Background: Complexity of health problems and aging of the population create an ongoing burden on the health care system with the general practitioner (GP) being the gatekeeper in primary care. In GPs daily practice, collaboration with specialists and exchange of knowledge from the secondary care play a crucial role in this system. Communication between primary and secondary care has shortcomings for health care workers that want to practice sustainable patient-centered health care. Therefore, a new digital interactive platform was developed: Prisma.
Objective: This study aims to describe the development of a digital consultation platform (Prisma) to connect GPs with hospital specialists via the Siilo application and to evaluate the first year of use, including consultations, topic diversity, and number of participating physicians.
Methods: We conducted a mixed methods observational study, analyzing qualitative and quantitative data for cases posted on the platform between June 2018 and May 2020. Any GP can post questions to an interdisciplinary group of secondary care specialists, with the platform designed to facilitate discussion and knowledge exchange for all users.
Results: In total, 3674 cases were posted by 424 GPs across 16 specialisms. Most questions and answers concerned diagnosis, nonmedical treatment, and medication. Mean response time was 76 minutes (range 44-252). An average of 3 users engaged with each case (up to 7 specialists). Almost half of the internal medicine cases received responses from at least two specialisms in secondary care, contrasting with about one-fifth for dermatology. Of note, the growth in consultations was steepest for dermatology.
Conclusions: Digital consultations offer the possibility for GPs to receive quick responses when seeking advice. The interdisciplinary approach of Prisma creates opportunities for digital patient-centered networking.
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http://dx.doi.org/10.2196/33630 | DOI Listing |
JACC Adv
December 2024
Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Background: Rheumatic heart disease (RHD) remains as 1 of the major contributors to indirect pregnancy-related mortality and morbidity worldwide and disproportionately affects marginalized populations.
Objectives: In this scoping review, the authors sought to explore the socioeconomic, cultural, and health care access-related causes of global disparities in outcomes of pregnancy among individuals with RHD.
Methods: We performed a literature search of all studies published between January 1, 1990, and January 1, 2022, that investigated causes for disparate outcomes in pregnant individuals with RHD.
JACC Adv
December 2024
University of Texas Health Sciences Center, Houston, Texas, USA.
The burden of cardiovascular disease has declined in high-income countries in the past 3 decades but is growing in low- and middle-income countries due to epidemiological, demographic, and socioeconomic shifts. A range of cost-effective policies and interventions are available for advancing cardiovascular health (CVH) through primordial, primary, and secondary prevention. We showcase multifaceted challenges that stifle the global progress of CVH including shortcomings in financial protection, health systems, primary health care, national health policies, service coverage, and surveillance.
View Article and Find Full Text PDFF1000Res
January 2025
Department of Nephrology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India.
Background: We evaluated if the course of recovery from sepsis-induced acute kidney injury (AKI) can be predicted using variables collected at admission.
Methods: A total of 63 patients admitted for sepsis-induced AKI in our Mangalore ICU were evaluated and baseline demographic and clinical/laboratory parameters, including serum creatinine (SCr), base excess (BE), Plethysmographic Variability Index (PVI), Caval Index, R wave variability index (RVI), mean arterial pressure (MAP) and renal resistivity index (RI) using renal doppler and need for inotropes were assessed on admission. Patients were managed as per standard protocol.
Crit Care Resusc
December 2024
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Objective: To describe the six-month functional outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA) in Australia.
Design: Secondary analysis of EXCEL registry data.
Setting: EXCEL is a high-quality, prospective, binational registry including adult patients who receive extracorporeal membrane oxygenation (ECMO) in Australia and New Zealand.
Front Child Adolesc Psychiatry
July 2024
Faculty of Social Work, University of Regina, Saskatchewan, Canada.
Introduction: The well-being of trauma-affected children and youth in residential care settings is contingent upon the well-being of the workers who care for them, who are increasingly expected to provide care in a trauma-informed manner. The well-being of residential care workers (RCWs) may be impacted by their own histories of adversity, their capacity individually and collectively to navigate to resources that sustain their well-being (resilience), and current perceptions of their professional quality of life.
Objective: This study aimed to fill a research gap by canvassing the perspectives of RCWs to determine what and how they need to be supported in their work.
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