ABSTRACT
Digital health interventions have become an essential component of every public health system since the COVID-19 pandemic. 'eSanjeevani OPD - Stay at Home OPD' is a telemedicine system that connects doctors and patients launched as part of the Ayushman Bharat project of the Indian government. This study analyses various factors affecting the intention to use eSanjeevani. A theoretical model integrating the health belief model and the theory of reasoned action was framed and empirically tested. Responses were collected using a survey questionnaire(n=248). A partial least square-structural equation modeling was used to analyze the linkages between the constructs. Perceived susceptibility and benefits were found to be the most contributing variables. Attitude has a significant mediating effect on the intention to use eSanjeevani. © 2023 IEEE.
ABSTRACT
INTRODUCTION: Clefts of the lip are of the most common congenital craniofacial anomalies. The development and implementation of an enhanced recovery after surgery (ERAS) protocol among patients undergoing cleft lip repair may decrease postoperative complications, accelerate recovery, and result in earlier postoperative discharge. METHODS: A modified ERAS program was developed and applied through Global Smile Foundation outreach craniofacial programs. The main components of this protocol include: (1) preoperative patient education, (2) nutrition screening, (3) smoking cessation when applicable, (4) use of topical anesthetic adjuncts, (5) facial nerve blocks, (6) postoperative analgesia, (7) preferential use of short-acting narcotics, (8) antibiotic administration, (9) use of elbow restraints, (10) early postoperative oral feeding and hydration, and (11) discharge planning. RESULTS: Between April 2019 and March 2020, GSF operated on 126 patients with cleft lip from different age groups and 58.8% of them were less than 1 year of age. Three patients (2.4%) had delayed wound healing and one (0.8%) had postoperative bleeding. There were no cases of mortality, length of hospital stay did not exceed 1 postoperative day, and patients were able to tolerate fluids intake at discharge. CONCLUSION: The implementation of an ERAS protocol among patients undergoing cleft lip repair has shown to be highly effective in minimizing postoperative discomfort while reducing opioids use, decreasing the length of stay in hospital, and leading to early oral feeding resumption. The ERAS principles described carry increased relevance in the context of the ongoing COVID-19 pandemic and opioid crisis and can be safely applied in resource-constrained settings.
ABSTRACT
INTRODUCTION: On-demand telehealth can have a high rate of patients requesting visits and dropping off without being seen by a provider, especially during the COVID-19 pandemic. METHODS: On-demand telehealth requests made to a large healthcare system in the USA between 15 March 2020 and 31 May 2020 were included for analysis with a focus on patients who were defined as left without being seen (LWBS). As part of a pilot program a registered nurse attempted to call LWBS patients within 24 hours of their telehealth request and asked if they were ok, if they sought care for their original visit reason, what that care was, or if they still needed guidance. This information and patient demographics were analyzed. RESULTS: During the study period there were 21,610 completed on-demand telehealth visits and 1852 patients for whom there were LWBS attempted follow-ups. Most patients LWBS for a reason that originated from the patient and not associated with the provider or telehealth platform. The mean wait time for LWBS patients was 12.4 min compared to patients waiting 15.1 min before engaging with a provider to complete a visit. Of the 1852 total LWBS patients in the follow-up programme, 819 (44.2%) were successfully contacted with a follow-up phone call. Most of these patients (63.2%) already completed or planned to complete a telehealth visit, 13.6% indicated they no longer needed to see a provider, and 12.8% planned or already completed an in-person visit. Only 2.2% went to an emergency department. DISCUSSION: Results suggest patients can effectively self-manage their care needs.
