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1.
Expert Systems with Applications ; : 119262, 2022.
Article in English | ScienceDirect | ID: covidwho-2104915

ABSTRACT

The onset of the COVID-19 pandemic has changed consumer usage behavior towards mobile payment (m-payment) services. Consumer usage behavior towards m-payment services continues to increase due to access to usage experiences shared through online consumer reviews (OCRs). The proliferation of massive OCRs, coupled with quick and effective decisions concerning the evaluation and selection of m-payment services, is a practical issue for research. This paper develops a novel decision evaluation model that integrates OCRs and multi-attribute decision-making (MADM) with probabilistic linguistic information to identify m-payment usage attributes and utilize these attributes to evaluate and rank m-payment services. First and foremost, the attributes of m-payment usage discussed by consumers in OCRs are extracted using the Latent Dirichlet Allocation (LDA) topic modeling approach. These key attributes are used as the evaluation scales in the MADM. Based on an unsupervised sentiment algorithm, the sentiment scores of the text reviews regarding the attributes are calculated. We convert the sentiment scores into probabilistic linguistic elements based on the probabilistic linguistic term set (PLTS) theory and statistical analysis. Furthermore, we construct a novel technique known as probabilistic linguistic indifference threshold-based attribute ratio analysis (PL-ITARA) to discover the weight importance of the usage attributes. Subsequently, the positive and negative ideal-based PL-ELECTRE I methodology is proposed to evaluate and rank m-payment services. Finally, a case study on selecting appropriate m-payment services in Ghana is examined to authenticate the validity and applicability of our proposed decision evaluation methodology.

2.
Computers & Industrial Engineering ; 174:108773, 2022.
Article in English | ScienceDirect | ID: covidwho-2104547

ABSTRACT

Developments in transportation systems, changes in consumerism trends, and conditions such as COVID-19 have increased both the demand and the load on freight transportation. Since various companies are transporting goods all over the world to evaluate the sustainability, speed, and resiliency of freight transportation systems, data and freight fluidity measurement systems are needed. In this study, an integrated decision-making model is proposed to advantage prioritize the freight fluidity measurement alternatives. The proposed model is composed of two main stages. In the first stage, the Dombi norms based Logarithmic Methodology of Additive Weights (LMAW) is used to find the weights of criteria. In the second phase, an extended Evaluation based on the Distance from Average Solution (EDAS) method with Dombi unction for aggregation is presented to determine the final ranking results of alternatives. Three freight fluidity measurement alternatives are proposed, namely doing nothing, integrating freight activities into Metaverse for measuring fluidity, and forming global governance of freight activities for measuring fluidity through available data. Thirteen criteria, which are grouped under four main aspects namely technology, governance, efficiency, and environmental sustainability, and a case study at which a ground framework is formed for the experts to evaluate the alternatives considering the criteria are used in the multi-criteria decision-making process. The results of the study indicate that integrating freight activities into Metaverse for measuring fluidity is the most advantageous alternative, whereas doing nothing is the least advantageous one.

3.
Heliyon ; 8(11): e11552, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2105016

ABSTRACT

Background: The COVID-19 outbreak has changed nearly all societal domains, including medical rehabilitation. Social distancing measures impacted patients as well as health professionals during the rehabilitation process. Enhancing patient participation should not be forgotten during exceptional situations, as restrictive measures are related to the self-determination of patients. Aim: In this exploratory trend study, we aimed to examine the association between COVID-19 restrictions with patients' motivation, their perception of the patient-provider-relationship, their participation in the rehabilitation process and their current state of health at the beginning of their rehabilitation. Methods: Adopting an exploratory approach, we compared data from a convenience sample of two different groups of patients, who stayed at a cardiac rehabilitation clinic at two different time periods: before the COVID-19 lockdown of rehabilitation clinics (n = 128) and after reopening during the COVID-19 period (n = 137). We used questionnaires on motivation for rehabilitation, patient-provider-relationship, patient activation and perceived state of health. We conducted t-tests and regression analysis to determine whether there were differences by gender, age, heart failure status, preferred form of decision-making (shared/not-shared) and time of rehabilitation (before/during COVID-19) related to the outcome variables. Results: Participants evaluated the quality of the patient-provider-relationship in a better way after the reopening of the rehabilitation clinics during the COVID-19 period (p < 0.05), their motivation, participation in the rehabilitation process and their current state of health at the beginning of their rehabilitation was comparable to the group before the COVID-19 lockdown of rehabilitation clinics. Differences in scepticism concerning the treatment and the quality of the patient-provider-relationship were related (p < 0.05) to age and the preferred form of decision-making. Differences in active participation were related (p < 0.05) to sex and differences in the perceived state of health (p < 0.05) to a heart failure diagnosis. Conclusions: Treatment providers could use the time patients spend in isolation after arrival to prepare them for virtual goal-setting conversations to enhance patient participation in exceptional situations.

