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1.
Ann Fam Med ; 20(4): 362-367, 2022.
Article in English | MEDLINE | ID: covidwho-1962968

ABSTRACT

In the wake of the racial injustices laid bare in 2020, on top of centuries of systemic racism, it is clear we need actionable strategies to fundamentally restructure health care systems to achieve racial/ethnic health equity. This paper outlines the pillars of a health equity framework from the Institute for Healthcare Improvement, overlaying a concrete example of telemedicine equity. Telemedicine is a particularly relevant and important topic, given the growing evidence of disparities in uptake by racial/ethnic, linguistic, and socioeconomic groups in the United States during the COVID-19 pandemic, as well as the new standard of care that telemedicine represents post-pandemic. We present approaches for telemedicine equity across the domains of: (1) strategic priorities of a health care organization, (2) structures and processes to advance equity, (3) strategies to address multiple determinants of health, (4) elimination of institutional racism and oppression, and (5) meaningful partnerships with patients and communities.


Subject(s)
COVID-19 , Health Equity , Racism , Telemedicine , COVID-19/epidemiology , Healthcare Disparities , Humans , Pandemics , United States
2.
2nd International Conference on Advances in Electrical, Computing, Communication and Sustainable Technologies, ICAECT 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1961384

ABSTRACT

The arrival of COVID-19 completely changed people's lives, at the end of December 2019 a new virus appeared that forced people to maintain social distancing and wear a mask in a mandatory way, because the virus caused by SARS-COV-2 is highly contagious and can be easily transmitted between people being announced as a pandemic by the World Health Organization. In the month of May, the virus infected more than 153 million people saturating the health system worldwide, therefore, it was established as a preventive measure to maintain social distancing in public places and use the mask in a mandatory way to help control COVID-19, as it reduces the amount of saliva emissions and respiratory microdroplets of individuals carrying the virus. In view of this problem, this article designed a face mask detection system to control the entry of people into a medical center, so that the system analyzes several people who want to enter the place and shows if they use the mask correctly through a monitor, requiring to respect this important biosecurity measure, in addition to being able to be implemented anywhere you want to control the entry of people with a mask. By designing the system, it can be said that the system works in the best way and would be helping to prevent several people from continuing to catch COVID-19. © 2022 IEEE.

3.
2nd International Conference on Advances in Electrical, Computing, Communication and Sustainable Technologies, ICAECT 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1961379

ABSTRACT

Currently the health system continues to fight against the pandemic caused by SARS-CoV2 because this virus has not yet disappeared and there are still outbreaks of infections in several places, this generated in people an indecision of what it can generate later since this virus generated a change in the world. Being a contagious and fast-spreading virus, WHO called on all governments to take appropriate measures to stop the spread of COVID-19 as there were many infected. Given this, there are people who need the care of a doctor because they suffer from a disease and that this implies the extraction of blood for a deep analysis or to place an intravenous injection in the patient's forearm, but in many cases the distribution of the veins can not be visualized and this hinders the work of the doctor. In view of this problem, in this article an automatic vascular detection system was carried out for the part of the forearm of patients and to be able to visualize the subcutaneous vein so that the doctor has access quickly and help the patient in an emergency. Through the development of the system, it was observed that it works in the best way, since in its development a 97.69% efficiency was obtained by showing the binary image where the distribution of the veins is observed taking 8.74 seconds, being an accepted value so that it can be implemented in several medical centers. © 2022 IEEE.

4.
Update in Anaesthesia ; 36:68-76, 2022.
Article in English | Scopus | ID: covidwho-1960258

ABSTRACT

Clinicians worldwide have been called to action against COVID-19, requiring development of effective systems to respond to the surge of pandemic cases. Anaesthesiologists are equipped to fulfil many roles in the operating room, critical care and retrieval settings. However, it was anticipated that the case load could overwhelm our existing referral structures, and put staff and patients at increased risk. We describe, using the “4S” components of surge capacity development, how systems, staff, space and stuff were utilised to create a COVID Anaesthesia, Intubation and Retrieval (CAIR) Team at Groote Schuur Hospital, Cape Town, South Africa. The primary aims of the team are to provide safe anaesthesia for patients with known or suspected COVID-19, and perform intubation and transfer in COVID wards or high care areas to intensive care units. Concurrently, promotion of strict infection control practices and risk mitigation through the use of a dedicated group of low-risk, highly trained individuals was achieved. Staff support systems, protocols for streamlined patient management, reallocation of spaces within the hospital, the capital and disposable equipment required for the service, and use of continual audit and iterative improvement are discussed in this article. © World Federation of Societies of Anaesthesiologists 2022.

