Association Between COVID-19 Pandemic and Serious Mental Illness: Systematic Review within Salutogenesis Model for Public Health Management

Background: The outbreak of the COVID-19 pandemic, the constant transformation of the SARS-COV-2 virus form, exposure to substantial psychosocial stress, environmental change, and isolation have led to the inference that the overall population's mental health could be affected, resulting in an increase in cases of psychosis. Objective(s): We initiated a systematic review to determine the impact of the SARS-COV-2 virus and its long-term effects-in both symptomatic and asymptomatic cases-on people with or without psychosis. We envisioned that this would give us an insight into effective clinical intervention methods for patients with psychosis during and after the pandemic. Method(s): We selected fifteen papers that met our inclusion criteria, i.e., those that considered participants with or without psychiatric illness and exposed to SARS-COV-2 infection, for this review and were retrieved via Google, Google Scholar, MEDLINE, PubMed, and PsychINFO Database. Key Gap: There is a dearth of research in understanding how COVID-19 affects people with or without a prior personal history of psychosis. Result(s): The systematic review summary provides insight into the state of knowledge. Insights from the systematic review have also been reviewed from the salutogenesis model's perspec-tive. There is moderate evidence of new-onset psychosis during the COVID-19 pandemic in which some antipsychotics treated the psychotic symptoms of patients while treating for COVID-19. Suggestions and recommendations are made for preventive and promotive public health strategies. Conclusion(s): The Salutogenesis model and Positive Psychology Interventions (PPI) provide another preventive and promotive public health management approach.Copyright © 2023 Bentham Science Publishers.

A path to new normal of nuclear medicine facilities: Considerations for reopening

The stormy clouds of the coronavirus disease 2019 outbreak caused a rapidly spreading epidemic still hanging over the sphere. Any steps to transition toward a new normal should be guided by health authorities, together with economic and societal considerations. There are various items mainly falling into three classifications, including patient worry, clinical demand, and economic recession. Social distancing, lay-offs, and decreased number of patients with health insurance may lead to a prolonged period to retrieve normalcy. To return to a new normal, an individualized management model should be developed for each laboratory based on staff, instruments, services, crowding, physical space, hospital base unit, or outpatient clinic. Continuous training of different occupational staffs is among the key parameters in maintaining this readiness. The proposed response model should have internal and systemic integrity as well as coherence among the included items in two intra- and inter-unit management categories, namely thinking globally and acting locally.Copyright © 2021 mums.ac.ir All rights reserved.

COVID-19 TravelCover: Post-Lockdown Smart Transportation Management System

Public transportation is not safe during the COVID-19 pandemic even after post lockdown, because it will be very hard to maintain social distancing in public transport. The COVID-19 pandemic is a worldwide pandemic because of which it became risky to allow public transportation without the proper mechanism to maintain social distancing. So to resolve this problem we came up with an idea of making an intelligent application to schedule the timings of transportation, avoiding over occupancy of public transport, providing them the shortest route to reach their desired destination, providing them proper guidelines, also providing them the information of the nearest hospitals for any emergency. In the proposed work, we have tested the result on 100 random users from various locations, determined the shortest distance of the vehicles, booked online tickets based on mask detection, and maintained the social distancing based on government guidelines. We have applied only 50% ticket booking for maintaining the social distancing and the ticket validation system has been checked with the user's images and it was successfully able to distinguish between masked and unmasked images. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Perceptions of telemedicine in specialist outpatient services

Introduction/Aim: COVID-19 has fast-tracked changes to healthcare delivery, including the introduction of a broad range of telehealth services. Work is needed to assess the ongoing suitability of telemedicine for the post-pandemic era. We sought to explore perceptions of telemedicine amongst patients and providers (clinicians and health administrators) who had appointments in cardiology, respiratory, neurology, rheumatology and gastroenterology services in hospital specialist outpatient clinics in Sydney Local Health District. Method(s): Semi-structured interviews explored perceptions of consultations undertaken virtually compared to in-person, seeking perspectives on the benefits, limitations and risks of outpatient telemedicine consultations. The 37 participants comprised 16 patients, 14 specialists, 3 Clinical Nurse Consultants and 4 administrators. Result(s): Patients indicated satisfaction with telemedicine consultations, especially during the pandemic. They valued saving on travel time and costs, and being able to access care from their homes, thereby minimising risk of COVID exposure. The chief disadvantage perceived by patients was inability to receive a physical examination. They noted greater challenges for people with hearing and visual impairments, limited digital skills and/or computer access. Providers' perceptions were more ambivalent. Although telehealth was understood to help meet demands during the pandemic, mis- and under-diagnoses were considered major concerns arising from the inability to perform physical examination. Most regarded telemedicine as an effective tool for review appointments but mentioned an associated increased workload. All participants mentioned the need for relevant education and training, better integration of telemedicine platforms into existing infrastructure and the need for a hybrid model of care. Conclusion(s): Telemedicine played a unique role in meeting patients' needs during the pandemic and its convenience was valued by patients. Clinicians expressed concerns about missed diagnoses, uncertain clinical outcomes, lack of administrative and technological infrastructure. The ultimate test of telemedicine will be its impact on clinical outcomes versus longstanding models of in person care.

