ABSTRACT
Introduction: Although there are several reports of COVID-19 in patients on peritoneal dialysis (PD), all of them were retrospective and mono-national-state designs, and none reported vaccination profiles. Method(s): The incidence of COVID-19 infection among PD patients and vaccination profiles of COVID-19 from 1 January 2020 to 30 September 2021 were retrieved from the survey of PD leaders in the ASEAN countries. Countries were excluded if their infection rates (IR) in PD populations were smaller than the lower limit value of 95% confidence interval (CI) of the overall pooled prevalence of 1.25 reported in kidney failure patients with COVID-19 infection globally, considering the possibility of under-reporting and if the number of PD population is less than 50 cases. Thus, Burma (45 cases, unknown IR), Cambodia (1 case, IR 0%), Indonesia (2,692 cases, unknown IR), Laos PDR (3 cases, IR 33%), and Vietnam (PD 1,500 cases, IR <1%) were excluded. Result(s): Figure 1 demonstrates the incidence of COVID-19 infection in PD populations in selected ASEAN members. The cumulative incidence of COVID-19 has gradually increased in all reported countries. The cumulative incidence rate of Singapore reached a plateau in the second quarter of 2020 but has since seen a surge in the third quarter of 2021 with an average incidence of 0.5-1.5 cases per 100 population. Overall IR ranged from 0.1% in Singapore to 23.8% in the Philippines with an average ASEAN IR of 2.6%. The majority of ASEAN had less than half of their populations fully vaccinated, ranging from only 13% in Vietnam to 46% in Brunei. Despite Laos being a low-income country, it was the first ASEAN to vaccinate its population. Singapore had the highest vaccination rates, with 83% and 81% of its population partially and completely vaccinated, respectively. Brunei, albeit being a high-income country, is the last country to roll out vaccination with a tardy vaccination rate, possibly due to the under-preparedness of the government and a false sense of security as Brunei had 15 months of zero cases before the latest wave. The incidence of ASEAN PD patients with COVID-19 infection surged during the second and third quartiles of 2021 despite the vaccine roll-out (Table 1). [Formula presented] Abbreviations: Ad26, Ad26.COV2.S;BBIBP, BBIBP-CorV;BNT, BNT162b2;Covishield, ChAdOx1 nCoV-19 (Covishield);Gam, Gam-COVID-Vac;mRNA, mRNA-1273;Vaxzeria, ChAdOx1 nCoV-19 (Vaxzeria) Remarks: Yellow, Conventional inactivated vaccines (BBIBP-CorV [Sinopharm], CoronaVac [Sinovac]);Green, RNA vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna]);Pink, Viral vector vaccines (Gam-COVID-Vac [Sputnik], ChAdOx1 nCoV-19 [Covishield], ChAdOx1 nCoV-19 [Vaxzeria] and Ad26.COV2.S [Johnson & Johnson]) [Formula presented] Figure 1. Cumulative incidence of COVID-19 infected PD patients in selected ASEAN Conclusion(s): Overall IR of the ASEAN PD population varied widely among countries. However, the rollout rate of vaccination lagged behind that of western countries. This should increase efforts to educate their population on the benefits of timely vaccination. There remain a lot of uncertainties regarding COVID-19, and hence there is an urgent need for large prospective studies with international collaboration, to address these questions. No conflict of interestCopyright © 2023
ABSTRACT
Entrepreneurship researchers have studied resilience across various contexts, including at the micro (that is, owner/business) and macro (that is, cluster/ecosystem/region) levels, by drawing from a myriad of academic disciplines. This Special Issue (SI) provides an opportunity to link resilience at the micro- and macro-level since collective small business owner resilience is foundational to macro-level resilience within clusters, ecosystems and regions. This point has become evident as businesses worldwide face similar challenges and economic adversities due to the lockdowns during the global COVID-19 pandemic. The collection of papers on small business resilience in this SI indicates the psychological, organizational, and economic responses undertaken by small businesses to overcome challenges faced, where they promoted their human, social, and financial capital while finding other responses less helpful. We hope the research and questions uncovered as a result of this SI provide continued food for thought and grounds for future research in small business resilience.
ABSTRACT
Poor communication skills can compromise patient care in palliative medicine. As accreditation bodies have only called for mandatory communication skills trainings (CSTs) in recent years, CSTs are new to most hospital departments. This systematic scoping review aims to gather data on existing CSTs to identify key factors in teaching and assessing communication skills in the palliative care setting so that effective evidence- based CSTs applicable to the post-COVID-19 era can be designed. Independent searches across 7 bibliographic databases were carried out. A 'split approach' comprising thematic analysis, directed content analysis and tabulated summaries of included articles was employed. 25,809 abstracts were identified, and 109 articles were included and analysed. Themes revealed include problems with existing CSTs;guiding principles for curriculum design;teaching methods;curriculum content;assessment methods and outcomes measured;integration of curriculum;and resources, facilitators and barriers to effective training. A major flaw in existing CSTs is the lack of curriculum structure, focus and standardisation. The planning and execution of a CST curriculum needs to be stepwise and competency based. Holistic assessment by faculty, simulated patients and peers on the learner's performance plays a key role in consolidating knowledge. The educational institute must clearly define the objectives of the programme, allocate sufficient administrative and financial resources, and ensure the wellbeing of its stakeholders. Beyond medical education, a spiral curriculum with longitudinal assessments will equip learners in palliative care with the necessary skills and confidence to face complex communication scenarios in our healthcare landscape. Good communication skills can improve patient satisfaction, treatment compliance, and reduce physician burnout and the frequency of malpractice claims. This strengthens the overall doctor-patient relationship in palliative care. (Table Presented) .