Italy is the main recipient of asylum seekers in the European region, and Sicily is their first point of arrival. This geographical position creates a large job for Health Authorities to identify and ...deal with the health of immigrants. This study evaluates the prevalence of disease among asylum seekers, assessing which are associated factors.
A cross-sectional study was conducted to analyse demographic and clinical data in an Acceptance Centres for Asylum Seekers from February 2012 to May 2013. All variables that were found to be significant on unvariable analysis for the most frequent pathologies were included in a multivariable logistic regression model.
Post-traumatic stress disorders with 17.4% and major depression with 7.3% were the most frequent diseases. The factors associated with post-traumatic stress disorders among asylum seekers were: major depression diagnosis (OR=2.91, p=0.004), Pakistan as a country of origin (OR=3.88, p<0.001), the largest number of medical visits (OR=1.02, p=0.033) and refugee status (OR=1.97, p=0.036). The variables linked with the diagnosis of major depression from the multivariable analysis were: suffering from post-traumatic stress disorders (OR=3.83, p<0.001), Pakistan as a country of origin (OR=3.45, p=0.004) and the highest number of visits to psychologist (OR=1.15, p<0.001).
The mental wellbeing of asylum seekers needs special attention, and interventions should be done to prevent the consolidation of psychiatric morbidity. A short psychological screening after the arrival might prove helpful here. Moreover, carefully designed longitudinal studies should be carried out when political recommendations try to change the organization of psychological and healthcare services.
Roma populations’ low health status and limited access to health services, including primary care, has been documented in many European countries, and warrants specific health policies and practices. ...A variety of experiences shows how primary care can adjust its practices to reduce the barriers to primary care for Roma populations.
At local level, establishing collaboration with Roma organisations helps primary care to improve mutual relations and quality of care. Mediation has proved to be an effective tool. Skills training of primary care practitioners may enhance their individual competences. Research and international sharing of experiences are further tools to improve primary care for the Roma people.
Introduction. Besides participation in the primary prevention, screening as secondary prevention is an important requirement for primary care services. The effect of this work is influenced by the ...characteristics of individual primary care practices and doctors’ screening habits, as well as by the regulation of screening processes and available financial resources. Between 1999 and 2009, a managed care program was introduced and carried out in Hungary, financed by the government. This financial support and motivation gave the opportunity to increase the number of screenings.
Method. 4,462 patients of 40 primary care practices were screened on the basis of SCORE risk assessment. The results of the screening were compared on the basis of two groups of patients, namely: those who had been pre-screened (pre-screening method) for known risk factors in their medical history (smoking, BMI, age, family cardiovascular history), and those randomly screened. The authors also compared the mortality data of participating primary care practices with the regional and national data.
Results. The average score was significantly higher in the pre-screened group of patients, regardless of whether the risk factors were considered one by one or in combination. Mortality was significantly lower in the participating primary practices than had been expected on the basis of the national mortality data.
Conclusion. This government-financed program was a big step forward to establish a proper screening method within Hungarian primary care. Performing cardiovascular screening of a selected target group is presumably more appropriate than screening within a randomly selected population. Both methods resulted in a visible improvement in regional mortality data, though it is very likely that with pre-screening a more cost-effective selection for screening may be obtained.
Uvod. Poleg primarne preventive je presejanje kot sekundarna preventiva pomemben člen pri storitvah osnovnega zdravstvenega varstva. Na uspešnost tovrstnega dela vplivajo značilnosti posameznih splošnih ambulant varstva in pripravljenost zdravnikov za izvajanje presejalnih pregledov kot tudi ureditev procesov presejanja in razpoložljivih finančnih virov. Med leti 1999 in 2009 je bil v Madžarski uveden in izpeljan program vodene oskrbe, ki ga je financirala vlada. Ta finančna podpora in spodbuda je omogočila priložnost za povečanje števila presejalnih pregledov.
Metode. 4462 pacientov iz 40 splošnih ambulant je bilo vključenih v presejalni pregled v sklopu ocene tveganja SCORE. Rezultate presejanja se je primerjalo na podlagi dveh skupin pacientov, in sicer tistih, ki so bili predhodno presejani (metoda predhodnega presejanja) za znane dejavnike tveganja v njihovi zdravstveni anamnezi (kajenje, indeks telesne mase, starost, zgodovina srčno-žilnih obolenj) ter tistih, ki so bili presejani naključno. Avtorji so primerjali tudi podatke sodelujočih splošnih ambulant o smrtnosti z regionalnimi in nacionalnimi podatki.
Rezultati. Povprečen rezultat je bil bistveno višji v predhodno presejani skupini pacientov, ne glede na to, ali so bili dejavniki tveganja upoštevani posamično ali v kombinaciji. Smrtnost je bila bistveno nižja pri sodelujočih splošnih ambulantah, kot je bilo pričakovati na podlagi nacionalnih podatkov o smrtnosti.
Zaključek. Ta program, ki ga je financirala država, je pomenil velik korak naprej k ustanovitvi ustrezne metode presejanja znotraj madžarskega sistema osnovne zdravstvene oskrbe. Izvajanje presejanja za ogroženost srčnožilnega sistema pri izbrani skupini je očitno bolj primerno od naključnih pregledov. Obe metodi sta vidno prispevali k izboljšanju regionalnih podatkov o smrtnosti, čeprav je precej verjetno, da se s predhodnim presejanjem doseže bolj stroškovno učinkovita izbira presejanj.
Za bolezni srca in ožilja je značilno, da imajo skupne dejavnike tveganja in jih z zdravim načinom življenja lahko uspešno preprečujemo ali vsaj odložimo njihov nastanek v kasnejše ...obdobje.Spreminjanje življenjskega sloga posameznika je proces, ki ima svoje zakonitosti in se pri posamezniku velikokrat prične zaradi zdravstvene ogroženosti ter zahteva podporo vseh zdravstvenih delavcev. Timski pristop v osnovnem zdravstvenem varstvu zagotavlja ustrezno pomoč posamezniku, saj so aktivnosti medicine in zdravstvene nege usmerjene k skupnemu cilju – zdravju. Pri tem ima veliko vlogo medicinska sestra kot izvajalka zdravstvene nege in zdravstvene vzgoje, ki se posveča človeku iz vidika osnovnih človekovih potreb.
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