ABSTRACT
"We experienced a medication shortage from December 22 to 28 last year as many patients were visiting this health center - given it's a designated one for COVID-19 treatment. FEATURES Since 2017, 55-year-old Li Ruiying has been the only doctor at the clinic in Erdaohe Village in northern suburban Beijing, where she has been stationed since 1999. But sooner rather than later, local medical authorities started allocating drugs, allowing us to resume our medication distribution on January 1 this year", Luo said. [Extracted from the article] Copyright of Beijing Review is the property of Beijing Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The COVID-19 pandemic has led to an urgent need in emerging economies to quickly identify vulnerable populations that do not live within access of a health facility for testing and vaccination. This access information is critical to prioritize investments in mobile and temporary clinics. To meet this need, the World Bank team sought to develop an open-source methodology that could be quickly and easily implemented by government health departments, regardless of technical and data collection capacity. The team explored use of readily available open-source and licensable data, as well as non-intensive computational methodologies. By bringing together population data from Facebook's Data for Good program, travel-time calculations from Mapbox, road network and point-of-interest data from the OpenStreetMap (OSM), and the World Bank's open-source GOSTNets network routing tools, we created a computational framework that supports efficient and granular analysis of road-based access to health facilities in two pilot locations—Indonesia and the Philippines. Our findings align with observed health trends in these countries and support identification of high-density areas that lack sufficient road access to health facilities. Our framework is easy to replicate, allowing health officials and infrastructure planners to incorporate access analysis in pandemic response and future health access planning. © National Academy of Sciences: Transportation Research Board 2022.
ABSTRACT
The onset of the COVID-19 pandemic has accelerated the adoption of virtual care as a modality for home-based care delivery to individuals and cohorts who might not otherwise have access. While a number of positive outcomes have been reported, rapid growth has occurred without critical consideration of clinician education and training. Little is known about the curricular and pedagogical requirements for educating current and future clinicians in virtual care provision. This review was informed by Arksey and O'Malley's five-stage methodological framework for scoping reviews, first published in 2005. Using a clearly articulated search strategy and reporting process, over 4000 pieces of literature were analysed to inform this review. A final 17 papers were included. Common themes emerging in relation to curricula content include the basics of virtual care, cultural awareness, interprofessional collaboration/training, telepresence, encompassing non-verbal, verbal and environmental considerations, and virtual care clinical skills. Standalone modules are recommended for delivering ‘the basics' of virtual care, while the interactive/participative approach is endorsed as an appropriate method of instruction. The reviewed literature reviewed offers a set of core inclusions and pedagogical approaches for a virtual care education program, although these are often mentioned in general terms and are not always well described. Moving beyond the COVID-19 pandemic, virtual care education for current and future clinicians requires a consistent and cohesive approach to curricula and pedagogies. These approaches should be rigorously evaluated as part of a continuous quality improvement process.
ABSTRACT
The COVID-19 pandemic has crumbled health systems all over the world. Quick and accurate detection of coronavirus infection plays an important role in timely referral of physicians and control transmission of the disease. RT-PCR is the most widely test used for identification of COVID-19 patients, but it takes long to deliver the report. Researchers around the world are looking for alternative machine learning techniques including deep learning to assist the medical experts for early COVID-19 disease diagnosis from medical imaging such as chest films. This study proposes an enhanced convolutional neural network (EConvNet) model for the presence and absence of coronavirus disease from chest radiographs to contain this pandemic. The model is accurate compared to the traditional machine learning algorithms (RF, SVM, etc.). The suggested CNN model is approximately as accurate as the classifiers based on transfer learning (such as InceptionV3, VGG16, and Densenet121). Despite being simple in terms of number of parameters learnt, it takes less training time and demands less memory.
ABSTRACT
The forecasting model used random forest algorithm. From the outcomes, it has been found that the regression models utilize basic linkage works and are exceptionally solid for forecast of COVID-19 cases in different countries as well as India. Current shared of worldwide COVID-19 confirmed case has been predicted by taking the world population and a comparatives study has been done on COVID-19 total cases growth for top 10 worst affected countries including US and excluding US. The ratio between confirmed cases vs. fatalities of COVID-19 is predicted and in the end a special study has been done on India where we have forecasted all the age groups affected by COVID-19 then we have extended our study to forecast the active, death and recovered cases especially in India and compared the situation with other countries.
