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Coronavirus disease 2019(COVID-19) poses a challenge to hospitals for the prevention and control of public health emergencies. As the main battlefield of preventing and controlling COVID-19, large public hospitals should develop service protocols of diagnosis and treatment for outpatient, emergency, hospitalization, surgery, and discharge. The construction of medical protocols should be based on the risk factors of key points and focused on pre-inspection triage and screening, to establish a rapid response mechanism to deal with exogenous and endogenous risk factors. Implementation of all-staff training and assessment, strengthening the information system, and use of medical internet service are important. This study explores the construction of medical protocols in large public hospitals during the pandemic, and provides a reference for the orderly diagnosis and treatment in hospitals during the pandemic.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.
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Chinese Journal of Microsurgery, based on the premise of doing well in the prevention and control of COVID-19 pandemics, shall keep on driving on the inheritance and innovation, carry forward the spirit of microsurgery, give full play to the advantages of microsurgery technology and improve the level of surgical repair and reconstruction, as well as try new ways for academic communications and give full play to the roles of an academic platform for a professional magazine;Clinical Orthopaedic Microsurgery (internal communication), the internal journal of editorial office, is the "showcase in China" to highlight and disseminate the achievements in microsurgery, focus on the support for the Chinese young microsurgeons who work in the front-line of medical services, provide a platform effectively for the young microsurgeons in China to actively participate in the Sino-English literary exchange, and truly "publish the papers on the land of our motherland".Copyright © 2022 by the authors.
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Background/Objectives: To date, not many studies have been conducted to examine the role of COVID-19 on gestation and fetal development. During COVID-19, pregnant women had difficulty accessing prenatal screening and care due to pandemics restrictions and lockdowns. In this retrospective study we aimed to assess the effect of the SARS-CoV-2 outbreak on fetal development in both prenatal and postnatal outcomes pre-and pre-COVID-19 pandemics in Northern Cyprus. Method(s): A total number of 61 aborted materials were karyotyped during the pre-pandemic period (January 2017 and March 2020) whereas 24 samples were analysed during the peripandemic period (March 2020-November 2021). On the other hand, 25 new-borns blood samples during the pre-pandemic and 44 samples during the pre-pandemic period were analysed. Result(s): No statistically significant difference found in health and abnormal aborted material karyotypes between two periods. On the other hand, a statistical significance was observed in postnatal chromosomal abnormalities (P = 0.04) after two long pandemic lockdowns, which are known as the first and the second waves, dramatically indicating that no baby with Down syndrome was between 2017-2020 whereas seven babies with Down Syndrome were born as consequences of without taking precaution against lockdowns. Conclusion(s): Overall, prenatal care is failed which resulting increased postnatal chromosomal abnormality due to heavy flight restrictions, economic inflation instability, limited access to medical services during COVID-19 pandemic lockdowns in Northern Cyprus.
