Treatable Mortality In Latvia Is Amongst The Highest In The Eu
Preventable mortality are deaths that could mostly be avoided if effective public health and primary prevention interventions are in place treatable mortality refers to deaths that could be avoided if effective health care interventions, including screening and treatment, were in place. Latvia has high rates of both preventable mortality and treatable mortality . Compared to OECD peers in 2015, Latvia has the second highest rate of treatable mortality and the second highest rate of preventable mortality .
The rate of treatable mortality in Latvia was 203 per 100 000 population, more than twice the EU average of 93 per 100 000 population in 2016 . The rate of treatable mortality in Latvia was particularly high for ischaemic heart diseases and stroke despite falling stroke and ischaemic heart disease mortality rates there is clear room for improvement if Latvia is to catch up with EU and OECD peers.
Note: Mortality from treatable causes is defined as death that can be mainly avoided through health care interventions, including screening and treatment. This indicators refers to premature mortality .
Source: OECD/European Observatory on Health Systems and Policies , Latvia: Country Health Profile 2019, State of Health in the EU, OECD Publishing, .
To Challenge The Theoretical Construct In Copd Management Through A Practice
Our vision was to raise the aspiration of the local NHS, its partners and the public to close the gap in life expectancy by 2 years to improve health outcomes … of COPD, primaryprevention, early detection, primary care, secondary/tertiary care and …
National Institute for Health and Care Excellence
Race Ethnicity And Asthma Incidence
Few US studies specifically provided detailed asthma incidence rates and none by race.- Beckett et al used data from a large multicenter study on coronary artery risk to evaluate weight gain and, in this case, cumulative incidence of asthma. Among the 4547 young adults aged 18 to 30 years, the 10-year cumulative incidence of asthma was 6.7%, 10.5%, 5.4%, and 9.7% for black males, black females, white males, and white females, respectively. The Childrenâs Health Study, a prospective study of 3792 fourth through tenth graders did report an overall incidence rate of asthma but not race-specific rates. Compared with non-Hispanic whites, the relative risk of new-onset asthma was 1.05 for Hispanics and 1.53 for blacks, although the latter made up less than 6% of the study population. A recent study of lead exposure used claims and encounter databases for 4634 managed care enrollees and reported incidence rates by race. The incidence rate of asthma for African American children was 3.0 per 100 person-years versus 1.2 per 100 person-years for white children . Adjusting for birth weight, sex, and SES did not alter this difference. Clearly, basic knowledge regarding racial differences in asthma incidence rates is lacking.
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Bundled Payment For Health Teams In France
In France, a new five-year pilot programme was launched in 2019 to experiment with bundled payments. The programme, called Payment for Health Professional Teams , has the objective is to ensure greater care integration, improved patient care pathways, and greater care co-ordination between primary health care and secondary care providers. The bundled payment will substitute the fee-for-service schemes, and will only apply for patients followed by a GP in a multi-professional health care centre . The pilot targets diabetes patients and elderly patients , but also includes all patients having a named GP. Bundled payments will eventually be rolled out nationally from 2023 if evaluations show positive results.
Source: OECD , Realising the Potential of Primary Health Care,
Pamphlets May Not Be Enough
Dr. Rao has some pamphlets alerting diabetic patients to the need for careful monitoring and control of their condition in order to avoid serious adverse outcomes but he recognizes that these are not helpful for Catherine, given her increasing memory difficulties. He sees the need for a broader support programme, involving her family members and other community members. He encourages her son Paul and his wife Julie to get Catherine to join a diabetic support group that he is planning to set up. He hopes that they can contribute by leading some physical activities that would get them actively engaged and be good for all of them.
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The Pap Smear Test Detects Cervical Cancer In Women At An Early Stage Of The Disease When There Are No Symptoms And The Disease Is Not Evident On Visual Examination Which Of The Following Statements Applies To A Woman With No History Of Cervical Cancer Who Undergoes A Pap Smear
A. She is practicing primordial prevention.
B. She is practicing primary prevention.
C. She is practicing secondary prevention.
D. She is practicing tertiary prevention.
E. This is a screening test, not a preventive procedure.
C) Secondary Prevention
Rationale:
A. Primordial prevention acts early in the causal chain, to alter general social or economic circumstances that give rise to risk factors. The Pap test does not address general circumstances, but a specific disease process.
B. Primary prevention is defined as the avoidance of disease having a Pap smear would not prevent the disease from occurring.
C. Secondary prevention is defined as the interruption of any disease process before the emergence of recognized symptoms or diagnostic findings of the disorder. The Pap smear test forms an essential step in this process: it identifies the disease process before the emergence of symptoms.
D. Tertiary prevention is defined as the avoidance of negative sequelae of a disease process, once the disease has been diagnosed and treated. The Pap smear concerns early detection it has nothing to do with subsequent effects of the disease.
E. Yes, it is a screening test, but that forms an integral component of an approach to prevention. So this response is splitting definitional hairs and presumably the physicians intent in administering the test was to prevent further progression of the cancer.