5.
Chaos, Solitons and Fractals ; 161, 2022.
Article in English | Scopus | ID: covidwho-1958531

ABSTRACT

We consider a behavioral SIR epidemic model to describe the action of the public health system aimed at enhancing the social distancing during an epidemic outbreak. An optimal control problem is proposed where the control acts in a specific way on the contact rate. We show that the optimal control of social distancing is able to generate a period doubling–like phenomenon. Namely, the ‘period’ of the prevalence is the double of the ‘period’ of the control, and an alternation of small and large peaks of disease prevalence can be observed. © 2022 Elsevier Ltd

6.
Psychiatr Serv ; : appips20220124, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-1950570

ABSTRACT

OBJECTIVE: This study was the first to examine the characteristics and referral outcomes for veterans calling the National Call Center for Homeless Veterans (NCCHV). METHODS: The authors analyzed data from NCCHV and U.S. Department of Veterans Affairs (VA) health care records. RESULTS: Between December 2018 and October 2020, the NCCHV received 266,100 messages, with no major increase in the first 6 months of the COVID-19 pandemic. Of 110,197 veterans who contacted NCCHV, 69.6% were at risk for homelessness, and 20.1% were homeless. Most contacts (90.2%) resulted in a referral or transfer to a local resource. About 59.5% of NCCHV veterans had a medical record in the Veterans Health Administration; their use of homeless programs increased from 25.9% to 81.3%. Uses of mental health services, substance use treatment, and medical services showed small-to-moderate increases after NCCHV contacts. CONCLUSION: NCCHV is important for linking veterans to health and social care. Additional work is needed to assess veterans' outcomes after an NCCHV contact.

7.
4th International Congress on Human-Computer Interaction, Optimization and Robotic Applications, HORA 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1948766

ABSTRACT

The COVID-19 pandemic has brought human life to a startling halt around the world from the moment it emerged and took thousands of lives. The health system has come to the point of collapse, many people in the world have died from being infected, and many people who have survived the disease have had permanent lung damage with the spread of COVID-19 in 212 countries and regions. In this study, an answer is sought to diagnose the disease-causing virus through Artificial Intelligence Algorithms. The aim of the study is to accelerate the diagnosis and treatment process of COVID-19 disease. Enhancements were made using Deep Learning methods, including CNN, VGG16, DenseNet121, and ResNet50. For this study, the disease was detected by using X-Ray images of patients with and without COVID-19 disease, and then it was evaluated how to increase the accuracy rate with the limited available data. To increase the accuracy rate, the results of data augmentation on the image data were examined and the time complexity of the algorithms with different layers was evaluated. As a result of the study, it was seen that data augmentation increased the performance rate in all algorithms and the ResNet50 algorithm was more successful than other algorithms. © 2022 IEEE.