Utilization of Health Resources During the Coronavirus Pandemic in Israel: Meuhedet Health Services' Real Data Analysis and Future Conclusions

Aim: This study aimed to examine the utilization of health resources during the first year of the COVID-19 pandemic in Israel through the analysis of Meuhedet Health Services' real-world database. Background(s): The history of COVID-19 in Israel comprises three waves: from February to May 2020, from May to November 2020, and from November 2020 to April 2021. Restrictions imposed on the Israeli population included travel limitations and even lockdowns. Meuhedet Health Services, the third largest health management organization in Israel, manages all its medical data through computerized electronic files and has collected various types of health services data from 2018 to 2020. This paper compared the consumption of Meuhedet Health Services over two consecutive years of the pandemic using a real-world database. Method(s): Electronic medical records from primary care physicians, laboratory tests, hospitalization medical histories, treatments in hospitals and institutes, visits to and treatments by community physicians, and prescriptions and medical equipment consumption were collected from 2018 to 2020. This research used aggregated, non-personalized, and decoded data from a cohort of insured individuals, and the research was approved by all the relevant institutional Helsinki Committees. The data analysis compared the corresponding data in a chosen month of the year with the data in the same month of the previous year. The differences were then scaled by the data corresponding to the month of the previous year, and the result was multiplied by 100 and plotted. To analyze drug consumption, we used the fixed price of every drug in a year multiplied by the difference in consumption of the drug in question between the month of the current year and the same month of the previous year, multiplied by 100. Result(s): A significant decrease was noted in hospitalization days, general hospital outpatient clinic visits, general hospital emergency room visits, and total numbers of visits to community physicians during the first lockdown in the first wave of the pandemic in comparison to 2019. At the end of the lockdown, however, a compensatory increase was noted in all services. In terms of drug consumption, the data showed no differences in the effects of the different waves. Our findings revealed that the first wave of COVID-19 was a shock, with a significant reduction in the consumption of health services, but this decrease attenuated with the second wave due to immediate management interventions and safety rules implemented in hospitals and clinics. Conclusion(s): People shun medical services during a fast-spreading epidemic that causes significant mortality. Since new variants of COVID-19 could be part of our lives for the next few years, we should learn how to continue living with the pandemic and develop alternative medical services to maintain healthy states. Digitization, remote services, telemedicine, and home care, including home hospitalization, should be part of the health services to cope with pandemic situations.Copyright © 2023 Klang et al.

NEI Congress 2023

The proceedings contain 53 papers. The topics discussed include: clinical study of lurasidone combined with nutritional intervention strategy in the treatment of chronic schizophrenia;analysis of clinical medication scheme and nursing measures of acute stress disorder complicated with delirium under the COVID-19;a study on the mental state of prisoners near the end of their sentence caused by a psychological anxiety case;a clinical study on the effect of peperidone combined with cognitive behavioral therapy on symptoms of schizophrenia;the clinical effect of feedforward control nursing combined with methylphenidate sustained-release tablets on children with attention deficit hyperactivity disorder;study on the effect of community legal consciousness health management on cognitive function of senile patients;effects of special sports training on autonomic nervous regulation;a study of positive intervention of music therapy and neurofeedback on negative emotions and attention in college students;and alleviating effect of the geriatric care system integrating physical and psychological on the common mental problems of the elderly.

Expert Consensus on Rapid SARS-CoV-2 Antigen Testing.

