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thank you very much thank you very much for the invitation
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good afternoon ladies and gentleman healthcare is not medical
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care we chose this title it's very provocative
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but we have to go back when we talk about the room
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care products while to you find in clinical packed is
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what i will go through in my presentation i
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was looking for a definition of health care
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only looking for a definition of health care was not very easy because you have that bastard but man
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off definitions and then what is medical care
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then i want to demonstrates what we find in clinical practised today
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then i want to demonstrate what kind of
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approach is needed in clinical project is
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and what are the requirements for dressings in that clinical protests
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when we talk about health care
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i found one i liked the most and uh after all that stick metric medical dictionary
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yeah it says that the prevention the treatments and management of
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illness and the preservation of mental and physical well being
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through the services offered by the medical and allied health professions
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let's see what does this mean i said we have to
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prevention something very important in today's a health care system
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the treatments with their for example with the room trusting the management of the
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entire illness the preservation of the mental and physical well being and then
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this is offered by and medical and allied health professionals
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so it's and multi decent disciplinary team approach
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this should be healthcare
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medical care we have a professional treatment for
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illness or injury or another definition
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the portion of here under a tarp physicians direction
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so we have to treatments of illness for illness and injury or
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we have to care entire care aspect and that physicians direction
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what do we find in clinical practitioners those who work clinic clay if you go back is
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it more of focus on the healthcare sign or
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in that on that medical care sites
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l. eighteen forty six uh sixty four years old she's living alone in her
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flat in the inner earl area in the western part of switzerland
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but i had nurses are hypertension diabetes type too
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and five weeks ago she discovered coincidence slipped that she
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has a an an ulcer on her foot
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she went to the g. p. a. the cheap you put some
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costs is on this wound because this was for him to
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the rights decision and he wanted to to cure this wound like this
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this lady went to hurt by appetite but a
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bit taller just answered uh a cardiologist
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they took care of her as well but only her feel their fields
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so when we see this we have three different
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position um special to us is this health care
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and i want to say in europe we half and
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medical care system not a health care system
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the focus it's mostly on disease and injury
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let's talk about disease and illness really you
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read this all over the the articles
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disease it's more the medical aspects that means diagnosis
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sector illness it's more the entire haitians
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the patient as a whole
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what we find out what we need it's more the
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illness prevention the prevention and the health promotion
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the problem i can i can say that mostly also for switzerland we have
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a little budget for prevention the budget should be bigger because
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prevention it's not a very sexy subject prevention
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it's also difficult to evaluate to measure you're not a lot there's not
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a lot of literature out there that is talking about prevention
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it's coming more and more and this is more from the nursing sides
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as a society we have some adverse lifestyle behaviours such as
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what did you use today how to you eat normally
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and and what kind of stress level for example do you have
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if you want to have an increasing uh increasing our
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lifespan and an overall improving improvement of our health
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you have to adjust our personal behaviours and see to that inner on an
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early stage it's not only for us it's also for our patients
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what do we finds it in a in a clinical practised this
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that this environmental and to so it's a
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social economical aspects they are important
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especially they have a big impact on the work life balance not only for us
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also for patients and afterwards on the healing right off the rooms and
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a big impact has also to salary how much do they are um
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what can daily uh what kind of food for example
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can they buy to um have a healthy line
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when we go to the top for example to the
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w. h. l. c. what kinds off um
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a major cost a soft that to be fines
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you're very good to demonstrate for example cancer is
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number one followed by zero vascular diseases
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but do we go back or two we have time to go back
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further to look what causes these diseases
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i went to the literature and was looking more kind of studies do we find from europe i
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couldn't find any study but there are a lot of studies in the united states they demonstrates
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they're from the rank order to call so soft that like tobacco
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smoking hype lots uh an pressure oh wait et cetera
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but when we see that even down here with the alcohol use
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that low intake of fruits and vegetables or the low directory
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a fatty acids what is this this is mainly on our behaviours
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and here we are more on the on the side again this should be prevention
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so when we go back in history
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really know that in the nineteen hundred it's we had a lot
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of infectious diseases that were all causing death not the bins
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it's a on their their responsibility off could control weaver prevent me
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till we develop preventive uh techniques such ass clean will too
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to drink to clean for example the rooms and
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then of course we have to anticipate antibiotics
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nowadays we have other elements we have namely coronary
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artery disease this that become very prevalent
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one thing that is also good what we can hear a
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and z. from statistics that fewer people's they're smoking pot
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then we go back on the behaviour side we have more t. i. b. s. we
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have more heart diseases we have more stroke you have high blood pressure et cetera
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and these are all uh illnesses that last over a lifetime
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so our medical here says and dawson to you with
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half we deal only with little bits of help
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so we concentrate on our t. z. sits on the trauma us
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what we need it's more illness that means that
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people or getting older and older so
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we have more call the more beta patients
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patients with hypertension with diabetes et cetera
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so all just patients that are developing a brooms so that they
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need a broom dressing that is corresponding to the or illness
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at the other thing is the last thing as that
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at that type patients life that means the costs
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the costs are rising who's paying that we have more more patients in
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the outpatient sector if you want to offer a patient centred care
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we have to offer them a holistic mart it isn't you pretty team approach
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and with that i think we can approach to go to to that
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our patients have a a very nice very good uh here
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well we tens right now in our clinical that practised is
