The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians

Geriatric Medicine (GM) holds a crucial role in promoting health and managing the complex medical, cognitive, social, and psychological issues of older people. However, basic principles of GM, essential for optimizing the care of older people, are commonly unknown or undermined, especially in countries where GM is still under development. This narrative review aims at providing insights into the role of GM to non-geriatrician readers and summarizing the main aspects of the added value of a geriatric approach across the spectrum of healthcare. Health practitioners of all specialties are frequently encountered with clinical conditions, common in older patients (such as cancer, hypertension, delirium, major neurocognitive and mental health disorders, malnutrition, and peri-operative complications), which could be more appropriately managed under the light of the approach of GM. The role of allied health professionals with specialized knowledge and skills in dealing with older people’s issues is essential, and a multidisciplinary team is required for the delivery of optimal care in response to the needs and aspirations of older people. Thus, countries should assure the educational background of all health care providers and the specialized health and social care services required to meet the demands of a rapidly aging society

Feasibility and impact of a short training course on frailty destined for primary health care professionals

BACKGROUND: There is an unmet need for training primary health care professionals on frailty, especially in countries where geriatrics is still emerging. PURPOSE: We aimed to evaluate the feasibility and efficacy of a training course for primary health care professionals on the detection, assessment, and management of frailty. METHODS: A single-day training course, developed and facilitated by three physicians trained in geriatrics abroad, was organized by the Aristotle University of Thessaloniki Primary Hearth Care Research Network. Primary health care professionals' attitudes, knowledge, and everyday practices regarding frailty were assessed by self-administered anonymous questionnaires (using Likert-type scales) at three time-points (before, upon completion of the training course, and 3 months afterward). RESULTS: Out of 31 participants (17 physicians, 12 nurses, 2 health visitors; 87.1% women; mean age 46.4 years), 31(100%) filled in the first, 30(97%) the second, and 25(81%) the third questionnaire. Improvements were reported in familiarization with the frailty syndrome (p = 0.041) and in self-perception of knowledge and skills to detect (p < 0.001) and manage (p < 0.001) frailty, that were also sustained 3 months afterward (p = 0.001 and p = 0.003 respectively). Improvement was also observed in the attitude that frailty is an inevitable consequence of aging (p = 0.007) and in the frequency of application of screening (but not management) strategies, 3 months following the workshop compared to baseline (p = 0.014). Participants reported less disagreement with the statement that systematic screening for frailty was unfeasible in their daily practice at 3 months compared to baseline (p = 0.006), mainly due to time restrictions. CONCLUSION: A short skill-oriented training course can significantly and sustainably improve primary health care professionals' attitudes and practices regarding frailty

Primary care professionals’ experiences during the first wave of the COVID-19 pandemic in Greece: a qualitative study

Background: The coronavirus outbreak (COVID-19) tested health care systems worldwide. This qualitative study aimed to explore and understand the experiences, beliefs and concerns of Primary Care Professionals (PCPs) regarding the preparedness and response of primary care to the first wave of the pandemic in Greece, a country where a public structured primary care system has been developing. Methods: We conducted semi-structured telephone interviews with 33 PCPs (General Practitioners, community General Internal Medicine Specialists, community Paediatricians and nurses) recruited from all regions of Greece after the first wave of the pandemic (June 2020). Interviews were transcribed verbatim, data were anonymised and analysed. Thematic analysis was applied developing a conceptual framework. Results: Four main themes were identified: a) Primary care unit adaptation and issues faced during the pandemic; b) Management of suspected COVID-19 cases; c) Management of non-suspected cases; d) Consequences of the pandemic. In the first phase of the pandemic, remote management of suspected cases and their referral to the hospital were preferred as a result of a shortage of personal protective equipment and inaccessibility to coronavirus testing in primary care. Due to the discontinuation of regular medical services and the limited in-person contact between doctors and patients, chronic disease management and prevention programmes were left behind. Social and emotional consequences of the pandemic, such as workplace stigma, isolation and social seclusion, deriving from fear of viral transmission, as well as burnout symptoms and exhaustion were commonly experienced among PCPs. Positive consequences of the pandemic were considered to be the recognition of the importance of an empowered public healthcare system by citizens and the valuable insight, knowledge and experience professionals gained in times of crisis. Conclusions: Primary care has a key role to play during and after the pandemic by using its information infrastructure to identify at-risk groups, detect new cases of COVID-19, provide care according to needs, and carry out vaccination programmes. Central coordination and empowerment of primary care will increase its effectiveness, via public awareness, holistic patient management, and unburdening of hospitals

Is zero underestimation feasible? Extended Vacuum-assisted breast biopsy in solid lesions – a blind study

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Towards a singing voice multi-sensor analysis tool: System design, and assessment based on vocal breathiness

Singing voice is a human quality that requires the precise coordination of numerous kinetic functions and results in a perceptually variable auditory outcome. The use of multi-sensor systems can facilitate the study of correlations between the vocal mechanism kinetic functions and the voice output. This is directly relevant to vocal education, rehabilitation, and prevention of vocal health issues in educators; professionals; and students of singing, music, and acting. In this work, we present the initial design of a modular multi-sensor system for singing voice analysis, and describe its first assessment experiment on the ‘vocal breathiness’ qualitative characteristic. A system case study with two professional singers was conducted, utilizing signals from four sensors. Participants sung a protocol of vocal trials in various degrees of intended vocal breathiness. Their (i) vocal output, (ii) phonatory function, and (iii) respiratory behavior-per-condition were recorded through a condenser microphone (CM), an Electroglottograph (EGG), and thoracic and abdominal respiratory effort transducers (RET), respectively. Participants’ individual respiratory management strategies were studied through qualitative analysis of RET data. Microphone audio samples breathiness degree was rated perceptually, and correlation analysis was performed between sample ratings and parameters extracted from CM and EGG data. Smoothed Cepstral Peak Prominence (CPPS) and vocal folds’ Open Quotient (OQ), as computed with the Howard method (HOQ), demonstrated the higher correlation coefficients, when analyzed individually. DECOM method-computed OQ (DOQ) was also examined. Interestingly, the correlation coefficient of pitch difference between estimates from CM and EGG signals appeared to be (based on the Pearson correlation coefficient) statistically insignificant (a result that warrants investigation in larger populations). The study of multi-variate models revealed even higher correlation coefficients. Models studied were the Acoustic Breathiness Index (ABI) and the proposed multiple regression model CDH (CPPS, DOQ, and HOQ), which was attempted in order to combine analysis results from microphone and EGG signals. The model combination of ABI and the proposed CDH appeared to yield the highest correlation with perceptual breathiness ratings. Study results suggest potential for the use of a completed system version in vocal pedagogy and research, as the case study indicated system practicality, a number of pertinent correlations, and introduced topics with further research possibilities. © 2021 by the authors. Licensee MDPI, Basel, Switzerland