Overview of the Healthcare Systems of the Maghreb Countries: Issues and Progress

Objectives: To provide an update overview on the current status of healthcare systems in the Maghreb region (Algeria, Morocco, and Tunisia) and to emphasize the progress made in the midst of the challenges facing these countries. Method(s): A descriptive comparative approach of healthcare systems in the three countries, based on data from sources with an established methodology, including descriptive healthcare data from the WHO database. Result(s): The population of the Maghreb will increase from 102 million to 132 million by 2050. The current population is mostly centered in Algeria and Morocco, accounting for 77%. Annual healthcare expenditure per capita is 447.9$, 776.8$ and 854.6$ in Morocco, Tunisia and Algeria, respectively. The average infant mortality rate per 1000 live improved to 10.9 in Tunisia, 16.8 in Morocco and 18.9 in Algeria. Maternal mortality rates have dropped to 43 and 48.5/100 000 births in Tunisia and Algeria, respectively while remaining relatively high in Morocco: 72.6. Number of hospital beds/1000 inhabitants is only 1.1 in Morocco, 1.9 and 2.9 in Algeria and Tunisia, respectively. The number of physicians/1000 people was 0.73 in Morocco, 1.3 in Tunisia and 1.72 in Algeria. This remains considerably low compared to the 3.9/1000 in Europe. The Maghreb countries are currently facing an exodus of physicians, mainly to France, which represents 7.1% and 10.7% of Tunisians and Moroccans, respectively, and more than 24% for Algerians. The Maghreb countries were very early mobilized (governments, ministries of health, civil society) to fight against COVID-19 and have successfully controlled the pandemic, according to pre-established control strategies and the strongly commitment of health professional. Conclusion(s): Despite the considerable progress made, the Maghreb countries still face major challenges. Physicians migration, rising cost of care and endemic infectious disease outbreaks constitute a huge hurdle on the already overburdened and resilient healthcare systems.Copyright © 2023

Vaccination status of the adult sickle cell anaemia population: The South Wales experience

The Sickle Cell Society have issued standards for additional immunisations that adults with sickle cell disease (SCD) require. These include annual influenza, 5-yearly pneumococcal conjugate vaccine (PPV23) and Hepatitis B vaccination. Patients who have not received their primary vaccination as part of the national schedule in the UK should also receive further additional vaccines. We reviewed whether adults with SCD in South Wales currently receive these. 49 adult patients were identified as having SCD under the care of the Hereditary Anaemia Service based in the University Hospital of Wales, Cardiff. GP records were not available for 5 patients leaving a final cohort of 44 patients to analyse. Average age was 33 years (range 17-67). Median age was 27 with the cohort predominantly lying in the 17-29 year category (52%). Results showed good compliance with the annual influenza vaccine in those over 40 (>80%). However, compliance for the 17-29 category and 30-39 categories were 37.5% and 42.8%, respectively. The improved compliance in those >40 was not seen with the 5-yearly pneumococcal vaccine. Compliance was worse in all age groups compared to the annual flu vaccine with only 23% compliance overall. However, when looking at those who had received a single dose of PPV23, the numbers improved to nearly 60%. Compliance with the SARS-CoV2 vaccination was highest at 61.3%. However, rates were lower in the 17-29 and 30-39 age groups in keeping with previous trends. Only 34.1% of patients had full hepatitis B cover. Again, trends in compliance mirrored previous with poorer rates in those under 40. Assessing compliance for the remainder of the standards was more challenging given that we could not confirm retrospectively how many of our cohort had received their primary vaccinations in other parts of the UK, thought to be around half. However, most of the cohort had not received any additional vaccines suggesting high non-compliance regardless. This review looked at data from 2020 and likely reflects the impact of the SARS-CoV2, whether positive or negative. The reduced compliance in 5-yearly pneumococcal compared to flu suggest better health-professional education is needed;if patients are attending for their annual flu vaccine, there is ample opportunity to administer other vaccines. The vaccination rate for our patient group is comparable to national rates by ethnicity although lower than the national average for age. Vaccination rates for the SCD population of South Wales are not adequate. Better education and engagement is needed.

