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Global process of personalisation in medicine - New perspectives in healthcare V. Costigliola Part I Healthcare systems around the globe Italian healthcare system in the global context: The cultural challenge of predictive, preventive and personalised medicine G. Trovato & F. Basile Healthcare in the UK - Predictive, preventive and personalised medicine perspective at the beginning of the 21st Century K. Grosios, P. Gahan & J. Burbidge The German Healthcare system A. Doring & F. Paul Healthcare overview in the Slovak Republic and implementation of predictive, preventive and personalized medicine M. Kapalla, D. Kapallova & L. Turecky An overview of the healthcare system in the Czech Republic with respect to predictive, preventive and personalized medicine J. Kinkorova & O. Topolcan Perpetual Transitions in Romanian Healthcare L. Spiru, R. Trascu, I. Turcu & M. Marzan An overview of the healthcare system in Georgia T. Rukhadze A general overview of the healthcare system in the Republic of Macedonia (FYROM): Healthcare indicators, organisation of healthcare system and its challenges N. Kamcev, M. Danilova, V. Ivanovska, G. Kamceva, N. Velickova & K. Richter Overview of the healthcare system in Turkey M. Dundar & S.Y. Ozdemir Taiwan's healthcare report W.S.H. Chan Mobility of medical doctors as an attribute of the cross-border healthcare: Challenges, opportunities and perspectives V. Costigliola Where is going the European Pharma Industry? M. Antonelli Part II Female health/care Changing long-held beliefs is never easy: A proposal for multimodal approaches in female healthcare - An integrative view O. Golubnitschaja A gender-specific nutritional approach to women's healthcare N. Shapira Implications of gender based biology in oral health issues - Are women more susceptible? R. Krishna & C. Drisco Simultaneous systematic approach to enable predictive, preventive and personalized medicine - Women healthcare as s case study M. Marcus-Kalish & H. Meiri Part III Traditional and non-conventional medicine Widening the Paradigm in Medicine and Health: Person Centred Medicine as Common Ground of Traditional and Non Conventional Medicine P. Roberti di Sarsina, M. Alivia & P. Guadagni Music-therapy, a personalised bridge towards healing beyond surgery and medication: European paediatrics overview R. Haus Part IV The role of laboratory medicine in healthcare Characterization and validation of biomarkers by immunoassays: Quality requirements, physical standards and data management in predictive medicine T. Waerner, J. Urthaler & K. Krapfenbauer Part V Economy of PPPM Effectiveness, cost effectiveness, and financial viability of personalized medicine: A role for comparative effectiveness research? P. Brown The economic challenge of predictive, preventive, and personalized medicine: The case study of lung-, head and neck cancer A. Kugler, C. Kertu & K. Krapfenbauer Health Promotion and Prevention in companies - economic aspects and prevention strategies for Shift work sleep disorders K. Richter Part VI Ethics of PPPM New ethical paradigm in preventive, predictive and personalised medicine E. Gefenas, A. Cekanauskaite, E. Tuzaite, V. Dranseika & D. Characiejus
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MEET I N G ABS T R A C T Open Access
Healthcare overview: new perspectives
Vincenzo Costigliola
From EPMA-World Congress 2013
Brussels, Belgium. 20-21 September 2013
In healthcare, the realisationofanoptimisticprognosis
against pessimistic ones depends on current innovations
in diagnostic and cost-effective treatment approaches
being widely adopted in clinical practice. Utilisation of
advanced early and predictive diagnostics, targeted pre-
vention and personalised medical approaches could
enable the elderly subpopulation to reach the 100-year
age limit in good physical and mental health, as actively
contributing members of society. This task requires
intelligent political regulations and creation of new
guidelines to advance current healthcare systems.
The European Association for Predictive, Preventive
and Personalised Medicine (EPMA) has created a robust
platform to discuss the topic which the current book
volume (Figure 1) is dedicated to, namely, an overview
of healthcare and professional outlook for its specific
branches. On a global scale, this is a unique concept
presenting
comprehensive review of historic, cultural, demo-
graphic, ethnic, socio-economical, political, and other
aspects which contribute to realisation of current
healthcare systems;
comparisons of data / information both from Europe
and worldwide in order to share issue-related experiences
and to learn from each other about advantages and disad-
vantages of single healthcare systems.
