Implications of COVID-19 Pandemic on Ovarian Cancer Mortality

Ovarian cancers are the most prevalent cancers with the highest mortality among women. Most women with advanced stages require multimodal therapy, including surgery, radiotherapy, and chemotherapy. The advent of the coronavirus disease in the 2019 has affected the entire system of healthcare delivery in majority of patients suffering from cancer. During these tough times, patients suffering from ovarian cancer face mental trauma, which involves delays in diagnosis and prognosis, surgeries, chemotherapy, and radiotherapy. Instead of in-person visits, tele consultations were performed with a fear of being infected with the pandemic. This review, have prioritized the repercussions of COVID-19 on patients with ovarian cancer, Monitoring of CA125 trend in patients of ovarian cancer with COVID-19 and how COVID-19 affects the rate of mortality in cancer patients. © 2023 Bharati Vidyapeeth, New Delhi.

The Evolution of International Health: Lessons to Be Learned

Despite the United States' unique delivery of healthcare and status as a place of discovery and cutting-edge science, overall life expectancy is actually lower than that of other countries with similar per capita income. In comparison, developing countries around the world are utilizing innovative tactics to provide care to large amounts of people in a cost-effective way. The coronavirus disease of 2019 (COVID-19) pandemic, if anything, has proven the interconnectedness of the world, showing how certain health diseases can directly affect those in other countries, bringing the need to understand global health to the forefront of medicine. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Evaluating Take 5: Virtual Learning Sessions on Trauma Informed Care forHealthcare Staff During COVID-19

Trauma disproportionately impacts people with HIV. To mitigate these adverse impacts, primary care providers canidentify and address trauma with clients using a trauma informed care (TIC) approach. In 2018, CAI, an organization thatprovides national level training and capacity-building developed a TIC implementation model, now delivered in HIV andprimary care agencies throughout the United States to integrate TIC into their culture, environment, and service delivery.New Jersey Trauma Informed Care (NJTIC) is the organization's longest standing TIC initiative. To respond to the complexchallenges of the COVID-19 pandemic, we developed a webinar series, Take 5, to leverage and expand upon the existingknowledge and skills of providers across 15 agencies part of the NJTIC project.This article describes the series' purpose, tosupport staff and sustain and develop their TIC competencies during this unprecedented reality. Results of our evaluationindicated the reaction, satisfaction, and impact described by staff, who enhanced their TIC knowledge and utilized newskills with clients and themselves. Staff and their supervisors reported that the series offered consistency and supportduring an uncertain time. These promising practices can be applied broadly during crises to bolster knowledge, skills,collaboration, and self-care © 2023, Online Journal of Issues in Nursing.All Rights Reserved.

Assessing the Benefits of a Teleassessment Solution Using a FVM Perspective

The recent COVID-19 pandemic has served to highlight the benefits of digital health in general and telehealth in particular. One area of telehealth that is particularly important is that of teleassessment. Currently, we are witnessing an exponential growth in total knee and total hip replacements (TKR) (THR) due to an aging population coupled with longer life expectancy which is leading to a high likelihood of an unsustainable burden for healthcare delivery in Australia. To address this imminent challenge, the following proffers a tele-assessment solution, ARIADNE (Assist foR hIp AnD kNEe), that can provide high quality care, with access for all and support for high value outcomes. A fit viability assessment is provided to demonstrate benefits of the proffered solution. © 2022 IEEE Computer Society. All rights reserved.

The Indian healthcare system turns to digital health: eSanjeevaniOPD as a national telemedicine service

Healthcare infrastructure in the emerging economies is largely concentrated in their urban areas, and the burgeoning rural population is usually deprived of quality medical care. Telemedicine systems are expected to bridge this gap. This case study documents telemedicine's significance and allows students to examine India's national patient-to-doctor telemedicine service, eSanjeevaniOPD. The portal provides free and contactless consultation by a government doctor using video calls. COVID-19 hastened the adoption of eSanjeevaniOPD in the country, but its post-covid future would largely depend on feature innovation, architecture development, and digital strategies. With a total of three million teleconsultations in one year, eSanjeevaniOPD is one of the world's largest digital healthcare delivery systems. This case provides insight into Indian health infrastructure, summarizes the journey of eSanjeevaniOPD, and raises questions on the digital transformation of the Indian healthcare delivery system.