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Objectives: Assess real-world evidence data on the prevalence and impact of long COVID (LC) to establish a baseline for the value of potential therapeutic interventions. Method(s): This study was a retrospective, longitudinal analysis of administrative claims from multiple payer channels spanning 4/1/2020-6/30/2022. Inclusion criteria: 1) ICD-10-CM diagnosis code of COVID-19 (U07.1) on or after 4/1/2020 (COVID-19 diagnosis date=index date), 2) 18+ years of age on index, and 3) at least -365/+30 days of continuous plan enrollment surrounding index. Employing a conservative LC definition, patients were classified as LC if they presented at least 1 claim >= 28 days following the index date which included both a COVID-19 diagnosis and >=1 of 8 LC-related symptoms. LC and non-LC patients were compared on demographics, COVID-19 symptoms, healthcare utilization, and medical costs. Descriptive statistics were presented for outcomes, and bivariate tests of significance were used to assess differences between cohorts. Result(s): Of 4,938,801 medically attended COVID-19 patients meeting inclusion criteria, 386,153 (7.8%) qualified as LC. The LC patients were older (Mean(SD) = 67.0(19.0) vs. 51.0(20.7)), were more likely to be female (65.1% vs. 60.4%), were in poorer health (Deyo-Charlson Comorbidity Index=3.51(3.24) vs. 1.47(2.45)), and presented greater baseline total medical expenditures ($39,769($60,401) vs. $15,275($35,640);p < 0.0001). On index, LC patients had a higher rate of LC-related symptoms, and in the 180-day post-index period, LC patients incurred increased total medical costs ($38,874($54,098) vs. $7,319($18,439);p < 0.001) and greater use of inpatient and outpatient medical services. Conclusion(s): Patients with LC presented elevated rates of symptoms and incurred 5-fold greater medical costs post-index compared to non-LC patients. This study is one of the first to longitudinally quantify the cost and symptom burden of LC in a real-world setting and helps to establish a baseline for the value of potential therapeutic interventions.Copyright © 2023
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Background: Although over 100 million pregnant women worldwide are at risk of infection with SARS-CoV-2, little data exists on the impact of COVID-19 and related treatments on maternal/neonatal health. Objective(s): (1) To quantify the prevalence of medication use in pregnancy to treat COVID-19, and (2) To quantify and compare the risk of adverse pregnancy/neonatal outcomes in those with and without COVID-19. Method(s): In the Canadian Mother-Child population-based cohort (CAMCCO), two sub-cohorts were identified using prospective data collection of medical services, prescription drugs, hospitalization archives data, and COVID-19 surveillance testing program (02/28/2020- 2021). The first cohort included all pregnant women during the study period regardless of pregnancy status (delivery, induced/planned or spontaneous abortion);this cohort was further stratified on COVID-19 status. The second cohort included all nonpregnant women (aged 15-45) with a positive COVID-19 test. COVID-19 in pregnant or nonpregnant women was assessed using COVID-19 test results or ICD-10CM code U07.1 from hospital data. COVID-19 severity was categorized based on hospital admission. Women were considered exposed to COVID-19 medications if they filled at least one prescription for a medicine included in the WHO list in the 30 days pre- or 30 days post-COVID-19 positive test/diagnosis. Considering potential confounders, association between COVID-19 during pregnancy, treated vs not, and perinatal outcomes were quantified using log-binomial regression models. Result(s): 150,345 pregnant women (3,464 (2.3%) had COVID-19), and 112,073 nonpregnant women with COVID-19 diagnoses were included. Pregnant women with COVID-19 were more likely to have severe infections compared to nonpregnant women with COVID-19 (11.4% vs 1.6%, p<0.001). The most frequent medications used in pregnancy to treat COVID-19 were antibacterials (13.96%), psychoanaleptics (7.35%), and medicines for obstructive airway disease (3.20%). In pregnancy COVID-19 was associated with spontaneous abortions (adjRR 1.76, 95%CI 1.37, 2.25), gestational diabetes (adjRR 1.52, 95%CI 1.18, 1.97), prematurity (adjRR 1.30, 95%CI 1.01, 1.67), NICU admissions (adjRR 1.32, 95%CI 1.10, 1.59);COVID-19 severity was increasing these risks but exposures to COVID-19 medications reduced all risks. Conclusion(s): COVID-19 severity was higher in pregnancy. Antibacterials, psychoanaleptics, and medicines for obstructive airway disease were the most used overall. COVID-19 was associated with adverse outcomes for mothers and newborns.
