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Introduction: The COVID-19 pandemic forced oncology nurses to deliver more consultations by telephone (teleconsultations). Nurses in Switzerland are in general not trained to provide teleconsultations, making this change of practice a considerable challenge. The Academic Society Oncology Nursing invited health care professionals to webinars in French and German to discuss their experiences related to COVID-19 policies. Method(s): Members of the Academic Society searched for international guidelines and already implemented digital tools to facilitate teleconsulta-tions in oncological settings. Overall, ten national and international health care experts including nurses, an oncologist, and an expert for telephone consultations participated at two webinars. The same outline was used in French and German and both webinars were video recorded. Result(s): COVID-19 pandemic policies drove an increase in teleconsulta-tions. Guidelines for telephone triage from the Oncology Nursing Society (ONS) in the USA and in the UK (UKONS) incorporated procedures to assess COVID-19 symptoms and to defne patient referrals based on local health system capacities. In France, the Gustave Roussy Institute created the CAPRI-COVID program to facilitate the remote monitoring of cancer patients during the COVID-19 pandemic. In Switzerland, nurses used local guidelines implemented for follow-up consultations by telephone to support cancer patient adherence to treatment and to assess symptom trajectories, to structure their teleconsultations. The assessment of COVID-19 symptoms was not always included. The sudden change to support patients remotely was challenging when no guidelines or standards for this kind of support were already in place. Documenting tele-consultations was difcult when no electronic documentation system was implemented. The reimbursement of nursing teleconsultations was a major, important barrier nurses faced, leading to unpaid provided services. Conclusion(s): The federal health system in Switzerland has provided no national recommendations for nursing teleconsultations. However, ONS and UKONS guidelines could inform the development of evidence based recommendations for oncology nursing teleconsultations in Switzerland. The Academic Society Oncology Nursing will take an initiative to discuss reimbursement of nursing teleconsultations with Swiss stakeholders including health care professionals and policy makers.
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The proceedings contain 27 papers. The topics discussed include: 'I can go in and get freshies because it is healthy for you and makes you feel better': the increasing Aboriginal peoples' use of services that reduce harms from illicit drugs project;older women's experiences of sex work in Queensland, pre- and post-COVID-19;learning in the time of COVID-19: adapting sexual health workforce education to the online environment;enteric and sexually acquired pathogens in men who have sex with men with clinical proctitis;oral and anal t. pallidum detection in men who have sex with men with early infectious syphilis: a cross-sectional study;antiseptic mouthwash for gonorrhea prevention (OMEGA): a randomized, double-blind, parallel-group, multicenter trial;incidence and duration of incident oropharyngeal gonorrhea and chlamydia infections among men who have sex with men: a prospective cohort study;and Goanna Survey 2: the second national sexual health survey for Aboriginal and Torres Strait Islander young people.
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The world is restoring life balance after the global Covid-19 pandemic. This situation, giving birth to new problems, arose as an outcome of pre-and post pandemic scenarios. Healthcare system was under tremendous burden during this pandemic. Government bodies, scientists, drug discovery and drug registration were working in cooperation to fight the situation and to save lives. Out of all such activities, one healthcare domain is a key player, and that is the radiological department of hospitals. As discovery made those Covid-19 effects on lungs, the pressure on CT scan activities rose. To generate a CT scan quickly and to diagnose lung condition is the need of hour. Furthermore, that became a challenge for early detection of lung conditions. Hence, this paper presents the proposed research to develop iterative techniques using deep learning computation. Paper presents the proposed lung image acquisition and augmentation algorithm developed using a convolution neural network named "AquiCNN". This proposed algorithm will be useful for quick and enhanced lung CT image analysis. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Health is an essential issue in all countries. It has further come into limelight on account of covid pandemic. Under the global impact of Covid pandemic public investment in health care is in the centre stage of discussion in recent past. This empirical study has attempted to understand the impact of public health care system under Government investment through the model of Fair price shop (FPS) situated in the government hospitals in West Bengal. Catastrophic Health Expenditure (CHE) has further augmented the burden of income in the most of the house hold ion India under the deadliest impact of Covid. This study has found the Public-private-partnership (PPP) model is the robust application in reducing the burden of the lower-level income group in terms of health-related expenditure. Accessibility of medical care has created an substantial impact on middle class and lower middle class people in West Bengal with the introduction of Fare Price Shop (FPS) initiated by Government of West Bengal. This empirical research has proposed a model to makes health care more accessible among mass section of beneficiaries in order to makes a social inclusion for health care. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Digital technology innovation is believed to increase the effectiveness of the health system's response to epidemics. Some of the potential benefits of mobile Health (mHealth) appli-cations for managing the coronavirus 2019 (COVID-19) pandemic have been explored. This study aimed to determine the trend of using mobile health applications during the COVID-19 pandemic in Surakarta, Central Java. Subjects and Method: This study was descriptive study conducted in Surakarta, Central Java, from February to August 2021. A sample of 184 subjects aged 15 to 64 years was selected in this study. Data were collected using a questionnaire through an online survey. Data were presented in descriptive-analytical form based on the characteristics of gender, age, occupation, and education.