3. Contrast the underlying philosophies of health promotion and health protection.
Asthma Action Plan And Prompt Interventions Of Exacerbations
Asthma action plans are highly recommended as they can be useful in educating patients about early recognition of exacerbation, and guide appropriate intervention strategies to prevent further deterioration.3,18 The Australian Asthma Handbook provides guidance as to how these action plans should be completed, including specific recommendations for escalation of therapy based on their usual maintenance regime.3 There are increasing data showing that early treatment using temporary escalation of ICS may ameliorate the need for oral prednisolone in the event of an exacerbation.
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Access And Health Care Delivery
Disparities in access to and receipt of quality asthma care are well documented. These include but are not limited to less prescribing of inhaled corticosteroids, less follow-up of acute exacerbations, and less availability of pharmacy resources in urban communities. The importance of health care coverage should also be underscored. In New Jersey, extension of a safety-net program to poor families who did not qualify for Medicaid resulted in significant increases in asthma diagnosis and treatment in a predominantly Latino community. Access to health care does not always explain these trends because disparities in care have also been documented among insured individuals.,
More On The Stages Of Prevention
Our presentation of prevention as discrete stages offers a useful introduction to the topic, but classifying a preventive action into a stage depends greatly on the context.
For example, checking and then controlling blood pressure may represent primary prevention if the condition you aim to prevent is a heart attack. But BP control may be seen as secondary prevention if the person has a family history of hypertension and you are screening for this. It may even be tertiary prevention if the patient has already had a heart attack and the goal is to prevent a recurrence. Bother!
Even more confusing: secondary prevention has been defined as slowing the progression of a disease or its sequelae at any point after its inception. From this perspective, treating a disease can be seen as prevention if it slows the progression of the disease or prevents adverse outcomes. From a public health perspective, treating an infectious disease might even qualify as primary prevention because it reduces the risk of transmission of the virus.
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Who Strategy For Prevention And Control Of Asthma
Asthma is included in the WHO Global Action Plan for the Prevention and Control of NCDs and the United Nations 2030 Agenda for Sustainable Development.
WHO is taking action to extend diagnosis of and treatment for asthma in a number of ways.
The WHO Package of Essential Noncommunicable Disease Interventions was developed to help improve NCD management in primary health care in low-resource settings. PEN includes protocols for the assessment, diagnosis, and management of chronic respiratory diseases , and modules on healthy lifestyle counselling, including tobacco cessation, and self-care.
Reducing tobacco smoke exposure is important for both primary prevention of asthma and disease management. The Framework Convention on Tobacco Control is enabling progress in this area as are WHO initiatives such as MPOWER and mTobacco Cessation.
The Philosophy Of Health Promotion
Health promotion reflects a characteristic set of liberal values, such as self-responsibility for health, that characterize much of the WHO thinking: Health promotion is the process of enabling people to increase control over, and to improve, their health. This definition derived from the WHO conception of health described in Chapter 1: The extent to which an individual or group is able to realize aspirations and to satisfy needs, and to change or cope with the environment.8 Along with self-responsibility, other core values of health promotion include many upstream factors, such as:
- Promoting equity and social justice
- Applying a holistic definition of health
- Consideration of the full range of health determinants
- Addressing environmental influences on health
- Empowering people and building individual and collective capacity
- Seeking to enhance peoples social participation and
- Fostering collaboration between agencies.
The principles on which health promotion strategies are designed were described in the Ottawa Charter for Health Promotion.
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Secondary Prevention Of Bronchial Asthma
Secondary prevention measures are aimed at children who, if there is sensitization, have no symptoms of bronchial asthma. These children are characterized by:
- a burdened family history of bronchial asthma and other allergic diseases
- other allergic diseases
- increase in the level of total IgE in the blood in combination with the detection of significant amounts of specific IgE to bovine milk, chicken eggs, and allergens.
For the purposes of secondary prevention of bronchial asthma, this group of risk is offered preventive treatment with cetirizine. Thus, the study of ETAS showed that the administration of this drug at a dose of 0.25 mg / kg per day for 18 months to high-risk children with domestic or pollen sensitization leads to a decrease in the frequency of bronchial obstruction from 40 to 20%. However, it was later shown that a reduction in the risk of developing bronchial asthma was detected in very small groups of patients with atopic dermatitis . Due to little evidence, the ETAS study was withdrawn from the new version of GINA .
Create More Capacity In Primary Care For Patient Education Disease Management And Disease Detection
Primary care providers, and specifically General Practitioners, are at the heart of secondary and tertiary prevention in Latvia. While some interventions are managed vertically, for instance breast and cervical cancer screening, and there are a small number of chronic disease cabinets for instance for diabetes, the bulk of screening, disease risk detection, patient contact, and chronic disease management, lies with General Practitioners. To strengthen secondary and tertiary prevention capacity, and impact, Latvia should look to increase capacity in primary care.
