Clinics in Integrated Care最新文献_第2页

The management of inflammatory bowel disease in older adults 老年人炎症性肠病的治疗

Clinics in Integrated Care Pub Date : 2024-04-25 DOI: 10.1016/j.intcar.2024.100201

Karishma Sethi-Arora, Jimmy K. Limdi

{"title":"The management of inflammatory bowel disease in older adults","authors":"Karishma Sethi-Arora, Jimmy K. Limdi","doi":"10.1016/j.intcar.2024.100201","DOIUrl":"https://doi.org/10.1016/j.intcar.2024.100201","url":null,"abstract":"<div><p>The rising incidence and prevalence of inflammatory bowel diseases (IBD) is increasing. Taken together with population ageing, the number of older adults with IBD globally is set to increase. The wide differential diagnosis of IBD in older adults may result in diagnostic delay. In addition, there is a higher prevalence of frailty among older people with IBD, which is recognisable across age groups. Despite some common features, there are important differences in the clinical presentation and natural history of older-onset IBD compared with those diagnosed at a younger age. Challenges posed by co-morbidity, polypharmacy and loco-motor dysfunction influence treatment considerations and require a holistic and often multi-disciplinary therapeutic approach. The typical exclusion of older persons from clinical trials of IBD therapies may negatively influence application of modern treatment paradigms in these individuals. Recognition of the potential disconnect between chronological and biological age, with careful dynamic risk-stratification including frailty assessment, must underpin pragmatic and when possible, evidence-based decisions in this potentially vulnerable group, taking care to avoid under-treatment. This review covers the clinical presentation, diagnostic considerations and complexities surrounding the holistic management of IBD in older patients.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"24 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140644436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The management of inflammatory bowel disease in pregnancy 妊娠期炎症性肠病的治疗

Clinics in Integrated Care Pub Date : 2024-03-14 DOI: 10.1016/j.intcar.2024.100200

Karishma Sethi-Arora, Yasmin Ingram, Jimmy K. Limdi

{"title":"The management of inflammatory bowel disease in pregnancy","authors":"Karishma Sethi-Arora, Yasmin Ingram, Jimmy K. Limdi","doi":"10.1016/j.intcar.2024.100200","DOIUrl":"https://doi.org/10.1016/j.intcar.2024.100200","url":null,"abstract":"<div><p>The peak incidence of inflammatory bowel disease (IBD) coincides with a woman's prime reproductive years. Pregnancy related knowledge remains suboptimal among healthcare professionals and women living with IBD. Preconception counselling can improve pregnancy specific IBD patient knowledge and provide a personalised risk assessment, to ensure optimal maternal and fetal outcomes. Although fertility rates in women with IBD are comparable with the general population, voluntary childlessness is common among women with IBD. IBD disease activity at conception and during pregnancy is a key determinant of the course of IBD during pregnancy. Active IBD during pregnancy is associated with adverse outcomes including spontaneous abortion, small for gestational age baby, and preterm birth. Most IBD medications are considered low risk during pregnancy and breastfeeding, except for methotrexate, JAK-inhibitors, ozanimod, ciclosporin, and allopurinol. Most women with IBD can have a vaginal delivery, but caesarean section should be considered in active perianal disease and history of ileal pouch surgery. We review the current evidence for preconceptual management of IBD, during pregnancy, and the postpartum period.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"23 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health maintenance strategies in adults with inflammatory bowel disease 成人炎症性肠病患者的健康维护策略

Clinics in Integrated Care Pub Date : 2024-02-15 DOI: 10.1016/j.intcar.2024.100191

Kavita Sethi, Karishma Sethi-Arora, Jimmy K. Limdi

引用次数: 0

‘Anyone can make bad use of a good law’: exploring how constrained choice can result in moral injury 任何人都可能滥用良法"：探讨受限选择如何导致道德伤害

Clinics in Integrated Care Pub Date : 2024-01-04 DOI: 10.1016/j.intcar.2023.100190

Sarah-Jane Fenton, Sarah Carr, Louise Isham

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Healthcare disparities 医疗差距

Clinics in Integrated Care Pub Date : 2023-12-17 DOI: 10.1016/j.intcar.2023.100181