Assessing frailty in care practices: quick reminders in the light of the Covid-19 pandemic.

The Covid-19 pandemic has brought the concept of frailty back to the centre of debate, particularly for its relevance as a determinant of health outcomes. Frailty is concept that has long been a used gerontology. Today, several theoretical models of frailty are proposed in the literature, with as many tools to operationalize it. This article provides a brief outline of the three main models of frailty and the corresponding measurement instruments. The choice of the model as well as the choice of the assessment tool are discussed in the light of the clinical objectives pursued by health professionals. More generally, this article highlights the value of assessing frailty in routine practice to determine health outcomes and adapt care to individual needs.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.

Girft in Action: Advanced Practice Physiotherapist and Advanced Practice Nurse Expertise Provides Valuable Triage and Assessment Clinics for Non-Urgent Rheumatology Referrals

Background/Aims Rheumatology referrals classified as non-urgent/routine are commonly non-inflammatory conditions or medically non-urgent and can have significant waiting times for appointments. These waits were further escalated by the COVID-19 pandemic. Early intervention for noninflammatory conditions can be crucial to good outcomes and long wait-times can have significant adverse impacts while appropriate care pathways are determined. Recent UK GIRFT recommendations include using non-medical health professional expertise in assessment and management pathways to support right place, right time, right care. This study evaluated effectiveness, impacts and patient experiences of Advanced Practice Physiotherapist (APP) and Advanced Practice Nurse (APN) Triage and Assessment Clinics for routine new referrals. Methods The non-urgent/routine referral waiting list was e-triaged by a Rheumatology APP and APN supported by clinical record searches. Patients were contacted by telephone to update on clinical status and appointment requirements determined. Triage criteria were applied to determine new referrals suitable for APP and APN Rheumatology clinics, which included low likelihood of inflammatory disease or new referrals for known diagnosis/stable conditions. Clinics were undertaken with collocated Consultant clinical supervision. Assessment findings were discussed and management agreed, or seen if needed. With waiting list attrition, clinics were expanded to include Consultantdetermined stable condition reviews and follow-up reviews for nonsuspected inflammatory disease. Results At 01 July 2021, 214 new routine referrals were waiting a Consultant appointment (n=103 over 2yrs). Since service initiation, clinic outcomes to date include: 69% (n=243/358) new routine referrals discharged to GP or directed to right pathway with information, advice and self-management resources;8% (n=29) escalated to urgent;3% (11/358) with medical complexity remained on Consultant waitlist. Most common presentations seen included: Osteoarthritis (general or hand);Back and other spinal pain;Fibromyalgia;Persistent Fatigue and Widespread Pain;JHS/hEDS;Positive ANA without clinical features;Musculoskeletal conditions- other. To date, no patients have been re-referred and 329 new patient and 89 follow-up Consultant direct consultations have been spared. There is currently no wait-time for non-urgent/routine appointments. Patient experience feedback on the service has offered a 100% recommendation to continue and expressed highly positive experiences with the MDT approach. Patients value the breadth of expertise and care support, and the timely, thorough and professional service provided. Conclusion Rheumatology non-urgent/routine new referrals with low probability of underlying autoimmune conditions may be effectively and efficiently managed in a collaborative model using an advanced practice physiotherapist and nurse. This innovation has expanded a traditionally medical pathway to an MDT model utilising value-adding nonmedical expertise in service delivery. It has enhanced interdisciplinary learning and is a valued, collaborative approach to patient care. The initiative provides support to GIRFT recommendations of using an MDT skill-set to support improved patient access, service efficiencies and earlier intervention.

Consensus of Chinese experts on the work and demonstration of online Balint groups working committee on doctor-patient relationship, Chinese psychiatrist association, Chinese medical doctor association.