Does Telemedicine Affect Physician Decisions? Evidence from Antibiotic Prescriptions

Telemedicine has long been of interest to the U.S. general public. Yet, despite the advent of high-speed internet and mobile device technology, telemedicine did not reach its full potential until the COVID-19 pandemic spurred its unparalleled adoption. This sudden shift in the setting of healthcare delivery raises questions regarding possible changes in clinical decision-making. Using a unique set of patient-provider encounter data from the U.S. in 2020 and 2021, we examine the effect of telemedicine on antibiotic prescription errors for urinary tract infections. After accounting for potential endogeneity issues using provider fixed effects and an instrumental variable approach, we find a significantly lower likelihood of prescription errors with telemedicine relative to in-person encounters. We also find heterogeneous effects by a provider's patient volume and the patient-provider relationship. © 2023 IEEE Computer Society. All rights reserved.

The Evaluation of Health Care Services for Children and Adolescents With Post-COVID-19 Condition: Protocol for a Prospective Longitudinal Study.

BACKGROUND: Some children and adolescents suffer from late effects of a SARS-CoV-2 infection despite a frequently mild course of the disease. Nevertheless, extensive care for post-COVID-19 condition, also known as post-COVID-19 syndrome, in children and young people is not yet available. A comprehensive care network, Post-COVID Kids Bavaria (PoCo), for children and adolescents with post-COVID-19 condition has been set up as a model project in Bavaria, Germany. OBJECTIVE: The aim of this study is to evaluate the health care services provided within this network structure of care for children and adolescents with post-COVID-19 condition in a pre-post study design. METHODS: We have already recruited 117 children and adolescents aged up to 17 years with post-COVID-19 condition who were diagnosed and treated in 16 participating outpatient clinics. Health care use, treatment satisfaction, patient-reported outcomes related to health-related quality of life (the primary endpoint), fatigue, postexertional malaise, and mental health are being assessed at different time points (at baseline and after 4 weeks, 3 months, and 6 months) using routine data, interviews, and self-report questionnaires. RESULTS: The study recruitment process ran from April 2022 until December 2022. Interim analyses will be carried out. A full analysis of the data will be conducted after follow-up assessment is completed, and the results will be published. CONCLUSIONS: The results will contribute to the evaluation of therapeutic services provided for post-COVID-19 condition in children and adolescents, and avenues for optimizing care may be identified. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41010.

Trends and Overview: The Potential of Conversational Agents in Digital Health

With the COVID-19 pandemic serving as a trigger, 2020 saw an unparalleled global expansion of tele-health [23]. Tele-health successfully lowers the need for in-person consultations and, thus, the danger of contracting a virus. While the COVID-19 pandemic sped up the adoption of virtual healthcare delivery in numerous nations, it also accelerated the creation of a wide range of other different technology-enabled systems and procedures for providing virtual healthcare to patients. Rightly so, the COVID-19 has brought many difficulties for patients (https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide ) who need continuing care and monitoring for mental health issues and/or other chronic diseases. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

African American Women Breast Cancer Survivors: Coping with the COVID-19 Pandemic.

African American women breast cancer survivors are among those with the greater burden of cancer. Breast cancer is the second leading cause of death among black women, and this death rate is 40% higher than that of white women. The COVID-19 pandemic increased the burden of morbidity and mortality among this population of cancer survivors. In this report, we explore the ways in which the COVID-19 pandemic was a source of stress for African American women breast cancer survivors and their subsequent responses to these stressors. This is a qualitative descriptive study with content analysis of data from the narratives of 18 African American breast cancer survivors. Participants were interviewed via phone and video conferencing platform and asked questions related to their experiences with the COVID-19 pandemic. The findings suggest stressors associated with (1) potential COVID-19 spreaders in their immediate environments; (2) closures and restricted access to social- and faith-based activities; (3) televised news broadcasts of COVID-19; and (4) disruptions to planned cancer prevention and control healthcare. Three categories emerged that captured the ways in which these women responded to stressors during the early phase of this pandemic: (1) seeking control in their social environments; (2) following the rules; and (3) seeking support from God, family, and friends. These findings can be used to better support breast cancer patients during the early phases of a pandemic.

