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1.
Global Health ; 18(1): 92, 2022 11 07.
Article in English | MEDLINE | ID: covidwho-2108844

ABSTRACT

BACKGROUND: Amidst the climate crisis, a key goal of the medical sector is to reduce its large carbon footprint. Although the Coronavirus disease 2019 (COVID-19) pandemic greatly impacted the medical sector, its influence on carbon footprints remains unknown. Therefore, the aim of this study was to evaluate changes in the carbon footprint of a university hospital with a medical research centre over the past 10 years. METHODS: Data on electricity, gas, and water usage, pharmaceutical and medical supply costs, and waste amounts were recorded for Nagoya University Hospital from April 2010 to March 2021. The relevant emission factors were obtained from the Japanese government and the overall monthly carbon footprint was reported according to the Greenhouse Gas Protocol. The effect of the COVID-19 pandemic on the carbon footprint was then compared for three types of emission sources. Moreover, a regression model was used to plot quadratic functions as approximate functions using monthly carbon emissions and monthly average external temperatures. Finally, the monthly carbon footprint was calculated per hospital admission. RESULTS: The overall carbon footprint of the hospital was 73,546 tCO2e in 2020, revealing an increase of 26.60% over the last 10 years. Carbon emissions from electricity consumption represented 26% of total emissions. The individual carbon footprints of pharmaceuticals, medical supplies, waste, and water usage also increased from 2010 to 2020. The overall monthly carbon footprint was positively correlated with the average monthly temperature (R2 = 0.7566, p < 0.001). Compared with 2019, the overall carbon footprint decreased by 2.19% in 2020. Moreover, the monthly carbon footprint per hospital admission increased significantly between 2018 (0.24 tCO2e/admission) and 2020 (0.26 tCO2e/admission) (p = 0.002). CONCLUSION: The overall carbon footprint of the hospital generally increased over the last decade. During the COVID-19 epidemic in 2020, the carbon footprint decreased slightly, likely because of the reduced number of patients. However, the carbon footprint per admission increased, which was attributed to more complicated patient backgrounds because of the ageing population. Therefore, evaluation of carbon emissions in the medical sector is urgently required in order to act on the climate crisis as soon as possible.


Subject(s)
Biomedical Research , COVID-19 , Humans , Carbon Footprint , COVID-19/epidemiology , Pandemics , Carbon , Water , Hospitals
2.
Rev Epidemiol Sante Publique ; 70(6): 265-276, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2095960

ABSTRACT

INTRODUCTION: Even though France was severely hit by the COVID-19 pandemic, few studies have addressed the dynamics of the first wave on an exhaustive, nationwide basis. We aimed to describe the geographic and temporal distribution of COVID-19 hospitalisations and in-hospital mortality in France during the first epidemic wave, from January to June 2020. METHODS: This retrospective cohort study used the French national database for all acute care hospital admissions (PMSI). Contiguous stays were assembled into "care sequences" for analysis so as to limit bias when estimating incidence and mortality. The incidence rate and its evolution, mortality and hospitalized case fatality rates (HCFR) were compared between geographic areas. Correlations between incidence, mortality, and HCFR were analyzed. RESULTS: During the first epidemic wave, 98,366 COVID-19 patients were hospitalized (incidence rate of 146.7/100,000 inhabitants), of whom 18.8% died. The median age was 71 years, the male/female ratio was 1.16, and 26.2% of patients required critical care. The Paris area and the North-East region were the first and most severely hit areas. A rapid increase of incidence and mortality within 4 weeks was followed by a slow decrease over 10 weeks. HCFRs decreased during the study period, and correlated positively with incidence and mortality rates. DISCUSSION: By detailing the geographical and temporal evolution of the COVID-19 epidemic in France, this study revealed major interregional differences, which were otherwise undetectable in global analyses. The precision afforded should help to understand the dynamics of future epidemic waves.