Balint group helps health professionals to get emotional support and different perspectives of feedback, inspire reflection, and alleviate job burnout. During the outbreak of COVID-19, it was difficult for medical staff to carry out the traditional form of in person Balint group. Referring to the work of international pilot online Balint group, leaders of Balint group all over China have accumulated some experience and encountered new problems by using the internet to carry out discussion. In order to assist and standardize the work of online Balint group and enrich the ways of expanding Balint work, the Working Committee on Doctor-patient Relationship, Chinese Psychiatrist Association, Chinese Medical Doctor Association organized experts to have two rounds of discussion, and developed the consensus on: Principles and forms of online Balint group, the way of using web platforms for demonstration and learning, matters needing attention, the future development, and so on.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

Virtual spirometry training is comparable to face-to-face training learning outcomes

Introduction: In response to COVID-19 restrictions, the Queensland Health Spirometry Training Program initiated virtual (V) workshops, as an alternative to face-to-face (F2F) training. The program included online pre-reading, a practical skills workshop (V or F2F), and a post-workshop workplace portfolio assessment. The aims of this study were to compare F2F and virtual training (1) portfolio assessment outcomes, and (2) post-workshop confidence with spirometry practice. Method(s): (1) Between 2019 and 2022, health practitioners (HP) who attended F2F or virtual workshops submitted a post-workshop workplace portfolio. The portfolio spirometry reports were assessed against the ATS/ERS spirometry standards (Graham et al., 2019). Three spirometry trials in each report were scored for acceptability criteria: fast start of test (SOT 1), start of test sharp peak (SOT 2), middle of test (MOT) and end of forced expiration (EOFE). Repeatability criteria (FEV 1 and FVC), technical comments and interpretation were also assessed. Mean scores for each criterion were compared between F2F and virtual workshop portfolio tests, using univariable linear regression analysis. (2) After F2F or virtual training, participants rated their confidence levels with spirometry performance, understanding the test, and quality assurance, using a 5-point Likert scale (very confident to not confident). Result(s): 138 HPs attended either F2F or virtual workshops and 62 portfolios were assessed. There were no significant differences (all p values >0.05) in the portfolio scores between F2F (n = 30) and virtual (n = 32) training for spirometry acceptability, repeatability, and reporting criteria. Post-workshop confidence levels with spirometry performance, understanding the test, and quality assurance were not significantly different (all p values >0.05) between the two training formats (n = 138). Comparison of scores between F2F (n = 30) versus V (n = 32) Scoring criteria Maximal score Mean difference 95% CI p value Acceptability SOT 1 3 0.014 -0.130 0.158 0.848 SOT 2 3 -0.023 -0.169 0.124 0.758 MOT 3 -0.024 -0.162 0.114 0.731 EOFE 3 0.053 -0.038 0.143 0.250 Repeatability FEV 1 1 0.039 -0.009 0.087 0.111 FVC 1 0.024 -0.035 0.084 0.421 Reporting Comments 2 0.019 -0.175 0.213 0.846 Interpretation 1 0.059 -0.009 0.127 0.087 Conclusion(s): This study provides confidence that the virtual spirometry training did not significantly impact learning outcomes compared with the F2F format.

A Novel Approach to Practice-Based Learning for Students in Allied Health Professions

Background The cancellation of placements due to the pandemic had a huge impact on the provision of clinical placements for Allied Health Professional (AHP) students. Educators developed new and innovative ways of delivering placements due to social distancing restrictions. Alternative models have included remote placements clinical simulation, research project-based education and leadership. Health Education England launched a Fair Share model asking all AHPs to commit to a minimum of 7 weeks of student placement per year. Methods In June 2021 the AHP education team at Great Ormond Street Hospital developed and delivered a split leadership placement for two physiotherapy students. The students spent four days a week on a remote leadership placement and one day with the physiotherapy team. The placement included supervision coaching formal teaching a leadership course, project work (development of leadership resources) and shadowing of senior leaders. Results We debriefed the students to discuss the placement and gather information about how the placement could be improved. The students enjoyed the opportunity and felt they had learnt a lot about leadership. Feedback included a preference for five days of leadership or an even split between leadership and clinical the same clinical days (to support peer learning) and the need for better IT systems. The students enjoyed meeting senior leaders peer work and facilitating the student forum. The average placement and supervising team scores were both 4.5 out of 5 (above target score). Conclusion This novel placement evaluated well and was enjoyed by educators and students alike. We plan to run another leadership placement and will be using feedback to further enhance and improve the learning opportunity. We are dedicated to providing AHP placements to ensure we can help met the shortfall and that all students can achieve their 1000 hours of practice-based education.

