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Background. Large-scale construction of industrial and transport facilities is underway in the Far North of Russia. The process involves more than 10,000 shift workers, and there was a Covid19 outbreak in this population. In order to contain the outbreak and prevent the spread of infection in this area the Russian Emergencies Ministry deployed an airmobile hospital. Purpose. The purpose is to present an experience of work with the mobile CT scanner as part of an airmobile field hospital deployed in the Far North of Russia to combat the Covid-19 outbreak. Materials and methods. On April 6, 2020, the construction site reported a "zero patient" who sought medical aid;the PCR test showed positive results of coronavirus. In the first half of April, over 300 rotation employees applied for medical care, most of them had a positive PCR test. On April 11, a state of emergency was declared in the construction site and, on April 17, 2020, airmobile hospital started operations. Its mission lasted 54 days. The mobile CT scanner (Brightspeed Elite Mobile, GE) was transported by land. The field hospital closely cooperated with the nearest medical institutions and the regional clinical hospital. Results. During its work the airmobile hospital examined 1,678 rotational workers and 408 employees of the Ministry of Emergency Situations of the Murmansk region, with 2,086 CT scans performed. The average age of the patients was 37.8 years, men predominated. In 91.2% of patients, fever was the first symptom of the disease. Blood saturation results ranged from 92% to 99%. The degree of lung involvement ranged from CT 0 to CT 4. During the work of the airmobile hospital, COVID-19 was diagnosed in 500 people, including 328 cases of mild form, 98 - moderate, 74 - severe, no mortalities. Conclusion. A positive experience of application of the mobile CT scanner as part of the AMH field hospital in unfavorable epidemiological conditions of the Far North of the Russian Federation was obtained. CT plays a key role in early detection of infection, differential diagnosis, and identification of complications. Determination of the severity of the disease based on CT data is crucial for patient routing.Copyright © 2021 Medical Visualization. All rights reserved.
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OBJECTIVE: Field hospitals, also known as alternative care sites, have been an important healthcare reinforcement during the SARS-CoV-2 pandemic worldwide. In the Valencian Community, three of these hospitals were opened, one for each province. Our study aimed to make a comprehensive analysis of this resource in Castellon. METHODS: A retrospective observational study was carried out with an analytical and statistical component of 3 aspects: infrastructure, satisfaction and clinical data from COVID-positive hospitalized patients. The sources of information were primary, institutional for the infrastructure and personal for the satisfaction surveys and clinical data. RESULTS: A set of 6x3 metres polyvalent tents was chosen, which joined formed a single-floor area of about 3.500 m(2). Although hospital opened for approximately a year and a half with multiple uses, most in relation to the COVID pandemic (vaccination center, emergency room observation, hospital assistance, warehouse...), reception of positive patients for the virus began during the third wave of the pandemic, remaining active for eleven days. A total of thirty-one patients with a mean age of 56 years were admitted. 41.9% did not have any comorbidity and 54.8% needed treatment with oxygen therapy. Furthermore, the length of stay was three days, finding a significant relationship between this one, the oxygen flow required during admission and the age. Satisfaction was measured by a survey of seventeen questions where an average satisfaction of 8.33/10. CONCLUSIONS: This is one of the few studies in the literature in which a field hospital is analyzed from such different points of view. After this analysis, it is concluded that it is an extraordinary and temporary resource whose use is useful without reflecting an increase of morbidity/mortality among our patients and with a very favorable subjective assessment.