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Interleukin-6 (IL-6) plays a key role in the pathogenesis of COVID-19, which determines the indications for the therapeutic use of its antagonists. However, data on their effectiveness and optimal timing of appointment are contradictory. The question of the possibility of their use in patients with impaired kidney function has not been studied. The aim of the study is to evaluate the efficacy and safety of the use of monoclonal antibodies to IL-6 receptors in COVID-19 in patients with chronic kidney disease (CKD) of stages 2-5 (predialysis) who do not need renal replacement therapy. Material and methods. A clinical retrospective uncontrolled single-center study included 45 patients (60% of men) with CKD stages 2-5 aged 22-95 years (median - 58 years) hospitalized with predominantly severe uncritical COVID-19 infection. Treatment of COVID-19 was carried out in accordance with the Interim guidelines for the prevention and treatment of new coronavirus infection of the Ministry of Health of Russian Federation. Results. The majority of patients (n=36;73.3%) had CKD stage 3b-5, CKD stage 2 was in 7 (15.5%) and stage 3a - in 5 (11.1%) patients. The median serum creatinine level (Cr) was 164 [131;292] mumol/l, glomerular filtration rate (GFR) was 30 [13;49] ml/min/1.73 m2, CRP 67.5 [37.2;106.75] mg/l. The introduction of monoclonal antibody to IL-6 receptors led to a decrease in the activity of the infectious process (CRP 1.55 [0.33;4.15] mg/l, p<0.001), regression of pneumonia, which did not require mechanical ventilation and hospitalization in the intensive care unit. According to the decision of the medical commission, patients were injected with monoclonal antibodies to IL-6 receptors: tocilizumab (n=36;80%), levilimab (n=2;4.4%), combined therapy with two drugs (n=7;15.5%). Therapy with IL-6 antagonists did not have a negative effect on kidney function. The levels of Cr decreased on average from 224.3+/-145.2 mmol/l at admission to 160+/-92.55 mmol/l at discharge (p<0.001), GFR increased from 32.6+/-20.9 ml/min/1.73 m2 at admission to 53+/-31.7 ml/min/1.73 m2 at discharge (p<0.001). In the majority of patients (n=36, 80%) GFR has risen, and only in 9 (20%) cases it remained approximately at the same low level. No serious adverse events have been reported with the use of IL-6 antagonists, as well as concomitant infectious complications. No deaths have been reported. The median length of stay in bed was 14 [10;19] days. Conclusion. The results of the study allow us to state that in patients with CKD, monoclonal antibodies to IL-6 receptors have a good safety profile and can be successfully used in moderate and severe forms of COVID-19, regardless of the state of kidney function.Copyright © 2022 by the authors.
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Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.Copyright © 2021 The authors.
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Background: Emergency medical technicians (EMTs) or paramedics may not be able to do according to their moral standards during the COVID-19 pandemic, which can cause burnout and job dissatisfaction. Objectives: This study aimed to evaluate moral distress (MD), job satisfaction, and burnout among EMTs during the COVID-19 pandemic. Methods: This cross-sectional study was conducted in Bam, Iran in 2020. In total, 134 EMTs completed the online survey that included demographic information, a MD scale, the Maslach Burnout Inventory, and an item for assessing job satisfaction. Descriptive statistics along with independent samples t-test, one-way analysis of variance, Mann-Whitney U, and Kruskal-Wallis tests, as well as multiple linear regression analysis were used to analyze data. Results: The mean scores of MD and job satisfaction were 25.44 +/- 12.78 and 3.63 +/- 1.07, respectively. Concerning severity, the mean scores of emotional exhaustion, depersonalization, and personal accomplishment (PA) were 35.45 +/- 5.04, 20.61 +/- 3.40, and 33.04 +/- 4.07, respectively. All three burnout subscales were significantly correlated with job satisfaction (P < 0.05) and MD (P < 0.05). Access to personal protective equipment and education level significantly predicted MD (P < 0.05). Conclusion: Despite high burnout and moderate MD, EMTs reported high job satisfaction, possibly because of increased social respect and salary. EMTs can avoid MD and burnout by learning how to handle ethical challenges during the COVID-19 pandemic.
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Background: The concern of contracting COVID-19 has prevented numerous individuals with ambiguous myocardial infarction symptoms from seeking medical attention, leading to delayed presentation and treatment of acute coronary syndrome (ACS). This delay could increase the risk of long-term consequences. Aim: The aim of this study is to evaluate the impact of illness perception on delay in seeking medical help in patients with acute chest pain in UAE during COVID-19 pandemic. Methods: A descriptive cross-sectional design was used. Results: A total of 222 in-patients participated in the study, with an average age of 54.3 years (SD=14, Range= 20-86). The average score of illness perception was 5.66 (SD=0.92), which indicates that CVD was perceived as moderately threatening to physical and emotional status. Univariate analysis showed that illness coherence having previous cardiac catheterization, diabetes and asthma were factors associated with delay in seeking medical services. The linear regression showed that college education was a strong predictor of delay, while a history of asthma and undergoing cardiac catheterization were independent predictors of shorter delay. Conclusion: Illness coherence perception and time of seeking medical help are correlated. In addition, illness perception of personal control is low, which indicates the need for educational intervention. Other clinical factors also impact patients' decisions, such as previous cardiac intervention and comorbidity, highlighting the target group for further attention from the healthcare team. © 2023 Mosleh et al.
