Primary Care [Working Title]最新文献

{"title":"“Anemia during Pregnancy and Its Prevalence”","authors":"Sehar Zulkifal, Shumaila Sarwar, Madiha Saddique, Khalida Yaqoob, A. Muneer, Aisha Fatima, A. Kabir, Muhammad Asad Mangat, Laiba Mateen, Z. Javed, M. Manzoor","doi":"10.5772/intechopen.99521","DOIUrl":"https://doi.org/10.5772/intechopen.99521","url":null,"abstract":"Anemia is a serious health issue throughout the world affecting both sexes of any age group. This nutritional disease is more common among the pregnant women of developing countries, where it is a major cause of maternal death and negative outcome of pregnancy. Among all anemic types, IDA is most prevalent one and is comprises of about 95% of all anemic cases around the world. In many developing countries it is more common in women of low socio-economic background and with no record of antenatal checkup. There is need for further health educational programs to overcome anemia especially for pregnant females.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"937 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116198980","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}

{"title":"Patient-Centred Point-of-Care Testing: A Life-Changing Technology for Remote Primary Care","authors":"B. Spaeth, S. Matthews, M. Shephard","doi":"10.5772/intechopen.100375","DOIUrl":"https://doi.org/10.5772/intechopen.100375","url":null,"abstract":"Point-of-care (POC) testing has proven to be a life-changing and transformational technology for patients with acute, chronic, and infectious diseases who live in regional and remote Australia. This technology facilitates patient-centred test results, of equivalent laboratory quality, that are rapidly available to inform clinical and public health decisions with immediate impact on case management. Traditionally, POC testing in high-middle income countries has been most widely used in tertiary or acute care settings to provide rapid diagnostic results for emergency departments, intensive care units, operating theatres and outpatient clinics. However, in low-middle income countries, POC tests are commonly used during antenatal and perinatal care for infectious disease detection, such as Human immunodeficiency virus (HIV) or syphilis, where laboratory services are too expensive, inaccessible, or non-existent. Similarly, the application of POC testing in primary care settings in Australia offers improved healthcare benefits to geographically isolated regional and remote communities, where access to laboratory-based pathology testing is poor and the burden of disease is high. Evidence-based data from research in established primary care POC testing networks for acute chronic, and infectious disease is used to describe the clinical, cultural, and economic effectiveness of POC technologies. Innovative solutions to address current barriers to the uptake of POC testing in primary care settings, which include clinical and cultural governance, high staff turnover, operator training and competency, device connectivity, quality testing, sustainable funding strategies, and the need for regulatory requirements are also discussed. POC testing can provide practical and resourceful opportunities to revolutionise the delivery of pathology services in rural and remote primary care sectors, where the clinical and community need for this technology is greatest. However, several barriers to the scale-up and sustainability of POC testing networks in these settings still exist, and the full potential of POC testing cannot be realised until these limitations are addressed and resolved.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126263465","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}

{"title":"The Newborn Baby Check","authors":"Harishan Tharmarajah","doi":"10.5772/intechopen.99524","DOIUrl":"https://doi.org/10.5772/intechopen.99524","url":null,"abstract":"The newborn baby check is often the first encounter a General Practitioner (GP) has with an infant and their family. It is an excellent opportunity to review the journey the family has taken antenatally, at the time of delivery and the weeks that have followed. It is also a time to detect and identify conditions that can be managed in their early stages. If untreated, some conditions can result in major morbidity. In this chapter we will look at what makes up a newborn baby check and important considerations to think about when undertaking this assessment. The examination is also performed in a systematic way to maximise the chance of detecting any abnormalities.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131158896","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}

{"title":"Managing Polypharmacy and Deprescribing in Elderly","authors":"Ç. Kaya","doi":"10.5772/intechopen.99637","DOIUrl":"https://doi.org/10.5772/intechopen.99637","url":null,"abstract":"The increase in the number of medications used may result many negative consequences for patients and health system. Elderly patients are more likely to encounter these health problems associated with polypharmacy. Deprescribing, the process of tapering, withdrawing, discontinuing, or stopping medications, is important in reducing polypharmacy, adverse drug effects, inappropriate or ineffective medication use, and costs. Deprescribing in elderly patients in accordance with the evidence based guidelines has many positive outcomes in older people such as decrease in the risk of falls, improvement in cognition, and improvement in patients’ global health status. Therefore, each visit of an elderly patient should be considered as an opportunity to evaluate the unnecessary use or harms of the prescribed or nonprescribed medications. Clinicians should decide to deprescription process by individualized care goals in line with current guidelines. Beers Criteria, STOPP/START and The Medication Appropriateness Index-MAI can be used to assit clinicians to identify unnecessary or potentially inappropriate drugs and reduce the number of medications in older patients. But, a balance is required between over and under prescribing. In conclusion, prevention of polypharmacy and withdrawing unneccesary and inappropriate medications may be the best clinical decision for family physicians who follow the elderly in primary care.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129800165","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}

