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Disease Management Programmes (disease + management_programme)
Selected AbstractsManagement of heart failure in elderly peopleINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2008M. Imazio Summary Aims:, To review currently available knowledge on presentation, clinical features and management of heart failure (HF) in elderly people. Methods:, To review currently available evidence, we performed a thorough search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines from National Guidelines Clearinghouse and a comprehensive MEDLINE search with the MeSH terms: ,heart failure', ,elderly' and ,management'. Results:, A number of features of ageing may predispose elderly people to HF, and may impair the ability to respond to injuries. Another hallmark of elderly patients is the increasing prevalence of multiple coexisting chronic conditions and geriatric syndromes that may complicate the clinical presentation and evolution of HF. Although diagnosis may be challenging, because atypical symptoms and presentations are common, and comorbid conditions may mimic or complicate the clinical picture, diagnostic criteria do not change in elderly people. Drug treatment is not significantly different from that recommended in younger patients, and largely remains empiric, because clinical trials have generally excluded elderly people and patients with comorbid conditions. Disease management programmes may have the potential to reduce morbidity and mortality for patients with HF. Conclusions:, Heart failure is the commonest reason for hospitalisation and readmission among older adults. HF shows peculiar features in elderly people, and is usually complicated by comorbidities, presenting a significant financial burden worldwide, nevertheless elderly people have been generally excluded from clinical trials, and thus management largely remains empiric and based on evidence from younger age groups. [source] Bacterial diseases of tomato in southern Spain: application of a detached tissue assay to evaluate bacterial pathogenicityEPPO BULLETIN, Issue 2 2000F. M. Cazorla Tomatoes are one of the most important crops in southern Spain, especially during the cold season. As a preliminary step in the design of an integrated disease management programme for tomato, a study on the occurrence of bacterial diseases in tomato houses of Almerķa (ES) was carried out during the 1993/1997 growing seasons. Sixty-four bacterial strains were isolated from tomato plants showing symptoms of bacterial diseases and 41 of them (64%) were characterized as pathogenic. The bacterial tomato pathogens most frequently isolated were Erwinia carotovora subsp. carotovora, Pseudomonas corrugata, Pseudomonas syringae pv. tomato and Xanthomonas vesicatoria. The pathogenicity of the bacterial isolates on tomato was tested by the conventional seedling assay and by an in vitro assay using detached tissues developed in our laboratory. Close correspondence between the two assays was observed. An in vitro detached tissue assay is proposed for determining the pathogenicity of bacterial isolates on tomato. [source] DIADEM: implementation of a comprehensive disease management programme for type 2 diabetesPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 3 2005Dr S Luzio PhD Clinical Trials Manager Abstract The purpose of the study was to evaluate the feasibility and acceptance of an IT-based diabetes disease management programme. The study was performed at two test sites in Aachen (Germany) and Cardiff (UK) including 166 and 137 patients respectively. The study focused on the technical feasibility of a web-based communication platform and its acceptance among medical professionals, the patient acceptance of entering self-measured data via phone and of service-centre support, the acceptance of implementing quality management measures, and the effects of all these measures on glycaemic control. The maximum programme duration was four months at Aachen and six months at Cardiff. The main outcomes were utilisation data, and satisfaction of both patients and physicians with the different components of DIADEM. HbA1c concentrations improved significantly from 7.1±1.0% to 6.8±1.1% in Aachen and from 7.7±1.0% to 7.1±1.1% in Cardiff (each p<0.001). The platform as a hosted ASP (application service provider) solution was accessible using a standard Internet enabled PC. Following training, a fast and efficient introduction of the software to professional users was obtained. Patient acceptance was very high both in terms of utilisation of the system (13 000 data entries performed during 6800 calls) and in terms of patient satisfaction assessed by a patient survey (93% very satisfied or satisfied). Patients strongly preferred a DTMF (dual tone multi-frequency) interface entering data by telephone key-pad rather than voice recognition. This study showed that an IT-based diabetes disease management service improved glycaemic control in patients with type 2 diabetes and could find acceptance by patients and professionals if convenient pathways for data entry and transmission are provided. Copyright © 2005 John Wiley & Sons, Ltd. [source] Fungicide Effectiveness during the Various Developmental Stages of Peronophythora litchii In VitroJOURNAL OF PHYTOPATHOLOGY, Issue 7-8 2009Hancheng Wang Abstract Litchi downy blight caused by Peronophythora litchii is one of the most