Subject(s)
COVID-19 , Humans , Female , Male , Aged , COVID-19/epidemiology , COVID-19/therapy , Pandemics , Retrospective Studies , France/epidemiology , Hospitalization
3.
Int J Environ Res Public Health ; 19(21)2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2090167

ABSTRACT

OBJECTIVE: To analyze COVID-19 deaths in public hospitals in a Brazilian state, stratified by the three waves of the pandemic, and to test their association with socio-clinical variables. METHODS: Observational analytical study, where 5436 deaths by COVID-19 occurred in hospitals of the public network of Espírito Santo, between 1 April 2020, and 31 August 2021, stratified by the three waves of the pandemic, were analyzed. For the bivariate analyses, the Pearson's chi-square, Fisher's Exact or Friedman's tests were performed depending on the Gaussian or non-Gaussian distribution of the data. For the relationship between time from diagnosis to death in each wave, quantile regression was used, and multinomial regression for multiple analyses. RESULTS: The mean time between diagnosis and death was 18.5 days in the first wave, 20.5 days in the second wave, and 21.4 days in the third wave. In the first wave, deaths in public hospitals were associated with the following variables: immunodeficiency, obesity, neoplasia, and origin. In the second wave, deaths were associated with education, O2 saturation < 95%, chronic neurological disease, and origin. In the third wave, deaths were associated with race/color, education, difficulty breathing, nasal or conjunctival congestion, irritability or confusion, adynamia or weakness, chronic cardiovascular disease, neoplasms, and diabetes mellitus. Origin was associated with the outcome in the three waves of the pandemic, in the same way that education was in the second and third waves (p < 0.05). CONCLUSION: The time interval between diagnosis and death can be impacted by several factors, such as: plasticity of the health system, improved clinical management of patients, and the start of vaccination at the end of January 2021, which covered the age group with the higher incidence of deaths. The deaths occurring in public hospitals were associated with socio-clinical characteristics.


Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Brazil/epidemiology , Hospitals, Public , Incidence
4.
Scand J Public Health ; : 14034948221119637, 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2089111

ABSTRACT

AIM: One-fifth of the Danish population smoke and exposure to second-hand smoke has well-documented adverse health effects. The smoking policy at hospital level prohibits hospital staff from smoking on the hospital grounds while patients and visitors may smoke in outdoor smoking cabins. This study aimed to quantify smoking at a Danish hospital and document any policy breaches. METHODS: In April 2020, we collected cigarette butts and observed smokers at the outdoor grounds to document smoking behaviour. RESULTS: In total, 7152 cigarette butts were collected during one week and 368 people were observed smoking at the outdoor grounds during four observation days. Of all collected cigarette butts, 55% were collected outside the smoking cabins and 62% of all smokers were observed smoking outside the smoking cabins. In addition, 31 staff were observed smoking. CONCLUSIONS: This study documents that smoking is prevalent at a smoke-free hospital and that the smoking policy is frequently violated. The frequency of smoking outside the cabins may at least partly be influenced by the COVID-19 pandemic. Smoking at a hospital can expose patients, visitors and staff to second-hand smoke with subsequent adverse health effects. Hospitals could play an exemplary role towards a smoke-free society (and not the exception), but the opportunity is not always seized.

5.
Front Sociol ; 7: 938734, 2022.
Article in English | MEDLINE | ID: covidwho-2080307

ABSTRACT

Communication patterns between doctors, nurses and patients determine both the efficiency of healthcare delivery, and the job satisfaction of healthcare workers. Job satisfaction is important to ensure retention of the doctor and nurse populations. Incidents of assault against physicians and nurses from relatives and family members of patients have become frequent both in the pre-pandemic and COVID-19 eras. Along with appreciation for frontline healthcare workers serving during the pandemic, there is physical violence directed at them for failing to salvage infected patients. Using Bourdieu's concepts of social space, forms of capital, and habitus this paper endeavors to theorize some of the interaction patterns observed in doctor-patient, nurse-patient, and doctor-nurse encounters that contribute to the waning of the relationship between healthcare workers and wider society as observed in West Bengal, India. Primary empirical data was collected through in-person, in-depth semi-structured interviews with both open and closed-ended questions conducted throughout 2018 across 5 government hospitals in Kolkata (major metropolitan center) and 1 hospital in a suburban area with population 100,000. The respondents consisted of 51 nurses (100% women), 20 doctors (5% women), and 33 patients (33.3% women) recruited using purposive and snowball sampling. Social space analysis indicated that the cumulative patient social capital is comparable to that of the doctors, despite the doctor's higher levels of cultural and economic capital because of the high patient to doctor ratio. The patient population can thus concentrate and delegate their social capital to select agents leading to violence against healthcare workers. Through this analysis, two doctors' habitus were postulated, along with a nurse and a patient habitus. The first doctor habitus is structured by the idealized status of doctors and the second habitus is structured by their resource-limited working conditions. The nurse habitus is structured by the desire for economic empowerment along with dutifully providing care as instructed. The patient habitus is structured by the need to balance healthcare expenditures with their limited financial means. This paper establishes how the habitus of the agents and the politics of healthcare interact to exacerbate extant tensions between healthcare workers and the population they care for.

