Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

EB-GIS4HEALTH UK aims at building a UK-oriented foundation evidence base and modular conceptual models for GIS applications and programmes in health and healthcare to improve the currently poor GIS state of affairs within the NHS; help the NHS understand and harness the importance of spatial information in the health sector in order to better respond to national health plans, priorities, and requirements; and also foster the much-needed NHS-academia GIS collaboration. The project will focus on diabetes and dental care, which together account for about 11% of the annual NHS budget, and are thus important topics where GIS can help optimising resource utilisation and outcomes. Virtual e-focus groups will ensure all UK/NHS health GIS stakeholders are represented. The models will be built using Protege ontology editor http://protege.stanford.edu/ based on the best evidence pooled in the project's evidence base (from critical literature reviews and e-focus groups). We will disseminate our evidence base, GIS models, and documentation through the project's Web server. The models will be human-readable in different ways to inform NHS GIS implementers, and it will be possible to also use them to generate the necessary template databases (and even to develop "intelligent" health GIS solutions using software agents) for running the modelled applications. Our products and experience in this project will be transferable to address other national health topics based on the same principles. Our ultimate goal is to provide the NHS with practical, vendor-neutral, modular workflow models, and ready-to-use, evidence-based frameworks for developing successful GIS business plans and implementing GIS to address various health issues. NHS organisations adopting such frameworks will achieve a common understanding of spatial data and processes, which will enable them to efficiently and effectively share, compare, and integrate their data silos and results for more informed planning and better outcomes.
 ...
PMID:Research protocol: EB-GIS4HEALTH UK - foundation evidence base and ontology-based framework of modular, reusable models for UK/NHS health and healthcare GIS applications. 1564 28

Obesity has been calculated traditionally by body mass index, but measuring waist circumference might be a more accurate way of identifying people at risk of cardiovascular disease. Excess visceral fat predisposes to several diseases, including diabetes and cardiovascular disease. The total cost to the NHS of obesity in 2001 was pounds sterling 2.5 billion. Waist circumference correlates well with visceral fat content.
 ...
PMID:The right measure. 1642 62

The complexity of policy-making in the NHS is such that systemic, holistic thinking is needed if the current government's plans are to be realized. This paper describes systems thinking and illustrates its value in understanding the complexity of the diabetes National Service Framework (NSF); its role in identifying problems and barriers previously not predicted; and in reaching conclusions as to how it should be implemented. The approach adopted makes use of soft systems methodology (SSM) devised by Peter Checkland. This analysis reveals issues relating to human communication, information provision and resource allocation needing to be addressed. From this, desirable and feasible changes are explored as means of achieving a more effective NSF, examining possible changes from technical, organizational, economic and cultural perspectives. As well as testing current health policies and plans, SSM can be used to test the feasibility of new health policies. This is achieved by providing a greater understanding and appreciation of what is happening in the real world and how people work. Soft systems thinking is the best approach, given the complexity of health care. It is a flexible, cost-effective solution, which should be a prerequisite before any new health policy is launched.
 ...
PMID:An illustration of whole systems thinking. 1684 58

Foot problems may be one of the lesser known complications of diabetes, but they have a major impact on people with the condition. The NHS National Diabetes Support Team has produced a guide to diabetic foot services and this article will look at some of the key areas in diabetic foot care today which are also outlined in the guide. The key areas are: prevention and screening, care pathways, multidisciplinary teams, and workforce and staff skills. Examples of how some of these issues are being tackled in England are featured in the article as case studies.
 ...
PMID:Feet first: a guide to diabetic foot services. 1693 99

Good science demands independent replication of new ideas and results and abandonment of accepted theories in light of more reliable evidence. Failure to comply leads to damaging bad science, as with the falsely claimed association between measles, mumps and rubella vaccination and autism. Progress of good science also often requires serendipity, 'making discoveries by accident and sagacity of things not sought'. Work on the pentraxin proteins, C-reactive protein (CRP) and serum amyloid P component (SAP), and on amyloidosis, has benefited from abundant serendipity, leading to routine clinical use of CRP measurements, the invention of SAP scintigraphy for amyloidosis, the establishment of the NHS National Amyloidosis Centre providing superior patient care, and latterly the invention of a novel pharmacological mechanism for therapeutic depletion of pathogenic proteins. New drugs using this mechanism are in development for amyloidosis and cardiovascular disease and potentially also Alzheimer's disease, type II diabetes and other tissue damaging conditions.
 ...
PMID:Science and serendipity. 1819 4