destructive diseases suffered by litchi in China. This study has evaluated the activities of the fungicides dimethomorph (DMM), azoxystrobin (AZB), famoxadone (FMD), metalaxyl (MTL), cymoxanil (CYX) and mancozeb (MCB) on the mycelial growth, sporulation, zoospores release, and germination of sporangia as well as of cystospores of P. litchii. Dimethomorph and MTL inhibited mycelial growth more effectively than the other fungicides tested. Mycelial growth was affected less by MCB, and only weakly by AZB, FMD and CYX. Sporangia production was more strongly reduced by DMM and MTL than by AZB, FMD, CYX or MCB. Zoospore release from the sporangia was most sensitive to AZB and FMD, less sensitive to MCB and insensitive to DMM, MTL and CYX. Direct germination of sporangia of P. litchii was the most strongly inhibited by AZB and FMD, followed by DMM and MCB, whilst the sensitivity of this life stage to MTL and CYX was relatively low. Germination of encysted zoospores of P. litchii was the most sensitive to AZB and FMD, followed by DMM. Mancozeb was moderately active, while MTL and CYX did not inhibit this development stage. This is the first report on the in vitro response of the litchi pathogen, P. litchii, to fungicides. These findings can be valuable tools in setting up efficient disease management programmes to control litchi downy blight. [source] A shift to ambulatory medical education in IsraelTHE CLINICAL TEACHER, Issue 2 2010Khaled Karkabi Summary Background:, The Council for Higher Education in Israel published an extensive report in 2007, calling for a significant increase of undergraduate medical education in Israel in ambulatory care settings. The objective of this article is to propose an action plan aimed at shifting undergraduate medical education in Israel towards ambulatory education. Context:, The main barriers to increasing ambulatory education in Israel are lack of academic recognition for teaching and excellence, conflict between patient care, income and teaching, lack of an adequate educational infrastructure and faculty in ambulatory care, and insufficient support and involvement of the health organisations. However, there is great potential for developing ambulatory education in Israel based on existing resources: Israel has a well-established primary care network, has chronic disease management programmes, community-based preventive medicine and health promotion activities, and an emerging structure for home, palliative and terminal care in the community. Innovation:, The proposed action plan presents a framework for enhancing ambulatory education in undergraduate medical education in Israel, and allows site-specific adjustments according to the preferences, resources and capabilities of each of the four medical schools. Implications:, A national shift to ambulatory education in Israel can be implemented through the existing coordination mechanism of the four medical schools. A government funding policy that encourages the collaboration between four medical schools will be beneficial both in terms of resource utilisation and the engagement of other stakeholders. The recognition of community services and educational excellence can be advanced by establishing academies of teaching scholars. [source] The importance of disease management programmes for wildlife conservationANIMAL CONSERVATION, Issue 3 2009K. Acevedo-Whitehouse No abstract is available for this article. [source] Crop traits and the tolerance of wheat and barley to foliar diseaseANNALS OF APPLIED BIOLOGY, Issue 2 2009I.J. Bingham Abstract The relationship between yield loss and disease severity can differ widely between crops. This has given rise to the concept of disease tolerance, with some crops exhibiting a smaller yield loss under a given severity of disease than others. Genetic improvement to minimise yield loss under disease is an attractive goal, as it exerts little or no selection pressure on pathogen populations, and could form a useful component of durable disease management programmes. However, progress towards this end requires a thorough understanding of the phenotypic traits that influence the response of yield to disease, their genetic control and the possible trade-offs involved with other desirable agronomic characteristics. This paper examines the candidate crop traits that may confer tolerance of foliar disease in wheat and barley and reviews evidence of genetic variation in their expression. In wheat grown under the relatively low light conditions of North-West Europe, post-anthesis source (assimilate supply) and grain sink capacity (capacity for dry matter accumulation) appear to be closely balanced. Traits associated with maintaining post-anthesis radiation interception and radiation use efficiency in spite of disease may confer tolerance. The most promising traits include a larger flag leaf and compensatory increases in photosynthetic rate in non-infected parts of leaves. In barley, yield is often more strongly sink limited, and early-season disease management is required to protect the formation of potential grain sites. A wider range of potential traits may influence tolerance including compensatory adjustments in leaf growth and morphology, and differences in the sensitivity of tiller and spikelet mortality to photoassimilate supply. Different methods for quantifying tolerance are suggested depending on the trait of interest. [source] | |||||||||||||