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Introduction: Since the beginning of COVID 19 pandemic, more than 641 million cases and 6.63 million confirmed deaths were reported worldwide. A rapid development of COVID 19 Vaccine was the breakthrough in the prevention and control of COVID 19. India has commenced its vaccination drive from January 16, 2021 and has administered more than 219 crores vaccination to date it its people. On war foot, Reliance Industries Limited also launched its free vaccination coverage program - Mission Vaccine Suraksha for employees, family members, and community by collaborating with local authorities and governments. The organization also provided free vaccination to Kerala, Gujarat, Rajasthan, and Maharashtra besides various other national and regional organisations to speed up the vaccination drive. Methodology: A taskforce including stakeholders form the Medical Services, HR, Procurement, Logistics, transportation, digital systems was formed to oversee, implement, monitor, and evaluate a successful vaccine roll-out drive. The drive included Covishield and Covaxin COVID 19 vaccines. As a single point of contact, Reliance Foundation HN Hospital procured, stored, and transported vaccines to all locations. At par with Govt. protocols, Reliance developed its own workplace COVID vaccination centres (CVCs) at its corporate headquarters and 11 other manufacturing sites in Maharashtra and Gujrat. For Cold chain management, Reliance procured Ice Lined Refrigerators (ILRs), refrigerators, vaccine carriers, icepacks, etc. for each CVC. Dedicated medical and paramedical staffs were recruited and trained to carry out vaccination drive with all the COVID 19 protocols in place. Reliance tied up with multiple hospitals to carry out pan-India vaccination drive. The entire operation was digitally enabled by involving mediums such as Reliance's in-house app JioHealthHub (JHH) that included end-to-end vaccination journey, i.e., from slot booking, CoWIN registration, post-vaccination care, uploading of the certificates, etc. Vaccine inventory was monitored by Reliance's digital system named KiviHealth. A vaccination dashboard was created to track real time vaccination update. Result(s): 40 lakh vaccine doses were provided free of cost to support the nationwide vaccination programme. Till date, 31,63,870 beneficiaries were covered under R-Suraksha under which, 15,94,357 people received their 1st dosage, 13,36,613 received the 2nd dose, and 2,32,900 people have received the precautionary dose. Reliance also commenced vaccination for children aged 12 to 17 years covering 7369 children for 1st dose, 5802 children for 2nd dose. Reliance has achieved 100% compliance for 2 doses of COVID 19 vaccination for its employees and contract workers across manufacturing units. Precautionary dose was administered to 75% of employees and contract workers to date. 25 mild and 3 moderate Adverse Event Following Immunization (AEFI) cases were recorded during vaccination at workplace CVCs, which were managed and sent home. Conclusion(s): Reliance's Mission Vaccine Suraksha has reached to all corners of the country, including people with disabilities, the elderly, homeless, and those in far-flung locations. Reliance faced hurdles in procuring and storing of the vaccines at the beginning of the operation. However, this was tackled effectively with strategic approach. The initiative is still ongoing ensuring maximum precautionary dosage coverage for everyone.
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Purpose of Study As a result of the coronavirus disease 2019 (COVID-19) pandemic and physical distancing, telehealth has been scaled up as a key strategy to address the need for virtual access to medical services. Previous studies have examined use of web-portals for accessing health information, but data on the use of live video telemedicine for disease management across different ethnicities is limited. The objective of this study is to determine if disparities exist among different ethnic groups in accessing live video telemedicine services. Methods Used A literature review was conducted using databases such as PubMed and Google Scholar. Key search terms included: telehealth, telemedicine, ethnicity, and disparities. Studies were included if a) they were conducted in the United States, b) patients used a live video telehealth service with a provider, c) focused on telemedicine use across different racial and ethnic groups, and d) investigated completed access to live video telemedicine at the individual level, and not potential access at the aggregate level. Summary of Results Of 25 articles found, 5 met our inclusion criteria. Overall, white patients had higher rates of telehealth visit completion and video telehealth use than non-white patients. Studies that used telehealth visits for diabetes education and glycemic control showed that self-care improved in all ethnic groups, but despite tailored intervention, minority groups never achieved the same level of self-care as whites. Conclusions Our review suggests that overall white patients have better access to live video telemedicine, and use the services at higher rates compared to non-white patients. However, since this trend was not seen in every study, it is likely that other factors beyond race and ethnicity play a role in access to telemedicine. Effective strategies are needed to mitigate disparities to ensure equitable telemedicine access.
