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Stone O.,Maccabi Healthcare Services | Werner P.,Haifa University
Qualitative Health Research | Year: 2012

The aim of this study was to explore and define the different dimensions of professional stigma attached to obese patients by dietitians. Four focus groups were conducted with 23 Israeli dietitians. Findings showed that while treating obese patients, dietitians underwent a stigmatization process involving cognitive, emotional, and behavioral phases. Obese patients with an internal locus of control, who took responsibility for their failure to diet, triggered positive feelings (e.g., pity and empathy), whereas obese patients with an external locus of control, who blamed others for their failure, triggered negative feelings (e.g., anger and frustration). Participants' emotional rejection of obese patients was manifested in three behavioral dimensions: instrumental avoidance (e.g., shorter sessions); professional avoidance (e.g., less energy and effort); and interpersonal avoidance (negative tone and evasive verbal and body language). Continuing education for dietitians is recommended to assist them in dealing with their negative feelings and behaviors toward resistant obese patients. © The Author(s) 2012. Source

Grossman Z.,Maccabi Healthcare Services
Harefuah | Year: 2012

As of February 2010, the 2009 H1N1 influenza has caused more than 15,000 deaths worldwide. Seasonal influenza vaccination rates among health care workers (HCW) have been universally low; the 2009 H1N1 influenza vaccination of HCW has also been disappointing. In several studies, a correlation between HCW seasonal influenza vaccination status and vaccine recommendation to adult patients was found. To examine the correlation between the declared influenza vaccination status of pediatric staff and vaccine recommendations to their patients. Instrument: Anonymous questionnaire concerning attitudes and practices regarding seasonal and 2009 H1N1 influenza vaccination. Respondents: 141 pediatric staff attending a conference. Seventy two percent of the respondents had been or intended to be vaccinated against seasonal influenza, 62% against the 2009 H1N1 influenza, and 56% against both diseases. Ambulatory setting employment was positively associated with the recommendation of seasonal influenza vaccination to all children. By multivariate Logistic regression analysis, the "vaccinated or intending to be vaccinated against seasonal influenza" was the only significant independent variable associated with recommending universal pediatric seasonal influenza vaccine (OR=15, 95% CI 6.1-41.4, p < 0.001). Similarly, "being or intending to be vaccinated against the 2009 H1N1 influenza" was the only significant independent variable associated with recommending universal pediatric vaccination against this disease (OR = 5.2, 95% CI 1.85-14.6, P = 0.002). A strong correlation between the influenza vaccination status of pediatric staff and the recommendation of the vaccines to children emphasizes that intense education of providers is a crucial step in assuring a positive recommendation to families. Source

Sternberg S.A.,Maccabi Healthcare Services | Schwartz A.W.,Mount Sinai School of Medicine | Karunananthan S.,McGill University | Bergman H.,McGill University | And 2 more authors.
Journal of the American Geriatrics Society | Year: 2011

An operational definition of frailty is important for clinical care, research, and policy planning. The literature on the clinical definitions, screening tools, and severity measures of frailty were systematically reviewed as part of the Canadian Initiative on Frailty and Aging. Searches of MEDLINE from 1997 to 2009 were conducted, and reference lists of retrieved articles were pearled, to identify articles published in English and French on the identification of frailty in community-dwelling people aged 65 and older. Two independent reviewers extracted descriptive information on study populations, frailty criteria, and outcomes from the selected papers, and quality rankings were assigned. Of 4,334 articles retrieved from the searches and 70 articles retrieved from the pearling, 22 met study inclusion criteria. In the 22 articles, physical function, gait speed, and cognition were the most commonly used identifying components of frailty, and death, disability, and institutionalization were common outcomes. The prevalence of frailty ranged from 5% to 58%. Despite significant work over the past decade, a clear consensus definition of frailty does not emerge from the literature. The definition and outcomes that best suit the unique needs of the researchers, clinicians, or policy-makers conducting the screening determine the choice of a screening tool for frailty. Important areas for further research include whether disability should be considered a component or an outcome of frailty. In addition, the role of cognitive and mood elements in the frailty construct requires further clarification. © 2011, The American Geriatrics Society. Source

Agency: Cordis | Branch: H2020 | Program: IA | Phase: PHC-20-2014 | Award Amount: 3.18M | Year: 2015

The average human lifespan increase has significant impacts on healthcare organizations and on every aspect of citizens wellbeing. One of the main areas of intervention focuses on elderly people affected by Cognitive Impairment (CI). These people, especially when living alone, are significantly exposed to undeniable risks that can affect their health (falling, malnutrition, hygiene issues, etc.). Limitations regarding CI can also translate into social and physical limitations during daily activities (cooking, showering, ect.). The DECI project aims to improve a healthy lifestyle for elderly people effected by CI, passing through a system monitoring vital signs, treating and managing diseases and, in general, supporting the adoption of a healthy and independent lifestyle. To achieve this, the project will revolve around the definition of a business model to supply assistance services (in-house for the elderly and with a remote-based approach supporting autonomy), allowing independent living for elderly people affected by CI, granting high levels of quality of life. The proposed business model will include an up-to-date organizational model, both modular, flexible and scalable, meant for regulators and service suppliers, and the support of an IT platform based on innovative and easy-to-replicate technologies. In order to validate the business model inside real-life environments, four pilot projects will be kicked-off, by involving patients in four different countries: Israel, Italy, Spain and Sweden. Every pilot project will pass through the implementation of the organizational model and the IT solution defined as part of the DECI initiative, therefore allowing tuning of the model and of all implemented devices. Business plan and economic models (in private/ public sectors and in different countries) will be adopted in order to address cost coverage issues related to the implementation of new procedures and technological solutions inside real healthcare environments.

Agency: Cordis | Branch: FP7 | Program: CP | Phase: ICT-2011.5.4 | Award Amount: 4.62M | Year: 2011

The USEFIL project aims to address the gap between technological research advances and the practical needs of elderly people by developing advanced but affordable in-home unobtrusive monitoring and web communication solutions. More specifically, USEFIL intends to use low cost off-the-shelf technology to develop immediately applicable services that will assist the elderly in maintaining their independence and daily activities. Installation of the USEFIL system will not require retrofitting in a persons residence and will be almost invisible once installed. Thus we expect that it can be used in a wide variety of residential environments, which will be validated in three different field trial studies.\nBecause the system will be software driven, based on open source platforms, applications can be easily added or subtracted with no real limit to the overall number of services offered. Furthermore, USEFIL intends to provide guidelines for the community of technology developers to optimize future generation of applications for an ageing population.\nWithin the domain of the USEFIL project, we will deploy systems and applications that can unobtrusively record elderly behavioural indicators such as cognitive decline, emotional status and health vital signs; supply information services in parallel; and provide the means to enable individuals to keep their social life active - all irrespective of an older persons mobility state. Technology implementation will be based on user acceptance and an understanding of user interactions that will truly address user needs. USEFIL aims to provide efficient and effective means of care delivery and increased adherence to medical recommendations and treatments by older patients. This should extend the time that older people can live independently in their homes while limiting increases in public expenditure.\nUSEFIL has ambitious objectives. However, a strong and committed team, together with a solid governance structure, will ensure that it is capable of tackling this challenging and important research agenda and maximizing market impact.

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