Racial Disparities in Endoscopy Cancellations During the COVID-19 Pandemic.

INTRODUCTION: The coronavirus disease 19 (COVID-19) pandemic has disrupted healthcare delivery including elective endoscopy. We aimed to determine the prevalence of endoscopy cancellations in the COVID-19 era and identify patient characteristics associated with cancellation due to the pandemic. METHODS: Medical charts were reviewed for adults who cancelled an outpatient endoscopic procedure from 5/2020 to 8/2020. The association of patient characteristics with cancellation of endoscopy due to COVID-19 was assessed using logistic regression. RESULTS: There were 652 endoscopy cancelations with 211 (32%) due to COVID-19, 384 (59%) due to non-COVID reasons, and 57 (9%) undetermined. Among COVID-19 related cancellations, 75 (36%) were COVID-19 testing logistics related, 121 (57%) were COVID-19 fear related, and 15 (7%) were other. On adjusted analysis, the odds of cancellation due to COVID-19 was significantly higher for black patients (OR 2.04, 95% CI 1.07-3.88, p = 0.03), while patients undergoing EGD (OR 0.56, 95% CI 0.31-0.99, p = 0.05) or advanced endoscopy (OR 0.18, 95% CI 0.07-0.49, p = 0.001) had lower odds of cancellation. The odds of cancelling due to COVID-19 testing logistics was significantly higher among black patients (OR 3.12, 95% CI 1.03-9.46, p = 0.05) and patients with Medi-Cal insurance (OR 2.89, 95% CI 1.21-6.89, p = 0.02). CONCLUSION: Black race is associated with an increased risk of COVID-19 related cancellation. Specifically, black patients and those with Medi-Cal are at increased risk of cancellation related to logistics of obtaining pre-endoscopy COVID-19 testing. Racial and socioeconomic disparities in access to endoscopy may be further amplified by the COVID-19 pandemic and warrant further study.

Attitudes and perceptions of outpatients towards adoption of telemedicine in healthcare during COVID-19 pandemic.

BACKGROUND: Asia is home to a burgeoning market for telemedicine with the availability of cheaper smartphones and internet services. Due to a rise in telemedicine use by doctors and patients, it is imperative to understand the perception of patients towards the adoption of telemedicine, the availability of telemedicine to the general population, the frequency with which patients avail these services, and the motivation or apprehensions in using them, especially during the COVID-19 pandemic. AIMS: The study is performed to understand the behavioral attitude and perceptions of the population regarding telemedicine and, in doing so, make services more user-friendly for patients. METHODS: A total of 1170 participants were surveyed using a structured online questionnaire to assess the perceptions towards the adoption of telemedicine in healthcare delivery services. Multivariate analysis was performed to identify key variables of knowledge and attitude affecting the utilization of telemedicine. RESULTS: Of the total respondents, 35.3% of patients never encountered telemedicine before and 26.9% did not come across telemedicine even during the COVID-19 pandemic. CONCLUSION: Understanding the perceptions of patients, using targeted health education, positive communication, and behavioral modifications, is the key factor to be addressed to mitigate the apprehensions towards telemedicine and improve the utilization of the services.

Impact of COVID-19 on Neuro-Ophthalmology in the United States: A National Survey.

PURPOSE: To evaluate the impacts of the COVID-19 on neuro-ophthalmology practice in the United States. DESIGN: Cross-sectional study. METHODS: The North American Neuro-ophthalmology Society distributed a survey on the impact of COVID-19 on neuro-ophthalmic practice to its members. The survey consisted of 15 questions regarding the impact of the pandemic on neuro-ophthalmic practice and perspectives. RESULTS: Twenty-eight neuro-ophthalmologists practicing in the United States responded to our survey. In this survey, 64% of survey respondents were male (n = 18), while 36% were female (n = 10). The average age of a respondent was 55 years old. According to 77% of survey respondents, various neuro-ophthalmic diseases were reported to have worsened during the pandemic including idiopathic intracranial hypertension, compressive optic neuropathy, optic neuritis, and giant cell arteritis. CONCLUSIONS: This survey represents one of the largest studies to describe the impact of the COVID-19 pandemic of neuro-ophthalmology. Given the underrepresentation of neuro-ophthalmology in the United States as described in the literature, this study strengthens the need for more neuro-ophthalmologists to provide timely care, particularly during the pandemic. Further interventions to incentivize the pursuit of neuro-ophthalmology training may help combat the effects of COVID-19 on neuro-ophthalmic conditions.

