Unnecessary hospitalisations and polypharmacy practices in Romania: A health system evaluation for strengthening primary health care.

Background: Children and pregnant women usually have multiple contacts with the health care system. While most conditions can be managed by primary health care (PHC) providers, hospitalisations are nevertheless common and often unjustified. The number of hospitalizations decreased in Romania at the start of the COVID-19 pandemic. While this is likely due to the disruption of health services and public health measures established to limit the spread of COVID-19, it also suggests that a proportion of hospitalisations prior to the pandemic were unnecessary. This healthcare system evaluation in Romania quantified unnecessary and unnecessarily prolonged hospitalisations in children, pregnant women and women hospitalised for delivery, and assessed antibiotic and polypharmacy practices in these groups. Methods: We conducted the healthcare system evaluation in 10 hospitals across the country. We extracted data from medical records of patients hospitalized between 2019 and 2020. In each hospital, we randomly selected 40 medical records for each of the following groups: children 2-59 months of age, pregnant women, and women hospitalised for delivery. Clinical data were compared against WHO standards indicating a need for inpatient treatment or antibiotic therapy. Results: Among 209 children and 349 pregnant women, unnecessary hospitalisations accounted for 57.9% and 56.2% of hospitalisations, respectively. Among necessary hospitalisations, a large proportion was unnecessarily prolonged, including 44.4% (n = 32/72) in children, 23.3% (n = 34/146) in pregnant women, and 45.8% (n = 110/240) in women after delivery. The proportion of unnecessary and unnecessarily prolonged hospitalisations did not differ between the pre-pandemic, the lockdown, and the post-lockdown periods. Antibiotics were prescribed to 53.1% (n = 43/81) of children with diarrhoea, while 50.8% (n = 61/120) of women with caesarean section received an unjustified prolonged course of antibiotics. Children and women were commonly prescribed unnecessary medications. Conclusions: Findings of this evaluation should inform evidence-based decisions and actions for strengthening PHC and the healthcare system structure and improving the management of common diseases in mothers, newborns, and children. The evaluation should be repeated periodically to monitor progress.

A QCA Analysis of Knowledge Co-Creation Based on University-Industry Relationships

This research aims to identify typologies of companies willing to cooperate with universities to foster knowledge co-creation and ease knowledge transfer to students within courses, training, communities of practises, etc., regardless of the business sector they are active in. To implement the research scope, we rely on the qualitative comparative analysis method (QCA). Interactions between causal factors within the university-industry relations, and knowledge co-creation have been examined. The results obtained indicate two typologies. Type 1 includes companies oriented towards supporting interactions with universities based on education, research, student placements, training, and community services such as consultancy, and product development. These acknowledge both the necessity of creating platforms to establish more ties with universities and the importance of alumni connections to develop effective campus management. Type 2 includes companies that are not interested in understanding or supporting the mission of universities in society, not developing ties with universities, and generating only a superficial interaction, which hinders their involvement in the creation of knowledge with universities. From a managerial perspective, this paper highlights the relationship between universities and industry and how this could contribute to increased resilience for a society facing unexpected challenges, such as the global crisis related to COVID-19 and the present state of international political instability.

Impact of COVID-19 Pandemic on Healthcare Professionals and Oral Care Operational Services: A Systemic Review.

The unprecedented climate of the COVID-19 pandemic has some restrictions on oral care operational services, which heavily impacted the delivery of aerosol generating procedures (AGPs). This led the health authorities to set up guidelines and policies that should be followed to minimize the virus spread and ensure safe and effective dental care delivery. This systemic review aimed to evaluate the current guidelines and strategies in providing safe dental services and ensuring efficacy of the current universal personal preventive and protective measures, as well the impact that this outbreak might have on practicing the dental profession in full scope. The review focus questions were as follows: are the current guidelines and measures in literature mitigated enough to ensure safe and effective oral care delivery to patients during the COVID-19 pandemic? Is it possible to highlight the essential and fundamental cross-infection control measures and policies? Twenty articles were chosen out of 180,248 after the inclusion and exclusion criteria were applied in the period between January 1st and August 1st 2020. Our results highlighted effective safety measures that can be implanted in protecting healthcare professionals and patients and ensuring optimal dental care delivery in a safe and healthy environment, taking into consideration the risk assessment and management of AGPs. In conclusion, informative updated standardized policies and protocols are required when more knowledge on the virus behavior keeps evolving. Moreover, there is a need for evidence-based protective measures to be modified on a regular basis to be followed, until a safe vaccine is produced.

Understanding COVID-19 Pandemic: Molecular Mechanisms and Potential Therapeutic Strategies. An Evidence-Based Review.

Initially, the SARS-CoV-2 virus was considered as a pneumonia virus; however, a series of peer reviewed medical papers published in the last eight months suggest that this virus attacks the brain, heart, intestine, nervous and vascular systems, as well the blood stream. Although many facts remain unknown, an objective appraisal of the current scientific literature addressing the latest progress on COVID-19 is required. The aim of the present study was to conduct a critical review of the literature, focusing on the current molecular structure of SARS-CoV-2 and prospective treatment modalities of COVID-19. The main objectives were to collect, scrutinize and objectively evaluate the current scientific evidence-based information, as well to provide an updated overview of the topic that is ongoing. The authors underlined potential prospective therapies, including vaccine and phototherapy, as a monotherapy or combined with current treatment modalities. The authors concluded that this review has produced high quality evidence, which can be utilized by the clinical scientific community for future reference, as the knowledge and understanding of the SARS-CoV-2 virus are evolving, in terms of its epidemiological, pathogenicity, and clinical manifestations, which ultimately map the strategic path, towards an effective and safe treatment and production of a reliable and potent vaccine.