An investigation into the effects of Omicron and winter pressures on stroke rehabilitation services across the East of England

Introduction: A service impact assessment was undertaken to understand the influence of winter pressures and omicron on stroke rehabilitation service delivery in November and December 2021. This followed concerns regarding rehabilitation provision raised by clinicians and stroke service managers including acute providers, community in patient teams and early supported discharge (ESD) teams across the East of England. Method(s): Questionnaires were distributed to all acute, community and ESD stroke services within the North and South Integrated Stroke Delivery Networks (ISDN), covering physiotherapy, occupational therapy, speech and language therapy and psychology disciplines. Ratings were made against the key themes that had been raised anecdotally as concerns to service delivery. (0=no impact, 1=some impact 2=significant impact) Follow up meetings were arranged for each Integrated Care System (ICS) to provide narrative around the rated themes. Allied Health Professional (AHP) representatives from each stroke service within the ICS were invited to these meetings. Finally, the ratings and narrative were taken back to the Rehabilitation Clinical Advisory Group (CAG) for solutionbased discussions to formulate a potential action plan to report to the Clinical Reference Group (CRG). In total 61 responses were received from professional leads across the four disciplines. Result(s): Issues, themes and recommendations have been established relating to: * Workforce. * Increased referral rates and caseloads. * Rehabilitation Intensity. * Access to care packages and equipment. * Visiting arrangements and the direct impact on discharge planning. * Perceived patient and family experience. Conclusion(s): Analysis is ongoing;however, ten recommendations are being prepared to enable increased robustness of service delivery in preparation for next winter.

High time for surgeons to engage with the universal right to a healthy environment

On Thursday, 28 July 2022, the General Assembly of the United Nations (UN) declared access to a clean, healthy and sustainable environment constitutes as a universal human right. This motion prompts action from diverse stakeholders across the globe. The surgical community has already taken consequent steps towards social participation and environmental sustainability in the recent years. However, the COVID-19 pandemic has increased the carbon footprint of surgical practice putting further impediments on the way towards a clean and healthy environment. Therefore, it is high time for surgeons to engage with the environment, mitigate the impact of the environmental crisis on surgical diseases and reduce the carbon footprint of surgical practice. Rethinking the use of energy - intensive technologies in the operating theater and collaborating with allied medical specialties and health professionals to decrease the ecological footprint of healthcare is pivotal.Copyright © 2022 The Author(s)

Seroconversion in nasal lining fluid antibodies after Covid19 infection in a health professional cohort