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BACKGROUND: Covidom was a telemonitoring solution for home monitoring of patients with mild to moderate COVID-19, deployed in March 2020 in the Greater Paris area in France to alleviate the burden on the health care system. The Covidom solution included a free mobile application with daily monitoring questionnaires and a regional control center to quickly handle patient alerts, including dispatching emergency medical services when necessary. OBJECTIVE: This study aimed to provide an overall evaluation of the Covidom solution 18 months after its inception in terms of effectiveness, safety, and cost. METHODS: Our primary outcome was to measure effectiveness using the number of handled alerts, response escalation, and patient-reported medical contacts outside of Covidom. Then, we analyzed the safety of Covidom by assessing its ability to detect clinical worsening, defined as hospitalization or death, and the number of patients with clinical worsening without any preceding alert. We evaluated the cost of Covidom and compared the cost of hospitalization for Covidom and non-Covidom patients with mild COVID-19 cases seen in the emergency departments of the largest network of hospitals in the Greater Paris area (Assistance Publique-Hôpitaux de Paris). Finally, we reported on user satisfaction. RESULTS: Of the 60,073 patients monitored by Covidom, the regional control center handled 285,496 alerts and dispatched emergency medical services 518 times. Of the 13,204 respondents who responded to either of the follow-up questionnaires, 65.8% (n=8690) reported having sought medical care outside the Covidom solution during their monitoring period. Of the 947 patients who experienced clinical worsening while adhering to daily monitoring, only 35 (3.7%) did not previously trigger alerts (35 were hospitalized, including 1 who died). The average cost of Covidom was 54 (US $1=0.8614) per patient, and the cost of hospitalization for COVID-19 worsening was significantly lower in Covidom than in non-Covidom patients with mild COVID-19 cases seen in the emergency departments of Assistance Publique-Hôpitaux de Paris. The patients who responded to the satisfaction questionnaire had a median rating of 9 (out of 10) for the likelihood of recommending Covidom. CONCLUSIONS: Covidom may have contributed to alleviating the pressure on the health care system in the initial months of the pandemic, although its impact was lower than anticipated, with a substantial number of patients having consulted outside of Covidom. Covidom seems to be safe for home monitoring of patients with mild to moderate COVID-19.
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COVID-19 , Humans , Cohort Studies , Hospitalization , Delivery of Health Care , Emergency Service, HospitalABSTRACT
As COVID-19 was declared a health emergency in March 2020, there was immense demand for information about the novel pathogen. This paper examines the clinician-reported impact of Project ECHO COVID-19 Clinical Rounds on clinician learning. Primary sources of study data were Continuing Medical Education (CME) Surveys for each session from the dates of March 24, 2020 to July 30, 2020 and impact surveys conducted in November 2020, which sought to understand participants' overall assessment of sessions. Quantitative analyses included descriptive statistics and Mann-Whitney testing. Qualitative data were analyzed through inductive thematic analysis. Clinicians rated their knowledge after each session as significantly higher than before that session. 75.8% of clinicians reported they would 'definitely' or 'probably' use content gleaned from each attended session and clinicians reported specific clinical and operational changes made as a direct result of sessions. 94.6% of respondents reported that COVID-19 Clinical Rounds helped them provide better care to patients. 89% of respondents indicated they 'strongly agree' that they would join ECHO calls again.COVID-19 Clinical Rounds offers a promising model for the establishment of dynamic peer-to-peer tele-mentoring communities for low or no-notice response where scientifically tested or clinically verified practice evidence is limited.
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Following the recent adjustments to coronavirus disease 2019 (COVID-19) prevention and control policies, an increasing number of medical staffs, especially those in primary care facilities are confront-ed with rapid growth of COVID-19 patients. Peking Union Medical College Hospital (PUMCH) has therefore compiled this recommendation for COVID-19 primary care practices based on a patient-centered perspective and following recommendations from domestic and international guidelines as well as the latest Chinese government policies. Further, PUMCH.s conception and compilation of this recommendation strictly adhere to evidence-based, concise and clinically applicable principles of practice. For the critical clinical questions with insufficient medical evidence, the recommendation offers insights on the basis of experience from PUMCH multi-disciplinary expert team and first-line medics.practices. Emphasizing on screening community residents with higher risk of severe illness, implementing early interventions including pharmaceutical treatment, enhan-cing nutritional support and improving sleep quality, we aim to construct a "Household-Community-Hospital" tertiary defense, with the hope of promoting health and reducing severe cases.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.
