ABSTRACT
The pandemic crisis and the resulting global uncertainties have obviously had a severe impact on the healthcare supply chain (HSC), leading scholars, healthcare executives, and policymakers to focus on the sustainability of the HSC. Technologies have emerged and developed rapidly in recent years, especially in the healthcare industry, for coping with the pandemic crisis and supporting the "new normal" for humankind. Within this context, various new technologies have been implemented to maximize the supply chain process, ensure patient and healthcare worker safety, and improve the quality of care. Hence, the integration of a technological dimension with the traditional three pillars of sustainability may aid in attempts to define the potential attributes of these dimensions of sustainability. Therefore, this study aimed to identify the key attributes of a sustainable healthcare supply chain (SHSC), and this paper presents a new, four-dimensional model for SHSCs, consisting of social, environmental, economic, and technological dimensions. A systematic literature review was conducted, resulting in the identification of 35 potential SHSC attributes. The Fuzzy Delphi Method (FDM) was then applied to determine the appropriateness of these potential attributes according to the consensus of 13 experts, including healthcare workers in a variety of medical specialties, who profoundly understand HSC sustainability. The results yielded 22 appropriate attributes, which were then categorized across the four dimensions. Consequently, a new model of an SHSC, which prioritizes patient safety, was constructed and is proposed here. This SHSC model can be applied strategically to the healthcare industry to enhance the safety of both medical personnel and patients in a sustainable manner.
ABSTRACT
The coronavirus (COVID-19) pandemic has had a huge impact all over the world. Healthcare industry is one that has been greatly affected by Global supply chain disruption, including shortages of critical medical equipment and drugs, insufficiency of diagnostic, and inadequacy of medical personnel. The aforementioned problems directly affect human health in the dimension of 'patient safety' which may cause life-threatening situations. Therefore, it is important to learn how to strengthen the healthcare supply chain (HSC) and increase safety, particularly for patients. There are various researchers who studied HSC performance in developed countries but the research in developing countries especially southeast Asia countries e.g., Cambodia is scarce. Therefore, this research aims to identify and synthesize HSC performance for patient safety and provide a novel model of HSC performance in developing countries' healthcare settings. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was conducted using a patient safety definition from WHO, International Patient Safety Goals from Joint Commission International (JCI), and the Hospital Accreditation institute (HA) from Thailand. The HSC performances are categorized under the easily recognizable heading SIMPLE (stands for patient safety goals in 6 domains as follows: Safe surgery, Infection Prevention & Control, Medication safety, Patient care process, Laboratory & blood product safety, and Emergency preparedness and response). The novel model of HSC performance for patient safety is provided to demonstrate the factors that can enhance the performance of HSC management in developing countries. Moreover, this study contributes to the meta-analysis by analyzing existing research and proposing new future research opportunities in HSC performance for patient safety that leads to social sustainability. © 2022 IEEE.
ABSTRACT
Introduction: Post-COVID-19 autoimmune encephalitis is a rare manifestation following COVID-19. Most cases have not demonstrated solid evidence regarding their pathogenesis. Some believe it to be an immune process. Case presentation: In this case report, we present a case of a young female who presented to our emergency department with visual, auditory, and olfactory hallucinations after successfully treating COVID-19 two weeks prior to this visit. On examination, her vital signs were stable, but she was agitated, distressed, and hallucinating. Neurological examinations were normal. Laboratory investigations, including autoimmune profiles, were all negative. Magnetic resonance imaging of the brain showed non-specific changes in the bilateral frontal area. Electroencephalography (EEG) showed lateralized rhythmic delta activity (LRDA) arising more from the right occipital lobes. Autoimmune psychosis was suspected due to psychosis, abnormal imaging, and abnormal EEG findings. She was given corticosteroids and antipsychotic medication. Her symptoms improved within ten days. On follow-up, she remained well without any return of psychosis. Conclusion(s): Possible autoimmune pediatric encephalitis following COVID-19 is a rare entity that has scarcely been reported. The majority of the cases were reported to have been related to stress following the infection. To establish the correct diagnosis, an extensive workup, including an autoimmune profile, lumbar puncture, magnetic resonance imaging, and electroencephalography, is recommended.Copyright © 2022 The Author(s)
ABSTRACT
Since the coronavirus (COVID-19) pandemic, it has been clear that the health dimension (HEDm) has a severe impact on sustainability, which was originally considered from the pillars of society, environment and economy. Hence, the integration of the health dimension into the other three pillars is plausible to define guidelines and criteria for progress monitoring and policy assessment towards a health-sustainable city. The objective of this study aims to present The Health Sustainability Model (HSM), a four-dimensional model for health sustainability (health, economy, environment, and society), using the Del-phi method to determine potential indicators agreed by eighteen experts, including physicians who deeply understand issues on health sustainability, and assess complex dimensions of health in the context of sustainability. The researchers have found that 45 indicators, later grouped into 15 elements and 4 dimensions, have a high level of agreement with Kendall's W (KW) at 0.36. The HSM was then examined by the structural equation model (SEM) with reliability and validity shown as follows: the absolute fit with CMIN/DF = 1.44, RMSEA = 0.033, GFI = 0.96, AGFI = 0.94, RMR = 0.025, and the incremental fit with NFI = 0.94, CFI = 0.98, TLI = 0.97, and IFI = 0.98. Based on the results, the model is valid, in line with the empirical data. For further application, the HSM is expected to support city planners and decision makers by identifying room for improvement in each dimension through the indicators employed in the model. In contrast to existing studies that mainly use qualitative data, by conducting quantitative assessment, the model enables policy makers to objectively evaluate conditions and appropriately design policies to improve residents' well-being.
ABSTRACT
Objective: NA Background: Due to the COVID-19 pandemic, Thailand has started its vaccination program since February 2021. After the launch of the mass vaccination with CoronaVac, there were reports of patients who suffer unusual hemiparesis across the country. We report the first case of a patient who suffered transient focal neurological deficit mimicking stroke following CoronaVac vaccination. However, instead of an ischemic stroke, motor aura was suspected. Design/Methods: A 24 year-old Thai female presented with left hemiparesis fifteen minutes after receiving CoronaVac. She also had numbness of her left arm and legs, flashing lights, and headaches. On physical examination, her BMI was 32.8. Her vital signs were normal. She had moderate left hemiparesis (MRC grade III), numbness on her left face, arms, and legs. Her weakness continued for 5 days. Results: A brain CT scan was done showing no evidence of acute infarction. Acute treatment with aspirin was given. MRI in conjunction with MRA was performed in which no restricted diffusion was seen. A SPECT was performed to evaluate the function of the brain showing significant hypoperfusion of the right hemisphere. The patient gradually improved and was discharged. Conclusions: In this study, we present the first case of stroke mimic after CoronaVac vaccination. After negative imaging studies, stroke is unlikely to be the cause. Asymmetrical abnormal functional imaging study showing multifocal hypoperfusion on the right could represent the ongoing neurological deficits. Therefore, we believed that it might be due to cortical spreading depression, in which motor aura could be responsible. The uniqueness in our case is the prolongation of weakness that we think might be due reverberating spreading depression wave. The cause is unknown, but we proposed that aluminum found to enhance the vaccine that could disrupt the Glutamate - Nitric oxide - cGMP pathway leading to the prolongation of motor aura.