Background: The novel coronavirus SARS-CoV- 2 has caused far-reaching consequences world-wide. Lack of immunity in human, severe airway disease based on a high virulence and its airborne transmission pointed to a significant role of the airways. To investigate immune responses and antibody seroconversion in nasal lining fluid and in serum we examined a cohort of health professionals at the university hospital Klinikum rechts der Isar in Munich. By long-term follow-up of infected and non-infected participants, we were able to investigate the development of local and systemic immunity against SARS-CoV- 2. Method(s): To learn about nasal antibody production we reached out for hospital staff with estimated high risk of a possible Covid19 infection due to their working conditions and staff members suffering from symptoms like fever, cough, loss of smell and taste or sore throat. To detect current infections, we performed SARS-CoV- 2 PCR testing at visit one (V1) and asked our participants to rate possible Covid19 symptoms by filling a questionnaire before every sampling. We eventually included participants, who had been tested positive for SARS-CoV- 2 before (n = 22), as well as people without detected infection, including high-risk contact persons of Covid19 patients and individuals with no Covid-19 infection so far (n = 85). The cohort included 107 hospital staff members, who were sampled six times overall between March and September 2020. Each of the six visits V1 -V6 contained the sampling of serum and nasal fluid to measure IgG, IgM, and IgA rates using immunoassay technique. Result(s): We were able to show the increase of IgA and IgG in the nasal mucosa after recent Covid19 infection. In infected individuals the levels of SARS-CoV- 2 specific nasal IgA increased until V2 with a mean of 4,81 +/- 1,92 mug/l compared to a mean of 0,13 mug/l in non-infected participants, followed by a plateau until V4 and decreased again until V6. Nasal IgG showed a similar trend, apart from a steeper decline after reaching a peak on V2 with a mean of 7,39 +/- 1,63 mug/l, which correlated to the antibody responses in serum. Non-infected individuals showed a mean level of 0,03 mug/l nasal IgG on V2. Serum IgA declined from V1 onwards and hereby showed a quicker drop of systemic antibody levels compared to the nasal lining fluid. Nasal antibody rates reached peaks of 40,00 mug/l (nasal IgA) and 25,74 mug/l (nasal IgG). However, these counts will need further confirmation by a vaccinated control group. Conclusion(s): Nasal measurement of SARS-CoV- 2 specific antibodies provides deeper understanding of mucosal processes while facing inflammation, which may pave the way to less invasive diagnostic possibilities in the future. Furthermore, nasal antibodies built-up after an infection with Covid19 may be protective features concerning a possible re-infection with the virus.

Covid-19 vaccination uptake by Hapu Mama - How are we progressing?

The Covid-19 vaccine has been recommended for pregnant people (hapu mama) in Aotearoa New Zealand since June 2021. We surveyed people birthing in a tertiary hospital regarding their vaccination status and reasons for this. There were 74% (142/191) of pregnant people who were fully vaccinated. Motivators for vaccination included protection against Covid-19 and antibody transfer to the baby (pepe). Unvaccinated participants worried about vaccine safety. Concerns were raised about the change in official advice without well-communicated reasons for the change. Future vaccine and booster rollouts must be delivered equitably and hapu mama must be a priority group.Copyright © 2022 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists. © 2022 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Impact of mass media on the population as a precautionary prevention from COVID-19 in Iraq

The aim of this study was to identify the impact of both traditional mass media and social digital media on the population to prevent the Corona virus disease-19 (COVID-19). Three hundred twenty participants were included. A questionnaire was prepared consisting of socio-demographic characteristics and the effect of traditional mass media and mobile digital media on the population. The sources used for information included TV (72.8 %), Facebook (71.2 %), health professionals (64.4 %), Instagram (28.1 %), Twitter (16.8 %), Radio (14.4 %) and mobile Apps (Viber and WhatsApp being 30.9 %). Social Media could be blamed for aiding the spread of stress and hysteria among people.Copyright © 2021 Health Biotechnology And Biopharma. All Rights Reserved.

Health education and promotion of #PhysicalActivity on Twitter before and during COVID-19

