United States physician office visits for asthma have increased since 1989, and most of these visits are to primary care physicians. The National Institutes of Health has published guidelines for asthma diagnosis and ...United States physician office visits for asthma have increased since 1989, and most of these visits are to primary care physicians. The National Institutes of Health has published guidelines for asthma diagnosis and management, implementation of which is expected to result in improved care and reduced costs. Compliance with asthma guidelines has been suboptimal, especially with spirometry recommendations, and more so in primary care clinics than in specialist clinics. Noncompliance has largely been attributed to physician and patient factors. This paper describes an experience with navigation of health system barriers to implementation of spirometry encountered at three primary care clinics affiliated with an internal medicine residency program. Included are perspectives and priorities of key individuals, systems issues related to institutions, and technical issues pertaining to spirometers. Navigation of ACGME core competencies is discussed.展开更多
The Baumann Skin Typing System diagnoses patients as having one of 16 skin types based on their answers to a validated questionnaire [i] known as the Baumann Skin Type Indicator [ii]. The BSTI questionnaire has been t...The Baumann Skin Typing System diagnoses patients as having one of 16 skin types based on their answers to a validated questionnaire [i] known as the Baumann Skin Type Indicator [ii]. The BSTI questionnaire has been tested over the last decade on over 200,000 people of various ages and ethnicities in different geographic locations around the world. In this study, data were collected from 52,862 patients to compare skin type prevalence between those who presented to doctor’s offices and those who took the quiz without supervision online. The most common skin types varied only slightly between patients that took the quiz online and those that completed the questionnaire in their doctor’s office. This indicates that the prevalence of skin types seen in the doctor’s office is similar to that in the general population and that supervision is not necessary to get an accurate result on the BSTI. [iii] In addition, comparison of data gathered in China, Korea, and the US did not show a significant difference in skin type prevalence between Asian and Caucasian skin types. [iv] This study demonstrates that the English version of the BSTI is valid for English speaking patients online, and in doctors’ offices in the US, China and Korea.展开更多
Background:Global health institutions have called for governments,international organisations and health practitioners to employ a human rights-based approach to infectious diseases.The motivation for a human rights a...Background:Global health institutions have called for governments,international organisations and health practitioners to employ a human rights-based approach to infectious diseases.The motivation for a human rights approach is clear:poverty and inequality create conditions for infectious diseases to thrive,and the diseases,in turn,interact with social-ecological systems to promulgate poverty,inequity and indignity.Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases,as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights.These social determinants and economic outcomes associated with infectious diseases should interest multinational companies,partly because they have bearing on corporate productivity and,increasingly,because new global norms impose on companies a responsibility to respect human rights,including the right to health.Methods:We reviewed historical and recent developments at the interface of infectious diseases,human rights and multinational corporations.Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases,which embraced rights-based disease control strategies.Results:Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations.Indeed,in an increasingly globalised and interconnected world,multinational corporations have an interest,and an important role to play,in advancing rights-based control strategies for infectious diseases.Conclusions:There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies.Guidance offered by the United Nations in 2011 that is widely embraced by companies,governments and civil society provides a roadmap for engaging business enterprises in rights-based disease management strategies to mitigate disease transmission rates and improve human welfare outcomes.展开更多
文摘United States physician office visits for asthma have increased since 1989, and most of these visits are to primary care physicians. The National Institutes of Health has published guidelines for asthma diagnosis and management, implementation of which is expected to result in improved care and reduced costs. Compliance with asthma guidelines has been suboptimal, especially with spirometry recommendations, and more so in primary care clinics than in specialist clinics. Noncompliance has largely been attributed to physician and patient factors. This paper describes an experience with navigation of health system barriers to implementation of spirometry encountered at three primary care clinics affiliated with an internal medicine residency program. Included are perspectives and priorities of key individuals, systems issues related to institutions, and technical issues pertaining to spirometers. Navigation of ACGME core competencies is discussed.
文摘The Baumann Skin Typing System diagnoses patients as having one of 16 skin types based on their answers to a validated questionnaire [i] known as the Baumann Skin Type Indicator [ii]. The BSTI questionnaire has been tested over the last decade on over 200,000 people of various ages and ethnicities in different geographic locations around the world. In this study, data were collected from 52,862 patients to compare skin type prevalence between those who presented to doctor’s offices and those who took the quiz without supervision online. The most common skin types varied only slightly between patients that took the quiz online and those that completed the questionnaire in their doctor’s office. This indicates that the prevalence of skin types seen in the doctor’s office is similar to that in the general population and that supervision is not necessary to get an accurate result on the BSTI. [iii] In addition, comparison of data gathered in China, Korea, and the US did not show a significant difference in skin type prevalence between Asian and Caucasian skin types. [iv] This study demonstrates that the English version of the BSTI is valid for English speaking patients online, and in doctors’ offices in the US, China and Korea.
基金Special thanks are addressed to Cynthia Donovan for insights into the role of agricultural economics in health considerations.KS is grateful to NewFields for a PhD fellowship,and to NomoGaia for funding research associated with this manuscript.
文摘Background:Global health institutions have called for governments,international organisations and health practitioners to employ a human rights-based approach to infectious diseases.The motivation for a human rights approach is clear:poverty and inequality create conditions for infectious diseases to thrive,and the diseases,in turn,interact with social-ecological systems to promulgate poverty,inequity and indignity.Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases,as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights.These social determinants and economic outcomes associated with infectious diseases should interest multinational companies,partly because they have bearing on corporate productivity and,increasingly,because new global norms impose on companies a responsibility to respect human rights,including the right to health.Methods:We reviewed historical and recent developments at the interface of infectious diseases,human rights and multinational corporations.Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases,which embraced rights-based disease control strategies.Results:Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations.Indeed,in an increasingly globalised and interconnected world,multinational corporations have an interest,and an important role to play,in advancing rights-based control strategies for infectious diseases.Conclusions:There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies.Guidance offered by the United Nations in 2011 that is widely embraced by companies,governments and civil society provides a roadmap for engaging business enterprises in rights-based disease management strategies to mitigate disease transmission rates and improve human welfare outcomes.