In this book-volume, we have collected contributions
from 15 countries that cover geopolitical regions in
around the globe. The contributions provide expert opi-
nions on timely and highly-relevant topics:
Personalisation of medical approaches in global
scale
Integrative view and multimodal approaches to
treat the patient individually and effectively
Overview of individual healthcare systems in the
global context
Overview of current healthcare-responsible institu-
tions and stakeholders
Innovative national and international programmes
dedicated to predictive and preventive medicine
Current position of the pharmaceutical industry in
PPPM
Correspondence: vincenzo@emanet.org
Book Editor, The European Association for Predictive, Preventive and
Personalised Medicine, Brussels, Belgium
Figure 1 Book Volume ISBN 978-94-007-4602-2 in the EPMA /
Springer Book Series Advances in Predictive, Preventive and
Personalised Medicine, http://www.springer.com/biomed/book/
978-94-007-4601-5
Costigliola EPMA Journal 2014, 5(Suppl 1):A13
http://www.epmajournal.com/content/5/S1/A13
© 2014 Costigliola; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creative commons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, pro vided the original work is properly cited. The Creative Commons Public Domain Dedication wai ver (http://
creativecommons.org/publicdoma in/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Systematic approaches of well-being concepts
Crucial aspects of individualised nutrition to enable
PPPM
Traditional and non-conventional medicine as one
of the cost-effective treatment approaches towards heal-
ing beyond surgery and medication
Gender particularities to be respected in PPPM
Health promotion and work
The role of laboratory medicine in healthcare
Standards and management in PPPM
Economy of predictive, preventive and personalised
medicine
Ethical paradigm shift in PPPM
Future outlook - new perspectives in healthcare in
the context of predictive, preventive and personalised
medicine.
The main objectives of these efforts are to mark the
stakeholders in the field, to consolidate professional
groups and to prepare expert recommendations of how
to optimise approaches for cost-effective healthcare
focused on the patient.
Published: 11 February 2014
doi:10.1186/1878-5085-5-S1-A13
Cite this article as: Costigliola: Healthcare overview: new perspectives.
EPMA Journal 2014 5(Suppl 1):A13.
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Costigliola EPMA Journal 2014, 5(Suppl 1):A13
http://www.epmajournal.com/content/5/S1/A13
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... The rural medical personnel refers to the village outpatient setting and is related to regional family medicine centre or polyclinic under agreement, which provides the specific monitoring for their professional activity and assists in the management of complex cases. For the past several years, up to 50 modernly equipped hospitals have started functioning [12-14,16,21]. ...
... Hospital locations were chosen based on the principle of 45-min geographic accessibility, with the number of beds based on population size and health needs. Newly reformed hospitals integrated psychology, necrology, oncology, obstetrics, gynaecology, paediatrics and infectious diseases meant to provide comprehensive quality health care [2,12,13,16,20]. ...
... The official report of MoLHSA and NCDCPH represented that the infant mortality rate in 2005–2007 was reduced per 1,000 live births, but in 2008, the rate was increased and reached to 17.0. The large discrepancy exists between rural and urban mortality rates among children under 5 years and almost twice many deaths have been registered per 1,000 live births in rural areas than in urban areas [4,7,12-16]. ...
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The main aim of this paper is to present the current statistics and situation of health care system in Georgia; the changes in the transition period within the society and the health care system. Also presented are the efforts from the Government and the Ministry of Labour, Health and Social Affairs of Georgia in the way of numerous initiatives and action in order to improve quality care of patients and sustain the health care system. This paper described the institutional framework, process, content and implementation of health and health care policies in Georgia in the context of predictive, preventive and personalised medicine.
... To relate our results to those of others, it is useful to put them in the context of the health care system in Taiwan. Health care is Taiwan is operated by the government with relatively low co-payments from patients [17,18]. Therefore, many tests and surgeries have become quite cheap and are over-prescribed. ...
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Background Cancellation of surgery close to scheduled time causes a waste of healthcare resources. The current study analyzes surgery cancellations occurring after the patient has been prepared for the operating room, in order to see whether improvements in the surgery planning process may reduce the number of cancellations. Methods In a retrospective chart review of operating room surgery cancellations during the period from 2006 to 2011, cancellations were divided into the following categories: inadequate NPO; medical; surgical; system; airway; incomplete evaluation. The relative use of these reasons in relation to patient age and surgical department was then evaluated. Results Forty-one percent of cancellations were for other than medical reasons. Among these, 17.7% were due to incomplete evaluation, and 8.2% were due to family issues. Sixty seven percent of cancelled cases eventually received surgery. The relative use of individual reasons for cancellation varied with patient age and surgical department. The difference between cancellations before and after anesthesia was dependent on the causes of cancellation, but not age, sex, ASA status, or follow-up procedures required. Conclusion Almost half of the cancellations were not due to medical reasons, and these cancellations could be reduced by better administrative and surgical planning and better communication with the patient and/or his family.
... The globalisation of markets and laboratory-related business requires the comparability, or the unification, of laboratory test values. The mobility of both patients and health care professionals as well as the increasing global data flow require such comparability [25]. Hence, the unification of laboratory tests should be placed at the top of the list of corresponding adapting measures. ...
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The European Association for Predictive, Preventive and Personalised Medicine (EPMA) considers acute problems in medical sciences as well as the quality and management of medical services challenging health care systems in Europe and worldwide. This actuality has motivated the representatives of EPMA to comment on the efforts in promoting an integrative approach based on multidisciplinary expertise to advance health care-related research and management. The current paper provides a global overview of the problems related to medical services: pandemic scenario in the progression of common non-communicable diseases, delayed interventional approaches of reactive medicine, poor economy of health care systems, lack of specialised educational programmes, problematic ethical aspects of several treatments as well as inadequate communication among professional groups and policymakers. In the form of individual paragraphs, the article presents a consolidated position of PPPM professionals towards the new European programme 'Horizon 2020' providing the long-lasting instruments for scientific and technological progress in medical services and health care-related programmes. In the author's opinion, Horizon 2020 provides unlimited room for research and implementation in Predictive, Preventive and Personalised Medicine. However, the overall success of the programme strongly depends on the effective communication and consolidation of professionals relevant for PPPM as well as the communication quality with policymakers. Smart political decision is the prerequisite of the effective PPPM implementation in the health care sector. This position is focused on the patients' needs, innovative medical sciences, optimal health and disease management, expert recommendations for the relevant medical fields and optimal solutions which have a potential to advance health care services if the long-term strategies were to be effectively implemented as proposed here.