{"title":"Aplication Arterial Oscilography to Study the Adaptive Capacity of Subject with COVID-19 in Primary Care","authors":"D. Vakulenko, L. Vakulenko, L. Hryshchuk, L. Sas","doi":"10.5772/intechopen.98570","DOIUrl":"https://doi.org/10.5772/intechopen.98570","url":null,"abstract":"The aim of study is finding complex pathological process markers occurred in COVID-19. Adaptive capacity, cardiovascular features, autonomic, central nervous systems in 67 patients with severe COVID-19 were studied and evaluated using (suggested by authors) temporal, spectral, correlation analysis of arterial oscillograms (AOG). The method is based on mathematical analysis adaptation of electrocardiographic signal heart rate variability to arterial pulsation variability analysis recorded during blood pressure measurement using an electronic tonometer VAT 41–2. Received results were compared with AOG 480 healthy (including 68 people after exercising) and 26 patients in a closed ward at psychoneurological hospital. Study results showed patients with severe COVID-19 have disorders at (four) cardiovascular system (CVS) regulation levels. It’s confirmed by lack of adequate sympathetic-adrenal response to a stressful situation due to severe COVID-19; higher than in healthy, parasympathetic part activity of autonomic nervous system. AOG spectral analysis revealed violation of management centralization, communication and coordination between CVS regulation levels. This leads to functional reserves decrease, low stress resistance of body and finally to a disease severe course and recovery processes. Arterial oscillography can be used to search markers of complex pathological processes occurred in COVID-19 and to improve methods of diagnosis, treatment, control of long-term results in clinical and family medicine.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115652791","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}

{"title":"Primary Care in the USA: The Long Struggle to Build its Foundational Role","authors":"J. Geyman","doi":"10.5772/INTECHOPEN.98792","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.98792","url":null,"abstract":"Family practice was recognized as the 20th specialty in American medicine in 1969. With the hope that primary care would become the foundation of an improved health care system, vigorous efforts were launched in medical education, research and practice to achieve that goal. This chapter traces the history of that effort, together with negative system changes that have obstructed that goal. Although primary care physicians have been shown to improve access to care, contain costs, decrease inequities, and improve patient outcomes, they are still too few in number to meet national needs for primary care. The COVID-19 pandemic revealed the extent of inadequacy and vulnerability of the system. The U. S. still lacks a system of universal access as has been in place for many years in most other advanced countries around the world. Corporate stakeholders in a largely privatized financing and delivery system continue to challenge the future of primary care. Lessons from the failure of reform initiatives over the last 50 years are discussed, as are current reform alternatives, only one of which would at last bring universal access to health care in this country.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121057171","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}

{"title":"Telephone Consultations by Medical Scheme Patients Consulting General Medical Practitioners, South Africa","authors":"Michael M. Willie, Neo Nonyana, S. Kabane","doi":"10.5772/intechopen.98496","DOIUrl":"https://doi.org/10.5772/intechopen.98496","url":null,"abstract":"Background: The COVID-19 climate has seen a shift in the manner that patients seek care. Lockdown measures and COVID-19 regulations, and the fear of contracting the virus at a health care facility has also changed health seeing behaviour among patients. The COVID-19 climate has seen a significant increase in the utilisation of virtual platforms to consult with providers. Objectives: The objective of this chapter was to conduct the descriptive analysis of telephonic consultations by members of medical schemes who consulted general medical practitioners. Methods: The study entailed a descriptive analysis of medical scheme claims data for the 2020 review period. The inclusion criteria were all National Pharmaceutical Product Interface (NAPPI) codes associated with a telephonic consultation consulting general medical practitioners. The ICD-10 code primary diagnosis was used to describe the diagnosis. The study mainly focused on outpatient patients with service dates between March and December 2020. Results: The analysis covered claims data from a total of 12 medical schemes. The schemes analysed accounted for 1,6 million lives. The total number of telephonic consultations was 17 237. The mean (SD) claimed amount for telephone consultation for a general medical practice consult was R2821 (SD = 20). This was slightly lower than the scheme tariff of R2872 (SD = 19). The study found that most telephonic consults were for Acute bronchitis, unspecified; Acute upper respiratory; Emergency use of U07.1 (Confirmed diagnosis); Emergency use of U07.2 (Suspected Diagnosis); Follow-up examination; Special screening. Conclusion: The study found evidence of patients utilising telephonic consultations for general medical practitioner services. The effect of COVID-19 in this respect was seen in the three main primary diagnoses that were associated with the consult, Acute upper respiratory, Emergency use of U07.1 (confirmed diagnosis) and Emergency use of U07.2 (suspected diagnosis). Even though the average telephonic consult was claimed at just under R3003, few general medical practitioners claimed between R4004 and R5005 which were higher than the industry average. There is a need to develop telephone consult guidelines at industry level, these should also address reimbursement rate differentials.","PeriodicalId":194226,"journal":{"name":"Primary Care [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128656990","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}