Objective: Twitter, a microblogging service, allows users to post short messages (tweets) and link posts through hashtags, creating online communities to enable dissemination of health education. The objective of this descriptive study was to examine Twitter's #PhysicalActivity health education and promotion efforts, including differences in response before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic. Design, setting and methods: A codebook was developed to conduct a quantitative content analysis of #PhysicalActivity tweets before and during the COVID-19 pandemic. Twitter's Advanced Search parameters included minimum 1 reply, 25 likes and 5 retweets. Tweets were double-coded for user characteristics, community response, tweet elements (video, photo, link, questions, events, original text, survey/response, journal article, infographic) and intended audience. T-tests examined differences in researcher-generated NET response (replies + retweets + likes) between COVID-19 and comparison years. Result(s): Data were collected from 400 tweets. Eighty percent of tweets were from personal accounts, with over half indicating the possession of a health professional degree. Twenty-nine percent of tweets gave behavioural recommendations of which 56.8% provided a rationale. Nearly all used at least two components, text and photos most common. The general public was the most intended audience with health professionals second. While the NET response was greater during COVID-19 (M = 139.6, SD = 156.8) than prior to it (M = 116.8, SD = 105.1), the difference was not statistically significant (p =.091). Conclusion(s): Twitter platform provided an opportunity to disseminate health education, specifically for the promotion of physical activity, while adhering to public health recommendations to #StaySafeStayHome. Our findings provide insights into engaging this online community to inform future physical education and promotion dissemination.Copyright © The Author(s) 2023.

A Qualitative Study exploring a Registered Nurse's perceptions and experiences of assessing stroke patients in the clinical area during the Covid 19 pandemic

Introduction: Stroke remains the largest cause of disability in the UK and skills assessment are a prerequisite for accurate diagnosis and treatment plans from healthcare professionals.The objectives of the study were to explore registered nurses' perceived barriers in relation to stroke assessment and finally to identify gaps from the research and enhance improvements for improving patients care. Method(s): An interpretive qualitative study utilising semi-structured interviews for data collection was the initial methodology.However, this methodology was disregarded due to the COVID-19 pandemic. The researcher opted to write a personal reflection from both a student and heath professional perspective, using both self-reflexivity and auto ethnography methodology (Hughes and Pennington,2017) and applying Clarke's 6 stages of the thematic analysis (Braun and Clarke, 2012). Result(s): The interpretive self reflection study identified three main themes by the researcher. These themes focused on anger and frustration;responsibilities as a health professional and feelings of powerless as a female student. Conclusion(s): COVID-19 restrictions meant there were limitations using the original semi-structured interviews from Registered Nurses with different levels of experience.Further discussion needs to be around undertaking the original semi-structure interviews when the incidence Covid-19 wanes, to identify weather these themes are generic to the stroke environment or unique to the pandemic. Recommendations are to fully complete the study in the post-pandemic period to assess,analyse and develop a stroke programme to educate, support and nurture the knowledge and skills required to deliver stroke care in future .

RISK FACTORS FOR EXPOSURE TO SARS-COV-2 DURING THE PANDEMIC IN PERU IN OCCUPATIONAL HEALTH PROFESSIONAL.

Introduction: Occupational health professionals (OHP) have played an important role in surveillance, prevention and control against COVID-19 at the workplace. Objective(s):To determine the risk factors associated with exposure to SARS-CoV-2 during the first and second waves of the Pandemic in Peru. Material(s) and Method(s): A cross-sectional study and secondary data analysis were made. OHP were virtually asked about exposed to COVID-19 at work and its social, educational and labor factors. Result(s): Of the 2,863 answers, we found in the multivariate analysis: there was more frequency of exposure to COVID-19 in the mining (p value=0.046);nutrition sector (p value=0.009);in the public sector (p value <0.001), manufacturing (p value<0.001);if the professional performs care work (p value<0.001);if they perform occupational medical evaluations (p value=0.001), who are nursing technicians (p value=0.016) and who are medical technologists (p value<0.001);On the other hand, there were less exposure when they were older (p value=0.006) and among those who had a specialty in occupational health (p value=0.025). Discussion(s): Important factors were associated with occupational exposure of OHP professionals, which can serve to prioritize professionals who should take care of themselves and to include into complete vaccination schedule.Copyright © 2022, Accion Medica S.A.. All rights reserved.