The epidemic of the highly contagious, long lasting and widely popular coronavirus disease 2019 (COVID-19) has imposed a huge burden to the global public health. As one of the key methods for early diagnosis of COVID-19 infection, rapid acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen testing has been gradually applied in China. To address concerns raised by both health care workers and the public, based on the latest research and clinical practices, the Sub-committee of the Clinical Microbiology Laboratory of the Chinese Hospital Association proposed"Expert Consensus on Rapid SARS-CoV-2 Antigen Testing(2022)". The consensus panel is composed of experts from multiple disciplines, including laboratory medicine, clinical medicine, infection control, public health, research and development of in vitro diagnostic products. The consensus describes its principle, technological characteristics, results interpretation and, disposal recommendations, and analyzes the strategies and matters needing attention in different application scenarios. We expect the consensus to help correct understanding and application of rapid SARS-CoV-2 antigen testing in the diagnosis, treatment, prevention, and control of COVID-19.Copyright © 2022, Peking Union Medical College Hospital. All rights reserved.

Championing Nursing Workforce Through Innovative Dialogues and Collaborations

Cumulatively, it has had a hand in the great resignation, pushed hospitals profit margins into the nether regions, and reached into the ranks of nursing students, as well as their faculty, the academic workforce (Leaver et al., 2022). [...]the public, while grateful at least in the most difficult days of the pandemic, not only failed to translate these actions into strong policies that would result in much tangible change on a national level (Aiken et al., 2022), they have seemingly turned their own frustrations with health care delivery upon their former heroes, nurses themselves, resulting in episodes of nurse-directed assaults and violence, with an average of two nurses assaulted each hour in the United States (Press Ganey, 2022). According to Becker's Hospital Review (2022), an industry news source, "hospital margins are collapsing, and some organizations wonder if it's even possible to make money in the acute care space." Left unabated, shortages will result in patients receiving less face time with health care workers, lengthening current delays in diagnosis, reducing quality of care, burdening the health system (and patients) with our medical errors, and regretfully, increasing disparities and failure to adequately address social determinants of health.

How Health Systems Can Survive: The Case of Musculoskeletal Care

Healthcare represents 19.7% of the gross national product, making it one of the largest expenses for all U.S. companies. It crowds out investment for growth and is generally considered unsustainable. And the biggest cost is hospitals. Every manager has a vested interest in lowering the cost of care and increasing the viability of hospitals in their community. More than 10% of U.S. hospitals are at immediate risk of closing because of financial losses and lack of financial reserves. Over 70% of 900 hospitals surveyed reported a decrease in operating revenue over the last year. The COVID-19 pandemic provided momentum toward developing alternative deliveries of care, including virtual health, home, and outpatient care. This has created a rapid, massive shift away from hospital-based care. Perhaps the greatest risk is the largest opportunity-to find solutions to this financial crisis in the rapidly changing revenue dynamic of subspecialties, with musculoskeletal care being the prime example. Alternative sites of care and innovative care delivery are being financed by capital market investment. One solution to this crisis is for hospitals to collaborate with capital market-backed companies creating a novel business model.

Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People: A Topical Review and Recommendation

Background: Neurodivergence has been established as associated with a significant number of co-occurring physical conditions, particularly for autistic individuals who are at risk for increased pain, hypermobility (including Ehlers-Danlos Syndrome) and gastrointestinal problems. However, data, so far, has been focused on adults and generally limited to discussions of condition prevalence alone. Method(s): The following article will present a topical review of the literature considering evidence for increased physical health concerns within neurodivergent populations, particularly autistic individuals, with a focus on the impact that these physical health concerns may have in an educational setting. Results and discussion: The impact of physical health concerns within neurodivergent populations in an educational setting may be concerning. Such populations may face a range of challenges in obtaining appropriate support for physical conditions. We discuss a number of said challenges including;communication challenges, misattributing physical health symptoms as a part of neurodivergence, and a history of not being believed, which limits symptomatic reporting. We further consider the potential impact these physical health concerns may have on scholastic and social development, such as impacts for attainment and attendance. Furthermore, we provide recommendations for teachers, parents/carers and other allied professionals in young people's lives, on supporting young neurodivergent people with physical health concerns.Copyright © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

ANALYSIS OF SPECIALIZED CARE FOR PATIENTS WITH DIABETIC FOOT SYNDROME IN ST. PETERSBURG FOR 2010-2021.

