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4.
Nihon Koshu Eisei Zasshi ; 66(9): 582-592, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31588094

RESUMO

Objective Many preventive care supporter (e.g. kaigo-yobo supporter) training programs, conducted to train community residents, are developed by municipalities. However, it is not necessary that only municipalities can train people effectively or efficiently. In this paper, we initially reviewed the relevant literature and clarified the definitions of concepts like "program contents" and "evaluation indicators," while also planning our own training programs. Later, we developed a program based on the review and examined the results.Methods The literature of the training program was examined, and the training program was developed based on the result. Four researchers and three public health nurses from a community general support center, in the Otsuchi Town of Iwate Prefecture, developed a training program from June to September 2017. The training program developed was then conducted from October to November 2017. To evaluate the participants' satisfaction with the program, a self-report survey was conducted. To evaluate the outcomes of the program, we measured their degree of comprehension of their community's challenges, before and after the program.Results The training program was divided into two parts following the literature review. In the first part, the content of the supporters' activities following the program was determined (Type A), and, in the second, the same content was evaluated by the participants within the program (Type B). Type A consisted of various aspects including both concrete knowledge and skills needed to conduct care preventiveactivities after the program. In Type B, there were many aspects-including both lectures and exercises-that aimed to increase the participants' awareness of community challenges, as well as inspection to learn about pioneering activities which helped them consider concrete care preventive activities following the program. In Otsuchi Town, we found it to be imperative for participants to consider how to respond to various situations and accordingly plan the training program for use in Type B. To evaluate the results, 12 participants were analyzed. Participants included two men and ten women, with an average age of 71.4±10.0 years [range: 53-88]. Comprehension levels of community challenges (3.1→4.1, P=0.046), as well as the confidence to actively involve themselves in their own preventive care strategies (3.4→4.0, P=0.035), significantly increased after involvement in the program. However, their confidence to work for community preventive care support groups (3.1→3.5, P=0.227) did not increase significantly.Conclusion We clarified certain viewpoints, such as the purpose, content, and evaluation indices of community care training programs, by reviewing the relevant literature. Based on the discovered viewpoints, we were then able to obtain certain results through implementing our own training programs, thereby significantly increasing participant comprehension and confidence levels.


Assuntos
Serviços de Saúde Comunitária , Educação em Saúde/métodos , Assistência de Longa Duração , Serviços Preventivos de Saúde/métodos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Voluntários/educação , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Revisão Sistemática como Assunto
5.
Heart Fail Clin ; 15(4): 435-445, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472879

RESUMO

Elevated blood pressure (BP) has a strong and continuous association with Stage B and C heart failure (HF) and carries the highest attributable risk for HF. Intensive treatment of hypertension is crucial, as progression from hypertension (Stage A HF) to left ventricular hypertrophy (LVH) or other structural damage (Stage B HF) is common despite therapy. Echo cardiography is the modality of choice to detect Stage B HF. Ideally, Stage B HF should be prevented. However, regression of established LVH and other structural damage is feasible and improves prognosis. Despite differences among antihypertensive agents, control of BP remains the most important goal.


Assuntos
Anti-Hipertensivos , Insuficiência Cardíaca , Hipertensão , Hipertrofia Ventricular Esquerda , Serviços Preventivos de Saúde , Anti-Hipertensivos/classificação , Anti-Hipertensivos/uso terapêutico , Progressão da Doença , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/diagnóstico , Hipertrofia Ventricular Esquerda/etiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Fatores de Risco
6.
BMC Public Health ; 19(1): 1092, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409343

RESUMO

BACKGROUND: Current evidence on chronic disease prevention suggests that interventions targeted at high-risk individuals represents the best way forward. We implemented a step-wise approach in the Danish primary care sector, designed for the systematic and targeted prevention of chronic disease. The intervention centered on a personal digital health profile for all participants, followed by targeted preventive programs for high-risk patients. The present paper examines individual characteristics and health-care usage of patients who took up the targeted preventive programs in response to their personal digital health profile. METHODS: A sample of patients born between 1957 and 1986 was randomly selected from the patient-list system of participating general practitioners in two Danish municipalities. The selected patients received a digital invitation to participate. Consenting patients received a second digital invitation for a personal digital health profile based on questionnaire and electronic patient record data. The personal digital health profile contained individualized information on risk profile and personalized recommendations on further actions. If at-risk or presenting with health-risk behaviour a patient would be advised to contact either their general practitioner or municipal health centre for targeted preventive programs. Attendance at the targeted preventive programs was examined using Poisson regression and chi-squared automatic interaction detection methods. RESULTS: A total of 9400 patients were invited. Of those who participated (30%), 22% were advised to get a health check at their general practitioner. Of these, 19% did so. Another 23% were advised to schedule an appointment for behaviour-change counselling at their municipal health centre. A total of 21% took the advice. Patients who had fair or poor self-rated health, a body mass index above 30, low self-efficacy, were female, non-smokers, or lead a sedentary lifestyle, were most likely to attend the targeted preventive programs. CONCLUSIONS: A personal digital health profile shows some promise in a step-wise approach to prevention in the Danish primary care sector and seems to motivate people with low self-efficacy to attend targeted preventive programs. TRIAL REGISTRATION: Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016 ). Prospectively registered on the 29th of April 2016.