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Pandemic of a new coronavirus infection is accompanied by advanced need for emergency medical care in Russia. However, this process is hampered by state of roads and no electricity sources in some cases. Mobile medical complexes are able to compensate this need. These ones include feldsher obstetric stations, complexes for medical examination, specialized medical complexes (Thyromobil, Mammography, mobile Diabetes Center and others), as well as convoys with diagnostic equipment (mammography, magnetic resonance imaging, computed tomography) and fully equipped offices of various specialists (therapist, urologist, gynecologist, ophthalmologist, endocrinologist). However, spread of such medical complexes is currently difficult in Russia. The manuscript is based on the author's analysis of publicly available documents on the state and number of mobile medical complexes in Russia. Mobile hospitals are not used in all Russian regions. Nevertheless, there is a need for qualified preventive and therapeutic services, especially in the northern and mountainous regions of our country (Pskov, Arkhangelsk regions, the republics of Komi, Karelia, Dagestan and others). The authors analyzed current situation and experience of mobile medical complexes in the Novgorod, Rostov regions and the Republic of Tatarstan. Introduction of mobile hospitals in all Russian regions within the national health strategy will improve population health including working age people and reduce costs in health care system. Medical organizations cooperate with mobile hospitals to qualifiedly meet the needs of patients in diagnosis and treatment. However, projects of mobile medical complexes and their routine implementation in each region of our country are required. This is a priority task for the state and local health authorities of the Russian Federation.Copyright © R.N. ABDULLABEKOV, V.E. FEDORCHUK, T.V. MINNIKOVA.
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Background: In contrast to alarming reports of exhaustion and burnout amongst healthcare workers in the first wave of the COVID-19 pandemic, we noticed surprisingly positive staff experiences of working in a COVID-19 field hospital in South Africa. The 862-bed "Hospital of Hope" was established at the Cape Town International Convention Centre specifically to cope with the effects of the first wave of the COVID-19 pandemic in Cape Town. Methods: We aimed to systematically describe and assess the effects on staff and the local health system. A cross-sectional descriptive study design was employed using mixed methods including record reviews and interviews with key informants. Results: Quantitative results confirmed high job satisfaction and low staff infection rates. The emerging themes from the qualitative data are grouped around a "bull's eye" of the common purpose of person-centeredness, from both patient and staff perspectives, and include staff safety and support, rapid communication, continuous learning and adaptability, underpinned by excellent teamwork. The explanations for the positive feedback included good disaster planning, adequate resources, and an extraordinary responsiveness to the need. Conclusions: The "Hospital of Hope" staff experience produced valuable lessons for designing and managing routine health services outside of a disaster. The adaptability and responsiveness of the facility and its staff were largely a product of the unprecedented nature of the pandemic, but such approaches could benefit routine health services enormously, as individual hospitals and health facilities realize their place in a system that is "more than the sum of its parts".
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Pandemics caused a change in the health service delivery system. In disasters with massive injuries or epidemic, the capacity to admit the injured and infected patients to provide health services faces the challenges. Covid-19 virus is a respiratory disease that from its emergence until January 18, 2023, the Covid-19 virus has infected more than 672 million people worldwide. In most countries, makeshift hospital has been set up as intermediate medical centers to keep people who are likely to be carriers of the disease to control communicable diseases. Most makeshift hospitals already have alternative uses and, have changed into temporary or intermediate care centers. Based on the search of research team, any standard tools were found to assess the makeshift hospitals safety. All the safety assessment tools were related to the hospital, but since makeshift hospitals are mostly non-hospital structures, the research team has designed and validate a makeshift hospital safety assessment tool for the first time in this study. The present study is a mixed method that was conducted in 3 phases including; a document review, explaining the components affecting non-structural and functional safety of the makeshift hospital, designing makeshift hospital safety assessment tools and analyzing the results and validating it in 2022. Content validity and reliability were measured by CVR and CVI, ICC and Cronbach's alpha. In the fourth phase, with the participation of 15 specialists, managers, experts, qualitative and quantitative validity of content was done. Data were analyzed by SPSS version 21 software. The final tool contains 186 items and a 5-point Likert designed for very low safety (1), low safety (2), moderate safety (3), good safety (4), and very good safety (5). The scores of each makeshift hospital were calculated based on the items and the degree of safety. Cronbach's alpha coefficient for tool was 0.98. Retesting the questionnaire after two weeks confirmed the stability of tool (ICC = 0.98). The validity and reliability of this tool were confirmed with 186 items in 2 factors and 26 subcategories including risk of disaster, non-structural safety, safety of windows and shutters, hospital access, information and communication management, patient safety and hygiene and etc. All centers providing health services, whether temporarily or permanently, must have safety to continue their activities in disaster and maintain the safety and health of staff and inpatients. The makeshift hospital safety tool can be a suitable tool for assessing the risk and eliminating their vulnerabilities, and it can also provide important indicators for the design and set up of the makeshift hospital to policymakers and executives in the field of health.
