Out of 121 million population, 2.86 crore accounts for disabled people which 1.21% of total population. It has been reported that oral health care status of disabled people are poor than normal population. The main reason for this situation is barrier to access health care centres. This article throws light on definition and types of disability listed by Indian government. It also highlights the prevalence of disability and their oral health status. Article focuses on barrier in accessing dental care and guidelines required to build a disable friendly dental health care deliver center to make the treatment acceptable for such pupils. It is utmost important to provide dental care to such patients by overcoming the barrier to accessibility. Before motivating the patients and caregivers, it is the dentist who has to be motivated first in fulfilling special health care needs of patients resulting in improvement of quality of life. ; Peer Reviewed
Out of 121 million population, 2.86 crore accounts for disabled people which 1.21% of total population. It has been reported that oral health care status of disabled people are poor than normal population. The main reason for this situation is barrier to access health care centres. This article throws light on definition and types of disability listed by Indian government. It also highlights the prevalence of disability and their oral health status. Article focuses on barrier in accessing dental care and guidelines required to build a disable friendly dental health care deliver center to make the treatment acceptable for such pupils. It is utmost important to provide dental care to such patients by overcoming the barrier to accessibility. Before motivating the patients and caregivers, it is the dentist who has to be motivated first in fulfilling special health care needs of patients resulting in improvement of quality of life. ; Peer Reviewed
There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. ; The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement nº 223123 which project is entitled/n"Impact on equity of access and efficiency of Integrated Health care Networks (IHN) in Colombia and Brazil" (Equity-LA). Moreover, a grant of the Ministry of Foreign Affairs and Cooperation to Development/n(Spain) was provided to Irene Garcia-Subirats, for the development of the fieldwork (Beca MAEC-AECID 2010e2011 and 2011e2012)
COVID-19; Política de salut; Nefrologia ; COVID-19; Política de salud; Nefrologia ; COVID-19; Nealth policy; Nephrology ; Objectives In a previously published Delphi exercise the European Pediatric Dialysis Working Group (EPDWG) reported widely variable counteractive responses to COVID-19 during the first week of statutory public curfews in 12 European countries with case loads of 4–680 infected patients per million. To better understand these wide variations, we assessed different factors affecting countermeasure implementation rates and applied the capability, opportunity, motivation model of behaviour to describe their determinants. Design We undertook this international mixed methods study of increased depth and breadth to obtain more complete data and to better understand the resulting complex evidence. Setting This study was conducted in 14 paediatric nephrology centres across 12 European countries during the COVID-19 pandemic. Participants The 14 participants were paediatric nephrologists and EPDWG members from 12 European centres. Main outcome measures 52 countermeasures clustered into eight response domains (access control, patient testing, personnel testing, personal protective equipment policy, patient cohorting, personnel cohorting, suspension of routine care, remote work) were categorised by implementation status, drivers (expert opinion, hospital regulations) and resource dependency. Governmental strictness and media attitude were independently assessed for each country and correlated with relevant countermeasure implementation factors. Results Implementation rates varied widely among response domains (median 49.5%, range 20%–71%) and centres (median 46%, range 31%–62%). Case loads were insufficient to explain response rate variability. Increasing case loads resulted in shifts from expert opinion-based to hospital regulation-based decisions to implement additional countermeasures despite increased resource dependency. Higher governmental strictness and positive media attitude towards countermeasure implementation were associated with higher implementation rates. Conclusions COVID-19 countermeasure implementation by paediatric tertiary care centres did not reflect case loads but rather reflected heterogeneity of local rules and of perceived resources. These data highlight the need of ongoing reassessment of current practices, facilitating rapid change in 'institutional behavior' in response to emerging evidence of countermeasure efficacy. ; The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Sistemes sanitaris europeus; Missió del càncer; Política científica ; Sistemas sanitarios europeos; Misión del cáncer; Política científica ; European healthcare systems; Cancer mission; Science policy ; A comprehensive translational cancer research approach focused on personalized and precision medicine, and covering the entire cancer research–care–prevention continuum has the potential to achieve in 2030 a 10-year cancer-specific survival for 75% of patients diagnosed in European Union (EU) member states with a well-developed healthcare system. Concerted actions across this continuum that spans from basic and preclinical research through clinical and prevention research to outcomes research, along with the establishment of interconnected high-quality infrastructures for translational research, clinical and prevention trials and outcomes research, will ensure that science-driven and social innovations benefit patients and individuals at risk across the EU. European infrastructures involving comprehensive cancer centres (CCCs) and CCC-like entities will provide researchers with access to the required critical mass of patients, biological materials and technological resources and can bridge research with healthcare systems. Here, we prioritize research areas to ensure a balanced research portfolio and provide recommendations for achieving key targets. Meeting these targets will require harmonization of EU and national priorities and policies, improved research coordination at the national, regional and EU level and increasingly efficient and flexible funding mechanisms. Long-term support by the EU and commitment of Member States to specialized schemes are also needed for the establishment and sustainability of trans-border infrastructures and networks. In addition to effectively engaging policymakers, all relevant stakeholders within the entire continuum should consensually inform policy through evidence-based advice.