Assuntos
Doença Crônica/prevenção & controle , Serviços Preventivos de Saúde/métodos , Atenção Primária à Saúde , Adulto , Estudos Transversais , Dinamarca , Registros Eletrônicos de Saúde , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos
7.
Pediatr Rev ; 40(8): 398-411, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31371633

RESUMO

Pediatric clinicians are on the front line for prevention of language and speech disorders. This review uses prevailing theories and recent data to justify strategies for prevention, screening and detection, diagnosis, and treatment of language and speech disorders. Primary prevention rests on theories that language learning is an interaction between the child's learning capacities and the language environment. Language learning occurs in a social context with active child engagement. Theories support parent education and public programs that increase children's exposure to child-directed speech. Early detection of delays requires knowledge of language milestones and recognition of high-risk indicators for disorders. Male sex, bilingual environments, birth order, and chronic otitis media are not adequate explanations for significant delays in language or speech. Current guidelines recommend both general and autism-specific screening. Environmental and genetic factors contribute to primary language and speech disorders. Secondary and tertiary prevention requires early identification of children with language and speech disorders. Disorders may be found in association with chromosomal, genetic, neurologic, and other health conditions. Systematic reviews find that speech-language therapy, alone or in conjunction with other developmental services, is effective for many disorders. Speech-language interventions alter the environment and stimulate children's targeted responding to improve their skills.


Assuntos
Desenvolvimento da Linguagem , Transtornos da Linguagem , Fala , Criança , Pré-Escolar , Humanos , Transtornos da Linguagem/diagnóstico , Transtornos da Linguagem/etiologia , Transtornos da Linguagem/terapia , Serviços Preventivos de Saúde/métodos
8.
BMC Public Health ; 19(1): 1183, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31462261

RESUMO

BACKGROUND: Early detection of lung disease may help reduce disease development. Detection through preventive health checks may be beneficial. Nevertheless, the knowledge is sparse on how to enhance the participation rate in health checks among citizens at risk of developing lung disease. This study investigates if focused information on spirometry can increase the participation rate in a general health check. METHODS: We conducted an open-label, household cluster-randomised trial with a two-group parallel design including 4407 citizens aged 30-49 years in Denmark and an average cluster size of 1.55 citizens per household. The control group (n = 2213) received a standard invitation describing the content of the general health check and containing practical information. The intervention group (n = 2194) received an extended invitation highlighting the benefits of early detection and prevention of lung disease. The primary outcome was difference in participation rate between the two groups. The secondary outcome was the proportion of participants at risk of lung disease in both groups. Risk profile was defined as current smoking or self-reported lung symptoms. The inclusion period was 25 November 2015-3 February 2017. RESULTS: No major difference in participation rate was seen between the intervention group (53.4%) and the control group (52.0%). Participants had statistically significantly higher education level compared to non-participants. A total of 24.2% of the participants were at risk of developing lung disease, but no difference was found between the intervention group and the control group. CONCLUSION: This study revealed no effect on participation rate of including focused spirometry information in the health check invitation. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02615769 . Registered on 25 November 2015. The trial protocol has been published.


Assuntos
Pneumopatias/diagnóstico , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/estatística & dados numéricos , Espirometria , Adulto , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato
9.
Obstet Gynecol Clin North Am ; 46(3): 441-453, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378287

RESUMO

Menstrual health assessment facilitates identification of pathologic conditions (eg, abnormal uterine bleeding, endometriosis), offers the opportunity to educate women on what menstrual symptoms may be normal or abnormal, and provides the opportunity to initiate treatment for women who are suffering because of problems with menstrual bleeding or associated symptoms. Heavy bleeding, pain, fatigue, and mood changes significantly affect a woman's physical, social, and emotional quality of life. Promptly identifying and treating these disorders by incorporating their assessment into routine well-woman care has the potential to positively affect the lives of a substantial number of women.