9.
BMJ Glob Health ; 7(7)2022 07.
Article in English | MEDLINE | ID: covidwho-1950117

ABSTRACT

Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is an innovative contraceptive method aimed at meeting women's unique circumstances and needs, largely due to its ability to be self-injected. Substantial research and advocacy investments have been made to promote roll-out of DMPA-SC across sub-Saharan Africa. To date, research on the demand for DMPA-SC as a self-injectable method has been conducted largely with healthcare providers, via qualitative research, or with highly specific subsamples that are not population based. Using three recent rounds of data from Performance Monitoring for Action, we examined population-representative trends in demand, use, and preference for self-injection among current non-users in Burkina Faso, the Democratic Republic of Congo (Kinshasa and Kongo Central regions), Kenya, and Nigeria (Lagos and Kano States). We found that while over 80.0% of women had heard of injectables across settings, few women had heard of self-injection (ranging from 13.0% in Kenya to 24.8% in Burkina Faso). Despite initial increases in DMPA-SC prevalence, DMPA-SC usage began to stagnate or even decrease in all settings in the recent three years (except in Nigeria-Kano). Few (0.0%-16.7%) current DMPA-SC users were self-injecting, and the majority instead were relying on a healthcare provider for administration of DMPA-SC. Among current contraceptive non-users wishing to use an injectable in the future, only 1.5%-11.4% preferred to self-inject. Our results show that self-injection is uncommon, and demand for self-injection is very limited across six settings, calling for further qualitative and quantitative research on women's views on DMPA-SC and self-injection and, ultimately, their contraceptive preferences and needs.


Subject(s)
Contraceptive Agents, Female , Medroxyprogesterone Acetate , Democratic Republic of the Congo , Female , Humans , Injections, Subcutaneous , Nigeria , Self Administration
10.
J Relig Health ; 61(3): 2212-2232, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1942367

ABSTRACT

Historically, there has be a close relationship between the nursing services and spiritual care provision to patients, arising due to the evolvement of many hospitals and nursing programmes from faith-based institutions and religious order nursing. With increasing secularism, these relationships are less entwined. Nonetheless, as nurses typically encounter patients at critical life events, such as receiving bad news or dying, nurses frequently understand the need and requirement for both spiritual support and religious for patients and families during these times. Yet there are uncertainties, and nurses can feel ill-equipped to deal with patients' spiritual needs. Little education or preparation is provided to these nurses, and they often report a lack of confidence within this area. The development of this confidence and the required competencies is important, especially so with increasingly multicultural societies with diverse spiritual and religious needs. In this manuscript, we discuss initial field work carried out in preparation for the development of an Erasmus Plus educational intervention, entitled from Cure to Care Digital Education and Spiritual Assistance in Healthcare. Referring specifically to post-COVID spirituality needs, this development will support nurses to respond to patients' spiritual needs in the hospital setting, using digital means. This preliminary study revealed that while nurses are actively supporting patients' spiritual needs, their education and training are limited, non-standardised and heterogeneous. Additionally, most spiritual support occurs within the context of a Judeo-Christian framework that may not be suitable for diverse faith and non-faith populations. Educational preparation for nurses to provide spiritual care is therefore urgently required.


Subject(s)
COVID-19 , Spiritual Therapies , Christianity , Hospitals , Humans , Spirituality
11.
Soc Sci Med ; 308: 115222, 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-1937217

ABSTRACT

The activities of community-based health actors are widely recognized as critical to pandemic response; yet, there exists a lack of clarity concerning who is included in this ecosystem of actors and how these actors experience the complexity of delivering community-level care in the context of a public health emergency. The objectives of this study were (1) to characterize the lived experiences of community-based health actors during the COVID-19 pandemic in the Philippines; and (2) to identify opportunities for further supporting these critical actors in the health workforce. Virtual semi-structured interviews were conducted (January-February 2021) with 28 workers employed by a Philippines-based non-governmental organization (NGO) to explore their lived experiences during the COVID-19 pandemic. Data were analyzed thematically using a hybrid inductive-deductive coding process, informed by Tronto's conceptualization of an ethic of care. Lived experiences among study participants were shaped by discourses of fear and care, and the interaction between these two affects. Participants reported everyday experiences of fear: NGO workers' fears of contracting and transmitting COVID-19 to others; perceived fear among community members where they worked; and fears around COVID-19 testing, recognizing the personal and social implications (e.g. stigma) of a positive test. Amid fear, participants had everyday experiences of care: care was a powerful motivator to continue their work; they felt supported by a caring organization that implemented safety protocols and provided material supports to those in quarantine; and they engaged in self-care practices. These findings contribute to understanding the ecosystem of actors involved in community-based health care and engagement efforts and the challenges they encounter in their work, particularly in a pandemic context. We highlight implications for civil society organizations charged with protecting the mental and physical well-being of their workers and describe how these actions can contribute to local health systems strengthening.