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Background: On March 2020, the federal government of Kosovo declared a nationwide lockdown due to the COVID-19 pandemic until May 2020. Since the lockdown, examinations and routine checkups have been restricted. This resulted in a severe decline in patient referrals to the hospitals. We want to assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological cancers. Method(s): The data are taken from our patient database. Data from 752 patients from the only cancer centre in Kosovo with newly diagnosed gynaecological cancer between 2019, 2020 and 2021 were collected. Incidence, age group, stages of diagnosis and geographical distribution were compared between the time before and after the COVID-19 outbreak. Result(s): Our results showed a slight decline in newly diagnosed cancers in 2020 as compared with 2019 and 2021: -17 % in 2020 versus an increase of 18% in 2019. We expected to have a major increase in 2021 but data shows that it was a slight increase of 17%. As we not expected after the COVID-19 pandemic we have a strong decline of metastatic new cases of 39% in 2021 compared to 2020 and a 60% decline in 2020 compared to 2019. The results show a slight increase of 13 % in the early stages from 2020 to 2021 and the same rates come up from 2019 to 2020. In all three years in a row the dominant type of cancer according to localization is corpus uteri then cervix uteri and ovarian cancer with respectively 39%, 26%, and 33% in 2019, 36%, 33%, and 29% in 2020 and the last, 40%, 26% and 32% in 2021. The groupages have a slight shift from 45-49 years old the peak of new cases in 2021. Conclusion(s): The lockdown led to a slight decrease in the number of newly diagnosed cases. The decreased accessibility of the medical services has not led to significant higher number of metastatic new diagnosed cases, on contrary lower metastatic cases and higher number of early cases and slight increase on advanced cases were presented in 2021. The impact on incidence were not significantly higher in 2021 despite the lockdown. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future. Effective, appropriate and affordable cancer prevention and control strategies are urgently needed in Kosovo for gynaecological cancer especially cervical cancer. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.Copyright © 2023 European Society for Medical Oncology
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During a large-scale epidemic, a local healthcare system can be overwhelmed by a large number of infected and non-infected patients. To serve the infected and non-infected patients well with limited medical resources, effective emergency medical service planning should be conducted before the epidemic. In this study, we propose a two-stage stochastic programming model, which integrally deploys various types of emergency healthcare facilities before an epidemic and serves infected and non-infected patients dynamically at the deployed healthcare facilities during the epidemic. With the service equity of infected patients and various practical requirements of emergency medical services being explicitly considered, our model minimizes a weighted sum of the expected operation cost and the equity cost. We develop two comparison models and conduct a case study on Chengdu, a Chinese city influenced by the COVID-19 epidemic, to show the effectiveness and benefits of our proposed model. Sensitivity analyses are conducted to generate managerial insights and suggestions. Our study not only extends the existing emergency supply planning models but also can facilitate better practices of emergency medical service planning for large-scale epidemics. © Operational Research Society 2023.