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Background. While numerous, most described cases of myocarditis and pericarditis following COVID-19 vaccination are mild and self-limited. We present two cases of life-threatening cardiac tamponade following COVID-19 vaccination. Methods. Two cases of cardiac tamponade in temporal association with COVID-19 vaccination were reviewed Results. Case 1: 75-year-old male with rheumatoid arthritis admitted with chest pressure and hypotension 2 days after his 1st dose of Pfizer-BioNTech COVID-19 vaccine. Pericardiocentesis removed 275 ml of exudative effusion with 14,140 nucleated cells/ml. Fluid bacterial and fungal cultures were negative;cytology was inconsistent with malignancy. He had no Epstein-Barr virus (EBV) or cytomegalovirus (CMV) viremia. Symptoms resolved on prednisone and colchicine. A week later, he had an uneventful second COVID-19 vaccine. He went on to have 3 recurrences of pericarditis starting two months after his first. One was within 48 hours of his COVID-19 booster. He is on long term prednisone. Case 2: 66-year-old male with non-Hodgkin's lymphoma in remission. He developed chest pain a day after his 2nd dose of Pfizer-BioNTech COVID-19 vaccine. Admitted 4 days later with pericardial effusion and managed medically. Readmitted a week later with fever and chest pain. Echocardiogram now showed cardiac tamponade. Pericardiocentesis removed 400 ml of exudative fluid with 1,191 nucleated cells/mL. Cultures for bacteria, fungi, and mycobacteria were negative. Cytology didn't show malignancy. Serologies for CMV, EBV and parvovirus represented past infection. He was discharged with a pericardial drain, colchicine, and NSAIDs. He was later readmitted with fevers. Echocardiogram only showed small pericardial effusion, which did not require drainage. Figure 1 Circumferential pericardial effusion seen on trans-thoracic echocardiography from patient in case 1. Conclusion. Given the proximity to COVID-19 vaccination and lack of alternative explanations, we believe that tamponade was a direct result of post-vaccine inflammatory pericarditis. Neither patient had a prior history of pericardial effusion. Both tested negative for SARS-CoV-2 by nasopharyngeal swab excluding active infection. Healthcare providers should consider the possibility of pericardial effusion and tamponade in patients with chest pain, shortness of breath, or hypotension following COVID-19 vaccination.
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Background. Sotrovimab, a monoclonal antibody (mAb), received Emergency Use Authorization (EUA) for the treatment of high-risk outpatients with symptomatic COVID-19. The study objective was to evaluate real-world effectiveness of sotrovimab (500 mg intravenous) in reducing the risk of mortality or hospitalization during the SARS-CoV-2 Delta and initial Omicron variant waves in the US. Methods. A retrospective analysis was conducted of de-identified patients (pts) diagnosed with COVID-19 (ICD-10: U07.1) from 9/1/2021 to 2/28/2022 in the FAIR Health FH NPIC claims database. Pts were divided into 2 cohorts based on HCPCS codes: treated with sotrovimab and not treated with any mAb (no mAb). Pts meeting EUA high-risk criteria were identified via pre-specified ICD-10-CM diagnoses in records <= 24 months prior to their first COVID-19 diagnosis (index date). Facility-reported mortality (referred to as 'mortality'), all cause hospitalizations and intensive care unit (ICU) admissions within 30 days of index were identified. Chi-square test, ANOVA, or t-tests were performed to statistically compare cohorts at a 0.05 level of significance (2-sided). P-values were not adjusted for multiplicity. Multivariable logistic regression was conducted to estimate the risk of mortality or hospitalization within 30 days, adjusting for demographic and clinical factors. Results. Of the high-risk COVID-19 pts identified, 13,140 were treated with sotrovimab and 1,283,284 received no mAb therapy. Compared to the no mAb cohort, the sotrovimab cohort was older, had more baseline conditions, and were more likely to be female (all p < 0.0001). In the no mAb cohort, 0.59% died and 5.74% were hospitalized (of whom 30% in ICU). In the sotrovimab cohort, 0.08% died and 2.50% were hospitalized (of whom 15% in ICU). After adjusting for potential confounders, treatment with sotrovimab was associated with 83% reduced odds of 30-day mortality (OR: 0.17, 95% CI: 0.09-0.31) and 61% reduced odds of 30-day hospitalization or mortality (OR: 0.39, 95% CI: 0.35-0.43) among high-risk COVID-19 pts. Conclusion. In this US real-world observational study of high-risk COVID-19 pts during the Delta and initial Omicron waves, treatment with sotrovimab was associated with reduced odds of mortality and hospitalization compared to no mAb treatment.