Healthcare system engagement and algorithm-identified cancer incidence following initiation of a new medication.

PURPOSE: Implausibly high algorithm-identified cancer incidence within a new user study after medication initiation may result from increased healthcare utilization (HU) around initiation ("catch-up care") that increases diagnostic opportunity. Understanding the relationships between HU prior to and around initiation and subsequent cancer rates and timing is important to avoiding protopathic bias. METHODS: We identified a cohort of 417 458 Medicare beneficiaries (2007-2014) aged ≥66 initiating an antihypertensive (AHT) after ≥180 days of non-use. Initiators were stratified into groups of 0, 1, 2-3, and ≥4 outpatient visits (OV) 60-360 days before initiation. We calculated algorithm-identified colorectal cancer (aiCRC) rates stratified by OVs and time since AHT initiation: (0-90, 91-180, 181-365, 366-730, and 731+ days). We summarized HU -360/+60 days around AHT initiation by aiCRC timing: (0-29, 30-89, 90-179, and ≥180 days). RESULTS: AiCRC incidence (311 per 100 000 overall) peaked in the first 0-90 days, was inversely associated with HU before initiation, and stabilized ≥180 days after AHT initiation. Catch-up care was greatest among persons with aiCRCs identified <30 days in follow-up. Catch-up care magnitude decreased as time to the aiCRC date increased, with aiCRCs identified ≥180 days after AHT initiation exhibiting similar HU compared with the full cohort. CONCLUSION: Lower HU before-and increased HU around AHT initiation-seem to drive excess short-term aiCRC incidence. Person-time and case accrual should only begin when incidence stabilizes. When comparison groups within a study differ by HU, outcome-detection bias may exist. Similar observations may exist in other settings when typical HU is delayed (e.g., cancer screening during SARS-CoV-2).

Caregivers' experience with telehealth during Covid-19: A quantitative study in the United States

Although home caregivers have been increasingly recognized as essential contributors to healthcare delivery, their perceived difficulties and requisites remain underexposed. With the emergence of telehealth adoption during Covid-19, caregivers are forced to be part of this technology. However, little attention has been given to their perceptions of telehealth technologies. This study explores the factors that impact caregivers' satisfaction with telehealth. We found that caregivers who thought that telehealth makes them use their time better are more likely to be satisfied with using it during Covid-19 (OR= 2.33 [1.89-15.35], P=0.006). In addition, the more caregivers thought telehealth helps them avoid problems of parking, driving, and delaying treatment, the more they were satisfied with their online visits. An increase in telehealth use due to Covid-19 made caregivers more satisfied with using it. Efforts to improve telehealth should not only focus on the design of the technology used and its usefulness. They, however, need to consider caregivers as part of the healthcare delivery process and adapt the technology to their needs. © 2022 IEEE.

Teledermatology May Benefit Marginalized Populations: National and Institutional Trends during the COVID-19 Pandemic.