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Introduction and Objectives: Limited healthcare access and resource inequities pose significant barriers to care, all of which have been amplified during the COVID-19 pandemic. DFUs represent an especially challenging medical problem to prevent and treat due to the resource intensive care required. We sought to evaluate the feasibility of multidisciplinary, mobile, DFU outreach clinics to improve access to care. Method(s): Our clinic model focused on creating mobile diabetic foot clinics staffed by volunteer clinical providers who specialize in Vascular Surgery, Diabetes, and Podiatry. We recruited volunteer healthcare providers from an academic medical center. We partnered with local community centers with established programs providing services to unhoused individuals. Result(s): Between June 2020 and August 2022, a total of 130 unhoused individuals were seen at four mobile clinics set up at different locations. Diabetic foot care was provided by volunteers from seven departments: Endocrinology/Diabetes, Vascular Surgery and Vascular Lab, Podiatry, Addiction Medicine, Smoking Cessation, and Financial. On average, 32 healthcare provider volunteers participated at each clinic. Services provided include: vitals, blood glucose, HgA1c, lipid panel testing, ankle-brachial index, podiatric exam, wound care, medical education, COVID vaccination/booster, insurance enrollment, and new socks and shoes. Of 130 unhoused patients, 29% had hypertension (38), 34% had abnormal ABI (44), and 14% had diabetes (18). Fifteen patients were further identified as high risk for developing DFU-associated amputation (12%) and were provided with ambulatory follow-ups. Conclusion(s): In our pilot experience, it is feasible to provide consistent comprehensive DFU care through mobile outreach clinics. By using the infrastructure of partner organizations and healthcare expertise of an academic center, our clinics could integrate into existing community services. [Formula presented]Copyright © 2022
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Since February 9th, 2020, the mobile CT in Jianghan mobile cabin hospital had begun to be used for scanning patients with COVID-19.The mobile CT has played an irreplaceable role in clinical diagnosis with its unique advantages. During CT scanning, the technicians should not only ensure that the patients receive the radiation dose as low as possible, but also be aware of the importance of the infection prevention and control. Meanwhile, we need concern the technicians about the psychological problems and should take effective action when they occured.Copyright © 2020 by the Chinese Medical Association.
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The objectives of this research are to explore dimensions of service quality and evaluate service quality expectations, perceptions and satisfactions of healthcare workers in a field hospital. Data were collected from 126 medical personnel who were caring for COVID-19 patients. The questionnaire was developed from guidelines for setting up field hospitals in Thailand. Exploratory Factor Analysis (EFA) extracted 7 dimensions, Service quality was analyzed with service gap analysis, Important Performance Analysis (IPA) and Priority nonconformity index (PNCI). The Gap analysis found that overall service quality was satisfactory. Infrastructure was a most satisfied dimension. Social responsibility was a most dissatisfaction. IPA showed logistics with risk management and administrative procedure were strength. The PNCI suggested to transfer resources from infrastructure medical service, occupational health and safety to improve personnel quality and social responsibility. © 2022 ACM.
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Introduction: Yale University designed and constructed a temporary field hospital for 100 COVID-19 symptomatic patients. Conservative biocontainment decisions were made in design and operational practices. Objectives of the field hospital included the safe flow of patients, staff, equipment and supplies, and obtaining approval by the Connecticut Department of Public Health (CT DPH) for opening as a field hospital. Methods: The CT DPH regulations for mobile hospitals were used as primary guidance for the design, equipment, and protocols. References for BSL-3 and ABSL-3 design from the National Institutes of Health (NIH) and Tuberculosis isolation rooms from the United States Centers for Disease Control and Prevention (CDC) were also utilized. The final design involved an array of experts throughout the university. Results and Conclusion: Vendors tested and certified all High Efficiency Particulate Air (HEPA) filters and balanced the airflows inside the field hospital. Yale Facilities designed and constructed positive pressure access and exit tents within the field hospital, established appropriate pressure relationships between zones, and added Minimum Efficiency Reporting Value 16 exhaust filters. The BioQuell ProteQ Hydrogen Peroxide decontamination unit was validated with biological spores in the rear sealed section of the biowaste tent. A ClorDiSys Flashbox UV-C Disinfection Chamber was also validated. Visual indicators were placed the doors of the pressurized tents and spaced throughout the facility to verify airflows. The plans created to design, construct and operate the field hospital provide a blueprint for recreating and reopening a field hospital in the future if ever needed at Yale University.