6.
Rev. baiana enferm ; 36: e37761, 2022.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2081186

ABSTRACT

Objetivo: relatar a experiência de liderança de enfermeiros no enfrentamento à COVID-19 em um hospital universitário na Região Sul do Brasil. Método: relato de experiência da atuação de enfermeiros-líderes no combate ao novo Coronavírus, no período de março a junho 2020, em um hospital de referência, no Sul do Brasil. Resultados: o relato teve por base as ações de prática avançada nos serviços de enfermagem, englobando pesquisa, educação, prática assistencial e gestão. Identificou-se algumas aproximações na atuação do enfermeiro-líder na Unidade de Terapia Intensiva COVID e na Unidade de Internação não referência, como: criação de protocolos e fluxos, treinamento das equipes de enfermagem, dimensionamento/realocação, adequações na assistência e diferentes sentimentos vivenciados. Conclusão: a liderança do enfermeiro frente à pandemia vem sendo permeada por inúmeros desafios, sendo necessário utilizar-se de suas habilidades e competências para proporcionar um ambiente de trabalho de qualidade, seguro e saudável.


Objetivo: reportar la experiencia de enfermeras líderes en el enfrentamiento a COVID-19 en un hospital universitario del sur de Brasil. Método: informe de experiencia del desempeño de enfermeras líderes en la lucha contra el nuevo Coronavirus, de marzo a junio de 2020, en un hospital de referencia en el sur de Brasil. Resultados: el informe se basó en las acciones de la práctica avanzada en los servicios de enfermería, abarcando la investigación, la educación, la práctica del cuidado y la gestión. Se identificaron algunos enfoques en el desempeño de la enfermera-líder en la Unidad de Cuidados Intensivos COVID y en la Unidad de Hospitalización No Referencial, tales como: creación de protocolos y flujos, capacitación de equipos de enfermería, dimensionamiento/reubicación, adecuaciones en la atención y diferentes sentimientos experimentados. Conclusión: el liderazgo de la enfermera frente a la pandemia ha estado impregnado de numerosos desafíos, y es necesario utilizar sus habilidades y competencias para proporcionar un ambiente de trabajo de calidad, seguro y saludable.


Objective: to report the experience of leading nurses in coping with COVID-19 in a university hospital in southern Brazil. Method: experience report of the performance of leading nurses in the fight against the new Coronavirus, from March to June 2020, in a reference hospital in southern Brazil. Results: the report was based on the actions of advanced practice in nursing services, encompassing research, education, care practice and management. Some approaches were identified in the performance of the nurse-leader in the COVID Intensive Care Unit and in the Non-Reference Inpatient Unit, such as: creation of protocols and flows, training of nursing teams, dimensioning/relocation, adequacies in care and different feelings experienced. Conclusion: the nurse's leadership in the face of the pandemic has been permeated by numerous challenges, and it is necessary to use their skills and competences to provide a quality, safe and healthy work environment.


Subject(s)
Humans , Nurse's Role , COVID-19/nursing , Hospitals/standards , Leadership
7.
Clin Nurs Res ; : 10547738221129711, 2022 Oct 17.
Article in English | MEDLINE | ID: covidwho-2079297

ABSTRACT

Hospitalized patients and their families may be reluctant to express safety concerns. We aimed to describe safety and quality concerns experienced by hospitalized patients and families and factors and outcomes surrounding decisions about voicing concerns, including those related to the COVID-19 pandemic. We conducted semi-structured interviews with 19 discharged inpatients or family members in a qualitative descriptive design. Some participants reported concern about staff competency or knowledge, communication and coordination, potential treatment errors, or care environment. Factors influencing feeling safe included healthcare team member characteristics, communication and coordination, and safe care expectations. Reasoning for voicing concerns often included personal characteristics. Reasons for not voicing concerns included feeling no action was needed or the concern was low priority. Outcomes for voicing a concern were categorized as resolved, disregarded, and unknown. These findings support the vital importance of open safety communication and trustworthy response to patients and family members who voice concerns.