ABSTRACT
Background: A new type of Corona virus that is SARS-COV-2 called COVID-19 had a huge pandemic worldwide. On January 30, 2020 the World Health Organization (WHO) declared the outbreak of COVID19 as a public health emergency of international concern. Method(s): Descriptive and retrospective study carried out at general hospital, Sapthagiri institute of medical science and research centre from September 2020 to September 2021. Result(s): Among 153 tested neonates, 91 were SARS-COV-2 positive. Out of 91 (59%), most common symptom reported is respiratory distress in the form of TTNB (43%) and require respiratory support for longer period compared to COVID negative group. Conclusion(s): 55% of neonates were symptomatic and reported higher incidence of NICU admission rates in SARS-COV-2 positive neonates born to SARS-COV-2 infected mothers which is comparable to our study.Copyright © 2022 Scientific Publishers of India. All rights reserved.
ABSTRACT
BACKGROUND: Since COVID-19 was declared a worldwide pandemic by the World Health Organization (WHO) in March of 2020, foundation-based cleft outreach programs to Low- and Middle-Income Countries (LMICs) were halted considering global public health challenges, scarcity of capacity and resources, and travel restrictions. This led to an increase in the backlog of untreated patients with cleft lip and/or palate, with new challenges to providing comprehensive care in those regions. Resumption of international outreach programs requires an updated course of action to incorporate necessary safety measures in the face of the ongoing pandemic. In this manuscript, the authors outline safety protocols, guidelines, and recommendations implemented in Global Smile Foundation's (GSF) most recent outreach trip to Beirut, Lebanon. METHODS: COVID-19 safety protocols for outreach cleft care and an Action Response Plan were developed by the GSF team based on the published literature and recommendations from leading international organizations. RESULTS: GSF conducted a 1-week surgical outreach program in Beirut, Lebanon, performing 13 primary cleft lip repairs, 7 cleft palate repairs, and 1 alveolar bone grafting procedure. Safety protocols were implemented at all stages of the outreach program, including patient preselection and education, hospital admission and screening, intraoperative care, and postoperative monitoring and follow-up. CONCLUSIONS: Organizing outreach programs in the setting of infectious diseases outbreaks should prioritize the safety and welfare of patients and team members within the program's local community. The COVID-19 protocols and guidelines described may represent a reproducible framework for planning future similar outreach initiatives in high-risk conditions.
ABSTRACT
Sclerosing cholangitis is a chronic cholestatic disease characterized by stricturing, beading, and obliterative fibrosis of the bile ducts. Sclerosing cholangitis is considered primary (PSC) if no underlying etiology is identified or secondary (SSC) if related to another identifiable cause. In this article, we will review the clinical features, pathogenesis, diagnosis, and imaging findings of PSC and SSC, with an emphasis on features that may aid in the distinction of these entities. We will also discuss various etiologies of SSC including recurrent pyogenic cholangitis, other infectious etiologies, ischemic damage, toxic insults, and immunologic, congenital, and miscellaneous causes, highlighting the unique imaging findings and clinical context of each diagnosis.
ABSTRACT
COVID-19 is a disease that is spreading exponentially worldwide. This pandemic situation proved that doctors, nurses, and front-line workers are real-life heroes. The patients and their family affected due to COVID-19 are increasing drastically. Family members who treat the patients wear all their personal protective accessories and clothes, yet, they get influenced as well. Family members can't be in direct contact with the patients frequently since the probability of spread is high. The patients need to be served with food, medicines, and other required things on a regular time basis. To reduce the spread, human force, and to maintain a strategic distance fromCOVID-19 affected patients, the best way is to utilize an COVID-19 Assist Robot (COBOT) to carry the essentials and transport it to the patient's room as per the line map given. A home environment that depicts the isolated ward with the COVID-19 affected patients is created using webots. The robots are simulated with the environment as such two robots take care of the left half and the other two robots take care of the right half of the isolated ward. © 2022 IEEE.