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Purpose: Exacerbated by the COVID-19 pandemic, adolescents from structurally marginalized communities face barriers to accessing sexual and reproductive health (SRH) care. Mobile health units (MHUs) may be effective in reaching these adolescents but few studies have assessed their feasibility in this population. Methods: We assessed the feasibility of an MHU to provide SRH care to adolescents in community settings. Adolescents were invited to community demonstrations of hypothetical MHU care ("Demonstration events”). Adolescents completed surveys (demographics, likelihood of future MHU-based care, and access to health care) and staff documented field notes. We then partnered with adolescents, health care providers, and community leaders to create adolescent-centered SRH care for MHU delivery ("Clinical events”). Free and confidential services provided on the MHU included contraceptive care, condoms, testing for pregnancy, Neisseria gonorrhea (GC), Chlamydia trachomatis (CT), Syphilis, and Human Immunodeficiency virus (HIV). Initially, we provided electronic prescriptions for contraception during MHU visits. We later designed a system to dispense contraception [I.e., emergency contraception (EC) for future use, combined hormonal oral contraceptives (CHOCs), patches and Medroxyprogesterone] in the MHU. After MHU care, adolescents completed surveys to report satisfaction while staff documented feedback through field notes. Results: At 8 community "Demonstration events”, 98 teens (mean age 15.8 years, 67% female at birth, 17% Genderfluid/Non-Binary/Trans, 49% heterosexual, 24% Hispanic, 49% Black, 40% White) were enrolled. Most (70%) reported no previous vaginal/penile sex. Many (46%) had forgone needed health care in the previous year. Most (77%) said they were very/somewhat likely to get care on the MHU if available in the future and 82% would recommend it to friends. Most thought the MHU would be a great way to increase access to SRH care because it eliminated transportation obstacles and appointment delays. Many felt the MHU would provide adequate privacy and advised bringing the MHU to school or community events. Teens recommended collecting urine specimens in nearby restrooms and using a brown bag to transport them to the MHU. Utilizing their feedback, we partnered with teen-serving community organizations and schools to host the MHU. At two "Clinical events”, we provided care for five patients (4 biologic females, 1 biologic male). Accepted health services included condom provision (n=5) and, pregnancy (n=3), GC/CT (n=4), and Syphilis/HIV (n=2) testing. Two MHU patients received contraceptive prescriptions, one received contraception onsite (EC and CHOCs), and one with a positive CT test was contacted and treated. Four adolescents completed a post-care survey. All (100%) were very satisfied with MHU care and said they would recommend it to a friend. All (100%) agreed/strongly agreed they learned something new about SRH and reported the information was helpful. Field notes revealed patients communicated appreciation for the care, felt comfortable on the MHU, and found school-based SRH care acceptable. We plan to host five additional MHU "Clinical events” (Fall 2022). Conclusions: As COVID-19 continues to negatively impact adolescent SRH care-seeking, our work offers key insights to customizing MHU-based SRH care to meet the unique needs of adolescents from structurally marginalized communities. Sources of Support: Institutional expansion of NIH-funded KL2 program (RB), 3R21HD098086-02S1 (MM), K23HD098299 (KM).