12.
2022 IEEE International Conference on Distributed Computing and Electrical Circuits and Electronics, ICDCECE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1932105

ABSTRACT

According to the World Health Organization, the coronavirus outbreak poses a daily threat to the global health system. Almost all countries' health resources are insufficient or unequally distributed. There are several issues, such as a lack of health care workers, beds, and intensive care units, to name a few. The key to the country's health systems overcoming this epidemic is to use limited resources at optimal levels. Disease detection is critical to averting an epidemic. The greater the success, the more tightly the covid viral spread may be managed. PCR (Polymerase chain reaction) testing is commonly used to determine whether or not a person has a virus. Deep learning approaches can be used to classify chest X-RAY images in addition to the PCR method. By analyzing multi-layered pictures in one go and establishing manually entered parameters in machine learning, deep learning approaches have become prominent in academic research. This popularity has a favorable impact on the available health datasets. The goal of this study was to detect disease in persons who had x-rays done for suspected COVID-19 (Coronavirus Disease-2019). A bi-nary categorization has been used in most COVID-19 investigations. Chest x-rays of COVID-19 patients, viral pneumonia patients, and healthy patients were obtained from IEEE [17] (Institute of Electrical and Electronics Engineers) and Kaggle [18]. Before the classification procedure, the data set was subjected to a data augmentation approach. These three groups have been classified through multiclassclassification deep learning models. We are also debating a taxonomy of recent contributions on the eXplainability of Artificial Intelligence (XAI). © 2022 IEEE.

13.
BMJ Glob Health ; 7(Suppl 1)2022 06.
Article in English | MEDLINE | ID: covidwho-1932713

ABSTRACT

BACKGROUND AND OBJECTIVES: The health workforce (HWF) is at the core of ensuring an efficient, effective and functional health system, but it faces chronic underinvestment. This paper presents a fiscal space analysis of 20 countries in East and Southern Africa to generate sustained evidence-based advocacy for significant and smarter investment in the HWF. METHODS: We adapted an established empirical framework for fiscal space analysis and applied it to the HWF. Country-specific data were curated and triangulated from publicly available datasets and government reports to model the fiscal space for the HWF for each country. Based on the current knowledge, three scenarios (business as-usual, optimistic and very optimistic) were modelled and compared. FINDINGS: A business-as-usual scenario shows that the cumulative fiscal space across the 20 countries is US$12.179 billion, which would likely increase by 28% to US$15.612 billion by 2026 but varies across countries-the highest proportional increases expected in Seychelles (117%) and Mozambique (69%) but lowest in Zambia (15%). Under optimistic assumptions, allocating an additional 1.5% of gross domestic product (GDP) to health even without further prioritising the proportional allocation to the wage bill could boost the cumulative fiscal space for HWF by US$4.639 billion. In a very optimistic scenario of a 1.5% increase in health expenditure as a proportion of GDP and further prioritisation of HWF within the health expenditure, the cumulative fiscal space for HWF could improve by some 105%-ranging from 24% in Zambia to 330% in Lesotho. CONCLUSION: Small increments in government health expenditure and increased prioritisation of HWF in funding in tandem with the 57% global average could potentially increase the fiscal space for HWF by at least 32% in 11 countries. Unless the HWF is sufficiently prioritised within the health expenditures, only increasing the overall health expenditure to even recommended levels would still portend severe underinvestment in HWF amid unabating shortages to deliver health services. Thus, HWF strategies and investment plans should include fiscal space analysis to deepen advocacy for sustainable investment in the HWF.


Subject(s)
Health Expenditures , Health Workforce , Africa, Southern , Gross Domestic Product , Health Services , Humans
14.
Anthropology in Action-Journal for Applied Anthropology in Policy and Practice ; 29(1):32-46, 2022.
Article in English | Web of Science | ID: covidwho-1928403

ABSTRACT

Around the world, Indigenous groups have been among the communities most severely affected by COVID-19, and the ability of health systems and social policy responses to support Indigenous responses to the pandemic has been affected by challenges of intercultural communication, sometimes compounded by racist and exclusionary social and political attitudes. The Brazilian Amazon has been a particularly extreme case. This article reflects on the experience of a group of Indigenous leaders and non-Indigenous anthropologists working to promote intercultural approaches to epidemic response in the Rio Negro region of Northwestern Amazonia. It brings together findings from in-person fieldwork on Indigenous responses to infectious disease outbreaks that affected the region before the COVID-19 pandemic and from remote research on COVID-19 response conducted in 2020 and 2021.