4.
Comput Ind Eng ; 174: 108811, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2104549

ABSTRACT

The COVID-19 pandemic hit the medical supply chain, creating a serious shortage of medical equipment. To meet the urgent demand, one realistic way is to collect abandoned medical equipment and then remanufacture, where the disassembled modules are shared with all stock-keeping units (SKUs) to improve utilization. However, in an emergency, the equipment should be processed sequentially and immediately, which means the decision is short-sighted with limited information. We propose a hybrid combinatorial remanufacturing (HCR) strategy and develop two reinforcement learning frameworks based on Q-learning and double deep Q network to find the optimal recovery option. In the frameworks, we transform HCR problem into a maze exploration game and propose a rule of descending epsilon-greedy selection on reweighted valid actions (DeSoRVA) and Espertate knowledge dictionary to combine the cost-minimizing objective with human judgment and the global state of the problem. A real-time environment is further implemented where the quality status of the in-transit equipment is unknown. Numerical studies show that our algorithms can learn to save cost, and the larger scale of the problem is, the more cost-down can be achieved. Moreover, the sophisticated knowledge refined by Espertate is effective and robust, which can handle remanufacturing problems at different scales corresponding to the volatility of the pandemic.

5.
Granular Computing ; 2022.
Article in English | Web of Science | ID: covidwho-2104180

ABSTRACT

The information aggregation of cubic fuzzy numbers and picture fuzzy numbers have played an important role in decision making. This paper introduces a novel approach to address the problem of testing facility of COVID-19 under picture cubic fuzzy environment. As the picture cubic fuzzy set is a generalized fuzzy structure to handle more uncertainty and ambiguity in decision making problems We discuss its various properties. Based on geometric aggregation operators and Hamacher operations, we introduce some Hamacher geometric aggregation operators under picture cubic fuzzy information. Namely, picture cubic fuzzy Hamacher weighted geometric aggregation operator, picture cubic fuzzy Hamacher hybrid geometric operator, picture cubic fuzzy Hamacher order weighted geometric aggregation operator. Discuss some properties of the defined operators. To verify the importance of the proposed operators, develop multicriteria group decision making (MCGDM) algorithm under picture cubic fuzzy environment and apply this strategy for the selection of an authentic laboratory for COVID-19 test. Further to validate the supremacy of our proposed operators, we present a comparative analysis with pre-existing aggregation operators. Results show that the proposed technique is more effective and suitable for MCGDM problems.

6.
Aging Clin Exp Res ; 2022 Nov 05.
Article in English | MEDLINE | ID: covidwho-2104164

ABSTRACT

BACKGROUND: In the Netherlands, it is customary to discuss directives regarding resuscitation, intubation, and ICU-admission with patients and/or their relatives upon hospital-admission. The outcome of this discussion is documented in a code status. Ideally, these advance care planning (ACP)-related decisions are made by a patient (and/or their relatives) and a professional together in a shared decision-making (SDM) process, to improve patient satisfaction and prevent undesired care. Given the bad outcomes in older COVID-19 patients, it is particularly important to discuss the code status upon admission. This study aims to describe the practice of SDM regarding code status during the COVID-pandemic. Specific aims were to find out to what extend patients took part in this decision-making process and whether all key elements of SDM for a shared decision were documented in medical reports. METHODS: In this retrospective cohort study, we included COVID-19 patients aged 70 years and older, admitted to two large teaching hospitals in the Netherlands, during the first months of the COVID-19 pandemic in 2020. Data about code status and the decision-making process were extracted from electronic healthcare records. RESULTS: Code status was documented for 274 of 275 included patients. Patient participation in the decision-making process was described in 48%. In 19% all key elements of shared decision-making have been described. Key elements of SDM were defined as the presence of a completed code status form, the presence of clinical notes showing that both patient's wishes and values and the opinion of the healthcare professional about the predicted outcome was taken into consideration and clinical notes of a patient-healthcare professional interaction during the admission. CONCLUSION: Our results show that a proper SDM process regarding code status is possible, even in hectic times like the COVID-19-pandemic. However, shared decision-making was not common practice in older patients with COVID-19 regarding code status (an ACP-related decision) in the early phase of the COVID-19 pandemic. Only in 19% of the patients, all key elements of SDM regarding code status were described.