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Introduction: Coronavirus Disease 2019 has prompted widespread school closures and physical distancing measures. Concerns regarding COVID-19 school closures often increase stress levels in parents. Objective(s): This study examined whether higher levels of parental concerns were associated with children's problematic behaviors and other factors during COVID-19-related primary school closures. Method(s): Participants were 217 parents who responded to a webbased questionnaire covering parental concerns, subjective stress, and depression;children's sleep patterns, behavioral problems, and changes in activity level after COVID-19;previously received mental health services;and media usage during the online-only class period from community center in Suwon city. Result(s): The number of parental concerns was associated with children's behavioral problem index (BPI) score (Pearson correlation 0.211, p < 0.01), sleep problems (0.183, p < 0.01), increased smartphone usage (0.166, p < 0.05), increased TV usage (0.187, p < 0.01), parents' subjective stress levels (0.168, p < 0.05), and parental depression (0.200, p < 0.01). In families with children who previously received mental health services, the children reportedly suffered from more sleep and behavioral problems but not increased media usage, and parents noted more stress and depression. Parental concerns are related to family factors such as change of caregiver, no available caregiver, decreased household income, and recent adverse life events. Economically vulnerable people also reported higher rates of reported caregiver burden during COVID-19-related primary school closures, thus will require the potential heightened mental health needs. Conclusion(s): Ongoing monitoring of mental health at risky group and multiple support systems should be considered for parents having difficulty in caring their children.
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Introduction: COVID-19 had direct and indirect impacts on both mental health and healthcare systems. Evaluating urgent psychiatric consultations may be useful to determine the effects of COVID-19 pandemic since it reflects the condition of psychiatric patients and healthcare systems Objectives: This study aims to determine the quantitative or qualitative changes in emergency psychiatry consultations after COVID- 19 pandemic. Method(s): The socio-demographic characteristics and clinical features of two hundred thirty three patients were retrospectively collected and analyzed in order to compare the emergency psychiatry consultations before (between the dates 11th of March 2019- 10th of March 2020) and after (between 11th of March 2020-10th of March 2021) the COVID-19 pandemic. Result(s): The ratio of patients consulted to psychiatry to total emergency department increase after pandemic (%0.03 vs %0.07). Among these patients, the diagnosis of 'alcohol and substance use disorder' (%6.1 vs. %15.4) (p=0.03) increased while the diagnoses of 'obsessive compulsive disorder (5.3% vs. 0%)(p=0.01) and bipolar disorder (%21.1 vs. %20.5) (p=0.02) decreased. Hostility among patient during consultation increased (%19.1 vs. %30.8)(p=0.04). Suicidal thoughts decreased (%25.2 vs. %14.5) (p=0.04). Furthermore, voluntary inpatient treatment (%20.9-%34.2) (p =0.02) increased, transfer to another clinic (%25.2 vs. %12) (p=0.01) and outpatient treatment (%46.1 vs. %42.7) (p=0.01) decreased. An increase in oral treatments (%10.4 vs. %26.5) (p=0.02) and decrease in parenteral treatments (%71.3 vs. 54.7) ( p=0.01) were also reported. Conclusion(s): Our findings confirmed that after COVID-19 spread the clinical features diagnosis, and treatment modality have changed among urgent psychiatric consultations.
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Introduction: The Covid-19 pandemic has brought with it farreaching consequences that affect the mental health of a significant population. Those suffering from somatic symptom disorder (SSD) present a significant focus on physical symptoms, with excessive thoughts and behaviours, to an extent that results in major distress and dysfunction. Aggravation of SSD could be associated with various stressors, including the current pandemic, and culminate in an increased severity of the base presentation. Objective(s): The authors present the case of an elderly man with previous diagnosis of SSD which began to aggravate and evolve into a depressive psychotic state, precipitated by the beginning of the Covid-19 pandemic. Method(s): The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question as well as presenting a clinical case as compliment. Result(s): With the pandemic overwhelming the globe, the literature has demonstrated a significant correlation with aggravation of mental health and psychiatric cases. The patient in question was previously followed in consultation for SSD. With the pandemic acting as precipitating stressor, the patient demonstrated a significant aggravation in his base presentation with the development of psychotic depression. He was subsequently hospitalized with implementation of psychotherapeutic and psychopharmacological methods, with remission of the psychotic state, with poor response of the SSD. Conclusion(s): External stressors are an important influence on psychiatric disorders. Whenever potential life stressors, especially those that exert influence on a global scale, the psychiatrist should be attentive to the possibility of significant aggravation of a stabilized clinical picture and offer support.