BACKGROUND: A decrease in the frequency of amputations due to diabetic foot syndrome (DFS) is one of the parameters that determine the quality of medical care for patients with diabetes mellitus. AIM: Our aim was to study the indicators characterizing medical care for patients with lower limb pathology in diabetes mellitus in St. Petersburg from 2010 to 2021. MATERIALS AND METHODS: Annual reports on the treatment of patients with DFS in city hospitals specializing in the surgical treatment of DFS and in outpatient offices <<Diabetic foot>> (DFO) from 2010 to 2021 were analyzed. RESULT(S): The average number of patients per year admitted to the DFO was 18,527 (34,440 visits). Proportion of patients with foot ulcers - 8,9%, with Charcot's arthropathy - less than 1%. Before 2020, the frequency of above the foot amputations decreased from 48.3% to 8.6%, hospital mortality - from 11.7 to 5.7%, the number of revascularizations increased from 37 to 642 per year. The increase in operational activity was not accompanied by a decrease in the frequency of amputations (59.3% in 2019). Of all amputations, 11.3% were patients referred from DFO. During the epidemic, the number of visits and patients admitted to the DFO decreased by 27,3% and 31%, respectively. The proportion of foot ulcers and the frequency of amputations have not changed. Inpatient care was characterized by a decrease in operational activity, a decrease in the availability of revascularization, a 2-fold increase in the proportion of high amputations and an increase in hospital mortality from 5.7% in 2019 to 14.9% in 2021. CONCLUSION(S): An analysis of the statistics of specialized care for patients with DFS over 12 years showed the reduction of the frequency of high amputations, but revealed an increase in the frequency of surgical interventions in DFS against the background of an almost unchanged proportion of amputations in the structure of all operations. Despite significant quantitative indicators, the outpatient service seems to be insufficiently effective in reaching the target population. The negative impact of the epidemic has led to a significant increase in the frequency of high amputations and mortality.Copyright © Endocrinology Research Centre, 2022.

The prevalence of depression in staff nurses treating covid 19 patients working in a tertiary care hospital

INTRODUCTION. COVID 19 outbreak of the disease has put a lot of psychological pressure on Hospital staff who are in a direct contact with the patients. According to World Health Organization, among physical and mental illnesses, depression is one of the most common mental disorder in the world. Nursing out of all the other occupations ranked 27th amongst those prone for mental illness. During COVID-19 pandemic, the heavier workload and life-threatening condition of nurses aggravated the psychological pressure and were more at risk for after contacting with COVID-19 patients. Methodology: This cross-sectional study was conducted at tertiary care centre using convenience sampling after approval by Institutional ethics Committee. Tools used were ICD 10 for diagnosis, Patient Health Questionnaire (PHQ-9). Socio demographic factors and clinical variables were compiled using semi structured proforma. Result(s): Out of 150 nurses working in tertiary care hospital,74.7% (109)were females and 25.3%(38) were males of which 83% (125)were married and 14.7%(22) were single. 40.7% were diagnosed with minimal depression, 45.3% had mild depression,10.7% had moderate depression with 2% had moderately severe, 1.3% with severe depression. Conclusion(s): During the pandemic, nurses have worked under intense pressure, which has negatively affected their resilience and caused higher levels of depression. Awareness of health administration about the level of stress, anxiety, and depression and can help to provide psychological support programs for improving the mental health of nurses during the COVID-19 pandemic.

An optimization-based methodology equipped with lean tools to strengthen medical supply chain resilience during a pandemic: A case study from Turkey

Drawing upon economic and environmental sustainability, this study explores how developing the operational resilience of the medical supply chain (MSC) contributes to maintaining healthcare in the face of disruption risks, such as the COVID-19 pandemic. To this end, an optimization-based roadmap is proposed by employing lean tools to achieve and realize MSC resilience. A novel two-stage stochastic optimization model and robust counterpart are developed with the objective of overall cost minimization to cope with the unknowable demand uncertainty represented by scenarios. The reason behind proposing a scenario-based stochastic model is to implement preparedness strategies during the (re)design phase by making strategic and operational level decisions. That being the case, seven cases are generated based on the demand uncertainty intervals along with seven different reliability levels for sensitivity analysis. Computational experiments are conducted through a real case study to compare the centralized and decentralized distribution models in terms of efficiency and responsiveness. The results obtained by the stochastic model and robust counterpart are compared to demonstrate how strong the proposed model is. On top of that, lean tools are used to visualize and analyze the improvement opportunities to contribute to the methodology. By doing so, this paper presents novel theoretical and empirical insights regarding MSC resilience. The computational results emphasize the importance of employing a pre-disruption strategy via the proposed methodology to design a resilient MSC to be prepared for pandemic-related risk. The findings from the sensitivity analysis also verify that regardless of the disruption degree, the developed roadmap with the centralized distribution model leads to up to 40% improvements in terms of the overall cost, order lead time, emission amount, and inventory shortage metrics. © 2023 Elsevier Ltd