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BACKGROUND: Low-income and racially diverse populations often have multiple barriers in accessing healthcare and are at increased risk of poor health outcomes. COVID-19 exacerbated these health inequities: decreased in-person appointments, difficult access to virtual care and deprioritization of elective clinical activity led to delays in well-child visits and vaccination. This public health emergency highlighted a need to develop alternative models to enable access to primary care for vulnerable children. While mobile clinics are well-established in the United States, little is known about them in Canada. OBJECTIVE(S): This study aims to characterize Canadian mobile clinics providing primary care health services to vulnerable populations, including children, and seeks to inform the implementation of a pediatric mobile clinic under development. DESIGN/METHODS: This environmental scan screened scientific databases and the grey literature using a combination of terms designating mobile health clinics and Canadian locations. Relevant Canadian primary care mobile clinic initiatives were subsequently included. We defined primary care mobile clinics as movable health care units providing primary healthcare services delivered by general medical practitioners (pediatricians and family physicians). Examples of excluded initiatives were mobile clinics focused on education/literacy, dental care, vision care, endocrinology, cancer screening, safe injection sites, vaccination, physical rehabilitation and urgent care. Descriptive statistics and qualitative analysis were performed. RESULT(S): 29 clinics were identified, of which 26 are still active. Most clinics were located in Ontario (n=11), followed by British Columbia (n=8), Alberta (n=5), Quebec (n=2) and the Maritimes (n=2). The first mobile clinic in Canada was launched in 1996, with an increasing number of new clinics in 2021. While all clinics served vulnerable populations, some targeted specific groups, such as children, people experiencing homelessness, immigrants, LGBTQ+ individuals and Indigenous peoples. We identified three pediatric mobile clinics, two of which targeted teenagers. Onboard the clinics, physicians often worked with nurses, outreach workers and social workers. These professionals provided primary care services, as well as healthcare navigation, sexual education, mental health care, harm reduction supplies, vaccination and emergency care. All mobile clinics partnered with their local government, charities or businesses to fund their initiative. CONCLUSION(S): Mobile health clinics are a growing model of primary care in Canada. They are the result of a multidisciplinary collaboration between healthcare providers, social workers and outreach workers. To this date, Canadian pediatric mobile clinics remain a handful and represent an interesting avenue to address health inequities in children, during the pandemic and beyond.
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Recently, the pandemic of coronavirus 2019 (COVID-19) raised number of patients who needed hospitalization higher than the existing medical resources and personnel. An increase of hospital occupancy rate caused an inadequate availability of COVID-19 beds in sanatoriums, hospitals, or field hospitals. Inaccessible medical care caused patients to delay treatment. Thus, home isolation or self-quarantine was an option for reducing hospital workload for patients with mild symptoms. In addition, Pribta Clinic was established as a center for distributing drug to home isolation patients as fast and accurately as possible. Researchers had an opportunity to join as volunteers in the Pribta Clinic for care of home isolation patients and had seen some gaps in care. The exploration of workflow and gap analysis were planned and executed after the pandemic reduced in magnitude. The research team had conducted a logistics and supply chain management gap analysis of self-quarantine in Thailand in four perspectives that included Information management and information technology management, Material planning and inventory management, Distribution management, and Leadership and governance, reflected on the problems and barriers of home isolation services that required improvement for better administration. The research team would like to present a Strategic Policy Framework. It contains seven elements including supply allocation, supply network nodes, supply network links, inventory policy, IT infrastructure, logistics working group, and cost/budget plan for improving quality and effectiveness of home isolation services and satisfying the patient and medical personnel needs. Copyright © 2022 Medical Association of Thailand. All rights reserved.
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Introduction: Gastrointestinal manifestations are common during coronavirus disease (COVID-19) infection. They can occur before respiratory symptoms, resulting in a diagnostic delay and an increased risk of disease transmission. Aims & Methods: The current study reports major gastrointestinal manifestations as initial symptoms of COVID-19. This prospective, descriptive, cross-sectional, and single-center study of 713 cases was conducted in a field hospital over a 5-week period from June 21 to July 25, 2020. Result(s): The average age of our patients was 31.95 years. Clinically, on admission, anorexia was the main symptom, present in 32.3% of patients. Gastrointestinal manifestations were present in 14.9% of patients, including watery diarrhea in 8.6% of cases, nausea and/or vomiting in 4.6% of cases, and abdominal pain in 1.6% of cases. Six hundred thirty-two patients were treated in accordance with one of the two therapeutic protocols recommended by the National Ministry of Health. The treatment-related effects that occurred in 61.4% of patients were primarily digestive in 55.3% of cases. In multivariate analysis, following adjustment of the studied parameters, only the presence of gastroin- testinal manifestations (odds ratio [OR]: 1.478 confidence interval [CI]: 1.286-1.698;p < 0.001) and treat- ment side effects (OR = 1.069, CI: 1.020-1.119, p = 0.005) altered the rate of negative polymerase chain reaction (PCR) tests on day 10. Conclusion(s): Gastrointestinal manifestations are common during COVID- 19 and seem to be linked to a longer duration of disease. SARS-CoV-2 (the causative virus of COVID-19) can persist in the digestive tract, with the possibility of fecal-oral transmission. Therefore, hygiene is extremely important, espe- cially handwashing and strict precautions when performing gastrointestinal endoscopy and handling stools from infected patients.