INTRODUCTION: Limited data exist regarding demographic-specific teledermatology (TD) utilization during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine TD utilization trends during the pandemic. METHODS: A retrospective cohort study for national and institutional populations was conducted. Patient encounters in the American Academy of Dermatology's DataDerm registry (DataDerm) were analyzed from 1 April 2020 through 30 June 2021. All dermatological patients seen by Duke University Health Systems (DUHS) were analyzed from 1 March 2020 through 30 April 2021. In-person clinic visits versus TD encounters (national and institutional) and no-show rates (institutional only) were collected for visit type (i.e., TD versus in-person), sex, race, age/generation, and in- versus out-of-state location (national only). TD utilization is defined as the cohort of interest using TD (e.g., females, whites) within a demographic group (i.e., sex, race) as a percentage of total TD users. This was compared with in-person utilization during the identical timeframe. RESULTS: For US national data, 13,964,816 encounters were analyzed. Sex, race, age, and location each had a significant association with TD utilization (adjusted p < 0.001). For institutional data, 54,400 encounters were analyzed. Sex, race, and age had a significant association with TD utilization (adjusted p < 0.001). Both datasets revealed majority female populations for telehealth visits (DataDerm 66.0%; DUHS 61.7%). Non-white populations accounted for a higher percentage of TD utilizers (DataDerm 15.0%; DUHS 37.3%) when compared with in-person utilizers (DataDerm 11.7%; DUHS 22.3%). Younger patients utilized TD (DataDerm 63.6%; DUHS 62.6%) more than in-person services (DataDerm 26.3%; DUHS 43.8%). Institutional no-show rates between telehealth and in-person visits were lower for Black patients (11.8% versus 19.2%), other non-white races (10.6% versus 13.6%), and younger ages/generations (9.8% versus 12.8%), respectively. TD utilization decreased over time nationally as a percentage of total visits (2.9% versus 0.3%) in 2020 versus 2021, respectively. CONCLUSIONS AND RELEVANCE: During the COVID-19 pandemic, certain populations (females, younger patients, non-white races) showed higher TD utilization. Understanding TD utilization trends is critical in defining the role of virtual care for improving universal care access, optimizing resources, and informing future healthcare models for all patient populations.

Digital Therapeutics in Migraine Management: A Novel Treatment Option in the COVID-19 Era.

Migraine is a chronic and often lifelong disease that directly affects over one billion people globally. Because access to migraine medical services is limited, only a minority of migraine patients are treated adequately. This situation worsened during the COVID-19 pandemic. Digital therapeutics (DTx) is an emerging therapeutic approach that opens up many new possibilities for remote migraine management. For instance, migraine management tools, online migraine diagnosis, guideline-based treatment options, digitally networked patients, and collecting anonymized information about migraine attacks and course parameters for scientific evaluation. Various applications of DTx in migraine management have been studied in recent years, such as the usefulness of digital migraine self-management tools in diagnosing and tracking migraine attacks, and the efficacy and safety of digital cognitive behavioural therapy. However, the development of DTx is still in its infancy and still faces many obstacles. The primary goal of this study is to review the latest research on DTx in migraine management, identify challenges, and outline future trends.

Palliative care nursing during the COVID-19 pandemic: reflections from Melbourne, Australia.

BACKGROUND: Nurses played a critical role in providing care for patients throughout the COVID-19 pandemic. AIM: This study aimed to explore perspectives of Australian palliative care nurses regarding the impact of COVID-19 on the provision of care for patients with advanced illness, or at the end of life. METHODS: The authors conducted a survey of palliative care nurses in ward- and consultation-based roles at a metropolitan health service in Victoria, Australia. FINDINGS: A total of 24 out of 39 nurses completed the survey. Responses included strong themes of fear of COVID-19 and sadness about separating dying patients from their families. CONCLUSION: Delivery of palliative care changed at an individual and service level. Importantly, there were strong themes of adapting to change and 'soldiering on' with the core business of palliative care.

The use of telemedicine in COVID-19 pandemic era: a systematic review

Introduction: Telemedicine is a form of healthcare that uses technology to provide various health services. This method has been widely used during the COVID-19 pandemic when physical distancing is called. This systematic review aimed to review various uses of telemedicine on 11 databases using the PRISMA flowchart from January 1(st), 2020, to December 31(st), 2021. Methods: This review has been registered in PROSPERO (https://www.crd.york.ac.uk/prospero/display_record. php?RecordID=269809). The search terms are: "COVID-19," "Coronavirus," 'SARS-CoV-2," "2019-nCoV," "Telemedicine," "Telehealth," "Teleconsultation," "Telemonitoring,' "Telemanagement," "Teleconferencing," "Video conferencing," "Video consultation,""Virtual care,""Virtual service,""Virtualtreatment,""Remote treatment,""Remoteservice,""Remote consultation," "Digital care," 'Digital treatment," "Mobile health, and "E-health." The quality assessment used indexed databases for the SCOPUS, Web of Science (ESCI), and PubMed (PMC and Medline). Results: On initial scrutiny, 2.031.242 articles were obtained;after screening with inclusion and exclusion criteria, 17 articles were included. Only 4 articles reported the use of telemedicine for respiratory-related diseases patients;3 of these were COVID-19-related cases. Other 13 articles reported the use of telemedicine for admission, anamnesis, diagnosis, treatment, follow-up, and monitoring purposes for non-respiratory-related diseases. Methods applied include voice calls, video conferences, and specific software on computers and smartphones. There were no significant differences between telemedicine and the face-to-face method, although the lack of health providers' presence has been complained about in the prior method. Conclusion: From this review, telemedicine is a beneficial tool for delivering health services during the COVID-19 pandemic.