Hand care: it's time to take the gloves off

The increased incidence of hand dermatitis (HD) is well documented in healthcare professionals (HCPs) (Flyvholm MA, Bach B, Rose M, Jepsen KF. Self-reported hand eczema in a hospital population. Contact Dermatitis 2007;57: 110-15). It is reported that HD accounts for 95% of all occupational dermatitis (Bains SN, Nash P, Fonacier L. Irritant contact dermatitis. Clinic Rev Allergy Immunol 2019;56: 99-109). We sought to better understand the prevalence of HD in HCPs in a large teaching hospital, identify any associated risk factors and assess their knowledge of hand care. Additionally, we aimed to assess the availability of ward facilities and posters for hand hygiene and hand care. The survey was conducted between November 2015 and January 2016. A review of ward facilities and posters for hand care and hand hygiene was conducted in October 2020. A total of 820 HCPs responded to the survey. Altogether, 444 respondents (54 1%) reported a previous history of HD and 226 (27 6%) reported active dermatitis. These included 153 (18 6%) doctors/ dentists, 76 (9 3%) allied health professionals (AHPs), 46 (5 6%) nurses/midwives, 27 (3 3%) administrative staff, 16 (1 9%) other, five (0 6%) technicians and 108 (13 2%) medical/ dental/nursing/midwifery/AHP students. Only 10 (1 2%) took time off work owing to their HD, with five (0 6%) requiring > 5 days off work, but 67 (8 2%) wished they had taken time off work. In total, 416 (50 7%) respondents washed their hands > 20 times daily and 229 (27 9%) used disinfectants > 20 times per day. Those with a prior history of atopic dermatitis (AD) were at higher risk of developing HD [relative risk (RR) 1 69, 95% confidence interval (CI) 1 52-1 89;P < 0 001], and within 6 months of starting their job/placement (RR 1 82, 95% CI 1 3-2 5;P < 0 002). Only 107 (13 0%) respondents were able to identify all 11 correct statements regarding hand care. Two hundred and twenty (49 5%) of the 444 HCPs with a history of HD never received hand care advice when they started their current role. The 24 adult wards surveyed had a total of 162 general-use sinks, all with hand soap and disinfectant, and 154 hand hygiene posters. In contrast, only 22 sinks had emollients available. No posters were seen regarding hand care and skin health. This survey highlights the high prevalence of HD among HCPs, especially those with AD, but many are still not aware of good hand care measures. Additionally, our survey reflects the need for early education and equal facilities for hand care and hand hygiene, as both are important when delivering good clinical care, to protect patients and staff, especially in the midst of the COVID-19 pandemic.

Awareness Among Dentists Regarding Oral Manifestations Of Post Covid 19 Disease: An Observational Crossectional Study In Central India

Background: It is very important to increase awareness and understanding of oral manifestations of post COVID-19 disease among dentists which can happen by continuing education and training for dentists to recognize and manage oral manifestations of post COVID-19 disease. Aims & objectives: The aim of this is to aware dentists regarding oral manifestation of covid 19 disease. The objectives of study were to assess the level of awareness, understanding and factors influencing awareness among dentists regarding oral manifestations of post COVID-19 disease. Evaluate the of oral manifestations of post COVID-19 among dentists in central India. Methodology: A cross-sectional, questionnaire-based study was carried out among COVID-19 recovered patients. A sample of 100 subjects, diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria. A well-structured questionnaire composed of total 21 Closed ended questions was send to sunjects. Result(s): The study comprised an almost equal number of male (54%) and female (48%) participants and among them, 47% belong to the health professional group. A total of 56% of subjects were aged above 35 years and 47% below 35 years. Xerostomia, frequent aphthous ulcers, swallowing difficulty, and burning mouth were the most frequently encountered symptoms in study subjects during the disease and post recovery. Conclusion(s): In the present study, dentists were found to have good knowledge toward novel corona virus disease with optimum preparedness level for dental practice modification. Dental fraternity is further advised to follow the standard guidelines overcoming this pandemic.Copyright © 2022 Authors. All rights reserved.