Assuntos
Distúrbios Menstruais/diagnóstico , Menstruação/fisiologia , Serviços Preventivos de Saúde/métodos , Adolescente , Adulto , Diagnóstico Diferencial , Endometriose/diagnóstico , Feminino , Humanos , Menorragia/diagnóstico , Distúrbios Menstruais/etiologia , Pós-Menopausa , Estados Unidos , Doenças Uterinas/complicações , Doenças Uterinas/diagnóstico , Saúde da Mulher
10.
J Stroke Cerebrovasc Dis ; 28(9): 2543-2554, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31296475

RESUMO

BACKGROUND: Today there exists few intervention researches on cerebro-vascular function in populations at high risk of stroke in China. METHODS: Patients more than 40 years old, with at least 1 of stroke risk factors were recruited from outpatient department in 3 hospitals. A quasi-experimental design was performed by assigning participants into 3 groups: comprehensive intervention group, health education group, and control group. Participants in the control group received no intervention but were informed of risk factors of stroke. For health education group, a health education class was performed. Except to the health education program, participants in the comprehensive intervention group received an additional health life and behavior guidance. RESULTS: After the intervention, the Cerebro-Vascular Function Scores (CVFS) had significant differences among 3 groups (F = 5.252, P < 0.05). There was a significant increase in CVFS compared to the control group (P = 0.003, 95%CI: 1.552-8.493). Significantly changes in obesity were observed in comprehensive intervention group before and after the intervention (χ2 = 9.0747, P = 0.0026). The results of logistic regression showed that comprehensive intervention group had a significant decrease in prevalence of obesity (OR = 0.482, 95% CI: 0.242-0.961) compared to the control group. CONCLUSION: Health education on stroke in a high-risk population combined with guidance on proper health life and behavior can be effective in preventing stroke.


Assuntos
Circulação Cerebrovascular , Comportamentos Relacionados com a Saúde , Educação de Pacientes como Assunto/métodos , Serviços Preventivos de Saúde/métodos , Comportamento de Redução do Risco , Acidente Vascular Cerebral/prevenção & controle , Adulto , China/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Prevalência , Fatores de Proteção , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de Tempo , Resultado do Tratamento
11.
High Blood Press Cardiovasc Prev ; 26(3): 191-197, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31041682

RESUMO

The atherosclerotic alterations that are the basis of cardiovascular diseases can start already in childhood. For this reason the prevention of cardiovascular diseases should be undertaken very early both in the general population and, in a targeted manner, in subjects at cardiovascular risk. Preventive strategies should include measures to encourage physical activity and correct eating habits and to reduce exposure to pollutants. The main actors responsible for carrying out these preventive interventions are the local and national political authorities. Moreover, particular attention should be paid to the first thousand days of life starting from conception, to prevent unfavorable epigenetic modifications. In addition to initiatives aimed at the general population, interventions should be planned by the medical community to assess the individual risk profile. The current obesity epidemic has in fact made it relatively frequent even among children and adolescents to find some cardiovascular risk factors known in adults such as arterial hypertension, dyslipidemia, glucose metabolism disorders and increased of uric acid values. The purpose of this review is to indicate lines of intervention for cardiovascular prevention in children and adolescents.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Síndrome Metabólica/terapia , Serviços Preventivos de Saúde/métodos , Adolescente , Idade de Início , Pressão Arterial , Biomarcadores/sangue , Glicemia/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Criança , Comorbidade , Dislipidemias/sangue , Dislipidemias/epidemiologia , Dislipidemias/terapia , Transtornos do Metabolismo de Glucose/sangue , Transtornos do Metabolismo de Glucose/epidemiologia , Transtornos do Metabolismo de Glucose/terapia , Nível de Saúde , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipertensão/terapia , Hiperuricemia/sangue , Hiperuricemia/epidemiologia , Hiperuricemia/terapia , Lipídeos/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/terapia , Fatores de Proteção , Fatores de Risco , Ácido Úrico/sangue , Ganho de Peso
12.
Geriatr Gerontol Int ; 19(7): 641-646, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31099138

RESUMO

AIM: To determine the characteristics associated with developing a new need for long-term care among older Taiwanese adults. METHODS: We analyzed the 1999 and 2003 datasets of the Taiwan Longitudinal Survey on Aging. A total of 1986 persons who were aged ≥70 years and had no disability in activities of daily living or need for long-term care at the baseline served as the study participants. We first identified the potential variables associated with developing a need for long-term care in demographic, socioeconomic, anthropometric, functional status, mental health, medical and global domains based on the literature and our earlier studies. We then carried out univariable logistic regression analyses to identify the variables most strongly associated with developing a new need for long-term care within each domain. Variables showing the strongest association were further analyzed in a forward stepwise multivariable logistic regression model to determine the significant predictors. RESULTS: The multivariable model identified age, sex, doing heavy housework, walking 200 m, carrying out calculation, appetite status, frequency of hospitalizations during the past 12 months, living arrangement and weight loss as significant (P < 0.05) predictors. CONCLUSIONS: The present study identified nine characteristics that predict the subsequent 4-year new need for long-term care of ≥70-year-old Taiwanese adults. Age, sex and functional status are the most powerful predictors. The results are useful for identifying older individuals at risk of developing a new need for long-term care within the next 4 years, enabling implementation of preventive strategies or timely care planning. Geriatr Gerontol Int 2019; 19: 641-646.