15.
Lancet Reg Health Am ; 13: 100313, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1926748

ABSTRACT

The COVID-19 pandemic has disrupted implementation of health interventions and set back priority programs aiming to control and eliminate communicable diseases. At the same time, the pandemic has opened up opportunities to expedite innovations in health service delivery to increase effectiveness and position health on the development and political agendas of leaders and policy makers. In this context, we present an integrated, sustainable approach to accelerate elimination of more than 35 communicable diseases and related conditions in the region of the Americas. The Elimination Initiative promotes a life-course, person-centred approach based on four dimensions - preventing new infections, ending mortality and morbidity, and preventing disability - and four critical lines of action including strengthening health systems integration and service delivery, strengthening health surveillance and information systems, addressing environmental and social determinants of health, and furthering governance, stewardship, and finance. We present key actions and operational considerations according to each line of action that countries can take advantage of to further advance disease elimination in the region.

16.
7th International Conference on Image and Signal Processing and their Applications, ISPA 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1922719

ABSTRACT

The virus new variants of Coronavirus disease 2019 (COVID-19) continue to appear, making the situation more challenging and threatening. The COVID-19 pandemic has profoundly affected health systems and medical centres worldwide. The primary clinical tools used in diagnosing patients presenting with respiratory distress and suspected COVID-19 symptoms are radiology examinations. Recently emerging artificial intelligence (AI) technologies further strengthen the power of imaging tools and help medical specialists. This paper presents an Augmented Reality (AR) tool for COVID-19 aid diagnosis, including Computerised Tomography Ct-scans segmentation based Deep Learning, 3D reconstruction, and AR visualisation. Segmentation is a critical step in AI-based COVID-19 image processing and analysis;we use the popular segmentation networks, including classic U-Net. Quantitative and qualitative evaluation showed reasonable performance of U-Net for lung and COVID-19 lesions segmentation. The AR-COVID-19 aid diagnosis system could be used for medical education professional training and as a support visualisation and reading tool for radiologist. © 2022 IEEE.

17.
JMIR Med Educ ; 8(2): e32614, 2022 Jun 07.
Article in English | MEDLINE | ID: covidwho-1923847

ABSTRACT

BACKGROUND: Access to continuing professional development (CPD) for health care workers in low- and middle-income countries (LMICs) is severely limited. Digital technology serves as a promising platform for supporting CPD for health care workers by providing educational content virtually and enabling virtual peer-to-peer and mentor interaction for enhanced learning. Digital strategies for CPD that foster virtual interaction can increase workforce retention and bolster the health workforce in LMICs. OBJECTIVE: The objective of this integrative review was to evaluate the evidence on which digital platforms were used to provide CPD to health care workers and clinical students in LMICs, which was complemented with virtual peer-to-peer or mentor interaction. We phrased this intersection of virtual learning and virtual interaction as mobile-social learning. METHODS: A comprehensive database and gray literature search was conducted to identify qualitative, quantitative, and mixed methods studies, along with empirical evidence, that used digital technology to provide CPD and virtual interaction with peers or mentors. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible articles were written in English, conducted in an LMIC, and used a mobile device to provide CPD and facilitate virtual peer-to-peer or mentor interaction. Titles, abstracts, and full texts were screened, followed by an assessment of the quality of evidence and an appraisal of the articles. A content analysis was then used to deductively code the data into emerging themes. RESULTS: A total of 750 articles were identified, and 31 (4.1%) were included in the review. SMS text messaging and mobile instant messaging were the most common methods used to provide continuing education and virtual interaction between peers and mentors (25/31, 81%). Across the included articles, participants had high acceptability for using digital platforms for learning and interaction. Virtual peer interaction and mentorship were found to contribute to positive learning outcomes in most studies (27/31, 87%) through increased knowledge sharing, knowledge gains, improved clinical skills, and improved service delivery. Peer-to-peer and mentor interaction were found to improve social support and reduce feelings of isolation (9/31, 29%). There were several challenges in the implementation and use of digital technology for mobile-social learning, including limited access to resources (eg, internet coverage and stable electricity), flexibility in scheduling to participate in CPD, and sociobehavioral challenges among students. CONCLUSIONS: The summary suggests that mobile-social learning is a useful modality for curriculum dissemination and skill training and that the interface of mobile and social learning serves as a catalyst for improved learning outcomes coupled with increased social capital.