However, as previously discussed in this chapter, given that Latvian GPs are broadly agreed to already be significantly time and resource stretched increasing secondary and tertiary prevention activities in primary care would require some further investment of resources in the sector. Should such resources be available, to improve secondary and tertiary prevention the priorities for increasing capacity should be focused on patient education, comprehensive disease management, and, eventually some systematic or opportunistic screening and check-ups to detect disease. Exploring whether there are ways for other health workers for instance nurses or pharmacists to play a role in delivering some of these key prevention activities is a possibility for Latvia to explore .
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Implementing Prevention Health Protection And Health Promotion Programmes
Prevention programmes may be delivered by public health agencies, by individual clinicians , or by community agencies . Ideally, programmes should be coordinated between these providers while we have many good programs in Canada, they tend to be delivered in relative isolation by the single agencies responsible for them, resulting in gaps and overlaps between programs. Programmes also need to be tailored to the local situation: one size does not fit all. This theme is discussed in programme planning in Chapter 12.
About The What Researchers Mean By Series
This research term explanation first appeared in a regular column called What researchers mean by that ran in the Institute for Work & Healths newsletter At Work for over 10 years . The column covered over 35 common research terms used in the health and social sciences. The complete collection of defined terms is available online or in a guide that can be downloaded from the website.
Prevention includes a wide range of activities known as interventions aimed at reducing risks or threats to health. You may have heard researchers and health experts talk about three categories of prevention: primary, secondary and tertiary. What do they mean by these terms?
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Prevention Strategies For Asthma Secondary Prevention
Secondary prevention of asthma is defined as intervention for infants and children who are at high risk for the development of asthma but who have not yet developed asthma symptoms or signs. These patients have a family history of allergic disease and 1 or more of the following: atopic dermatitis or eczema, allergic rhinitis, food allergy, bronchial hyperreactivity, blood eosinophilia, elevated total IgE levels, elevated allergen-specific IgE, or skin-test reactivity to specific allergens.,,
Promote Chronic Disease Management Through Organisational And Payment Incentives
To improve outcomes for people with chronic diseases in Latvia, who represent a significant proportion of the overall disease burden, it will be critical to strengthen chronic disease management. This should include coordinated and proactive interventions for people identified as at-risk of chronic diseases, for example pre-diabetic patients, comprehensive support for disease management and self-management for controlled chronic diseases, and high responsiveness in the event of disease complications. Improving chronic disease management should also be seen as a way of improving efficiency. Timely interventions in the pre-disease period can stop the progress of a condition and reduce a patients need for care. Effective chronic condition management can reduce complications which can be very costly, both in terms of more intensive specialist support including hospital stays, and increased disability which can take people out of the workforce earlier in their life course.
Latvia can look to strengthen chronic disease management in a three-step process, that could be pursued simultaneously or incrementally depending on capacity, and whether it is possible to undertake some pilot projects in the country:
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Development of clinical guidelines or disease management pathways
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Development of chronic care management programmes led by dedicated multi-disciplinary teams
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Development of bundled payments for chronic conditions.
Development of bundled payments for chronic conditions
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Racial Disparities In The Context Of Disease Prevention
The concept of disease prevention encompasses an understanding of the cause and consequences of disease in populations and is often described at the stage of intervention . Ways to reduce racial disparities in asthma can also be discussed in this context. As such, primary prevention targets reductions in asthma incidence through the identification and elimination of exposure to risk factors that are more common among minorities. Secondary prevention is the mitigation of established disease and involves disease detection, management, and control, all of which might be suboptimal in minority populations. Tertiary prevention, the reduction of disease complications, involves identifying race differences in the treatment and control of severe disease and factors related to asthma mortality. Reducing racial disparities in asthma will require that contributing factors at each level of disease prevention are understood and that this knowledge be translated into clinical practice and public health policy.
Race Ethnicity And Risk Factors For Asthma
Risk factors prevalent in minority populations, such as obesity and low birth weight, might affect asthma risk. It has been suggested that obesity might be directly related to the development of asthma through histologic changes in lungs, alterations of hormonal patterns and immune function, or mechanical stress on the respiratory system, such as decreased airway caliber or pulmonary vascular congestion.- Obesity is more prevalent among African American and Latino populations when compared with non-Hispanic whites. According to recent data, almost 50% of US African American women are obese. Indirectly, obesity might be associated with a sedentary lifestyle, leading to an increase in exposure to indoor allergens. Prospective studies in US populations are consistent in finding an interaction between obesity and asthma risk by sex but do not agree on whether the risk is higher in female or male subjects.,, As a modifiable risk factor, the role of obesity in asthma incidence warrants exploration and might provide further insight into racial-ethnic disparities. To date, no studies of racial differences in the relationship of obesity to asthma have been conducted.
Low birth weight is more prevalent among African Americans and is also a risk factor for asthma. Results of 2 different analyses found that low birth weight accounted for 30% to 68% of the racial differences in asthma observed in the populations studied.,
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