Physical therapists should be aware, that several characteristics of major depression (e.g. loss of interest, motivation and energy, generalised fatigue, a low self-worth and self-confidence, fear to move, and psychosomatic complaints) and physical health problems interfere with participation in exercise. Therefore, motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation and adherence in exercise programs. Implications for Rehabilitation For mild to moderate depression, the effect of exercise may be comparable with antidepressant medication and psychotherapy; for severe depression, exercise seems to be a valuable complementary therapy to the traditional treatments. Exercise therapy also improves physical health, body image, patient's coping strategies with stress, quality of life, and independence in activities of daily living in older adults. Motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation.
Background:Political and public health leaders increasingly recognize the need to take urgent action to address the problem of chronic diseases and multi-morbidity. European countries are facing unprecedented demand to find new ways to deliver care to improve patient-centredness and personalization, and to avoid unnecessary time in hospitals. People-centred and integrated care has become a central part of policy initiatives to improve the access, quality, continuity, effectiveness and sustainability of healthcare systems and are thus preconditions for the economic sustainability of the EU health and social care systems.Purpose:This study presents an overview of lessons learned and critical success factors to policy making on integrated care based on findings from the EU FP-7 Project Integrate, a literature review, other EU projects with relevance to this study, a number of best practices on integrated care and our own experiences with research and policy making in integrated care at the national and international level.Results:Seven lessons learned and critical success factors to policy making on integrated care were identified.Conclusion:The lessons learned and critical success factors to policy making on integrated care show that a comprehensive systems perspective should guide the development of integrated care towards better health practices, education, research and policy.
Integration of NiTi superelastic bars with steel reinforcing bars is a promising path for increasing the seismic performance of reinforced concrete structures. Welding of NiTi alloy to steel is however not straightforward with standard welding techniques. Friction welding is investigated for performing this dissimilar junction using both regular friction (forced controlled) and milling (position-controlled) machines. When adequate shortenings and forging forces are selected, the welds can withstand the tensile strength of the steel rebars. Failure actually occurs in the heataffected zone of the steel bars. The intermetallic (IM) layer at the welded interface should be kept thin and cracks should be limited in the steel layer next to the interface in order to avoid early brittle interfacial cracking.
High quality people-centred integrated care conducive to universal health coverage (UHC) is a construct for which there is no universally agreed conceptual framework available. This systematic literature review provides a comprehensive overview of policies, programmes and strategies that are of relevance in relation to this construct, either directly of indirectly. The review was done as part of work commissioned by the World Health Organization (WHO) to inform the development of WHO's People-centred and Integrated Health Services Strategy. A parallel search strategy was performed via Medline, EMBASE, The Cochrane Library of Systematic Reviews, CINAHL, and PRE CINAHL, complemented with a reference review of key articles that resulted in a total of 442 articles. The search strategy included a combination of Medical Subject Headings (MeSH) terms with regard to patient-centered and integrated care. English articles as from January 1, 2007 until August 31, 2013 were selected that examined the effects of patient-centered and/or integrated care policies/programmes/interventions with regard to different services, in different settings, for different patients' needs, for different life stages, countries, and goals set. We appraised policies/programmes/interventions on high-quality patient-centered and integrated care, using a pre-defined set of attributes of high quality patient-centered and integrated care.The review revealed a set of 12 distinct categories of policies that deal with 1. the integration of people-centred, integrated care as a strategic direction for health system reform, 2. the development of inter-sectoral action programmes, 3. the integration of the financial allocation system with a performance evaluation system, 4. investments in public private partnerships, and, 5. academic and healthcare partnerships, 6. the integration of service levels and providers, 7. the integration of different professional disciplines into professional (post-graduate) education, 8. the World Congress on Integrated Care 2014, Sydney, November 23-26, 2014.
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