7.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 84(1-B):No Pagination Specified, 2023.
Article in English | APA PsycInfo | ID: covidwho-2101857

ABSTRACT

Innovation in causal inference and implementation of electronic health record systems are rapidly transforming medical care. In this dissertation, we present three examples in which use of methods in causal inference and large electronic health record data address existing challenges in medical decision-making. First, we use principles of causal inference to examine the structure of randomized trials of biomarker targets, which have produced divergent results and controversial clinical guidelines for management of hypertension and other chronic diseases. We discuss four key threats to the validity of trials of this design. Second, we use methods in causal inference for adjustment of time-varying confounding to estimate the effect of time-varying treatment strategies for hypertension. We report the results of a study which used longitudinal electronic health record data from a prospective virtual cohort of veterans. Third, we use individual-level electronic health record data to predict the need for critical care resources during surges in COVID-19 cases, to aid hospital administrators with resource allocation in periods of crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

8.
Health Evidence Network synthesis report|76 ; 2022.
Article in English | WHOIRIS | ID: covidwho-2101132

ABSTRACT

This report explores how knowledge translation (KT) and cultural contexts are conceptualized and utilized, with a focus on health policy-making theory and practice. KT takes place within cultural contexts that can powerfully frame what policy problems are and what type of research is accepted by policy-makers. This is illustrated with studies from the COVID-19 pandemic regarding the use of face masks across cultures and of the influence of cultural contexts on KT and evidence-informed decision-making arising from the Black Lives Matter movement. Many Indigenous cultures conceptualize physical health in a holistic manner that encompasses both social and ecological aspects, which are often not considered in the biomedical understanding of health. Effective KT within local cultural contexts requires going beyond general categories (such as Indigenous culture) and assumptions about particular types of culture. Some KT models and frameworks include local context as a factor in translation, identifying community-, culture- and language-focused strategies to improve cultural competency for health-care interventions. Policy considerations are suggested that support the adoption of complex understandings of cultures in knowledge production, communication, translation and use.

9.
Asia Pacific Journal of Health Management ; 17(2), 2022.
Article in English | Web of Science | ID: covidwho-2100726

ABSTRACT

PURPOSE: COVID-19 has been recognized as a contagious disease which can cause serious health problems, even proving to be fatal in some cases. The swift spread of COVID-19 epidemic shook the world which led to lockdowns, isolation, and social distancing for the general population so as to curb and contain the spread. This was found to lead to mental health disorders amongst people. This study examines the prevalence and severity of anxiety, stress perception, and well-being levels among the people at the time when the COVID-19 was in regression (decline) in India.METHODS: In this cross-sectional study, 374 respondents' mental health was evaluated using three standardized questionnaires: Generalized Anxiety Disorder [GAD-7], Perceived Stress Scale [PSS-4], and Five Wellbeing Index [WHO-5].RESULTS: The study revealed that almost 82% of respondents had moderate to severe levels of stress while 66% of respondents had mild to moderate levels of anxiety. Overall, 60% of respondents had poor (low) mental well-being. A strong negative correlation was found between mental well-being and perceived stress, and mental well-being and level of anxiety, in comparison to the correlation between anxiety and perceived stress was positive and statistically significant.CONCLUSIONS: This study identified several long-term psychological effects of COVID. The presence of stress and anxiety and poorer mental well-being even at the time of decline in COVID-19 cases, highlights the need for serious attention to be given to psychological and psychiatric help and support throughout the duration and regression of such diseases. Health policymakers must ensure coherent and consistent plans for screening the mental health of the general population are in place to provide the required support in managing the long-term psychological and psychiatric effects of COVID.