Assuntos
Certificado de Necessidades/organização & administração , Avaliação Geriátrica , Assistência de Longa Duração/organização & administração , Saúde Mental/estatística & dados numéricos , Desempenho Físico Funcional , Fatores Etários , Idoso , Avaliação da Deficiência , Feminino , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Estudos Longitudinais , Masculino , Serviços Preventivos de Saúde/métodos , Fatores Sexuais , Fatores Socioeconômicos , Taiwan/epidemiologia
14.
Can J Public Health ; 110(3): 279-284, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30847801

RESUMO

A focus on populations, and a corresponding population-level approach to intervention, is a foundation of public health and is one reason why public health matters today. Yet, there are indications that this foundation is being challenged. In some policy and practice domains, and alongside growing concern about the social determinants of health and health equity, there has been a shift from a population-level or universal approach to intervention, to a targeted approach focusing on those experiencing social or economic vulnerability. More than 30 years ago, Geoffrey Rose articulated strengths and limitations of population-level and high-risk approaches to prevention. In light of a strong analogy between "high risk" and "targeted" approaches, it seems timely, in a forum on why public health matters today, to revisit Rose's points. Focusing on points of overlap between strengths and limitations of the two approaches as described in public health (population-level; high-risk) and social policy (universal; targeted), I illustrate strengths of a population-level approach from the point of view of health equity. Although different circumstances call for different intervention approaches, recent discourse about the weakening of public health suggests that there is value in discussing foundations of the field, such as the population-level approach, that we as a community may wish to defend.


Assuntos
Saúde da População , Serviços Preventivos de Saúde/métodos , Saúde Pública , Canadá , Equidade em Saúde , Humanos , Medição de Risco , Determinantes Sociais da Saúde
15.
Dis Colon Rectum ; 62(4): 403-405, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30844969

RESUMO

CASE SUMMARY: A 56-year-old man with a history of hypertension and hyperlipidemia was referred by gastroenterology for bleeding per rectum. Because of a family history of colon cancer, he had several prior colonoscopies, most recently 3 years ago, without evidence of pathology. His mother was diagnosed with colon cancer in her mid-40s. His current colonoscopy demonstrated a 2.4 × 1.5 cm cecal adenocarcinoma. Staging workup revealed no evidence of metastatic disease. Because of the patient's family history, the specimen was further evaluated and found to have high microsatellite instability (MSI-H). The patient was referred to a genetic counselor and found to have a germline pathogenic variant in MSH6 on gene panel testing. The patient did not have a family history of any extracolonic malignancies.The patient underwent an uncomplicated laparoscopic total abdominal colectomy with ileorectal anastomosis, which revealed a T2N0Mx adenocarcinoma with abundant peritumoral lymphocytes. He was discharged on postoperative day 2, and recuperated appropriately from surgery. Follow-up surveillance proctoscopy showed no evidence of disease. His sole offspring, a 25-year-old man, was negative for a pathogenic variant in MSH6 and had no polyps on colonoscopy. His siblings did demonstrate a pathogenic variant in MSH6 and are currently opting for annual surveillance colonoscopy.


Assuntos
Adenocarcinoma , Colectomia/métodos , Neoplasias do Colo , Colonoscopia/métodos , Neoplasias Colorretais Hereditárias sem Polipose , Proteínas de Ligação a DNA/genética , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/fisiopatologia , Adenocarcinoma/cirurgia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Neoplasias do Colo/fisiopatologia , Neoplasias do Colo/cirurgia , Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Neoplasias Colorretais Hereditárias sem Polipose/genética , Neoplasias Colorretais Hereditárias sem Polipose/terapia , Saúde da Família , Humanos , Laparoscopia/métodos , Masculino , Anamnese/métodos , Instabilidade de Microssatélites , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Serviços Preventivos de Saúde/métodos , Resultado do Tratamento
16.
Medicine (Baltimore) ; 98(8): e14664, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30813211