ABSTRACT
This research was aimed to extract association rules on the morbidity and mortality of corona virus disease 2019 (COVID-19). The dataset has four attributes that determine morbidity and mortality;including Confirmed Cases, New Cases, Deaths, and New Deaths. The dataset was obtained as of 2nd April, 2020 from the WHO website and converted to transaction format. The Apriori algorithm was then deployed to extract association rules on these attributes. Six rules were extracted: Rule 1. {Deaths, NewDeaths}=>{NewCases}, Rule 2. {ConfCases, NewDeaths}=>{NewCases}, Rule 3. {ConfCases, Deaths}=>{NewCases}, Rule 4. {Deaths, NewCases}=>{NewDeaths}, Rule 5. {ConfCases, Deaths}=>{NewDeaths}, Rule 6. {ConfCases, NewCases}=>{NewDeaths}, with confidence 0.96, 0.96, 0.86, 0.66, 0.59, 0.51 respectively. These rules provide useful information that is vital on how to curtail further spread and deaths from the virus, both in areas where the pandemic is already ravaging and in areas yet to experience the outbreak.
ABSTRACT
Hygiene organization is an essential part of infection prevention in nursing homes. The Commission for Hospital Hygiene and Infection Prevention (KRINKO) published recommendations on necessary structures as early as 2005 [i]. The effects of the COVID-19 pandemic have also drawn public, professional and political attention to hygiene in nursing homes. Standard operating procedures for hygiene are available in most nursing homes. The situation is different for the infection control practitioner, for whom there are currently no uniform specifications. The establishment of a hygiene com-mission can support infection prevention in the home;however, has so fat only rarely existed. The article gives an overview of the organizational structures of hygiene in nursing homes.
ABSTRACT
Since March 2020, the corona pandemic has consistently exposed the weaknesses of the inpatient care system at the expense of those in need of case. No population group in Germany died more frequently as a result of corona-related infections (outbreaks) than residents of inpatient care facilities. By the end of March 2022. nearly 60% of Munich nursing home residents had become nosocomially infected with COVID-19, of which 18% died COVID-19 associated. Inadequate hygiene measures in the facilities could not and still cannot prevent large outbreaks. Because nursing facilities were not previously required to have hygienic staff, the Munich Health Department conducted standardized inspections and consultations during outbreaks. In almost no facility was a professionally correct outbreak management implemented. In addition, numerous hygiene deficiencies were identified that favored the transmission of SARS-CoV-2 infections to third parties. Furthermore, it became apparent that despite years of professional advice to the nursing facilities, no lasting positive effect on their hygiene management could be achieved. There are several reasons for this: a very high staff turnover, a low ratio of skilled workers, and a lack of commitment on the part of the facilities to a structured hygiene management system. Due to the continuing risk to the vulnerable population group in full inpatient care facilities, there is a fundamental need for regulation of binding hygiene management in these facilities - also with regard to risks from outbreaks with other pathogens. This was met by the legislature in September 2022 with an amendment to the Infection Protection Act. However, the theory-practice transfer required for functioning hygiene management can only succeed if sufficient numbers of professionally qualified staff with knowledge of German are available in the facilities to care for those in need of care.
ABSTRACT
Purpose>Positive transformative leadership development practices in health care are perhaps the most important pathway that, collectively, can be pursued while heading towards a post-corona virus disease 2019 world, and race towards 2030. As a practitioner paper, based on front line and leadership experience, this study aims to argue that we need transformational leaders who will go beyond knowing to practice and implementation. While the findings from research is presented from different organisations and companies, they all have something in common – people. Hence, important lessons can be extrapolated to health-related organisations in the future.Design/methodology/approach>The approach is based on practical research findings based on the literature. The approach uses real practical examples from companies and organisations to demonstrate the need for a new, radical way forward.Findings>The findings from the literature clearly indicate that mindfulness-based transformative leadership development program is a worthwhile investment for decision-makers and organisations. A new transformative leader for the future of health care needs to be developed with care with investment in that development.Research limitations/implications>Implications of this paper show that health-care organisations need to begin this journey. There is a paucity in the literature to demonstrate the implementation of mindfulness-based transformative leadership development programs.Practical implications>Organisations of the future face even greater challenges brought about by intelligent technology, new pandemics and even tighter government regulation. The time to prepare for such eventualities is now. This is not a choice but an imperative for organisations to know what to do rather than react with regret.Originality/value>There is a paucity in the health-care literature that tracks, measures, and reports on the long-term results of a mindfulness-based transformative leadership development program. This needs to be addressed, and health care should be a leader in the field of mindfulness and transformative leadership of the future.