10.
BMC Med Ethics ; 23(1): 45, 2022 04 19.
Article in English | MEDLINE | ID: covidwho-1798405

ABSTRACT

BACKGROUND: Commentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units (ICUs). Our aim was twofold: (1) to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and (2) determine the association between the ethical climate, moral distress, and intention to leave. METHODS: We performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire (EDMCQ) and the Measure of Moral Distress for Healthcare Professionals (MMD-HP) tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave. RESULTS: Nurses perceived the ethical climate for decision-making as less favorable than physicians (p < 0.05). They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/Pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units (3.54 ± 0.66 vs. 3.43 ± 0.81 vs. 3.30 ± 0.69; respectively; both p ≤ 0.05) and also demonstrated lower moral distress scores (both p < 0.05) and lower "intention to leave" scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated (r = -0.58, p < 0.001); moral distress and "intention to leave" was positively correlated (r = 0.52, p < 0.001); and ethical climate and "intention to leave" were negatively correlated (r = -0.50, p < 0.001). CONCLUSIONS: Significant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care.


Subject(s)
Attitude of Health Personnel , Intention , Child , Cross-Sectional Studies , Hospitals , Humans , Infant, Newborn , Intensive Care Units , Job Satisfaction , Morals , Stress, Psychological , Surveys and Questionnaires
11.
Ann Oper Res ; : 1-43, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1820664

ABSTRACT

The year 2020 can be earmarked as the year of global supply chain disruption owing to the outbreak of the coronavirus (COVID-19). It is however not only because of the pandemic that supply chain risk assessment (SCRA) has become more critical today than it has ever been. With the number of supply chain risks having increased significantly over the last decade, particularly during the last 5 years, there has been a flurry of literature on supply chain risk management (SCRM), illustrating the need for further classification so as to guide researchers to the most promising avenues and opportunities. We therefore conduct a bibliometric and network analysis of SCRA publications to identify research areas and underlying themes, leading to the identification of three major research clusters for which we provide interpretation and guidance for future work. In doing so we focus in particular on the variety of parameters, analytical approaches, and characteristics of multi-criteria decision-making techniques for assessing supply chain risks. This offers an invaluable synthesis of the SCRA literature, providing recommendations for future research opportunities. As such, this paper is a formidable starting point for operations researchers delving into this domain, which is expected to increase significantly also due to the current pandemic.

12.
Eur J Med Res ; 27(1): 223, 2022 Oct 29.
Article in English | MEDLINE | ID: covidwho-2098456

ABSTRACT

PURPOSE: Gamma knife radiosurgery (GK) is a commonly used approach for the treatment of intracranial lesions. Its radiation response is typically not immediate, but delayed. In this study, we analyzed cases from a prospectively collected database to assess the influence of COVID-19 pandemic on the decision making in patients treated by gamma knife radiosurgery. METHODS: From January 2019 to August 2021, 540 cases of intracranial lesions were treated by GK with 207 cases before COVID-19 pandemic as a control. During the COVID-19 pandemic, 333 cases were similarly treated on patients with or without the COVID-19 vaccination. All the GK treated parameters as well as time profile in the decision making were analyzed. The parameters included age, sex, characteristic of lesion, targeted volume, peripheral radiation dose, neurological status, Karnofsky Performance Status (KPS), time interval from MRI diagnosis to consultation, time interval from the approval to treatment, frequency of outpatient department (OPD) visit, and frequency of imaging follow-up. RESULTS: Longer time intervals from diagnosis to GK consultation and treatment were found in the pandemic group (36.8 ± 25.5/54.5 ± 27.6 days) compared with the pre-COVID control (17.1 ± 22.4/45.0 ± 28.0 days) or vaccination group (12.2 ± 7.1/29.6 ± 10.9 days) (p < 0.001, and p < 0.001, respectively). The fewer OPD visits and MRI examinations also showed the same trends. High proportion of neurological deficits were found in the pandemic group (65.4%) compared with the control (45.4%) or vaccination group (58.1%) (p < 0.001). The Charlson comorbidity in the pandemic group was 3.9 ± 3.3, the control group was 4.6 ± 3.2, and the vaccination group was 3.1 ± 3.1. There were similar inter-group difference (p < 0.001). In multiple variant analyses, longer time intervals from the diagnosis to consultation or treatment, OPD frequency and MRI examination were likely influenced by the status of the COVID-19 pandemic as they were alleviated by the vaccination. CONCLUSIONS: The decision making in patients requiring gamma knife treatment was most likely influenced by the status of the COVID-19 pandemic, while vaccination appeared to attenuate their hesitant behaviors. Patients with pre-treatment neurological deficits and high co-morbidity undergoing the gamma knife treatment were less affected by the COVID-19 pandemic.