Pharmacists' Roles and Practices in Pharmaceutical Services During Covid-19 Pandemic: A Qualitative Study

The World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020. Pharmacists as health workers also play an important role in this pandemic. This study aims to dig deeper into how pharmacists perceive their role and pharmaceutical services during this pandemic through a qualitative study with Focus Group Discussions (FGDs). Fifteen pharmacists from The Riau Islands Province were involved in the study based on a purposive sampling technique. They were purposively selected to include a wide range of pharmacists from the community pharmacies, hospitals, and community health centers. The FGDs were conducted via recorded Zoom meetings. The collected data were then transcribed and analyzed with inductive content analysis. This study found five themes with 18 sub-themes. The five themes were the roles and efforts of pharmacists in managing medicines, medical devices, and disposable medical materials (personal protective equipment);the roles of pharmacists in providing pharmaceutical care;community behaviors during the pandemic;development of pharmacists' roles and capacity during the pandemic;and external factors influencing the roles and practice of pharmacists during the pandemic. During the pandemic, pharmacists continued to work according to their previous roles and adjusted their roles and practice in pharmaceutical services to follow changes in community behaviors. This condition also encouraged pharmacists to develop their roles and capacities. The healthcare management team, the government, and the professional organizations influenced their roles, both positively and negatively. The results of this study provide a deeper understanding of pharmacist roles and practices during the pandemic. This understanding will be useful for the pharmacist in developing their potential and capability to be involved as healthcare professionals, specifically during the pandemic situation and generally in disaster management.Copyright © 2022 by Indonesian Journal of Pharmacy (IJP).

Provider Financial Pressures Mount in 2023

All these factors led to disheartening headlines regarding health system losses, hospital closures, and even physicians leaving the profession.1 Additionally, as of November 2022, Becker's Hospital Review reported significant dips in cash on hand for multiple large health systems.2 Despite this decrease in cash, many large health systems still have healthy cash reserves. [...]there is some positive news for Medicare reimbursement through the final Outpatient Prospective Payment System (OPPS) rule released in late 2022. [...]one more item to monitor in 2023 will be the status of the Public Health Emergency (PHE) period declared during the COVID-19 pandemic.

Health management in care for the Indigenous and Afro-Peruvian population in the COVID-19 pandemic.

Objective: To determine the barriers in the management of health facilities that serve the indigenous and Afro-descendant population in Peru. Material(s) and Method(s): A virtual survey on health management was designed for first level health care personnel in 89 health facilities (EESS) in 27 provinces during October and November 2021. Result(s): In 73% of the EESS, the personnel reported not knowing the plan against the third pandemic wave, 14.8% of the EESS reported not being trained in the management of COVID-19, in 22.7% of the EESS they met to coordinate how to face the third pandemic wave, in 83% of the EESS the personnel reported not having a budget for their plan against COVID-19. Conclusion(s): There are barriers in the vision, management and budget in EESS that serve indigenous and Afro-Peruvian populations, which would affect the effective execution of strategies for the control of the pandemic by COVID-19.Copyright © Colegio Medico del Peru. All rights reserved.

The Balancing Act of Clinical Leadership: Lessons Learned from the COVID-19 Pandemic

The COVID-19 pandemic disrupted the world of leadership. Every healthcare professional-front-line staff and leaders alike-adapted their work to confront this virus. The contributions of clinical leaders during the COVID-19 pandemic are unique and important. Experiences of clinical leadership reinforce the critical nature of leadership strategy, quality improvement principles, and commitment to integrated, whole-system quality. Clinical leaders, possessing the dual responsibility of front-line care and system-level leadership, hold critical insights regarding change in healthcare organizations as a whole. In their pandemic response, clinical leaders demonstrated key leadership characteristics that required individual growth and facilitated team cohesion: communicating with consistency and humanity;being the first to try;attending to burnout and moral injury;and building bridges to strengthen the overall response. John Kotter's landmark book, Leading Change, provides an anchoring framework for examining the experiences and strategies of clinical leaders during the COVID-19 pandemic.