Clinics in Integrated Care最新文献

The focus of this article is on the current and future state of people taking more control over their health information in a way that is facilitated by the use of technology. Nurses and midwives are already taking a significant leadership role in this space in advancing this agenda in healthcare. In the future, nurses and midwives will have an increasingly important role in not only advocating and advancing access of health information to patients, but also in identifying and providing supports to allow this to happen in both a meaningful and helpful way. The article will provide an overview of some of the current technologies that individuals use to obtain access to their health information. It will discuss some of the barriers to, and facilitators of, access and use of these technologies. Lastly, the article will conclude with a focus on the future, where trends and future outlooks related to increasing access to health information will be described.

The last decade has seen an expansion in digital health which was rapidly advanced during the COVID-19 pandemic. Digital healthcare has the potential to both increase the quality of care provided to patients as well as enabling access to care in marginalised groups and communities promoting health for all. However, if the implementation of digital healthcare is not managed carefully then it could inadvertently widen the health gap. There are many individuals, groups and communities who find themselves digitally excluded, and this can also include nurses and midwives themselves. It is important in any service design that consideration is given to digital inclusivity, ensuing that no one is left behind.

Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration.

Mindfulness-based interventions (MBIs) have a growing body of support in the literature and are increasingly popular for treating a variety of mental health disorders. The two most investigated MBIs include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).

We provide a comprehensive up-to-date review of MBIs for reducing anxiety and depression in a broad range of clinical populations.

MBIs outperformed passive controls for treating anxiety and depression. However, the effect sizes are mixed when compared to active controls.

The healthcare system is steadily becoming more diverse at an alarming pace brought on by multiple refugee crises, employment opportunities, environmental factors, educational purposes, and reuniting with families. Therefore, healthcare providers, healthcare delivery systems, and policymakers must create and deliver culturally competent services. Providing culturally competent healthcare allows the providers and the healthcare system to effectively deliver services that meet social, cultural, and linguistic needs. Research has shown that providing culturally competent healthcare improves patient health outcomes and delivers quality care that reduces racial and ethnic health disparities. Most healthcare professionals work very hard under challenging conditions to ensure that patients receive the best possible healthcare. However, multiple studies have shown that biases, prejudice, and stereotyping on the part of healthcare providers or the system influence care delivery.

The incorporation of technology in healthcare is essential to driving an integrated model of care - one which is holistic, patient-centred, and shows clear communication between different specialities, providers, and levels of care. This is gaining support from doctors and patients alike and moving healthcare from reactive to preventative. Advances in technology and healthcare have led to explosive growth in virtual consultations, remote monitoring mobile health, digital therapeutics, and artificial intelligence/machine learning applied to health. Not only have their adoption led to more integrated care systems, but also more cost effective, efficient, and higher quality ones at scale. The role and importance of digital health in integrated care has never been greater. The COVID-19 pandemic has allowed trials of a variety of new technologies and created a foundation for digital health to drive integrated care. This up-to-date review discusses the latest developments, challenges, opportunities, and future potential of digital health in integrated care. Understanding this field is critical as we work towards a fully integrated model of care – the validation and adoption of new medical advances, using critical insights from health information, and optimising specialists and providers for patient-centred, high-quality, cost-effective care.

Adolescence is a unique developmental period when young people experience pivotal biological, psychological, social and cognitive changes as they transition from child to adulthood. Although mortality rates among young people are considered to be relatively low, the rate at which mortality is falling among adolescents does not mirror the significant declines seen in other age groups.

Research in adolescent neurocognitive development has shown a high degree of plasticity that may be particularly sensitive to experiences and environments. Adolescence represents a significant opportunity for many youths to feel empowered and learn important life skills. Adolescents are often simultaneously exploring new experiences and potentially engaging in risk behaviors that can significantly interfere with their health trajectories.

Adolescents are also uniquely vulnerable to relational, cultural, and other environmental factors that contribute to health. Notably, the top two causes of death, unintentional injury and suicide, are influenced by the social networks, systems and environments where young people live and therefore could be prevented with effective interventions and services.

Important contributors to morbidity among adolescents include substance use, sexually transmitted infections (STIs), mental illness (e.g. eating disorders), non-communicable diseases (e.g. obesity), and other chronic issues (e.g. chronic fatigue syndrome) which impact their quality of life.

Pain is an unpleasant experience that results from both physical and psychological responses to injury. A complex set of pathways transmits pain messages from the periphery to the central nervous system, where control occurs from higher centres. Primary afferent pain fibres synapse with second-order neurons in the dorsal horn of the spinal cord. Ascending spinothalamic and spinoreticular tracts convey pain signals to the brain, where they are processed by the thalamus and sent to the cortex. Descending tracts, via the midbrain periaqueductal grey and nucleus raphe magnus, have a role in pain modulation. When nerves are damaged, neuropathic pain results and various mechanisms have been proposed for how this takes place. These mechanisms involve both peripheral and central sensitization.

Specific body systems have focused examinations. In this article the process of taking a clinical history from someone with abdominal pain and the assessment required is discussed. This article will guide the reader into the requirements of how to assess a patient with a presentation of abdominal pain. It will also inform how to clinically focus when presented with the multitude of possibilities and what information is required to establish a differential diagnosis. History and clinical examination is discussed in detail to allow the reader to develop their assessment skills to an advanced practice level.

Childhood overweight and obesity is one of the most significant public health concerns at a global level. A BMI >85TH Percentile is a widely accepted definition of overweight and children and young people with this BMI should be screened for comorbidities. Aetiology is complex and multifactorial, involving an interaction of genetic and non-genetic factors. Treatment must therefore be wide-reaching and the importance of identification of the at risk child and prevention must not be underestimated.