18.
BMJ Glob Health ; 7(6)2022 06.
Article in English | MEDLINE | ID: covidwho-1923225
19.
BMJ Glob Health ; 7(Suppl 5)2022 07.
Article in English | MEDLINE | ID: covidwho-1923217

ABSTRACT

Non-communicable disease (NCD) prevention and care in humanitarian contexts has been a long-neglected issue. Healthcare systems in humanitarian settings have focused heavily on communicable diseases and immediate life-saving health needs. NCDs are a significant cause of morbidity and mortality in refugee settings, however, in many situations NCD care is not well integrated into primary healthcare services. Increased risk of poorer outcomes from COVID-19 for people living with NCDs has heightened the urgency of responding to NCDs and shone a spotlight on their relative neglect in these settings. Partnering with the United Nations Refugee Agency (UNHCR) since 2014, Primary Care International has provided clinical guidance and Training of Trainer (ToT) courses on NCDs to 649 health professionals working in primary care in refugee settings in 13 countries. Approximately 2300 healthcare workers (HCW) have been reached through cascade trainings over the last 6 years. Our experience has shown that, despite fragile health services, high staff turnover and competing clinical priorities, it is possible to improve NCD knowledge, skills and practice. ToT programmes are a feasible and practical format to deliver NCD training to mixed groups of HCW (doctors, nurses, technical officers, pharmacy technicians and community health workers). Clinical guidance must be adapted to local settings while co-creating an enabling environment for health workers is essential to deliver accessible, high-quality continuity of care for NCDs. On-going support for non-clinical systems change is equally critical for sustained impact. A shared responsibility for cascade training-and commitment from local health partners-is necessary to raise NCD awareness, influence local and national policy and to meet the UNHCR's objective of facilitating access to integrated prevention and control of NCDs.


Subject(s)
COVID-19 , Noncommunicable Diseases , Refugees , Community Health Workers , Health Workforce , Humans , Noncommunicable Diseases/prevention & control , Primary Health Care , United Nations
20.
BMJ Glob Health ; 7(Suppl 5)2022 07.
Article in English | MEDLINE | ID: covidwho-1923215

ABSTRACT

People living with non-communicable diseases (PLWNCDs) are at greater risk of severe COVID-19 illness. This case study highlights the adaptations that were made to humanitarian health programmes in five countries to reduce exposure risk for PLWNCDs during the COVID-19 pandemic. Common adaptations included facility-level administrative and engineering controls, improved triaging, change in prescribing practices, decrease in frequency of stable patient visits, shift to remote consultations and expanded scope of responsibility for existing community health workers. Despite fears of the impact on health service utilisation, PLWNCDs continued to seek services and changes in utilisation rates between the pre-COVID-19 and COVID-19 periods were attributed more to factors like population changes, COVID-19 travel restrictions, closure of other health services, and enhanced health education and community engagement. This study highlights the resilience and creativity of frontline health staff and managers, and their ability to make quick shifts in service delivery modalities in response to changes in risk for client groups in accordance with the evolving contextual reality. Other contextual changes such as infectious disease outbreaks, conflicts and natural disasters happen regularly within humanitarian settings, and specific groups are often more at risk. With more specific information about risks for different client groups, targeted approaches can be done to ensure that those most at risk of a specific threat are able to ensure access to sustained services.


Subject(s)
COVID-19 , Noncommunicable Diseases , Disease Outbreaks , Humans , Noncommunicable Diseases/epidemiology , Noncommunicable Diseases/therapy , Pandemics/prevention & control , SARS-CoV-2
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