8.
Cureus Journal of Medical Science ; 14(7), 2022.
Article in English | Web of Science | ID: covidwho-2072159

ABSTRACT

Introduction: There is a growing focus on researching the management of children with COVID-19 admitted to hospital, especially among developing countries with new variants alongside concerns with the overuse of antibiotics. Patient care can be improved with guidelines, but concerns with the continued imprudent prescribing of antimicrobials, including antibiotics, antivirals, and antimalarials. Objective: Consequently, a need to document the current management of children with COVID-19 across India. Key outcome measures included the percentage of prescribed antimicrobials, adherence to current guidelines, and mortality. Methodology: A point prevalence study using specially developed report forms among 30 hospitals in India. Results: The majority of admitted children were aged between 11 and 18 years (70%) and boys (65.8%). Reasons for admission included respiratory distress, breathing difficulties, and prolonged fever. 75.3% were prescribed antibiotics typically empirically (68.3% overall), with most on the Watch list (76.7%). There were no differences in antibiotic prescribing whether hospitals followed guidelines or not. There was also appreciable prescribing of antimalarials (21.4% of children), antivirals (15.2%), and antiparasitic medicines (27.2%) despite limited evidence. The majority of children (92.2%) made a full recovery Conclusion: It was encouraging to see low hospitalization rates. However, concerns about high empiric use of antibiotics and high use of antimalarials, antivirals, and antiparasitic medicines exist. These can be addressed by instigating appropriate stewardship programs.

9.
Ieee Access ; 10:104169-104177, 2022.
Article in English | Web of Science | ID: covidwho-2070272

ABSTRACT

Specific 5G Release 17 work items are dealing with critical medical applications. Moreover, the adoption of mobile health (m-health) and e-health has been accelerated by the COVID-19 pandemic. This paper first examines the requirements of critical medical applications that 5G is expected to support. Then it illustrates possible data protection, management, and privacy issues. Finally, it shows a first implementation of an m-health framework supporting physical distance management. Experimental results show that, by exploiting 5G connectivity and the computing capacity provided by an accelerated edge cloud, the proposed framework can detect physical distance violations faster than a user equipment (UE)-based implementation, while saving UE energy.

10.
Sustainability ; 14(3):1156, 2022.
Article in English | ProQuest Central | ID: covidwho-1680086

ABSTRACT

The distribution of medical supplies tied to the government-owned nonprofit organizations (GNPOs) is crucial to the sustainable and high-quality development of emergency response to public health emergencies. This paper constructs a two-sided GNPO–hospital game model in a Chinese context, and explores the strategies and influencing factors of medical supply distribution in public health emergencies based on evolutionary game theory. The results show that: (1) GNPOs, as the distributor of medical supplies, should choose strategies that balance efficiency and equity as much as possible. (2) Hospitals, as the recipient of medical supplies, should actively choose strategies that maximize the total benefit to society and strengthen trust in GNPOs. Meanwhile, hospital managers need to pay attention to reducing the impact of communication and coordination costs and strive for the reduction of conflicts between different values. (3) The government should strengthen supervision to avoid conflicts between medical distributors and receivers during a public health emergency and ensure the rescue efficiency. This study provides some reference for the sustainable development of emergency relief in public health emergencies.