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George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
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BACKGROUND: Lower limb ulceration is a common cause of suffering in patients and its management poses a significant burden on the NHS, with venous leg ulcers (VLUs) being the most common hard-to-heal wound in the UK. It is estimated that over one million patients in the UK have lower limb ulceration, of which 560,000 were categorised as VLUs, with a cost burden of over £3 billion each year. OBJECTIVE: The aim of this service evaluation was to assess the effects of implementing a self-care delivery model on clinical outcomes with the intention of limiting face-to-face health professional contact to one appointment every 6 weeks. METHOD: A suitability assessment was conducted and a cohort of patients were moved to a self-care delivery model. Patient data were collected, anonymised and independently analysed, comparing time to healing against data on file from a previous report. RESULTS: This highlighted that, in 84 of the 95 patients selected, the VLUs had healed by week 24 on the pathway, a further 10 patients' VLUs had healed by week 42 and only one remaining patient reached 42 weeks without healing. CONCLUSION: These results support the hypothesis that patients with VLUs can self-care and deliver clinical effectiveness. It is recommended that all services explore the possibility of introducing a self-care model for VLU care.
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Leg Ulcer , Varicose Ulcer , Cost-Benefit Analysis , Humans , Leg Ulcer/therapy , Self Care , Varicose Ulcer/therapy , Wound HealingABSTRACT
OBJECTIVE: Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients. METHOD: A retrospective review was performed to identify patients 18 years of age or younger referred for HBOT during 2020. Patient characteristics, referral indications and HBOT complications were collected. Changes implemented to the HBOT centre to accommodate the treatment of paediatric patients were documented. RESULTS: A total of seven paediatric patients were evaluated for HBOT and six were treated. The mean patient age was four years (range: 1-11 years). Referral diagnoses included sudden sensorineural hearing loss, skin flap or graft compromise, and radiation-induced soft tissue necrosis. All patients tolerated HBOT treatment in monoplace chambers without significant complications noted. Enhancements made to our clinical practice to facilitate the safe and effective treatment of paediatric patients included ensuring the availability of acceptable garments for paediatric patients, maintaining uninterrupted patient grounding (in relation to fire safety), and enhancing social support for anxiety reduction. CONCLUSION: The results of our review show that paediatric patients can be safely treated within the monoplace hyperbaric environment.
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COVID-19 , Hyperbaric Oxygenation , Child , Child, Preschool , Humans , Infant , Pandemics , Retrospective Studies , SARS-CoV-2ABSTRACT
OBJECTIVE: In light of the COVID-19 pandemic, which has resulted in changes to caseload management, access to training and education, and other additional pressures, a survey was developed to understand current awareness and implementation of the wound hygiene concept into practice one year on from its dissemination. Barriers to implementation and outcomes were also surveyed. METHOD: The 26-question survey, a mixture of multiple choice and free-text, was developed by the Journal of Wound Care projects team, in consultation with ConvaTec, and distributed globally via email and online; the survey was open for just over 12 weeks. Due to the exploratory nature of the research, non-probability sampling was used. The authors reviewed the outputs of the survey to draw conclusions from the data, with the support of a medical writer. RESULTS: There were 1478 respondents who agreed to the use of their anonymised aggregated data. Nearly 90% were from the US or UK, and the majority worked in wound care specialist roles, equally distributed between community and acute care settings; 66.6% had been in wound care for more than 8 years. The respondents work across the spectrum of wound types. More than half (57.4%) had heard of the concept of wound hygiene, of whom 75.3% have implemented it; 78.7% answered that they 'always' apply wound hygiene and 20.8% 'sometimes' do so. The top three barriers to adoption were confidence (39.0%), the desire for more research (25.7%) and competence (24.8%). Overall, following implementation of wound hygiene, 80.3% reported that their patients' healing rates had improved. CONCLUSION: Respondents strongly agreed that implementing wound hygiene is a successful approach for biofilm management and a critical component for improving wound healing rates in hard-to-heal wounds. However, the barriers to its uptake and implementation demonstrate that comprehensive education and training, institutional support for policy and protocol changes, and more clinical research are needed to support wound hygiene.