ABSTRACT
More contemporary approaches, as Schedlitzki and Edwards (2021) outline, encompass concerns with context, followership, power and politics, a wider distribution of leaders, culture, communication, learning, gender and diversity, ethics and even the Phoenix leaders managing change in contemporary firestorm disruption (Woodward et al., 2021). The flip side of this is what Hofmann and Vermunt (2020, p. 252) claim is the need "to develop a conceptually sound outcome model for clinical leadership (CL) development in healthcare, linking individual professional learning and organisational change.” Yet, context is crucial in consideration of aspects of leadership in health services. [...]for us, the interconnectedness of healthcare and the disability sector is an ever-growing consideration and challenge, especially with the introduction and implementation of the National Disability Insurance Scheme in Australia and the recent Australian Royal Commission into the Disability sector. Leaders were required to develop innovative responses to service delivery (including face-to-face and digital responses), redirect and re-train workforces, develop new clinical and social supports, and manage the safe return to work to those who fell ill (Phillips et al., 2022;Whelehan et al., 2021).
ABSTRACT
NFL-derived markers correlate with magnetic resonance imaging (MRI)-derived markers and predicts white matter degeneration and functional outcome at 6 to 12 months. Usual diagnostic methods for neurocysticercosis include computed tomography, MRI, and blood/serum based immunological tests. Neurosurgery is rapidly evolving specialty and neurosurgeons are passionate professionals in learning the complex procedures. [Extracted from the article]
ABSTRACT
Background: Monitoring uptake of infection prevention and control (IPC) interventions is critical for the targeted and rational use of limited resources. A national facility readiness assessment conducted in August 2020 provided key information for targeted interventions to strengthen priority IPC areas. We assessed the level of COVID-19 preparedness in the facilities, identified priority COVID-19 IPC gaps, and generated a baseline report to further guide IPC investments at all levels. Methods: The Kenya Ministry of Health in collaboration with the CDC and International Training and Education Center for Health adapted a WHO Facility Readiness Assessment tool to include COVID-19–specific areas. In August 2020, data were collected using tablets through an Android-based electronic platform and were analyzed using descriptive statistics. Assessments were conducted in public, private, and faith-based health facilities nationally after 4 months of preparedness and investment in the healthcare system. Results: We assessed 684 facilities of the targeted 844 (81%). Overall facility readiness in Kenya was rated above average (61%), and the performance score significantly increased with the Kenya Essential Package for Health level, with level 5 and 6 facilities scoring an average of 83% and 79% respectively. Of the assessed facilities, 82% had an appointed IPC coordinator. Only 14% of the facilities had all the required guidelines, policies, and the appropriate COVID-19 case definitions. 67% of the facilities had updated supply inventories for past week. Only 50% of the facilities had adequate supplies of N95 masks. The assessment revealed that 52% of healthcare facilities had trained their healthcare workforce;morticians were the least trained (only 17% of facilities). Moreover, 41% of the facilities had clear work plans for monitoring healthcare workers exposures to COVID-19, but only 33% of the facilities had policies on the management of infected healthcare workers. Conclusions: The findings provided critical information for stakeholders at all levels to be used for policy decisions, to prioritize key intervention areas in leadership and governance of facility IPC programs, for guideline development, and for capacity building and targeted investment in IPC to improve COVID-19 facility preparedness.Funding: NoneDisclosures: None
ABSTRACT
Background: Hand hygiene (HH) remains arguably the most effective way to prevent healthcare-associated infections (HAIs) and ultimately improve the prospect of patient safety. Studies have shown that as many as 50%–70% of infections are transmitted through hands due to poor HH practices. HH with use of alcohol-based hand rub (ABHR) is preferred over handwashing with soap and water because of its wide microbial efficacy, time efficiency, and improved skin tolerance. It is also well known that ABHR can be used as an effective prevention measure during disease outbreaks. Before and during the COVID-19 pandemic, health facilities in Sierra Leone have been challenged with HH infrastructural problems such as lack of sinks with constant running water. Before Sierra Leone recorded its first case of COVID-19 in March 2020, the consumption of ABHR in the health facilities was estimated to be 24,000 L per year, which doubled during the COVID-19 pandemic. The demand for commercially available ABHR increased, leading to acute shortages. The estimated cost of the locally produced ABHR ~$2–3 per 500 mL, although it may cost up to $10 for 500 mL when buying imported ABHR products from the local market. Methods: All ingredients were procured locally, and ABHR production was based on WHO formula 1. The