Clinics in Integrated Care最新文献

Engaging with the media is a critical skill for professionals at any career stage, enabling them to contribute to public dialogue on significant issues. This article emphasizes the importance of the preparation and skill development for media interactions, whether proactive or reactive. Detailed guidance is provided on crafting effective press releases. Key preparatory steps for reactive interviews include understanding the journalist's intent and setting clear boundaries. The article underscores the necessity of honing a single, compelling message and offers strategies for effective communication during interviews, including the ABC technique (Acknowledge, Bridge, Communicate). Recommendations for post-interview follow-up and self-reflection are provided to enhance future media engagements. The article serves as a guide for professionals aiming to communicate their expertise and viewpoints effectively through various media channels.

This article provides comprehensive guidance on accessing and using the research literature. It outlines the reasons for reading research papers, from being informed about professional developments to understanding publication trends and exploring unanswered research questions. The article details the initial steps of accessing online databases like PubMed and employing effective search strategies. It emphasizes the importance of evaluating articles to determine their relevance and comprehensibility. Guidance is provided on reading papers critically, focussing on the authorship, background, methodology, results, and discussion sections. Finally, it discusses methods for recording and organizing relevant papers using reference management software, ensuring efficient future retrieval.

The objective of this article is to examine the current understanding of the factors influencing the quality of life (QoL) among individuals with heart failure (HF), with a focus on exploring the multifaceted aspects of physical, psychological, and social well-being to improve health. Through a comprehensive review of literature, this article aims to identify key determinants of QoL in HF patients, assess the impact of various nursing interventions and strategies on improving QoL outcomes, and highlight areas for future research and clinical practice development to enhance the overall well-being and holistic care of individuals living with HF.

Social prescribing is an approach that connects people to activities, groups and services in their community, but it can also be counter-productive and disabling. It exists between state and market paradigms.

The ‘community paradigm’ reflects a belief that people and communities themselves have the best insight into their own situation. It seeks long-term solutions within communities, rather than for them.

What matters most to people with long-term health conditions are: being respected; health; understanding yourself; purpose and being valued; quality relationships; and enjoyment.

An approach reflecting the ‘community paradigm’ would address the determinants of health and well-being, rather than the symptoms. It would integrate social approaches and public services.

The offer would be more a community offer than a service offer. People would experience success as participating, interdependent members of their community, recognized and valued for their gifts.

This requires change within communities and systems, through genuine co-production between the two. Making social solutions as or more attractive than service solutions requires an open and honest reflection on, and redistribution of, collective power and wealth.

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.

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.

The Inflammatory Bowel Diseases (IBD) and associated immune-modulating pharmacotherapies are associated with an increased risk of avoidable complications, including vaccine-preventable opportunistic infections, cancers, osteoporosis, anxiety, and mental health disorders. The expanding therapeutic armamentarium requires a critical understanding of such complications and the preventative approaches required to reduce morbidity in these patients. Despite this, primary prevention strategies are often not prioritised in IBD patients.

This review aims to summarise appropriate health maintenance strategies, including appropriate pre-treatment infection screening and vaccination recommendations within the context of immunosuppression, and promotes timely screening for malignancies, osteoporosis, and psychological conditions. Clear communication, individualised action plans and cohesion between gastroenterologists and primary care physicians is crucial in optimising health maintenance in IBD patients.