Subject(s)
Brain Neoplasms , COVID-19 , Radiosurgery , Humans , Radiosurgery/adverse effects , Radiosurgery/methods , COVID-19/epidemiology , Pandemics , COVID-19 Vaccines , Retrospective Studies , Decision Making , Follow-Up Studies , Treatment Outcome
13.
Scand J Trauma Resusc Emerg Med ; 29(1): 173, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-2098403

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic and the risk of an extensive overload of the healthcare systems have elucidated the need to make decisions on the level of life-sustaining treatment for patients requiring hospitalisation. The purpose of the study was to investigate the proportion and characteristics of COVID-19 patients with limitation of life-sustaining treatment decisions and the degree of patient involvement in the decisions. METHODS: A retrospective observational descriptive study was conducted in three Danish regional hospitals, looking at all patients ≥ 18 years of age admitted in 2020 with COVID-19 as the primary diagnosis. Lists of hospitalised patients admitted due to COVID-19 were extracted. The data registration included age, gender, comorbidities, including mental state, body mass index, frailty, recent hospital admissions, COVID-19 life-sustaining treatment, ICU admission, decisions on limitations of life-sustaining treatment before and during current hospitalisation, hospital length of stay, and hospital mortality. RESULTS: A total of 476 patients were included. For 7% (33/476), a decision about limitation of life-sustaining treatment had been made prior to hospital admission. At the time of admission, one or more limitations of life-sustaining treatment were registered for 16% (75/476) of patients. During the admission, limitation decisions were made for an additional 11 patients, totaling 18% (86/476). For 40% (34/86), the decisions were either made by or discussed with the patient. The decisions not made by patients were made by physicians. For 36% (31/86), no information was disclosed about patient involvement. CONCLUSIONS: Life-sustaining treatment limitation decisions were made for 18% of a COVID-19 patient cohort. Hereof, more than a third of the decisions had been made before hospital admission. Many records lacked information on patient involvement in the decisions.


Subject(s)
COVID-19 , Denmark/epidemiology , Humans , Patient Participation , Retrospective Studies , SARS-CoV-2
14.
J Surg Educ ; 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2095711

ABSTRACT

OBJECTIVE: The abrupt cessation of in-person education due to the COVID-19 pandemic has made it difficult for preclerkship students to explore a career in surgery. To supplement the lack of exposure, the Surgical Exploration and Discovery (SEAD) program was transitioned to an entirely virtual format. This study aims to describe the virtual SEAD program and evaluate its effectiveness as a career decision-making (CDM) intervention. DESIGN: The week-long program was delivered on Microsoft Teams, featured 11 surgical specialties, and comprised four activities: live demonstrations, virtual operating room observerships, career talks, and technical skills workshops. The program was evaluated using the four levels of the Kirkpatrick model: (1) reactions, (2) knowledge, (3) CDM behaviors - assessed using the Career Decision-making Difficulties Questionnaire (CDDQ) - and (4) results. The latter was indirectly assessed using CDDQ scores from an in-person SEAD program, where lower CDDQ scores indicate less difficulty with CDM. SETTING: Faculty of Medicine at the University of Ottawa in Ontario, Canada. PARTICIPANTS: Forty pre-clerkship students (27 first and 13 second year students) at the University of Ottawa RESULTS: Level 1: 97.5% of participants rated the program as good or very good. Live demonstration and technical skills workshops were the highest rated activities. Level 2: participants' scores on knowledge-based questions about a surgical career significantly increased following the program (pre: 9/25 vs post: 15/25, p = 0.008). Level 3: overall mean CDDQ scores (±SD) decreased difficulties with significantly following the program (pre: 45.6 ± 10.5 vs post: 38.8 ± 10.9, p < 0.001), which indicates decreased CDM difficulties. Level 4: Except for one sub-category, the difference in mean CDDQ scores between the virtual and in-person programs were not significantly different. CONCLUSION: The program received the positive reactions and significantly increased participants' knowledge. The change in CDDQ scores following the virtual program suggests it may reduce career decision-making difficulties in the short-term. In-person surgical exposure remains important; however, a hybrid model may be valuable in resource limited settings. WC: 300.