... The globalisation of markets and laboratory-related business requires the comparability, or the unification, of laboratory test values. The mobility of both patients and health care professionals as well as the increasing global data flow require such comparability [9]. Hence, the unification of laboratory tests should be placed at the top of the list of corresponding adapting measures. ...
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The authors consider acute problems in the quality and management of medical services challenging health care systems worldwide. This actuality has motivated the representatives of the European Association of Predictive, Preventive and Personalised Medicine and European Federation of Clinical Chemistry and Laboratory Medicine to consider the efforts in promoting an integrative approach based on multidisciplinary expertise to advance health care. The current paper provides a global overview of the problems related to medical services: pandemic scenario in the progression of common chronic diseases, delayed interventional approaches of reactive medicine, poor economy of health care systems, lack of specialised educational programmes, problematic ethical aspects of treatments as well as inadequate communication among professional groups and policymakers. Further, in the form of individual paragraphs, the article presents a consolidated position of the represented European organisations. This position is focused on the patients' needs, expert recommendations for the relevant medical fields and plausible solutions which have a potential to advance health care services if the long-term strategies were to be effectively implemented as proposed here.
... Beyond the general perspective that the declining gender LE gap was associated primarily with changes in smoking and alcohol use [14], a new perspective on women's health should include their specific metabolic risks and differing timetables, i.e. earlier and higher risk of lifelong obesity, differential fat distribution and risk measures, i.e. body mass index (BMI), waist circumference (WC), and delayed risk manifestation to postmenopausal age, which is associated with reduced estrogen protection. Here, predictive, preventive, personalised nutrition should take a lead—before the risk manifestation—according to the specific timing of physiological events, critical periods, early programming, and their metabolic patterns [15]. ...
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Women's evolution for nurturing and fat accumulation, which historically yielded health and longevity advantages against scarcity, may now be counteracted by increasing risks in the obesogenic environment. Increasing awareness of women's differential metabolism/disease risks, i.e. the major gender dimorphisms in fat accumulation/distribution, exemplified during puberty/adolescence, suggest metabolic differences potentially related to obesity risks/diseases. Women's higher body fat percentage than men, even with equal body mass index, may be a better risk predictor. Differential metabolic responses to weight reduction diets, with women's lower abdominal fat loss and higher risks associated with sedentariness vs. exercise benefits, and tendency toward delayed manifestation of metabolic syndrome, diabetes mellitus, cardiovascular disease, and certain cancers until menopause---but accelerated thereafter---suggest a need for differing metabolic and chronological perspectives for prevention/intervention. This manuscript reviews women's differential metabolic risks, chronological manifestations, and responses to lifestyle changes that strongly support a gender nutrition approach within predictive, preventive, and personalised medicine.
... • TCAM systems are based on salutogenetic principles. Patients perceive this generation of health as a growing feeling of wellbeing, consequent to the stimulation of innate self-healing abilities through the adoption of a healthier lifestyle and the medication and non-medication therapies specific to each TCAM system [11]. ...
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Depending on innovation in medical services and healthcare systems as a whole, two potential scenarios are considered. A pessimistic scenario considers the pandemic of type 2 diabetes mellitus and the dramatic increase of neurological disorders, CVD and cancer diseases, with severe economic consequences to the society. The optimistic scenario considers integrated concepts of early, so-called predictive diagnostics, targeted preventive measures, and treatments tailored to the person as the future of healthcare. Global research and implementation programs in bio-medicine, communication amongst scientific entities, healthcare providers, policy-makers, educators, and patient organisations, together with consolidation of professional groups in the field of personalised medicine, will play a decisive role in driving the situation towards one of the two scenarios. PPPM concepts aim to promote the optimistic scenario in Europe and worldwide. The long-term strategies of the European Association for Predictive, Preventive and Personalised Medicine towards scientific and technological innovation as well as advanced medical services are described.
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Over the next 10–20 years, a pessimistic prognosis considers pandemic scenario for type 2 diabetes mellitus, neurodegenerative disorders and some types of cancer followed by the economic disaster of healthcare systems in a global scale. Well-recognised deficits of currently provided medical services result from the delayed 'disease care'. Herewith EPMA releases the long-term strategies for the effective promotion of predictive, preventive and personalised medicine (PPPM) considered as the medicine of the future. Under the EPMA-umbrella, an international forum of currently 45 countries is actively contributing to the development and implementation of the innovative PPPM concepts. EPMA is open for collaboration with other leading European and global professional networks relevant for the effective promotion of PPPM in sciences and practical implementation.
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