ABSTRACT
Palliative care has been primarily delivered to patients in person since its inception. During the Covid-19 pandemic, providing palliative care was especially challenging for clinicians due to public health measures to contain the virus that required them to interact virtually with patients and families. While the rapid implementation of telehealth has been examined in other clinical contexts, limited research has studied the impact of the pandemic on palliative care delivery. This study examined the experiences clinicians faced when providing palliative care to older adult patients during the pandemic. Between April 2021 and March 2022, we interviewed 29 geriatricians and palliative care specialists from 11 institutions across the US. We asked clinicians about their experiences with palliative care during the pandemic, including challenges and opportunities related to the changing nature of palliative care delivery. We analyzed interviews using reflexive thematic analysis. The following three themes emerged from the analysis: (1) Clinicians' challenges adjusting to virtual care;(2) System-level barriers, restrictions, and uncertainties about Covid-19;and (3) Older adult patients' context and vulnerability (i.e., loss of social engagement, isolation, loneliness, delayed access to care) that increased the complexity of their health conditions. In conclusion, clinicians' experiences during the pandemic shed light on the evolution of palliative care delivery and the importance of preparing them for new care models that account for virtual delivery and that address the diverse needs of older adults that emerge during public health crises.
ABSTRACT
In response to the emergence of COVID-19 during Spring 2020, many countries implemented nationwide lockdowns and mandatory stay-at-home orders, which resulted in historically clean ambient air quality. However, in many parts of the world, biomass burning for cooking is a common activity, and in India specifically, it has been implicated as the leading contributor to indoor and ambient PM2.5, and its activity was not stopped and likely increased during lockdowns. Here, we first estimate baseline and lockdown PM2.5 exposures specific to India using new, nationwide time-use survey data coupled with fine-scale PM2.5 estimates within various microenvironments. We then extend this framework to estimate the population globally that will have experienced higher PM2.5 exposures during lockdowns, due both to an increase in residential biomass burning activity as well as the entire day being spent in the more-polluted home environment for biomass fuel using households. Sixty five percent of Indians, the percent that uses biomass fuels for cooking, were exposed to higher PM2.5 levels during the lockdown compared to their modeled baseline exposures, with the average modeled exposure increasing by 13% (95% distribution: 8–26) (from 116 (82–157) to 131 (104–170) μg m−3). We further leverage this exposure framework to present India’s most comprehensive, to date, PM2.5 exposure disparity and environmental justice assessment;although women were still exposed to the highest levels of PM2.5 during the lockdown (from 135 (91–191) μg m−3 baseline to 147 (106–200) μg m−3 during the lockdown;8.8% (5–18) increase), the demographic groups that experienced the highest exposure increases were working-age men and school-age children, whose average modeled exposures increased by 24% (18–48) (from 88 (63–118) to 108 (94–139) μg m−3) and 18% (8–31) (from 98 (75–134) to 115 (98–145) μg m−3), respectively. Globally, we conservatively estimate that 34.5% (21–51) of the global population observed increased PM2.5 exposures during COVID-19 lockdowns, concentrated in low-income regions with high biomass usage. There have been a number of clean-cooking initiatives introduced in India and throughout the world to replace biomass cookstoves, but the finding that PM2.5 exposures increased for the majority of Indians and a third of the global population—driven largely by residential biomass burning for cooking—during a period of historically clean ambient air quality, re-emphasizes the urgent need to further address clean cooking interventions to reduce PM2.5 exposures and in turn improve health outcomes.
ABSTRACT
The number of people infected with COVID-19 is skyrocketing all over the world. It causes symptoms such as fever, shortness of breath, and other breathing difficulties and it affects people differently. Elevated heart rate (above 90 beats per minute), increase in body temperature (above 37 degree Celsius), lower oxygen saturation (less than 94 percent) are serious symptoms. To detect the virus early and restrict its spread, Cov-Verhindern is a versatile device that can be used anywhere such as shops, malls and educational institutions. 'Verhindern' is a German term that means 'Try to avoid'. We're attempting to stop the spread of COVID-19 here, hence the term 'Cov-Verhindern'. This system includes sanitizing session, temperature sensing, oxygen saturation and heart beat monitoring through an IoT-based program along with a gate mechanism and interaction process. © 2022 Author(s).