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Background: The sudden COVID-19 has changed people's living habits, and skin diseases closely related to lifestyle have also changed quietly. We aimed to analyze the changing of pediatric dermatological disorders spectrum before and during the COVID-19 pandemic in China. Method(s): This retrospective study encompasses consecutive patients attending a number of dermatological outpatient clinics in National Center for Children's Health from 1 January 2019 and 31 December 2021. The information about the season, age, number, disease type and origin of the patients was filled in for all the patients. The diseases were sub-classified on etiological basis. Result(s): The total number of patients was 449032, including 323142 newly diagnosed patients, with a male/female ratio of 1.15:1. The patients were mainly school-age children. 91.3% of the patients suffered from a single skin disease. During the epidemic of COVID-19-epidemic, Atopic Dermatitis (AD )and other types of dermatitis constituted the main diseases, followed by infectious skin diseases, urticaria, erythema and drug responsive skin diseases, and finally parasites and bite responsive skin diseases. The top three skin diseases ranked in descending order of incidence from 2019 to 2021 were the same, followed by AD, urticaria and papular urticaria. During the epidemic period, the proportion of patients with molluscum contagiosum, verruca vulgaris and vitiligo increased. Because of wearing masks, the proportion of infectious skin diseases transmitted by respiratory tract has decreased significantly. In addition, pediatric telemedicine can be used to increase timely access and improve practical efficiency during the epidemic. Conclusion(s): The pediatric dermatological disorders spectrum has changed during the epidemic of COVID-19. AD is the most common skin disease, and the proportion of infectious skin diseases has decreased significantly. During the epidemic, pediatric internet medical services were fully used to promote the sustainable development of children's skin health.Copyright © 2023
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Chinese village doctors, the "gatekeepers" of rural residents' health, shoulder heavy responsibility of providing basic public health services (BPHS) for rural residents. The health-care reform on BPHS launched in 2009 has much influenced village doctors as well as the delivery of health service. This chapter has depicted the challenges and struggles facing Chinese village doctors in the BPHS. COVID-19 is the specific setting for a better understanding of a more real situation. The findings suggest that the diverse roles that the village doctors display as well as the multiple challenges faced by village doctors in the setting of China's prevention and control against COVID-19, however, make the supply of rural medical services uncertain and unsustainable, which would undermine China's reform of primary medical and health care system. © 2023 Nova Science Publishers, Inc.
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With the increasing number of foreigners residing in Korea, there is a need for further research on medical service satisfaction for this demographic. Therefore, this study aimed to analyze the impact of medical service quality on customer satisfaction and revisit intention of foreigners in Korea during the COVID-19 pandemic. An online survey was conducted from 15 March to 15 May 2022 to gather data from foreign residents in Korea. A total of 201 questionnaires were analyzed using IBM SPSS Statistics 26.0 and Smart PLS3.0 for empirical analysis. The results of the study demonstrate that reliability, empathy, and COVID-19 regulations (excluding responsiveness, assurance, and tangibles) positively impact customer satisfaction with medical services. Additionally, customer satisfaction with medical services positively affects revisit intention. Furthermore, variables, such as nationality and medical department, show average differences. These findings suggest that hospitals should focus on COVID-19 prevention and the quality of medical services, while also taking into account unique characteristics, such as nationality and medical department. This study provides essential reference data for medical institutions exposed to infinite competition, informing management strategies to increase customer satisfaction and revisit intention during COVID-19. © 2023 by the authors.
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Outcomes: 1. Learners will identify cultural barriers to the establishment of trust between patients' loved ones and the healthcare provider team and integrate methods to reduce cultural barriers. 2. Through this presentation healthcare providers will strengthen ability to understand how to be a cultural guest of patients, and their loved ones, in healthcare settings. In the stressful environment of the intensive care unit (ICU), cultural differences between healthcare providers and patients' loved ones can prevent the establishment of trust. Healthcare providers can address this barrier by respecting cultural practices utilized as comfort mechanisms by patients and their loved ones. The objective of this research is to determine how healthcare providers can be genuine cultural guests of patients and their loved ones in the ICU setting. We employed a qualitative descriptive design with 22 family caregivers. Semi-structured, audio-recorded phone interviews were conducted between February 2021 and October 2021, with caregivers whose family member had been in the ICU between May 2019 and August 2020. The sample included a majority of female (87%), Black (53%) caregivers with an average age of 53. The research team employed a conventional and directed qualitative content analysis to code transcribed interviews, followed by the development of a formative categorization matrix, and theoretical labeling of the main categories and subcategories. We identify four pillars that facilitate the cultural guest mindset: form genuine connection, build trust, establish expectations, and respect culture. The formation of genuine connection entails healthcare provider investment, specifically by keeping the patient's family regularly updated on the patient's condition. Building trust also necessitates that healthcare providers engage in frequent open communication with the family, while avoiding the use of complex medical jargon. Establishing expectations requires healthcare providers to assess the culture of patients and their loved ones in order to understand how to best support the family's needs. Finally, respect of cultural practices can foster a sense of collaboration with patients and their families, who may feel that the healthcare providers are on an opposing team. Implementing these practices, healthcare providers can provide medical services in a way that complement patients' culture, enhancing the patient and caregivers' ICU experience.Copyright © 2023