production was set for 12 months to cover the estimated annual consumption of ABHR, with periodic monitoring to ensure effective distribution and availability at the point of care. Analysis of assessment results in 12 hospitals from the pre-COVID-19 era (2019) to the COVID-19 era (2021) was performed based on the WHO IPC Assessment Framework (IPCAF) indicator. Results: With an average monthly production of 3,482 L, a total of 41,780 L ABHR was produced and packaged in branded 500-mL containers for distribution to healthcare facilities. This quantity exceeded the estimated demand for ABHR during the COVID-19 pandemic. The data show a considerable increase (from 25% to 44%) in the number of available and functioning HH stations with mainly locally produced ABHR. Results from the monitoring of 575 peripheral health units (PHUs) in 2021 also showed that >67% of PHUs had HH facilities in all clinical areas and that the locally produced ABHR was used in 79% of these HH stations. Conclusions: Locally produced ABHR has shown to be a cost-effective and evidence-based intervention to optimize HH at the point of care. Therefore, localities are encouraged to undertake this realistic and sustainable approach to address issues of acute shortage of ABHR, especially during a global pandemic.Funding: NoneDisclosures: None
ABSTRACT
Background: During the COVID-19 pandemic, the World Health Organization (WHO) has recommended hand hygiene (HH) stations (ie, with soap and water for handwashing or alcohol-based hand rub or ABHR) at entrances and exits of every public or private commercial building, including healthcare facilities (HCFs). Methods: Enumerators observed the HH materials present at the entrances and exits of 37 public HCFs in the Moroto and Kotido districts and patient and visitor use of those HH materials. When handwashing stations were nonfunctional or out of water, no HH observations were made. Results: Of the 37 HCF entrances and exits assessed, 4 (11%) met the recommended guidance for HH materials: 3 (8%) had water and soap, and 1 (3%) had ABHR and water and soap. In other HCFs, 12 (32%) had no HH station present, 13 (35%) handwashing stations had no water, and 8 (22%) had water but not soap. Of 180 persons observed, 52 (29%) attempted HH and only 10 (6%) used appropriate HH technologies (4 with ABHR and 6 with water and soap). Of 52 people who attempted HH, 42 (81%) used only water without soap. All HH observed occurred when entering facilities;no HH occurred when exiting (0 of 68). Of those 52 who performed HH, 48 (92%) performed HH for the recommended time of >20 seconds. However, only 9 (5%) of 180 adhered to suggested HH technologies and length of time (used water and soap scrubbing for ≥20 seconds or used ABHR). Conclusions: We detected poor HH practice by patrons at entrances and exits of HCFs, which may be due to lack of appropriate HH materials, particularly lack of soap. Optimal strategies for adherence to WHO-recommended HH practices at entrances and exits of public and private commercial buildings, including HCFs, should be explored.Funding: NoneDisclosures: None
ABSTRACT
Background: Rapid response is critical to control healthcare-associated infection (HAI) and antibiotic resistance threats within healthcare facilities to prevent illness among patients, residents, and healthcare personnel. Through this analysis, we aimed to quantify public health response activities, by healthcare setting type, for (1) novel and targeted multidrug-resistant organisms or mechanisms (MDROs), (2) SARS-CoV-2, and (3) other possible outbreaks. Method: We reviewed response activity data submitted by US state, territorial, and local health department HAI/AR programs to the CDC as part of funding requirements. We performed descriptive analyses of response activities conducted during the funding reporting period (August 2019–July 2020). SARS-CoV-2 response activities were reported from January through July 2020. Data were analyzed by response category (novel or targeted MDRO, SARS-CoV-2, other HAI/AR responses), and healthcare setting type. Results: During August 2019–July 2020, 57 HAI/AR Programs (50 state, 1 territorial, 5 local health departments, and District of Columbia) reported 18,306 public health responses involving healthcare facilities. These data included 3,860 responses to 1 or more cases of novel or targeted MDROs, 13,992 responses to SARS-CoV-2 outbreaks (beginning in January 2020), and 454 responses to other possible outbreaks. Novel and targeted MDRO responses most frequently occurred in acute-care hospitals (ACHs, 64.5%), skilled nursing facilities (SNFs, 24.5%), and long-term acute-care hospitals (LTACHs, 5.8%). SARS-CoV-2 responses most frequently occurred in SNFs (55%), and assisted living facilities (24%). Other HAI/AR responses most frequently occurred in ACH (50%), SNF (28.4%), and outpatient settings (19.6%). Of the "other” HAI/AR responses, 76% were responses to cases, clusters, or outbreaks, and 23.8% were responses to serious infection control breaches including device and instrument reprocessing, injection safety, and other deficient practices. Conclusions: During the study period, public health programs performed a high volume of HAI/AR response activities largely focused on SARS-CoV-2 in nursing homes and assisted living facilities. Other important response activities occurred across a range of other healthcare settings, including responses to novel and targeted MDROs, HAI outbreaks, and serious infection control breaches. Whereas SARS-CoV-2 response activities largely centered in long-term care settings, MDRO and other HAI/AR responses occurred mostly in acute-care settings. These data demonstrate the importance of building and sustaining public health response capacity for a broad array of healthcare settings, pathogens, and patient populations to meet the range of current and emerging HAI/AR threats.Funding: NoneDisclosures: None