RESUMO

South Africa recently implemented the 'test and treat' strategy for all HIV-infected individuals receiving diagnosis at the health facility level. However, the impact of this programme in terms of the prevention of HIV transmission, morbidity and mortality associated with HIV can only be maximized if patients are diagnosed early. This study determines the prevalence of late presentation among newly diagnosed HIV-infected individuals and also examines the socio-demographic and clinical determinants for late presentation in health facilities in the Eastern Cape Province, South Africa.In this cross-sectional study, a total of 335 newly diagnosed patients were recruited consecutively between August 2016 and July 2017. Late presenter for HIV care was defined in accordance with the European Late Presenter Consensus working group as a patient who reports for care when the CD4 count is below 350 cells/µL and/or when there is an established AIDS-defining clinical condition, irrespective of CD4 count. Adjusted and unadjusted logistic regression analysis was used to examine the determinants of late HIV diagnosis.Participants' mean age was 33.6 (SD: 10.6). Almost 96% of the participants believed their route of HIV infection was heterosexual sex. Most newly diagnosed HIV-infected patients (60%) were late presenters (CD4+ count ≤350 cells/µL and/or having an AIDS-defining illness in World Health Organisation (WHO)-defined stage III/IV), with 35% presenting with Acquired Immune Deficiency Syndrome (AIDS)-related complications. In the adjusted model, only male sex (AOR: 2.81; CI: 1.51-5.23), no formal education (AOR: 5.63; CI: 1.68-18.85), and overweight body mass category (AOR: 2.45; CI: 1.04-5.75) were independently associated with late HIV diagnosis.The majority of newly diagnosed HIV-infected individuals were late presenters. To maximize the impact of the 'test and treat' policy aimed at reducing new HIV transmissions and preventing the morbidity and mortality associated with HIV, there is a need for programmes to improve early detection of HIV in the study settings. This programme should target males and individuals with no formal education for maximum impact.


Assuntos
Controle de Doenças Transmissíveis , Diagnóstico Tardio , Diagnóstico Precoce , Infecções por HIV , Serviços Preventivos de Saúde , Adolescente , Adulto , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Estudos Transversais , Diagnóstico Tardio/prevenção & controle , Diagnóstico Tardio/estatística & dados numéricos , Demografia , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Prevalência , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Fatores de Risco , Fatores Socioeconômicos , África do Sul/epidemiologia
19.
Isr J Health Policy Res ; 8(1): 23, 2019 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-30732652

RESUMO

PURPOSE: Pediatric preventive health services are delivered in many different formats throughout the world. In Israel, these services for young children are provided in designated Maternal Child Health Clinics (MCHC). The history and operation of Israel's MCHC have been described primarily in the Hebrew language medical literature with most of these reports being over a decade old. This paper provides an up to date summary of the evolution and current care in Israel's one-hundred-year old model for the provision of preschool preventive health services. As these clinics have been recognized by the World Organization as a model for emulation, it is important that such information be made available. Israel's MCHC provide universal care to infants and preschool children (0-6 years), free of charge. These community-based clinics provide developmental surveillance, growth monitoring, and routine childhood immunizations. Anticipatory guidance is offered to families on topics including nutrition, parenting and child safety. Screening is also performed for maternal postpartum depression and family violence. Care is given by public health nurses working in collaboration with physicians. The vast majority (> 96%) of the country's children receive care in this system. Immunization coverage rates through this system are in line with World Health Organization guidelines - over 95% overall average nationally. Unfortunately, the allocated funding has not increased in proportion to the population growth. There is ongoing debate on the role of the national government in health services: should it be that of a direct services provider or focus on guidance and regulation of the health system. CONCLUSION: MCHC well child care can help assure widespread provision of pediatric preventive health care. For this model to function, both its funding and content needs to be updated on an ongoing basis to reflect current preventive health care needs.


Assuntos
Pediatria/história , Serviços Preventivos de Saúde/história , Adolescente , Criança , Bem-Estar da Criança/história , Bem-Estar da Criança/tendências , Pré-Escolar , Feminino , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , Israel , Masculino , Pediatria/tendências , Serviços Preventivos de Saúde/métodos
20.
Soins ; 64(832): 29-30, 2019.
Artigo em Francês | MEDLINE | ID: mdl-30771845

RESUMO

E-coaching is an emerging therapeutic tool. It provides effective support for patients using a progressive, adaptive and viable model. It has a vast scope of application and the population likely to comply with it is significant. The framework for its use, yet to be defined, could be similar to that of a medication-based therapy.


Assuntos
Tutoria/métodos , Serviços Preventivos de Saúde/métodos , Telemedicina , Humanos
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