As with many other aspects of the modern world, in healthcare, the explosion of data and resources opens new opportunities for the development of added-value services. Still, a number of specific conditions on this domain greatly hinders these developments, including ethical and legal issues, fragmentation of the relevant data in different locations, and a level of (meta)data complexity that requires great expertise across technical, clinical, and biological domains. We propose the Patient Dossier paradigm as a way to organize new innovative healthcare services that sorts the current limitations. The Patient Dossier conceptual framework identifies the different issues and suggests how they can be tackled in a safe, efficient, and responsible way while opening options for independent development for different players in the healthcare sector. An initial implementation of the Patient Dossier concepts in the Rbbt framework is available as open-source at https://github.com/mikisvaz and https://github.com/Rbbt-Workflows. ; This work has received funding from the Elixir-Excelerate project, from the European Union's Horizon 2020 Research and Innovation Programme, under grant agreement N. 676559, and from Plataforma de Recursos Biomoleculares y Bioinformáticos PT13/0001/0030. Additional support came from the Lenovo - BSC Master Collaboration Agreement (2015) and from the IBM-BSC Deep Learning Centre (2016). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ; Peer Reviewed ; Postprint (published version)
Si queremos comprender con mayor perspectiva la historia de la arquitectura en España, resulta decisivo acercarnos a los equipamientos sanitarios construidos durante la segunda mitad del siglo XX en zonas periféricas. Muchos de estos hospitales, planeados para el cuidado integral de la salud, tuvieron una relevancia extraordinaria en el ordenamiento administrativo del país en provincias, en cuya capital, generalmente, se asentaron para dar asistencia a los residentes en cada territorio. Con este modelo, el Seguro Obligatorio de Enfermedad quiso garantizar la cobertura universal de sus afiliados y, simultáneamente, hacer de estos centros el referente asistencial de la provincia, aunque también arquitectónico, más allá del gestionado por las diputaciones. Paralelamente, se buscó también acercar la sanidad a las zonas más alejadas de los núcleos de investigación y desenvolvimiento de la medicina y la ciencia españolas establecidos en las principales ciudades, y especialmente a las regiones menos desarrolladas. Profundizamos en este propósito atendiendo al caso de Zamora y estudiando el proceso de creación de su residencia sanitaria. Tomamos esta ciudad como ejemplo de sus mismas circunstancias en otras provincias de la España interior, que entre las décadas de 1950 y 1970 se alejaba de la actual situación de despoblación. Hemos recurrido al estudio de fuentes primarias, como la documentación producida por órganos ministeriales y administraciones locales, la correspondencia generada durante el proceso y los proyectos arquitectónicos. Todo ello nos ha permitido ser testigos de la extraordinaria dotación que recibieron y de la respuesta que estos equipamientos arquitectónicos ofrecieron a la extensión universal de la sanidad y la medicina en España. ; Si volem comprendre amb major perspectiva la història de l'arquitectura a Espanya, resulta decisiu acostar-nos als equipaments sanitaris construïts durant la segona meitat del segle XX en zones perifèriques. Molts d'aquests hospitals, planejats per a la cura integral de la salut, van tenir una rellevància extraordinària en l'ordenament administratiu del país en províncies, a la capital de les quals, generalment, es van assentar per donar assistència als residents en cada territori. Amb aquest model, l'Assegurança Obligatòria de Malaltia va voler garantir la cobertura universal dels seus afiliats i, simultàniament, fer d'aquests centres el referent assistencial de la província, encara que també arquitectònic, més enllà del gestionat per les diputacions. Paral·lelament, també es va buscar acostar la sanitat a les zones més allunyades dels nuclis de recerca i desenvolupament de la medicina i la ciència espanyoles establerts a les principals ciutats, i especialment a les regions menys desenvolupades. Aprofundim en aquest propòsit atenent el cas de Zamora i estudiant el procés de creació de la seva residència sanitària. Prenem aquesta ciutat com a exemple de les mateixes circumstàncies en altres províncies de l'Espanya interior, que entre les dècades de 1950 i 1970 s'allunyava de l'actual situació de despoblació. Hem acudit a l'estudi de fonts primàries, com la documentació produïda per òrgans ministerials i administracions locals, la correspondència generada durant el procés i els projectes arquitectònics. Tot això ens ha permès ser testimonis de l'extraordinària dotació que van rebre i de la resposta que aquests equipaments arquitectònics van oferir a l'extensió universal de la sanitat i la medicina a Espanya. ; If we want to understand the history of architecture in Spain more clearly, it is essential to look at healthcare facilities built in the provinces during the second half of the 20th century. Many of these hospitals, planned for integrated healthcare, were extraordinarily important in the administration of the nation's provinces, being generally built in provincial capitals to provide healthcare for the residents of each territory. With this model, the Compulsory Health Insurance system wanted to guarantee universal coverage for its members and, at the same time, make these centres exemplary providers of both healthcare and architecture for the whole province, separate to those run by the Provincial Councils. It also tried to bring healthcare closer to areas furthest away from the centres of research and development of Spanish medicine and science established in the main cities, and especially to the less developed regions. We look more closely at this idea by studying the case of Zamora, and the process of creating its hospital. We take this city as an example of similar circumstances occurring in many other provinces of inland Spain, where from the 50s to the 70s the situation was very different to the current case of depopulation. We have looked at primary sources such as documentation produced by government ministries and the local administrations themselves, correspondence generated during the process, and the hospital's architectural plans. All this has highlighted the extraordinary endowment these facilities received, and the contribution they made to the universal availability of health and medicine in Spain.