15.
BMC Emerg Med ; 22(1): 170, 2022 10 24.
Article in English | MEDLINE | ID: covidwho-2089162

ABSTRACT

BACKGROUND: Acute appendicitis is the most common cause of acute abdomen. During the pandemic, to contain the spread of COVID-19, there were some integral changes in the medical processes based on the pandemic prevention policy, especially regarding emergency surgery. This study was conducted to investigate whether this pandemic also impacted the decision-making for both patients and medical personnel along with the treatment outcomes. METHODS: Patients of age 18 years or older who were diagnosed clinically and radiologically with acute appendicitis between Jan 1, 2017, and Dec 31, 202,0 were reviewed. The data of 1991 cases were collected and used for this study. Two groups were formed, one group before and the other group after the outbreak. The gathered data included gender, age, appendiceal fecalith, outcomes of treatment, and long-term outcomes of non-operation (8 months follow-up). We also collected details of surgical cases from the above two groups. This data also included age, gender, appendiceal fecalith, fever, jaundice, length of onset before presenting to an emergency department (ED), anesthesia, surgery, white cell count, pathology, complications, and length of stay. We compared the above data respectively and analyzed the differences. RESULTS: Compared to the period before the outbreak, patient visits for acute appendicitis remarkably dropped (19.8%), but surgical cases showed no change (dropped by roughly 5%). There were significant differences (P < 0.05) in failure of non-operation(after the pandemic 8.31% vs. before pandemic 3.22%), interval appendectomy(after pandemic 6.29% vs. before pandemic 12.84%), recurrence(after pandemic 23.27% vs. before pandemic 14.46%), and outcomes of recurrence. There was a significant difference (P < 0.05) in anesthesia method, surgery way, and complications( before pandemic 4.15% vs. after pandemic9.89% P < 0.05) in patients who underwent the surgery. There was no statistical difference (P > 0.05) concerning age, gender, fever, jaundice, appendiceal fecalith, white cell count, and length of onset before presenting to the ED. CONCLUSION: The current pandemic prevention policy is very effective, but some decision-making processes of doctor-patient have changed in the context of COVID-19 pandemic, that further influenced some treatment outcomes and might lead to a potential economic burden. It is essential to address the undue concern of everyone and optimize the treatment process.


Subject(s)
Appendicitis , COVID-19 , Fecal Impaction , Humans , Infant , Adolescent , Appendicitis/epidemiology , Appendicitis/surgery , Appendicitis/diagnosis , COVID-19/epidemiology , Pandemics , Fecal Impaction/epidemiology , Appendectomy/methods , Acute Disease , Retrospective Studies , Length of Stay
16.
Understanding Complex Systems ; : 139-159, 2022.
Article in English | Scopus | ID: covidwho-2085256

ABSTRACT

COVID-19 has created many economic disruptions in the way a supply chain (SCs) is being managed. The rapid spread of the contagion has impacted tremendously the meat processing, food service and poultry SCs. Botswana being an underdeveloped country adopted supply chain management best practices to stay afloat during the pandemic. The lessons learned from Botswana can be used in developing countries to highlight the needed essential SCs elements during a pandemic. Botswana strong competitive advantages during crisis appears to be: service, operations, inbound and outbound logistics. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

17.
Ethique Sante ; 19(4): 231-238, 2022 Dec.
Article in French | MEDLINE | ID: covidwho-2086190

ABSTRACT

During the first months of the Sars-Cov-2 pandemic, French caregivers faced difficult situations, organizational changes, and rapidly changing recommendations. The occupational physicians of the hospital staff had to accompany the caregivers, both to answer their questions, both to better prevent the risks to their health in connection with the pandemic. Recommendations were quickly issued by the Société française de médecine du travail (French Society of Occupational Medicine). In our CHU, an evaluation of exposures was made by department. Occupational physicians advised agents and the institution to limit the risks to the health of agents. However, faced with the uncertainties linked to ignorance of the virus, how can we play both the role of protection of each agent, and that of a doctor registered in a health war? This article revisits from a distance the ethical tensions of the hospital occupational physician and the qualities necessary for the accomplishment of these missions.

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