Telehealth in physiotherapy during the COVID-19 pandemic, the perspective of the service users: A cross-sectional survey

OBJECTIVE: The satisfaction and acceptance of telehealth by the Irish physiotherapy service user is currently unclear. This study aims to evaluate the Irish service users' experience of physiotherapy delivered totally or partially via telehealth, using a cross-sectional self-reported anonymous postal survey. METHODS: Service users (n = 250) of the Cavan Monaghan physiotherapy department, Health Service Executive (HSE), Republic of Ireland were surveyed. Data was collected on demographics, experience with technology, experience and satisfaction with physiotherapy delivered via telehealth. Qualitative thematic analysis of the free-text responses was completed. RESULTS: A response rate of 40% was achieved. Participants attended physiotherapy for an average of 2.65 months. Upper limb complaints comprised 29% of participants, 27% had a back complaint, 21% had a lower limb complaint and 14% attended for a women's health issue. Those who received their physiotherapy consultation over the phone comprised 78%, while 15% received it virtually and 85% were highly or somewhat satisfied with the telehealth physiotherapy they received. However, 49% prefer blended care (combination of telehealth and face-to-face), 41% prefer face-to-face consultations only and 10% are satisfied with telehealth solely. The recipients of virtual calls were all satisfied. In the future, 60% of these participants would prefer blended care, 20% would prefer face-to-face care only and 20% would be satisfied with telehealth solely. CONCLUSION: The physiotherapy telehealth services were well received. There was a greater acceptance of future telehealth usage by video call recipients compared to those who received a phone call only. Engagement with appropriate service users and their needs will be required to ensure the longevity and success of telehealth. © 2022-IOS Press. All rights reserved.

Patient satisfaction with hospital services in COVID-19 era: A cross-sectional study from outpatient department of a tertiary care hospital in Jammu, UT of J&K, India.

Background: In the coronavirus disease (COVID-19) era, healthcare delivery toward patient-centered orientation has gone a paradigm shift. High levels of adherence to treatment and recommended prevention are usually the outcome of perceived patient satisfaction. Aims: The present study aimed to assess patient satisfaction levels in the COVID-19 era and explore its determinants. Settings and Design: A cross-sectional study from outpatient department of a tertiary care hospital in Jammu, UT of J&K, India. Materials and Methods: The present cross-sectional study was carried out in outpatient department of a tertiary care hospital in the Jammu district. A total of 220 patients were interviewed using consecutive sampling. The tool used to assess patient satisfaction was the patient satisfaction questionnaire-18 (PSQ-18). Statistical Analysis: Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Tests of significance used were ANOVA and t-test. Results: The overall mean satisfaction score was found to be 2.91 ± 0.17 and it was highest in the communication domain (3.12 ± 1.50), whereas it was lowest in the accessibility and convenience domain (2.73 ± 1.17). Except for religion, which was found to be statistically significant (P < 0.05) with overall mean satisfaction score, other sociodemographic variables (occupation, marital status, and monthly family income) were found to be statistically insignificant (P > 0.05). Conclusions: Out of the seven subscales of patient satisfaction, results revealed high scores for communication and financial aspects. Only religion as a demographic variable was found to be significantly associated with patient satisfaction scores. There is a need to improvise the healthcare services in this COVID-19 era in such a manner so that we can contribute to better patient trust leading to a positive influence on health outcomes.