ABSTRACT
The expanded availability of telehealth due to the COVID-19 pandemic presents a concern that telehealth may result in an unnecessary increase in utilization. We analyzed 4,114,651 primary care encounters (939,134 unique patients) from three healthcare systems between 2019 and 2021 and found little change in utilization as telehealth became widely available. Results suggest telehealth availability is not resulting in additional primary care visits and federal policies should support telehealth use.
ABSTRACT
BACKGROUND: Recent COVID-19 surges are attributed to emergence of more transmissible SARS-CoV-2 variants of concern (VOCs). The relative severity of VOCs in children is unknown. METHODS: We performed a single-center retrospective cohort study of children ≤18 years old diagnosed with COVID-19 from October 2020-February 2022 and whose SARS-CoV-2 isolate underwent Illumina sequencing. We measured the frequency of five markers of COVID-19 severity. Logistic regression models were fitted to estimate the odds of each severity marker with each VOC. RESULTS: Among 714 children, 471 (66.0%) were infected with a VOC: 96 (13.4%) alpha, 38 (5.3%) gamma, 119 (16.7%) delta, and 215 (30.1%) omicron. High-risk medical conditions and increasing age were independently associated with COVID-19 severity. After adjusting for age, race, ethnicity, high-risk medical conditions, and COVID-19 community incidence, neither alpha, delta, nor omicron was associated with severe COVID-19. Gamma was independently associated with hospitalization (OR 6.7, 95% CI 2.0-22.1); pharmacologic treatment (OR 5.7, 95% CI 1.2-26.8); respiratory support (OR 11.9, 95% CI 2.7-62.4); and severe disease per the WHO Clinical Progression Scale (OR 11.7, 95% CI 2.1-90.5). Upon subgroup analyses, omicron was independently associated with ICU admission and severe disease per the WHO Clinical Progression Scale in children without SARS-CoV-2 immunization or prior COVID-19 infection. CONCLUSIONS: Compared to non-VOC COVID-19, the gamma VOC was independently associated with increased COVID-19 severity, as was omicron in children without SARS-CoV-2 immunization or prior COVID-19 infection. SARS-CoV-2 vaccination and prior COVID-19 prevented severe outcomes during the omicron surge.
Subject(s)
COVID-19 , SARS-CoV-2 , Child , Humans , Adolescent , COVID-19 Vaccines , Retrospective Studies , Patient AcuityABSTRACT
BACKGROUND: COVID-19 vaccines are vital tools in the defense against infection and serious disease due to SARS-CoV-2. There are many challenges to implementing mass vaccination campaigns for large, diverse populations from crafting vaccine promotion messages to reaching individuals in a timely and effective manner. During this unprecedented period, with COVID-19 mass vaccination campaigns essential for protecting vulnerable patient populations and attaining herd immunity, health care systems were faced with the dual challenges of vaccine outreach and distribution. OBJECTIVE: The aim of this cross-sectional study was to assess the effectiveness of a COVID-19 vaccine text outreach approach for patients aged 65 years and older. Our goal was to determine whether this approach was successful in scheduling patients for COVID-19 vaccine appointments. METHODS: We developed SMS text messages using the Tavoca platform. These messages informed patients of their vaccine eligibility and allowed them to indicate their interest in scheduling an appointment via a specific method (email or phone) or indicate their lack of interest in the vaccine. We tracked the status of these messages and how patients responded. Messages were sent to patients aged 65 years and older (N=30,826) at a nonprofit health care system in Washington, DC. Data were collected and examined from January 14 to May 10, 2021. Data were analyzed using multivariate multinomial and binary logistic regression models in SAS (version 9.4; SAS Institute Inc). RESULTS: Approximately 57% of text messages were delivered to patients, but many messages received no response from patients (40%). Additionally, 42.1% (12,978/30,826) of messages were not delivered. Of the patients who expressed interest in the vaccine (2938/30,826, 9.5%), Black or African American patients preferred a phone call rather than an email for scheduling their appointment (odds ratio [OR] 1.69, 95% CI 1.29-2.21) compared to White patients. Patients aged 70-74 years were more likely to schedule an appointment (OR 1.38, 95% CI 1.01-1.89) than those aged 65-69 years, and Black or African American patients were more likely to schedule an appointment (OR 2.90, 95% CI 1.72-4.91) than White patients. CONCLUSIONS: This study provides insights into some advantages and challenges of using a text messaging vaccine outreach for patients aged 65 years and older. Lessons learned from this vaccine campaign underscore the importance of using multiple outreach methods and sharing of patient vaccination status between health systems, along with a patient-centered approach to address vaccine hesitancy and access issues.
