ABSTRACT
The following sections are included: • Introduction • Post-Covid Challenges and Responses • Business Continuity Management • Managing Cost • Supply Base • Supply Routes • Custom Clearance • Associated Services • Alternative Material • Inventory Visibility and Safety Stock • Agility • Digitalisation • Smart Warehouse Technologies. • Conclusion • References © 2023 by World Scientific Publishing Co. Pte. Ltd.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has necessitated a rapid uptake of telemedicine in primary care. However, a comprehensive evaluation of such programs is currently lacking and there are substantial differences between telemedicine programs rolled out in different practices. We undertook this study to understand patients' and providers' experiences with telemedicine in primary care. METHODS: We conducted semi-structured interviews with primary care providers (n=21) and patients (n=65) with a chronic disease in three PCORnet sites in New York City, North Carolina and Florida. We specifically asked about barriers to and facilitators of, as well as benefits of and challenges with, telemedicine use. Three coders developed the code key and coded transcripts individually. Codes were compared and discrepancies resolved. Data was analyzed using interpretive description. RESULTS: Of the primary care providers, 62% were female and 9% selfi dentified as Black, 48% White, 24% Asian, 14% Hispanic and 5% Other. Of the patients, 60% were female and 25% self-identified as Black, 42% were White, 23% Hispanic, 1% Asian and 9% Other. Patients and providers both agreed that the benefits of telemedicine included increased convenience particularly for patients, eliminating travel hassle and time constraints. Primary challenges associated with telemedicine were the inability to do a physical exam, decreased patient-physician rapport and some concern about quality of care. Technology (internet difficulties, lack of access to video capability), lower technology literacy, complicated telemedicine platforms were seen as challenges to telemedicine use. Both patients and providers recommended more technological and ancillary support as well as increased education about telemedicine would facilitate telemedicine use. CONCLUSIONS: Patients and providers report several benefits of telemedicine during the COVID pandemic but telemedicine cannot fully replace in-person visits for a variety of reasons. Telemedicine can both exacerbate and ameliorate disparities in healthcare, and technology issues and improving technological and ancillary support may increase telemedicine use and reduce disparities in care.
ABSTRACT
BACKGROUND: The health and financial burdens faced by cancer survivors, compounded by the significant disruption in care and their increased risk for morbidity and mortality during the COVID-19 pandemic, emphasize the need to assess the mental health impact of the pandemic in this population. We examined the association between beliefs about COVID and posttraumatic stress disorder (PTSD) symptoms among breast and prostate cancer survivors. METHODS: Participants from two longitudinal cohort studies completed surveys assessing their beliefs about COVID- 19, as well as stress and PTSD symptoms. COVID beliefs were assessed using questions adapted from a previous coronavirus survey developed through an iterative process. PTSD symptoms were assessed using the PTSD Checklist (PCL-5). Participants with PCL-5 scores ≥ 33 were classified as having COVID-related PTSD symptoms. Surveys were completed between May 2020 and June 2021 and were categorized into four time points: season 1 from May 2020 to August 2020, season 2 from September 2020 to November 2020, season 3 from December 2020 to February 2021 and season 4 from March 2021 to June 2021. Chi-square, Fisher, Signed Rank Wilcoxon tests and general linear models were performed to assess the relationships between COVID beliefs and PTSD symptoms. RESULTS: Participants were 276 older cancer survivors (mean age 67 years), of whom 157 (57%) were female and had breast cancer and 118 (43%) were male with prostate cancer. Seventy (25%) self-identified as Black, 147 (53%) as White, and 36 (13%) identified as Latinx. Twenty-four participants (7%) had COVID-related PTSD symptoms. Participants with PTSD symptoms were more likely to be very worried about getting COVID (65% vs. 33%, p=0.007), more likely to think that ≥10% of people with COVID would die (75% vs. 40%, p=0.006), and that it was very likely that they or someone they know will get sick from COVID (64% vs. 23%, p=0.006). As the pandemic drew on, cancer survivors' beliefs about COVID changed such that fewer respondents reported that COVID changed their daily routine a lot in season 4 compared to season 1 (88% vs 65%, p <0.001), and fewer were very worried about getting COVID (38% vs. 19%, p=0.056). Temporality was also significantly associated with a decrease in PTSD symptoms with average PCL-5 scores decreasing from 14.2 to 8.9 in season 1 compared to season 4 (p <0.0001). CONCLUSIONS: As the pandemic progressed, cancer survivors tended to have decreased levels of PTSD symptoms, were less likely to have their routines disrupted and were less worried about getting COVID. However, among participants who had PTSD symptoms, concerns about COVID were significantly higher than among those without PTSD symptoms, emphasizing the need for mental health screening and counseling to better support survivors' coping with the impacts of the pandemic.
ABSTRACT
We report a case of atypical clinical manifestation of pneumonia infected by 2019-novel coronavirus, which is helpful to improve the understanding of the clinical characteristics of pneumonia caused by the virus. At the same time, some suggestions on the discharge criteria and hierarchical management of admission of 2019-nCoV pneumonia are put forward. The results are constructive for effective prevention and control of 2019-nCoV pneumonia and optimizing patient process management in China. © 2020, Iranian Journal of Public Health. All rights reserved.