ABSTRACT
Agent-based modellers frequently make use of techniques to render simulated populations more computationally tractable on actionable timescales. Many generate a relatively small number of "representative” agents, each of which is "scaled up” to represent some larger number of individuals involved in the system being studied. The degree to which this "scaling” has implications for model forecasts is an underdeveloped field of study;in particular, there has been little known research on the spatial implications of such techniques. This work presents a case study of the impact of the simulated population size, using a model of the spread of COVID-19 among districts in Zimbabwe for the underlying system being studied. The impact of the relative scale of the population is explored in conjunction with the spatial setup, and crucial model parameters are varied to highlight where scaled down populations can be safely used and where modellers should be cautious. The results imply that in particular, different geographical dynamics of the spread of disease are associated with varying population sizes, with implications for researchers seeking to use scaled populations in their research. This article is an extension on work previously presented as part of the International Conference on Computational Science 2022 (Wise et al., 2022)[1]. © 2023 The Authors
ABSTRACT
Doctors are perceived as the primary decision makers in antimicrobial therapy, but prescribing decisions are influenced by the multidisciplinary team. Antimicrobial stewardship (AMS) programs formalise interprofessional advice-giving. No studies capture the advice provided by pharmacists. This study aimed to describe the volume and nature of antimicrobial prescribing advice that healthcare professionals seek from hospital pharmacists. A prospective audit of antimicrobial-related advice requests received by pharmacists (n = 18) at an Australian public hospital was undertaken in July 2020. Antimicrobial advice was sought from 11 pharmacists on 300 occasions. Most requests (80%) were received by the AMS pharmacist. A mean (range) of 30 (17-40) requests per day was recorded and the AMS pharmacist received 24 (16-31) requests daily. Most requests came from the intensive care unit (22.1%), pharmacy (21.4%), and infectious diseases (17.1%). The AMS pharmacist was mostly contacted by consultants and pharmacists, and other pharmacists were contacted by registrars and junior medical officers. Despite COVID-19 adaptations, face-to-face interaction was most common. This audit demonstrates the value of an AMS pharmacist, and indicates the importance of face-to-face interactions and the formalisation of pharmacists' role in prescribing decision-making. Pharmacists provided antimicrobial advice daily to other healthcare professionals. Further research is required to provide insights into the barriers and enablers to effective advice-giving interactions.Copyright © 2022 The Authors. Journal of Pharmacy Practice and Research published by John Wiley & Sons Australia, Ltd on behalf of Society of Hospital Pharmacists of Australia.
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Background and Aims: The coronavirus pandemic challenged countries worldwide in a race against contaminations and variants. Vaccination campaigns were the answer to such an infectious spread. This descriptive study presents the organizational process of the setting up of a Covid-19 vaccination center in a French University Hospital in January 2021, the issues encountered along the way and assessment of adaptability.
ABSTRACT
Background: Primary care practices faced many challenges responding to the COVID-19 pandemic including a downturn in patient attendances, the rapid adoption of telehealth and increased bulkbilling requirements. Aim(s): The aim of this research was to understand impacts of COVID-19 and public health response on practice financial viability. Method(s): An online survey of Australian general practices and community allied health practice (AHP) staff operating prior and during the pandemic was administered in April 2021. The survey explored adaptations and impacts on practice finances during early lockdown (March 2020) and a year into the pandemic (March 2021). Respondents were recruited through primary health networks, peak bodies and social media. Survey data were analysed using Stata 16. Finding(s): 72% (n=213) of valid responses were from general practices, including general practitioners (GPs) (n=142), practice managers (n=49) and practice nurses (n=19). 28% (n=84) of responses were from AHPs (most commonly psychologists n=22, chiropractors n=19). During early lockdown most respondents reported reductions in patient numbers (66%) and income (72%). One year into the pandemic most practices reported patient numbers had increased as had practice costs. 46% of respondents reported decreased practice profitability one year after pandemic onset. Reduced profitability was more commonly reported by GP respondents (56%) than AHPs providing mental health services (24%) or physical health services (31%). Implications: Many primary care practices continue to suffer negative financial impacts one year after the pandemic onset. This has potential to decrease practice viability, affecting the sustainability of the primary care workforce, access to services and current models of primary care.