ABSTRACT
Textile is a necessary commodity and is of paramount importance in a variety of areas. The properties of textiles can be further enhanced and the horizon of their applications can be broadened by the incorporation of nanoparticles using nanotechnology. Nanoproducts ranging from nanofibers, nanocomposite fibers, and intelligent polymeric nanocoatings are frequently incorporated in conventional textiles to provide improved performance and new functionality. Nanocoatings offer numerous specific properties like antimicrobial, wrinkle resistance, and protection against UV radiations. These properties lead to a variety of textile applications including medicinal textiles, and sportswear. In the COVID-19 pandemic situation, nanotechnology has paved the way for need-based customization such as antiviral masks, PPE kits, etc. This paper provides an overview of the nanomaterials suitable for the textile industry, enhancement in the properties of fabrics due to incorporation of nanomaterials, advantages, disadvantages, and a few applications. © The Electrochemical Society
ABSTRACT
Accurate diagnostic system is significantly important for timely COVID-19 identification. Diagnosing COVID-19 from chest x-ray images employing the CNN model is recommended for accurate recognition of COVID-19. The existing diagnosis techniques of COVID-19 still lack high accuracy. To handle this problem in this work, we have proposed accurate detection method for COVID-19. In the proposed method, a CNN is incorporated for the diagnosis of COVID-19 using chest x-ray images data. The experimental results illustrate that our technique is good for COVID-19 accurate diagnosis and can be easily implemented in health care systems. © 2021 IEEE.
ABSTRACT
This article draws on the concept of the chronotope – spatiotemporal entanglements theorized in literary and anthropological studies – and extends the same to an engagement with and an understanding of the experiential and ontological defamiliarization, deceleration and suspension of space, time and security generated by the COVID-19 pandemic. This article, thus, offers a study of COVID-19 as a connective metaphor and a crisis chronotope – denoting the un-certain space–time marked and defamiliarized by changed orders and vocabularies of presence, distance, trust, tactility and memory – characterizing a world of alienation, insecurity and fear of infection. In arguing how the globality of COVID-19 has ironically informed isolation, incomplete identification and new fiction-formations, while also foregrounding the difference between human time and planetary time, the article will re-examine the crisis chronotope through a study of sudden death and the defamiliarized public space, exemplified in the city of New Delhi during the second wave of the pandemic in April–May 2021. © The Author(s) 2021.
ABSTRACT
A worldwide pandemic, COVID-19 has been caused by a newly discovered strain of coronavirus SARS-Cov-2. Its common symptoms are high fever, coughing, and shortness of breath. With the rising number of COVID-19 cases, manual detection of infectious individuals at public spaces is a hectic task. Artificial Intelligence (AI) based detection systems can be deployed at public places like airports, railway stations, etc. for continuous monitoring of potential infectious individuals and screening based on common symptoms exhibited. In this paper, a new algorithm is developed for detecting repetitive coughing action which is the main symptom in COVID-19 cases, and thus detecting people with COVID-19 based on it. The performance of the proposed system is tested on an existing sneeze-cough dataset and also on a real-time dataset. The evaluation shows that the proposed method has superior performance over the state-of-the-art methods.