Background: Appropriate provision of assistive technology services (ATS) and products are a global health issue and essential for achieving the Sustainable Development Goals (SDGs). The Sixth African Network for Evidence-to-Action on Disability (AfriNEAD) conference included a workshop on collaboration, cohesion and coherence in ATS delivery in Africa. Objective: This article aimed to summarise the workshop proceedings and to provide some recommendations on how coherence and cohesion can be facilitated in assistive technology services in Africa. Method: A round table and small group discussions on assistive technology were facilitated in the virtual space of the AfriNEAD conference. Organisations and role players in ATS and products in Africa participated as keynote speakers, round table members and in small group discussions. Results: There was consensus amongst participants that cohesive collaboration must be facilitated. They further agreed that users must be central to future action. There are local, national and regional initiatives, but none of these have grown into an African assistive technology platform. World Health Organization (WHO) Africa can bring partners together and facilitate creation, officialisation and operationalising of a continental assistive technology platform, through building on the existing initiatives. The AfriNEAD disability research country working groups can act as in-country coordinating bodies for ATS and afford a possibility of a structured approach to assistive technology research. Conclusion: It is time to break away from Western institutionalised biomedical ways of providing ATS in Africa. Africans must develop coherent, cohesive ATS driven by empowered users who build on Africa's strengths and addresses the continents' unique needs.

• Publikační typ
• časopisecké články MeSH

Background: Whilst assistive technology (AT) can play an important role to improve quality of life, health inequity regarding access to appropriate AT for people with intellectual disabilities (ID) is still very much present especially in low resource countries. Objectives: This study focused on exploring factors that influence access to and continued use of AT by people with ID in the Western Cape province of South Africa and to suggest potential implications of these findings and actions required to promote access to AT. Method: A qualitative approach was used to explore the experiences of people with ID and providers of AT. Face-to-face interviews with 20 adults with mild to profound ID, and 17 providers of AT were conducted and the data were analysed thematically. Results: People with ID within the study setting faced many challenges when trying to access AT and for those who managed to acquire AT, its continued usage was influenced by both personal characteristics of the user and environmental factors. Important factors that influence AT access and use for people with ID found in this study were (1) attitudes from the community, (2) knowledge and awareness to identify AT need and (3) AT training and instructions to support the user and care network. Conclusion: With the perspectives of both the providers and users of AT, this study identified priority factors, which could be addressed to improve AT access and use for people with ID in the Western Cape province.

• Publikační typ
• časopisecké články MeSH

• MeSH
• postižení MeSH
• rehabilitace MeSH
• Publikační typ
• periodika MeSH
• Geografické názvy
• Afrika MeSH

• Konspekt
• Fyzioterapie. Psychoterapie. Alternativní lékařství
• NLK Obory
• zdravotně postižení
• rehabilitační a fyzikální medicína

BACKGROUND: Traditionally, acute myocardial infarction (AMI) has been described as either STEMI (ST-elevation myocardial infarction) or non-STEMI myocardial infarction. This classification is historically related to the use of thrombolytic therapy, which is effective in STEMI. The current era of widespread use of coronary angiography (CAG), usually followed by primary percutaneous coronary intervention (PCI) puts this classification system into question. OBJECTIVES: To compare the outcomes of patients with STEMI and ST-depression myocardial infarction (STDMI) who were treated with emergency PCI. METHODS: This multicentre registry enrolled a total of 6 602 consecutive patients with AMI. Patients were divided into the following subgroups: STEMI (n = 3446), STDMI (n = 907), left bundle branch block (LBBB) AMI (n = 241), right bundle branch block (RBBB) AMI (n = 338) and other electrocardiographic (ECG) AMI (n = 1670). Baseline and angiographic characteristics were studied, and revascularisation therapies and in-hospital mortality were analysed. RESULTS: Acute heart failure was present in 29.5% of the STDMI vs 27.4% of the STEMI patients (p < 0.001). STDMI patients had more extensive coronary atherosclerosis than patients with STEMI (three-vessel disease: 53.1 vs 30%, p < 0.001). The left main coronary artery was an infract-related artery (IRA) in 6.0% of STDMI vs 1.1% of STEMI patients (p < 0.001). TIMI flow 0-1 was found in 35.0% of STDMI vs 66.0% of STEMI patients (p < 0.001). Primary PCI was performed in 88.1% of STEMI (with a success rate of 90.8%) vs 61.8% of STDMI patients (with a success rate of 94.5%) (p = 0.012 for PCI success rates). In-hospital mortality was not significantly different (STDMI 6.3 vs STEMI 5.4%, p = 0.330). CONCLUSION: These data suggest that similar strategies (emergency CAG with PCI whenever feasible) should be applied to both these types of AMI.

• MeSH
• analýza přežití MeSH
• elektrokardiografie MeSH
• infarkt myokardu mortalita   patofyziologie   chirurgie   MeSH
• koronární angioplastika * MeSH
• koronární cévy chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• registrace MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• urgentní zdravotnické služby MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

• MeSH
• primární zdravotní péče MeSH
• rodinné lékařství MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• všeobecné lékařství
• NLK Publikační typ
• elektronické časopisy

• MeSH
• hojení ran MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• chirurgie
• urgentní lékařství
• NLK Publikační typ
• elektronické časopisy

• MeSH
• bioetika MeSH
• právní vědy MeSH

• Konspekt
• Právo
• NLK Obory
• právo, zákonodárství
• etika, bioetika, lékařská etika
• NLK Publikační typ
• elektronické časopisy

The post-Communist countries in Central Europe, including the Czech Republic, underwent a rapid transformation of their legal systems, within which the concept of patient rights passed through revolutionary changes. This process however often left significant gaps in patient rights protection. There are practical difficulties for patients in defending their rights before the courts, such as problems with obtaining evidence and independent expert opinions, long delays and high costs of court proceedings, strict burden of proof rules and low compensation levels. Modern patient rights often collide with the systems of health care provision that are still unprepared for patient autonomy and responsibility. The experience gained in the transition process might be applicable also to other countries that undergo changes from traditional to modern system of patient rights protection.

• MeSH
• dostupnost zdravotnických služeb zákonodárství a právo   MeSH
• lidé MeSH
• práva pacientů zákonodárství a právo   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• kardiovaskulární nemoci * MeSH
• Publikační typ
• periodika MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie

In modem societies, people are strongly urged to get the best health care for themselves and their families. Although controlled costs of the health care system may be an important goal for society as a whole, the individual patient is seldom satisfied with being an object of health care rationing. When, due to financial constraints, the health services covered by the public programs become rationed and their quality is perceived as decreasing, patients tend to contract with the providers directly. From the societal viewpoint, supplemental payments for improved care play a negative role when they lead to competition for limited resources in public programs and therefore decrease access for the non-paying patient. They, however, play a positive role when they create new resources and when they thus do not affect the access for the poor negatively, or even improve it by increasing overall health services supply.

• MeSH
• disparity zdravotní péče MeSH
• dostupnost zdravotnických služeb ekonomika   zákonodárství a právo   MeSH
• financování osobní ekonomika   zákonodárství a právo   MeSH
• financování vládou MeSH
• lidé MeSH
• poskytování zdravotní péče ekonomika   zákonodárství a právo   MeSH
• přidělování zdravotní péče MeSH
• programy národního zdraví MeSH
• reforma zdravotní péče MeSH
• zdravotnické služby - potřeby a požadavky MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH
• Spojené státy americké MeSH