Shondell V. Hickson

引用次数: 0

Nurses finding a global voice by becoming influential leaders through advocacy 护士通过倡导成为有影响力的领导者，找到了全球的声音

Clinics in Integrated Care Pub Date : 2023-10-01 DOI: 10.1016/j.intcar.2023.100165

Elizabeth A. Madigan, Emily McWhirter, Greta Westwood, Ruth Oshikanlu, Zipporah M. Iregi, Munashe Nyika, Jonathan Bayuo

{"title":"Nurses finding a global voice by becoming influential leaders through advocacy","authors":"Elizabeth A. Madigan, Emily McWhirter, Greta Westwood, Ruth Oshikanlu, Zipporah M. Iregi, Munashe Nyika, Jonathan Bayuo","doi":"10.1016/j.intcar.2023.100165","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100165","url":null,"abstract":"<div><p><span>Nursing has long faced barriers to effective advocacy, based on the gendered identity of the profession and its status as a second class or “softer” profession. The Covid pandemic showed the importance of the profession to the health of the world and the profession has been adversely impacted as a result of the pandemic. The nursing profession has long had skill in advocating for the recipients of their care but many nurses do not make the connection with advocacy for change in the </span>health care systems in which they work or for themselves. Yet, advocacy for change in the health care system and for the profession will impact larger areas of global health than advocacy at the individual care recipient level. Advocacy for system change includes: recognizing the context, problem solving, building relationships, excellent communication skills and leveraging influence. Nursing has a long history of advocating for those who are historically marginalized and now it is time to advocate for nurses who are historically marginalized, like those who are internationally educated and working outside their home countries. Effective advocacy techniques that go beyond individual interactions to advocating for policy and systems change must be included in future leadership development for nurses.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"20 ","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49710129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Responding to global emergencies: what has the role of nurses been and what can it be in the future? 应对全球紧急情况:护士的作用是什么?未来可以发挥什么作用?

Clinics in Integrated Care Pub Date : 2023-10-01 DOI: 10.1016/j.intcar.2023.100166

Marcus Wootton, Lydia Davidson

引用次数: 0

Assessment of cultural competency 文化能力评估

Clinics in Integrated Care Pub Date : 2023-09-30 DOI: 10.1016/j.intcar.2023.100173

Shondell V. Hickson

引用次数: 0

Personal account: the impact of eating disorders on my mental health 个人叙述:饮食失调对我心理健康的影响

Clinics in Integrated Care Pub Date : 2023-08-01 DOI: 10.1016/j.intcar.2023.100158

Hope Virgo

引用次数: 0

Do not attempt cardiopulmonary resuscitation decisions (DNACPR) – Policy approaches in Wales 不要尝试心肺复苏决定(dacpr) -威尔士的政策方法

Clinics in Integrated Care Pub Date : 2023-08-01 DOI: 10.1016/j.intcar.2023.100149

Mark Taubert, Ben Rose, Miriam Rigby

{"title":"Do not attempt cardiopulmonary resuscitation decisions (DNACPR) – Policy approaches in Wales","authors":"Mark Taubert, Ben Rose, Miriam Rigby","doi":"10.1016/j.intcar.2023.100149","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100149","url":null,"abstract":"<div><p>Cardiopulmonary resuscitation (CPR) was first described in 1960, when Kouwenhoven and colleagues described a novel technique of ‘closed chest cardiac massage’. CPR is an emergency medical intervention undertaken in an attempt to restore breathing and circulation following a respiratory or cardio-respiratory arrest. The intervention includes the administration of external chest compressions, artificial ventilation<span>, and consecutive electric shocks applied to the bare chest (known as defibrillation) and the rapid administration of medicines intravenously or intra-osseously. But there are clear differences in who will and will not respond to these ferocious interventions in cardiac arrest situations. In some instances, clinicians may be as certain as they can be that future attempts at CPR will not work. In those situations, a Do Not Attempt CPR form may be filled out, after a consultation with the patient. Here, the authors review current policies, guidelines and resources, discuss how the prospect of a natural, anticipated and accepted death in the near future can be a trigger to advance care planning, and outline resources that can help improve communication in an area rife with misconceptions and misunderstanding.</span></p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"19 ","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49732814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0