11.
Clinical Medicine ; 22(5):496-497, 2022.
Article in English | ProQuest Central | ID: covidwho-2067214

ABSTRACT

Letters should be limited to 350 words, and sent by email to: clinicalmedicine@rcp.ac.uk End-tidal carbon dioxide as a screening tool in excluding pulmonary embolism Editor - In our 2014 article, we demonstrated that end-tidal carbon dioxide (ETCO2;the level of carbon dioxide that is released at the end of an exhaled breath) is a reliable screening test to rule out pulmonary embolism.1 There were a small number of patients (n=100), with only 38 patients with pulmonary emboli (PEs). The fact that NiV is in the World Health Organization (WHO) Research and Development (R&D) Blueprint list of epidemic threats requiring urgent R&D action highlights the global concern regarding NiV.2 Despite the high mortality from NiV infection ranging from 40% to 91%, Dr Alam also emphasises that there are no licensed treatments, with care being only supportive.1 Lessons must be learnt from our experiences with the COVID-19 pandemic as well as the ongoing multi-country monkeypox outbreak.3 Greater efforts must be made to optimise our preparedness for future potential threats (such as NiV) and take advantage of any opportunities that may facilitate this preparedness;for example, regarding antiviral therapy for NiV infection, a study was conducted in which African green monkeys were challenged with a lethal dose of NiV (Bangladesh genotype): all animals who received remdesivir survived whereas all the control animals died.4 Remdesivir has been used widely during the COVID-19 pandemic and continues to feature in current national COVID-19 treatment guidelines.5 We should, therefore, utilise our vast experience with the use of this antiviral to study its potential role in the treatment of human NiV infection. In macaques, remdesivir penetrates poorly into the central nervous system (CNS) with a brain:plasma ratio of <0.05.6 However, its CNS penetration in humans is largely unknown but is of interest not only because NiV frequently causes an encephalitis but also in view of the fact that there have been numerous reports of COVID-19-associated encephalitis.7 Many patients with COVID-19-associated neurological disease receive remdesivir that potentially provides an opportunity to study its blood brain barrier penetration and/ or characterise the effects of remdesivir on brain tissue through post-mortem studies, indirectly providing valuable information regarding its possible utility in the treatment of CNS disease caused by NiV.8,9 * TEMI LAMPEJO Consultant in infectious diseases and virology, King's College Hospital, London, UK References 1 Alam AM.

12.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(10):1686-1691, 2022.
Article in English | ProQuest Central | ID: covidwho-2067052

ABSTRACT

[...]in a small proportion of cases like immune deficient patients or those with comorbid conditions, the disease can progress to a more severe stage characterized by a dysregulated immune response with hyperinflammation with subsequent development of acute respiratory distress syndrome. Real-time polymerase chain reaction test of the oropharyngeal/ nasal swab was the confirmatory laboratory evidence to identify COVID-19 infection. [5] In India, a wide range of repurposed drugs including azithromycin, remdesivir, dexamethasone, and even multivitamins such as zinc and Vitamin C was recommended for the management of hospitalized patients with COVID-19. The demographic and prescription characteristics such as age, sex, SPO2 at the time of admission, CT - chest score if available, duration of stay in the hospital, details of treatment received with the number of days of treatment for each drug, route of administration, presence of comorbid conditions, and adverse reactions if any, until the occurrence of a clinical endpoint, namely, inpatient death or non-fatal discharge were all collected.

13.
Journal of Agriculture, Food Systems, and Community Development ; 12(1):1, 2022.
Article in English | ProQuest Central | ID: covidwho-2067032

ABSTRACT

Across the country, hospitals are buying more sustainable food and passing internal policies in support of sustainable food procurement. This reflective essay describes the results of the sustainable procurement goals and policy of the University of California's five health systems from 2009 to 2021. Based on my observations as a staff person in the University of California and my participation in internal meetings with foodservice and sustainability staff, I discuss the evolution of the University of California's sustainable food procurement policy goals and its definition of "sustainable." I describe staff and programmatic support for purchasing environmentally sustainable food and beverages and the growth of the University of California's sustainable food purchases as a percentage of its hospitals' food budgets. This essay also explores staff debates about the sustainability of sourcing poultry with the label of "no antibiotics ever" after a 2020 COVID-19 outbreak at a poultry processing facility in California that led to the deaths of several workers. These debates about labor and working conditions in poultry supply chains from the five University of California health systems offer insights into ongoing challenges and opportunities for institutional food procurement and policy to change the food system utilizing existing supply chains and third-party certifications and label claims. The University of California's experiences also illustrate the ongoing need for farm-to-institution and farm-to-hospital efforts to better integrate values around working conditions in supply chains into sustainable procurement goals.