ABSTRACT
Agent-based models frequently make use of scaling techniques to render the simulated samples of population more tractable. The degree to which this scaling has implications for model forecasts, however, has yet to be explored;in particular, no research on the spatial implications of this has been done. This work presents a simulation of the spread of Covid-19 among districts in Zimbabwe and assesses the extent to which results vary relative to the samples upon which they are based. It is determined that in particular, different geographical dynamics of the spread of disease are associated with varying population sizes, with implications for others seeking to use scaled populations in their research. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Purpose: Compared to cisgender peers, gender diverse youth (GDY) face significant mental health disparities. Parent affirmation reduces these disparities, but there are few evidence-based support programs for parents of GDY and none centered on 1:1 parent peer support, which has shown promise in other pediatric settings. This study aimed to evaluate a 1:1 peer mentor program for parents of GDY, the Parent Outreach Program (POP). Methods: We created anonymous online surveys consisting of open-ended questions about the POP distributed via email to program mentors (parents providing support) and mentees (parents receiving support). Participants were asked why they became involved, benefits and challenges, and how this program compared to others they had participated in. Open-ended responses were coded by two authors using two iteratively developed codebooks (one each for mentors and mentees);codes were adjudicated to consensus and key themes were identified for both participant types. Results: In total, 20 participants (6 mentors, 14 mentees) completed parallel surveys. Themes identified for mentors included feeling giving back was important, their mentoring experience, challenges, and personal growth resulting from being a mentor. Mentors wanted to help other families, “[POP was] rewarding in knowing that by helping the parents you can ultimately help the kids”. They shared logistical challenges like “coordinating schedules” as well as the potential for conversations to be triggering;“Sometimes it brings up a memory of my own family that evokes an emotion”. Mentors also noted their participation was a positive experience: “[POP] offers us the opportunity to grow in our knowledge and feelings in regard to our own child”. Themes identified for mentees included the importance of finding community through the POP, receiving education, relating to their mentors, practical considerations, and qualities of a good mentor. Parent mentees shared relief in finding a “sense of community”;as one mentee said, “It was a lifeline to some sanity”. They also noted that the POP gave them specialized information and that they connected with mentors based on shared experiences: “We craved parents with a true understanding of the many feelings, changes, activities…”. They addressed practical considerations like the intimacy of 1:1 support and that recommendations from a provider mattered to them: “This [program] is more intimate and focused on our stories;” “When the social worker offered it, I had no doubt.” Mentees stressed that mentors “being non-judgmental, willing to listen” was critical. All mentees noted that they would recommend POP to other parents. Conclusions: Both parent mentors and mentees shared that 1:1 peer support was valuable and allowed mentors to give back and experience personal growth, while providing community and resources to mentees who were struggling to understand and support their GDY’s journey. The POP also provides an alternative to large support groups given the ongoing COVID-19 pandemic. This program and others offering 1:1 parent peer support may fill an important gap in supporting parents of GDY, ultimately improving mental health outcomes for their young people. Sources of Support: Dr. Kidd was supported by the National Center for Advancing Translational Science of the NIH, Award Number TL1TR001858.
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Background and importanceThe COVID-19 pandemic has challenged all countries in a race against infection and the emergence of variants. Vaccination campaigns were the answer to this public health crisis.In our university hospital, a multidisciplinary team was mobilised for the opening of two vaccination centres (VCs): for health professionals and for patients with high risk of severe COVID-19 illness according to national health authority guidelines.Aim and objectivesThe aims of our study were to collect patient and nurse satisfaction regarding these VCs and to identify adverse events (AEs) related to vial manipulation.Material and methodsThis prospective study was conducted from April to May 2021. Two satisfaction questionnaires for patients and nurses were created, each containing 13 questions subdivided into four items. Patient items were: organisation of vaccination, care, service and quality of care. Nurse items were: VC organisation, handling of vials and syringes and interprofessionalism. Responses were rated from ‘poor’ to ‘very good’.ResultsOver 1 month, 51 patient questionnaires and 4 nurse questionnaires were collected.Regarding patient satisfaction, 82% of respondents expressed ‘very good’ satisfaction with their medical care. VC location and the convenience of the vaccination boxes received 61% and 65% of ‘very good’ ratings. Some patients mentioned low confidentiality measures.The nurses’ general satisfaction was 100% ‘very good’, as well as the cooperation with the pharmacy department. As for the information technology (IT) service, 50% answered ‘rather bad’. The impact of the media on their activity was perceived as ‘bad’ for half of them and ‘average’ for the other half.Nurses reported four AEs: broken vial, leakage during dilution, mishandling by some vaccinators, and defective vial.Conclusion and relevancePatients were generally satisfied with the care received and the nurses reported a positive general satisfaction of their experience at the VC. The IT poor appreciation can be explained by network difficulties affecting data collection and certificate edition. The presence of a referring vaccination pharmacist at the VC was associated with positive feedback, which testifies to the the efficiency of the pharmacist–nurse relationship. The AEs reported allowed the good manipulation pamphlets to be updated. For the continuation of COVID-19 vaccination campaigns with booster shots, these data will allow improvement of the installation of future VC.References and/or acknowledgementsConflict of interestNo conflict of interest