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Background: Hospital capacity management has been one of the main public health problems in many countries during the COVID-19 outbreak. Field hospitals were developed as a means of taking care of patients with limited resource utilization. Objective: To demonstrate clinical presentations and treatment outcomes of patients infected with COVID-19 treated at a field hospital. Additionally, cost and utilization were also evaluated. Materials and Methods: The present study was a retrospective study. Data from the medical records of the patients diagnosed with COVID-19 admitted and discharged from a field hospital between April 2021 and June 2021 were reviewed. Clinical presentation, treatment outcomes, cost, and utilization were analyzed, classified by disease severity. Results: Seventy-two patients with a mean age (SD) of 30.2 (8.4) years were enrolled in the present study. Thirty-six patients (50.0%) were asymptomatic. Nasal congestion was the most common symptom of COVID-19 (30.6%). Patients with mild pneumonia had higher body mass index (BMI) and older age than asymptomatic cases, and symptomatic COVID-19 cases without pneumonia (p=0.014, 0.028, respectively). The two common final diagnoses were acute pharyngitis (27.8%) and pneumonia (26.4%). Asymptomatic pneumonia was found in 5.6%. The mortality rate was 0% in the field hospital. The average length of stay was 12 days, and the mean total cost of treatment was 48,396 THB per patient. The patients with mild pneumonia had significant higher total cost of treatment than asymptomatic cases and symptomatic COVID-19 cases without pneumonia. Conclusion: Field hospitals could be the most efficient option for taking care of COVID-19 patients when healthcare resources in hospital are limited. COVID-19 patients’ triage was important to determine the outcomes. Asymptomatic cases, symptomatic cases without pneumonia, and cases with mild pneumonia could be treated in a field hospital with cost-effective outcomes. © 2022 JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.
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Objectives: The objective of this study is to find the association between mortality and COVID-19 and risk factors among patients with acute liver injury. Materials and Methods: The research method uses a cross-sectional study design. The participants were COVID-19 patients with acute liver injury admitted in the Field hospital and Somdejphrajaotaksin Maharaj Hospital between 1 March 2020 and 30 September 2021. The data collected included patient's medical history and laboratory results. The analysis used was descriptive statistics and inferential statistics such as chi-square and multiple-logistic regression. Results: The results showed that the number of total participants was 806. Patients with advanced age (more than 60 years) (ORadj = 9.72;95%CI = 4.16-22.12), hypoalbuminemia (≤ 3.5 g/dl) (ORadj = 26.92;95%CI = 6.78-106.87), hepatitis (AST>40 U/L) (ORadj = 5.57;95%CI = 1.91-16.28) and those with a length of hospital stay of at least 7 days (ORadj = 0.13;95%CI = 0.03-0.50) showed a statistically significant association with death. Note that mortality showed the greatest effect size with hypoalbuminemia compared with other variables. The severity of coronavirus infection 2019 (mild, moderate to severe), ALT>40 U/L and ALP>126 U/L. It was found that there was no correlation to mortality with statistically significant. Conclusion: Therefore, the treatment for COVID-19 patients with acute liver injury should be prioritized for high risk patients, especially the elderly, patients with hypoalbuminemia (≤ 3.5 g/dl), hepatitis (AST>40 U/L) and patients with long admission days, relative to other patients, in order to prevent mortality. (Table Presented).