General practitioner (GP) practice-based commissioning (PBC) is a much debated politically driven NHS innovation at a time of ongoing change. Unlike GP fundholding it is envisaged that PBC will involve all GP practices by 2008. A possible outcome is that some current secondary care services may be commissioned in primary care in the form of local enhanced services or intermediate clinics and run by GPs with special interests. Examples where this has occurred are diabetes and anticoagulation. Similarly, private providers may be commissioned. Inevitably there will be an impact on hospital services through a possible reduction in funding and consultants being subcontracted to provide services in primary care. Issues such as clinical governance and cost-effectiveness, however, require evaluation to determine the potential effect on the working relationships and so the interface between generalists and specialists.
 ...
PMID:Practice-based commissioning: implications for secondary care. 1862 22

Diabetes and chronic kidney disease (CKD) are two disease processes that remain with patients from diagnosis to the end of their lives. Both are destructive conditions that must be diagnosed early to prevent longer-term complications, such as retinopathy and neuropathy. Diabetes remains the single most important cause of kidney failure. Diabetes in hospital accounts for 10% of all admissions, but this figure is much higher within renal medicine with diabetes significantly increasing length of stay, with excess bed days suggested at 20%. Inpatient care is currently the largest single component of medical costs for diabetes, while diabetes costs 10% of the NHS budget. The number of patients with both diabetes and CKD are increasing, and to help slow down the progression to complications patients must receive education on how to control their diabetes. Training packages are designed to facilitate this educational process but the NHS needs to invest in refresher courses as the educational structure needs to support lifetime learning. It is vital from first referral that all patients lead in the decisions made about their health. Healthcare professionals have a duty of care to ensure patients are given clear, concise and accurate information in language they understand with the use of medical terminology and jargon limited. Patients must then be allowed to gather their thoughts and ask any further questions before supporting them in the choices that they make.
 ...
PMID:Diabetes and chronic kidney disease: a complex combination. 1841 3

The incidence of diabetes is increasing and therefore patients with diabetic foot ulcers will become increasingly common in the community. The NHS model of Health and Social Care (Department of Health (DH), 2005) places a high emphasis on self care and disease management, and, as a long-term condition, diabetes mellitus requires efficient and effective management. The supervision and organization of the care of diabetic patients is multi-factorial and for this reason, a multi-disciplinary approach is essential for effective care, without which patients with diabetic foot ulcers are at high risk of complications. Diabetic wounds present differently to other chronic wounds; unless these are adequately assessed and treated, there may be devastating consequences for the patient--the most serious being major amputation and/or death. In the first article, accurate assessment was discussed; in this second article, the management of diabetic foot ulcers is explored.
 ...
PMID:Management of the diabetic foot ulcer: exercising control. 1855 70

The use and benefits of insulin pump therapy for children and young people with diabetes are discussed. A case is made for extending the availability of insulin pumps for children and young people under the NHS. It is argued that the costs would be offset by improved blood glucose control and quality of life for children with type 1 diabetes and prevention of longer-term complications.
 ...
PMID:The benefits of insulin pump therapy for children and young people with diabetes. 1875 52

In the UK, patients normally see their general practitioner first and 86% of the health needs of the population are managed in general practice, with 14% being referred to specialist/hospital care. Early diagnosis is the privilege of general practice since general practitioners make most medical diagnoses in the NHS. Their historic aim has been to diagnose as early as possible and if possible before patients are aware of symptoms. Over time, diagnoses are being made earlier in the trajectory of chronic diseases and pre-symptomatic diagnoses through tests like cervical screening. Earlier diagnosis benefits patients and allows earlier treatment. In diabetes, the presence of lower HbA1c levels correlates with fewer complications. Methodologically, single practice research means smaller populations but greater ability to track patients and ask clinicians about missing data. All diagnoses of type 2 diabetes, wherever made, were tracked until death or transfer out. Clinical opportunistic screening has been undervalued and is more cost-effective than population screening. It works best in generalist practice. Over 19 consecutive years, all 429 patients with type 2 diabetes in one NHS general practice were analysed. The prevalence of type 2 diabetes rose from 1.1% to 3.0% of the registered population. Since 2000, 95.9% were diagnosed within the general practice and the majority (70/121 = 57.9%) of diagnoses were made before the patients reported any diabetes-related symptom. These patients had median HbA1c levels 1.1% lower than patients diagnosed after reporting symptoms, a clinically and statistically significant difference (P = 0.01).
 ...
PMID:Diagnosing type 2 diabetes before patients complain of diabetic symptoms--clinical opportunistic screening in a single general practice. 1876 8


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>