14.
Zhongguo Jiguang/Chinese Journal of Lasers ; 49(20), 2022.
Article in Chinese | Scopus | ID: covidwho-2066650

ABSTRACT

Objective Since the outbreak of COVID-19, many hospitals have become overloaded with patients seeking examination, resulting in an imbalance between medical staff and patients. These high concentrations of people in hospital settings not only aggravate the risk of cross-infection among patients, but also stall the public medical system. Consequently, mild and chronic conditions cannot be treated effectively, and eventually develop into serious diseases. Therefore, the use of deep learning to accurately and efficiently analyze X-ray images for diagnostic purposes is crucial in alleviating the pressure on medical institutions during epidemics. The method developed in this study accurately detects dental X-ray lesions, thus enabling patients to self-diagnose dental conditions. Methods The method proposed in this study employs the YOLOV5 algorithm to detect lesion areas on digital X-ray images and optimize the network model's parameters. When hospitals and medical professionals collect and label training data, they use image normalization to enhance the images. Consequently, in combination with the network environment, parameters were adjusted into four modules in the YOLOV5 algorithm. In the Input module, Mosaic data enhancement and adaptive anchor box algorithms are used to generate the initial box. The focus component was added to the Backbone module, and a CSP structure was implemented to determine the image features. When the obtained image features are input into the Backbone module, the FPN and PAN structures are used to realize feature fusion. Subsequently, GIOU_Loss function is applied to the Head moudule, and NMS non-maximum suppression is used to generate a regression of results. Results and Discussions The proposed YOLOV5-based neural network yields satisfactory training and testing results. The training algorithm produced a recall rate of 95%, accuracy rate of 95%, and F1 score of 96%. All evaluation criteria are higher than those of the target detection algorithms of SSD and Faster-RCNN (Table 1). The network converges to smoothness after loss is reduced in the training process (Fig. 6), which proves that the network successfully learns the necessary features. Thus, the difference between predicted and real values is very small, which indicates good model performance. The mAP value of network training is 0.985 (Fig. 7), which proves that the network training meets the research requirements. Finally, an observation of the visualized thermodynamic diagram reveals that the network's region of interest matches the target detection region (Fig. 8). Conclusions This study proposes the use of the YOLOV5 algorithm for detecting lesions in dental X-ray images, training and testing on the dataset, modifying the network's nominal batch size, selecting an appropriate optimizer, adjusting the weight parameters, and modifying the learning rate attenuation strategy. The model's training results were compared with those of algorithms used in previous studies. Finally, the effect of feature extraction was analyzed after the thermodynamic diagram was visualized. The experimental results show that the algorithm model detects lesion areas with an accuracy rate of more than 95%, making it an effective autonomous diagnostic tool for patients. © 2022 Science Press. All rights reserved.

15.
Sustainability ; 14(19):12757, 2022.
Article in English | ProQuest Central | ID: covidwho-2066459

ABSTRACT

This paper focus on the quantitative measurement of public health systems and its mismatch with socio-economic development. Based on systematic theory, we divide the public health system into four sub-systems: resource inputs, planning in decision-making, operations, and service outputs. We also provide a method to analyse the ability to match between the public health system and social-economic development by using the grey correlation and coupling method. Then we introduce data from China as a case of empirical research. The main findings are as follows: (1) China’s public health system has progressed from 2012 to 2019, and the development of China’s public health system is typically “input-driven”. Second, the level of public health management in China lacks sustainability. (2) The main reason for this problem is the mismatch between the central and local governments in China in terms of public health management authority. (3) Third, the coupling between China’s public health system and socio-economics development has shown a decreasing trend, which indicates an increasingly significant mismatch problem between public health and economic growth, urbanization, and population aging. Our study will enrich the understanding of the relationship between the public health system and socio-economics development.

16.
Int J Environ Res Public Health ; 19(19)2022 Oct 10.
Article in English | MEDLINE | ID: covidwho-2066091

ABSTRACT

In the midst of COVID-19, radical change in the work environment further exacerbated the detrimental effects of critical illness in the intensive care unit (ICU). This may be heightened if the patient experiences a lamentable end-of-life experience due to inadequate end-of-life care (EoLC). Anchoring on the theory of bureaucratic caring and the peaceful end-of-life theory, insights can be gained into the motivations and behaviors that support the delivery of palliative care during COVID-19. With this having been having said, the objective of this study was to use a narrative approach to examine the lived experience of 12 nurses who provided EoLC in the COVID-19 ward of several hospitals in the Western Philippines. Participants' narratives were transcribed, translated and analyzed. Among the themes that have emerged are: establishing a peaceful journey to death, holistic caring for the end of life, venturing into risky encounters in the call of duty, staying close amidst the reshaped work environment, and preparing the family life after a loved one's departure. The study identified the importance of assisting patients on their journey to a peaceful death, but this journey was also accompanied by a sense of self-preservation and safety for colleagues and families.