Quality of life of a group of Ecuadorian health professionals in covid-19

Introduction: Covid-19 was the cause of a pandemic that claimed thousands of human lives. The pandemic has caused health professionals mental health problems that influence emotional, psychological and social well-being, which affects the way they think, feel and act in daily life. Objective(s): To de-termine the quality of life of health personnel during the Co-vid-19 pandemic in public institutions in the city of Cuenca. Material(s) and Method(s): Descriptive, cross-sectional and observational study. The study sample was 338 health professionals belonging to the Ministry of Public Health of the Canton Cuenca, province of Azuay-Ecuador, doctors, nurses, dentists, psychologists, assistants and biochemists who work at differ-ent levels of care were included. Two WHOQOL surveys and the Lazarus and Folkman scale of coping modes were used, for the tabulation of the data the RStudio statistical program was used. Result(s): In the psychological domain, no significant destructuring was found in the personnel studied. In the field of health, it should be noted that the personnel studied reported the inability to carry out the activities they need and the diffi-culty in moving from one place to another. Conclusion(s): When investigating the relationship of health personnel with the envi-ronment, no statistically significant alteration was found, but it was evidenced that social support is a protective factor for the mental health of personnel.Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

Covid-19 Vaccine Hesitancy: Frequency and causes among Population of Lahore

Background: Covid-19 vaccine hesitancy is prime hurdle in control and eradication of Covid-19 pandemic. The rapid Procedure of development of new vaccines resulted in a lot of false information and rumors leading to decrease trust of the public in the safetyand effectiveness of the vaccine. Aim(s): To study the frequency and causes of Covid-19 vaccine hesitancy amid population of Lahore. Method(s): This cross sectional study design was done on a sample of 385 participants from lahore were included in the study. Frequency and causes were recorded on the prescribed questionnaire. Result(s): Frequency of hesitancy was found to be 41.7%. 12.8% had doubts related to efficacy and safety of the vaccine. 9.9% were of the view that the risks of the vaccine are greater than its benefits. 5.7% assumed that vaccines were promoted for gains of pharmaceutical companies. 4.4% were concerned about the immediate side effects of the vaccine. 2.6% responded by saying that vaccine was not recommended by health professionals. 2.3% had myths related to vaccine. And lastly, 1.63% said vaccine was not available free of cost. Conclusion(s): Hesitancy of covid-19 vaccine is seen more in illiterate people and the main cause of hesitancy is uncertainty related to protection and efficacy of covid-19 vaccine.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Clinical Placement Expansion Programme at Gosh - a Two-Year Review

Background The Clinical Placement Expansion Programme (CPEP) aims to increase clinical placements in the National Health Service (NHS) and to support growth across all Allied Health Professionals (AHPs). At Great Ormond Street Hospital (GOSH), this programme was implemented in 2020, and extended to 2022, with the aim to steadily increase placement capacity across all AHP services. Additionally, the Fair Share model was introduced in London to help benchmark the provision of practice learning relative to workforce capacity, focusing specifically on Speech and Language Therapy, Physiotherapy and Occupational Therapy. The aim is to provide seven weeks of student placement per whole time equivalent. Methods Retrospective data were collected from seven AHP services throughout two academic years: September 2020 to September 2022. This included achieved number of students and placement weeks. Student placement feedback was collected and reported as an average out of five for both academic years. Results From September 2020 to September 2021, a total number of 400 student placements (1153 weeks) were supported at GOSH. From September 2020 to September 2021, 145 students were placed (433 weeks) and from September 2021 to September 2022, a total of 255 students were placed (720 weeks). This shows an increase of 110 students and 283 weeks from 2020/2021 to 2021/2022. The average student feedback for academic years 2020-2022 was 4.75 out of 5. Conclusion Student numbers and weeks increased per academic year from 2020-2022. Barriers to increasing student capacity included clinical capacity and staff pressures, lack of space, changes in service delivery during the COVID-19 pandemic, and staff attitude towards student placements. Placement innovation, such as leadership placements and hybrid working models, positively influenced student numbers at GOSH. There is a continued drive to achieve the Fair Share model, and the sustainability of placement expansion should be reviewed in future.