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that we have only single provider treatments as
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we saw all on this um
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on the case i was i was showing you that the patient had
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f. decision for her heart for for it uh
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and that general practitioner that was taking care
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of to do and and that the diet technologist that is taking care of the diabetes
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but we knew what we need is multiple providers and
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somebody that is taking care of the entire patient
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and that is talking with all the different kind of disciplines
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let's go back to this female patients what can we offer her
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as already said we can offer her a holistic care approach
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in rooms management this a holistic care approach as a philosophical orientation
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that is on the p. painting the fundamental holders of the human being
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it emphasises the importance of this that balance within the person
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and between the person and his her uh environments
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what's to be included in this holistic approach we
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have the entire a physiological opera and
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aspects that we uh dimensions that we
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involve the psychological sociological aspects
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economical aspects as well as the psychological and spiritual dimensions
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that provides an opportunity to assess the patient as a whole
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and in relation to her leaving and a context
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with a holistic approach we can uh it's it's uh it's in contrast
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to and modern medical model of approach of health and illness
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it considers this individual aspects of the patient
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within a the entire living context
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and it's what we need it's the evidence based treatments
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in rooms care we have a lot of studies
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but we do not have and good
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ballads clinical data we have a lot off case studies we
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have not a lot of or c. t.s for example
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and with these or c. t. is when you have to put intervention then we can
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offer the patient that into mention and it's not the over medication that means
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each discipline has his own and vision
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by focusing on wound care this holistic approach
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highlights the patient as a whole and not only the
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boomed and obviously the patients or the focus
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also the family and the environment factors are taken in consideration as we find
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wound care mostly into home care setting and the patient itself
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and the family is taking care of the rooms
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if you wanted to and assessments uh an
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holistic care assessment this is to optimise
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the healing by it takes into consideration all the factors that influence to care
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and to maximise the available source resources that we have
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we want to prevents fragmented and or inappropriate care
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individual patients and it contributes to have focus on cost effectiveness
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and a high quality of care for our patients
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i don't know how many times
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there was a mixture with this lights uh_huh oh let's go uh it's
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give a little bit more focus on this holistic care approach
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this holistic care approach has several elements that or importance
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and most of my colleagues and uh off that physicians they say
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get me to that but yeah be to tap briefly
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read to you that not in depth for example that patients
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physical needs that disease is the functional capital capital t.
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the psychological needs what order fifty years of the patients when they have rooms
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what or if they are purely use do you want to have that is wound
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is healing is does always to go what are the social needs et cetera
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additionally we half the patients personal resources and empowerment
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how much is their income then we come back to this prevention what's kind of ability
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of involvement is is it possible for the patients
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because most of the rooms care takes
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at that at the home care in the tone kept setting is
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the family mall is the patients living by himself or herself
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patients a a living happy it's what already this patient for
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example i was walking each day with the dog
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so they have i we have to uh to to adjust our dressings treat her daily living
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what are the room them perry room status that's this is more text a technical what or
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to sentence what's to be find their houses
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documents it's who is taking here um
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of that and efficient use of resources
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for example what kind of dressings or available
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what kind of pressing or reimbursed
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this this uh this is an element that is very important within wound care
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when we go to dressings what's kind of dressings can be used
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in certain uh and uh for for for all these bins
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this is from a document and we've published a two year two three years ago
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from the european movement association and there we propose
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that we use safe products what is safe that
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we have and minimum a cultural effects
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it has to be easy not very sophisticated it's
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we need to products that are disposable
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we need products that reduce pain because most of the rooms are very painful
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you have to use products that have a wide range of application that means
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products second used in different basis of wound healing
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we have to and no tact that
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healthcare professionals when there is selecting
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dressings what's kind of pressing scanned they select they have to be and
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if and used to extend the ports of the dunes healing continuum
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they have to be dressings that should not stick on the doomed grounds
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unfortunately we see that and i in the everyday life
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and product start easy to use and access and especially to excess most
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of the patients they don't know where to get the doomed products
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and have to to the prevention off these uh uh
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not to cater a a recurrence for example
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we need to move products that enable the lowest overall cost
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most of the patients are paying the product out of their own pockets because it's not covered by
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the health care insurance and of course we need
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products that are you friendly when we summarise
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what we see we have and what we finds in clinical
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practised we have more and medical system not healthcare system
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what we have to go in which direction you have to
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go it's in preventive we have to take care
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an hour of the individual aspects of the
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patient with in the living context
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we have to have a great to focus on the onus
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is illness prevention to health promotion has to begin
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i say in childhood as early as possible
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we have to recognise that chronic illnesses are the
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ones that not only last a lifetime part
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they are also to diseases that are driving to high costs of here
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we need evidence based treatments this that means good solid start this
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interventions that we can all for our patients be needs to cut up the
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costs can uh brought down and can't be brought down quite substantially
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through a better approach in a patient care so that everybody's
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working together not each of us is doing something
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that means we use a multi professionally team approach and
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one thing i think that is more wishful thinking
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that imploring needs to calculate enough time
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for holistic assessment of each patient that for example room
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to patients so that we can have an all
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over the globe who who are you to pay she and then you have to do that