Subject(s)
COVID-19 , Terminal Care , Humans , Intensive Care Units , Palliative Care , Philippines , Qualitative Research
17.
Int J Environ Res Public Health ; 19(19)2022 Sep 29.
Article in English | MEDLINE | ID: covidwho-2065974

ABSTRACT

Climate change has been recognised as a multiplier of risk factors affecting public health. Disruptions caused by natural disasters and other climate-driven impacts are placing increasing demands on healthcare systems. These, in turn, impact the wellness and performance of healthcare workers (HCWs) and hinder the accessibility, functionality and safety of healthcare systems. This study explored factors influencing HCWs' disaster management capabilities with the aim of improving their resilience and adaptive capacity in the face of climate change. In-depth, semi-structured interviews were conducted with thirteen HCWs who dealt with disasters within two hospitals in Queensland, Australia. Analysis of the results identified two significant themes, HCWs' disaster education and HCWs' wellness and needs. The latter comprised five subthemes: HCWs' fear and vulnerability, doubts and uncertainty, competing priorities, resilience and adaptation, and needs assessment. This study developed an 'HCWs Resilience Toolkit', which encourages mindfulness amongst leaders, managers and policymakers about supporting four priority HCWs' needs: 'Wellness', 'Education', 'Resources' and 'Communication'. The authors focused on the 'Education' component to detail recommended training for each of the pre-disaster, mid-disaster and post-disaster phases. The authors conclude the significance of the toolkit, which provides a timely contribution to the healthcare sector amidst ongoing adversity.


Subject(s)
Climate Change , Disasters , Delivery of Health Care , Health Personnel , Humans , Public Health
18.
Advances in Civil Engineering ; 2022, 2022.
Article in English | ProQuest Central | ID: covidwho-2064336

ABSTRACT

Coronavirus disease (COVID-19) is a viral infection caused by the SARS-CoV-2 virus that first surfaced in December 2019. According to the World Health Organization, most persons infected with this virus suffer from mild to severe respiratory infections and recover without specific treatment or hospitalization. Some people, however, may acquire serious illnesses that need medical attention and isolation facilities. This paper investigates the use of multi-criteria decision analysis (MCDA) based on GIS technology to determine the optimal site selection for isolation hospitals for coronavirus patients in Nile Delta region in Egypt using the fuzzy analytical hierarchy process (F-AHP) and the weighted overlay tool analysis method (WOA). The research of isolation hospital site selection in Nile Delta governorates in Egypt is one of the areas that have received insufficient attention due to the current global coronavirus epidemic. Several criteria are applied to identify and select the isolation hospital location, including World Health Organization regulations, Egyptian Ministry of Health conditions, previous research studies, and field visits. Geodatabase is created using ArcGIS Pro software, and manual digitization is done. As a conclusion of the study, numerous additional optimal sites for isolated hospitals have been found and chosen. There are around 29 proposed ideal sites for isolated hospitals utilizing F-AHP and approximately 24 sites using WOA approach in Nile Delta region. These planned hospital locations might be permanent as a central hospital or temporary, to be relocated after the epidemic is over. The paper emphasizes the need to use the study criteria while selecting and defining the location of coronavirus isolation hospitals.

19.
BMJ Leader ; 2022.
Article in English | ProQuest Central | ID: covidwho-2064257

ABSTRACT

Tell us a little bit about your leadership role and how it is changing as a result of the pandemic? I hold three roles, first as a clinician practising infectious diseases at two of the University of Toronto’s academic teaching hospitals. [...]as a scientist and professor studying epidemics of emerging diseases and teaching medical trainees. At BlueDot, my leadership role has evolved significantly over the course of a pandemic. [...]recently, I was overseeing multiple teams including product development, engineering, data analytics, marketing and commercialisation. [...]it was that formative experience that inspired me to create BlueDot.

20.
Gut ; 71(Suppl 3):A91-A92, 2022.
Article in English | ProQuest Central | ID: covidwho-2064235

ABSTRACT

P80 Figure 1This ongoing project will enable our team to identify those requiring blood tests and potential treatment. As we continue we expect an increase in patient numbers to our CNS clinics. One major limitation is limited access to regional hospital laboratory results. Another limitation is staff being available to review files, responses to letters and chasing blood tests or results.Public Health England (2017). Hepatitis C in the UK – 2017 Report.Working to Eliminate Hepatitis C as a Major Public Health Threat. London: PHE.Thursz M. (2017). The fight against hepatitis C has not yet been won: here’s what we have to do. Huffington Post;10 August 2017.Vine LJ et al. Diagnosis and management of hepatitis C. British Journal of Hospital Medicine;2015;76:11, 625–630.World Health Organization (2016). Combating Hepatitis B and C to Reach Elimination by 2030. Geneva: WHO.

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