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STATEMENT OF PROBLEM/QUESTION: Even though they face a higher risk of COVID-19-related morbidity and mortality, racial and ethnic minorities in the Greater Boston area have had less access to COVID-19 testing and vaccinations. DESCRIPTION OF PROGRAM/INTERVENTION: We implemented a novel, community-based mobile health unit program by repurposing transportation vans with COVID-19 testing equipment, preventive hygiene kits, and mRNA vaccines. Our goal was to expand testing and vaccine availability in highly affected communities in the Greater Boston area. We used a “double equity” model by hiring workers from a local transportation company whose staff were at risk of unemployment. The vans were staffed with racially/ ethnically diverse and multilingual staff, including members of the target communities themselves. We incorporated a system of “trusted messengers” to answer questions about COVID-19 and in particular, vaccination from the community. We implemented this program with crucial input from community-based organizations and municipal public health departments. Van location sites were guided by community partners, in some cases incorporating SARS-CoV-2 wastewater surveillance data to meet rapidly changing community needs. MEASURES OF SUCCESS: Our goals were to (1) demonstrate the feasibility of a COVID-19 testing program guided by community partnerships and SARS-CoV-2 wastewater surveillance data;(2) improve access to COVID-19 testing in underserved communities;and (3) improve access to COVID-19 vaccination among racial/ethnic minorities. We collected ongoing feedback (e.g. through the local community advisory groups etc) on the mobile health program from community partners, patients, and staff. We compared sociodemographic characteristics of mobile health participants with the general population of the state of Massachusetts and the population of the target communities. FINDINGS TO DATE: From January 2021 - January 2022, our mobile health units have tested greater than 4500 persons in predominantly low socioeconomic communities that have been highly impacted by the pandemic. From May 2021 - January 2022, we vaccinated 5480 persons in these communities. An analysis of our program from January 2021 - January 2022 demonstrated that mobile health unit participants receiving COVID-19 vaccines were significantly more likely to be non-White and Hispanic compared with the general vaccinated population of the state of Massachusetts and of the target communities, and these findings were statistically significant. We also found that the mobile health units vaccinated more youth and adolescents in the target community compared with the general state vaccination data. KEY LESSONS FOR DISSEMINATION: Delivery of preventive COVID19 care via mobile health units is feasible and associated with high usage from affected communities when implemented with high stakeholder engagement and expertise from local public health departments. Employing diverse, multilingual, and well-trained healthcare staff as trusted messengers likely improved COVID-19 vaccine uptake in this population.
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Field hospitals were a great help in global pandemics and catastrophes such as earthquakes and the spread of airborne viruses. This study focused on the design of an interrupted oxygen supply since continuous oxygen provision for covid-19 patients is a huge problem facing field hospitals around the world, three methods to avoid any oxygen supply interruptions are discussed, where the outlet of the oxygen concentrator is lowered to 4.5 bar, and the outlet of the liquid oxygen vaporizer is regulated at 4.25 bar, and the outlet of the oxygen cylinders is set to 4 bars, a final one-way valve connecting the three lines of oxygen which are set to 4 bars. © 2022 IEEE.
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Background and importance Digital health is the concept that incorporates information and communication technologies into healthcare services. Nowadays, and favoured by the SARSCoV- 2 pandemic, hospital pharmacy has been forced to adopt digital technologies and tools to improve patient care. Aim and objectives If any area of hospital pharmacy has gained prominence in recent years, it is the area of digital health. Therefore, it was decided to analyse current clinical trials in relation to technological devices or wearables. Material and methods Descriptive study of current clinical trials on technological devices from the pharmacological aspect. The following filters were applied: active trials, devices in digital pharmacy, all phases, all ages and both sexes. The type of device was analysed as intervention, pathology, location, and study topic. Both observational and interventional studies were included. The tool used for evaluation was the ClinicalTrials. gov clinical trials registry. Results Nineteen current active phase clinical trials were analysed. The phases of the projects were: phase I-7, phase II-3, phase III-2 and phase IV-7. The main pathologies of the clinical trials were: musculoskeletal disorders (6), chronic obstructive pulmonary disease (3), Parkinson's neurodegenerative diseases (3), oncology (2), autism (1), renal system (1), cardiac system (1) and self-injection devices (1). The main countries conducting clinical trials were: United States (13), Europe (4), Asia (1) and Oceania (1). Seven projects were detected in the patient recruitment phase. Conclusion and relevance Although the use of wearables in the field of hospital pharmacy is a little known topic, it is increasingly gaining prominence in the literature and in scientific research. Digital health is the driver of change towards new models of care between patients and healthcare professionals. Therefore, it is necessary to continue with research and clinical trials to promote digitisation in hospital pharmacy.