллергена эффект АСИТ, а следовательно, изменение режимов или сокращение сроков терапии могут влиять на конечный результат. При недостаточной эффективности АСИТ необходимо в первую очередь рассматривать вероятность низкого комплаенса. Сублингвальная АСИТ (СЛИТ) требует от пациента высокой вовлеченности в процесс лечения. Задачей врача в данном случае становится повышение терапевтического сотрудничества как одного из важнейших факторов обеспечения эффективности СЛИТ. Основными способами в данном случае являются улучшение понимания пациентом цели терапии и регулярный контроль со стороны врача.According to WHO at last 50 of the patient dont follow doctors recommendations. Ultimately, this leads to a decrease or absence of the treatment effect. In this regard, all the latest international and national guidelines mention the need to take into account the patients preferences in the choice of therapy. Allergen-specific immunotherapy (AIT) is one of the main methods of treatment of allergic diseases such as allergic rhinitis, allergic conjunctivitis and atopic asthma, and has disease modifying properties and the long-term efficacy after stop treatment. AIT refers to a preventive and long-term method (recommended for at least 3 years), that is often the cause of reduced adherence to therapy. Various studies have confirmed the dose-dependent effect of AIT, and, consequently, changes in regimens or shortening of therapy may affect the end result. In case of insufficient effectiveness of AIT, the probability of low compliance should be considered first of all. Sublingual AIT (SLIT) requires the patient to be highly involved in the treatment process. The task of the doctor in this case is increasing therapeutic cooperation, as one of the most important factors to ensure the effectiveness of SLIT. The main methods in this case are to improve the patients understanding of the purpose of the therapy and regular monitoring by the doctor.

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