ABSTRACT
This article explores the emergent scientific evidence driving the growing ap- plication and interest of mindfulness within the sectors of education, healthcare, and the workplace. As the world navigates a global pandemic, a multifaceted set of challenges is arising. The complexity of the situation is leading to an increase in individual stress and burnout, which naturally extends to communities and broader societal systems. Therefore, it is crucial at this time to explore knowledge that can support effective training and maintenance of resiliency and wellbeing. Drawing upon research from the fields of neuroscience, education, healthcare, and the workplace, this article provides a comprehensive overview for how this evidence is being operationalized across key sectors of society. The aim is to support the discerning and considerate implementation of mindfulness training, as both an immediate and preventive measure, to foster resiliency and wellbeing as a means for individual and societal transformation.
ABSTRACT
The start of the COVID-19 pandemic was devastating, affecting every country and territory around the world. COVID-19 prompted immediate lockdowns and the implementation of measures that brought daily operations of life to an immediate halt. The virus contributed to many closures and posed challenges for businesses, organizations, government agencies, and academic institutions. Similar to businesses, higher education institutions (HEIs) faced enormous challenges, as they were forced to take swift action to ensure the safety of their students, faculty, staff, and administration. The purpose of this qualitative study was to gather lessons learned from the perspective of higher education professionals and academic scholars (HEP/AS, [N = 196]) regarding how their institution prepared for the pandemic and to gain insight into responses to the disruptions created by the pandemic. Using the SWOT (strengths, weaknesses, opportunities, and threats) analysis model, the researchers collected information from professionals and academic scholars about how this virus impacted their HEIs. The HEP/AS findings are indicative of five main strengths encompassing the importance of organizational action aimed at preventing and controlling the devastating effects of COVID-19. The results, highlighted the strengths, identified weaknesses, and provided recommendations for the future.
ABSTRACT
Universities were forced to quickly pivot to remote instruction in response to the COVID-19 pandemic. As a result, those working in higher education suddenly faced an insurmountable challenge to pivot to alternate—often foreign—methods of instruction. In addition, as universities began to provide multimodal instruction, many faced issues of learner access and resource inequities. Now, with learners returning for future terms, some completely online, universities confront a new normal of multimodal instruction and must move beyond the pivot, which requires sustainable resource allocation and long-term planning. Nevertheless, future pivots are inevitable as higher education braces for unknown future challenges. The following considerations have been curated to stimulate a discussion about moving from remote instruction toward a more desired experience in a new norm of multimodal instruction.
ABSTRACT
For many health professional programs, practicum capstone experiences are vital to the application of theory to practice, evaluation of knowledge gained, and building confidence in students before entering the workforce. In spring 2020, the ability to provide these experiences as usual suddenly changed due to the halt of practicum placements caused by Covid-19. This paper discusses how the capstone course was altered under these unusual circumstances, the student experience, and lessons learned. Three practicum options were created: a traditional in-person practicum, virtual practicum experiences with a health administrator or as a research assistant, and a virtual multi-pronged practicum. The multi-pronged virtual practicum experience combined a case study acquired from AUPHA, an 8-hour Covid-19 webinar module set, and three Zoom meetings with a quality-of-life specialist. Feedback received from students was that in-person practicum experiences are viewed as superior;practicum supports the application of knowledge;students felt prepared for practicum, and Covid-19 was impactful. The need for increased transparency, clearer directions, and weekly meetings for virtual practicum experiences are some of the lessons learned. Finally, the need for support during a crisis, especially from specialty organizations like AUPHA, is crucial to creating valid solutions and bringing some tranquility to the chaos.
ABSTRACT
There are a host of changes that will affect family physicians, including new vaccine codes and bundled Medicare payments for chronic pain management.