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1.
Sosyoloji Konferanslari ; 41(2):175-198, 2021.
Article in Turkish | ProQuest Central | ID: covidwho-1824268

ABSTRACT

Tıp teknolojileri, zaman içinde tıbbi ethos’ta çok çeşitli dönüşümlere neden olmuştur. Teknolojinin, insan varoluşunun hemen her alanına sızan niteliği, özellikle COVID-19 Pandemisi’nin kurguladığı steril gerçeklikte daha da görünür olmuş, eğitimden çalışmaya hayatın birçok alanı, teknolojinin ivmelenmiş eklemlenmesiyle yeniden şekillenmiştir. Tıp teknolojileri, zaman içinde tıbbi ethos’ta çok çeşitli dönüşümlere neden olsa da, özellikle COVID-19 Pandemisi’nin alan içinde hâlihazırda var olan eğilimini hızlandırdığı tele-tıp uygulamaları, tıbbın hem techne hem praxis seviyesinde tümden bir dönüşüme neden olabilecek olasılıklarla birlikte gelmiştir. Makalenin amacı, teknik ve pratik seviyelerdeki dönüşümlerin birbiriyle ilişkisinin ortaya konması;teknolojinin doğrusal olmayan ilerlemesinin kriz ânında âni uyarlanma pratiği üzerinden tartışılmasıdır. Bu bağlamda, tele-tıp uygulamalarının tıbbi pratikteki yeri, sağlık hizmetine erişim olanakları, kriz hâline uyarlanma, hasta-hekim ilişkisi gibi konular söz konusu olduğunda içerdiği çeşitli olasılıklar kavramsal boyutlarıyla ele alınmakta, bu dönüşümlerin COVID-19 Pandemisi’nin inşa ettiği yeni gerçeklik içindeki anlamı sorgulanmaktadır. Tele-tıp kapsamındaki uygulamalar, içerdiği farklı olasılıklarla birlikte düşünülmüş;dolayısıyla makale boyunca tartışılan bütün olasılıklar teknolojinin içkin determinizmi üzerinden değil, bir teknolojik nesnenin toplumsal kurgusu sırasında yapılan seçimler üzerinden kavramsallaştırılmıştır. Bu toplumbilimsel kavramsallaştırma, tele-tıbbın alanda konumlandırılmasına da katkı sağlayacaktır.Alternate : Medical technologies have brought about various transformations in the medical ethos over time. The permeating character of technology penetrates almost every aspect of human existence and has become even more visible within the sterile reality the COVID-19 pandemic has constructed, with many areas of life from education to work having been reshaped by this accelerated articulation of technology. Despite medical technologies having caused a wide variety of transformations in the medical ethos over time, telemedicine applications, whose existing tendency to emerge and spread in the medical field has been accelerated with the reality constructed by the COVID-19 pandemic, have been able to result in a total transformation both at the techne and praxis levels of the profession. The main aim of this article is to reveal the relationship between transformations at the technical and practical levels and to discuss the nonlinear advancement of technology through the sudden adaptation of telemedicine in times of crisis. In this context, the article conceptually discusses the different possibilities telemedical applications have in terms of medical practice, healthcare access, crisis adaptation, and the patient-physician relationship and questions the meaning of these transformations in the new reality built by the COVID-19 pandemic. This paper argues the practices and applications within the scope of telemedicine to contain different possibilities;therefore, all the possibilities discussed throughout the article will be conceptualized not through the inherent determinism of technology but through the choices made during a technical object’s social construction. This sociological conceptualization will contribute to telemedicine’s positioning in the field.

2.
Australian Journal of General Practice ; 51(5):357-364, 2022.
Article in English | ProQuest Central | ID: covidwho-1823777

ABSTRACT

PATIENT-CENTRED CARE (PCC) is a priority for primary healthcare clinicians, researchers and policymakers.1-3 In Australia, general practitioners (GPs) and patient advocates have defined PCC to contain six interrelated components: 1) understanding the whole person, 2) finding common ground, 3) experiencing time, 4) aiming for positive outcomes, 5) considering the system and collaborating in care and 6) optimising the general practice environment.3 The concept of PCC is integral to the Australian primary care system, and practice-based research plays a part in supporting PCC. In Australia, social distancing regulations and government-enforced lockdowns have affected the availability of general practice staff and influenced the way patients access and interact with general practice services.4 Initially, fewer patients attended general practice services for routine care.4'5 Then the number of telehealth consultations delivered by GPs increased, despite information and communication technologies (ie telehealth) historically being used predominately to provide care across geographic, time, social and cultural barriers.6 After the onset of the pandemic, the scope of funding for telehealth within the Medicare Benefits Schedule (MBS) was expanded, and this also contributed to an increased number of telehealth consultations.5 Primary Health Networks across Australia collaborated with general practices to roll out and administer COVID-19 vaccinations to the nation. Data collection Descriptive practice data collected were practice name, location (postcode), number of employed full-time equivalent GPs and business model type. Enacting PCC was severely affected in areas with a high number of COVID-19 cases because of the significant disruption that increased community transmission of COVID-19 caused the local health system.

3.
Osteopathic Family Physician ; 13(6):9-16, 2021.
Article in English | EMBASE | ID: covidwho-1822746

ABSTRACT

Introduction: Telemedicine is an emerging field in which physicians can interact electronically with patients to improve health. During the COVID-19 pandemic, the use of telemedicine has grown exponentially. As physicians work to provide equally high-quality care for their patients remotely, their experiences must be considered. Methods: This study utilized an online anonymous survey of physicians to assess their satisfaction, comfort level and student involvement when using telemedicine for patient care. Results: Overall, physicians’ experiences with the integration of telemedicine into their practices varied based on gender, the presence of medical students, age and prior experience with telemedicine. Physicians are more comfortable with telemedicine now than they had been prior to the start of the COVID-19 pandemic, and physicians who had prior experience were less likely to find it stressful to incorporate. Physicians in both the youngest (30–39 years old) and oldest (60 and older) categories reported the highest levels of satisfaction with telemedicine. Female physicians indicated they will be more likely to incorporate more telemedicine into practice in the future, beyond the COVID-19 pandemic. Of the specialties surveyed, family physicians report the lowest levels of comfort and satisfaction with telemedicine. Conclusion: Physician respondents of this survey provided valuable data on the perceptions of the widespread incorporation of telemedicine during the COVID-19 pandemic. Further research can follow which physicians choose to keep telemedicine integrated into their practices and how the demand for these virtual visits may change in the coming months.

4.
Siberian Journal of Oncology ; 21(1):99-106, 2022.
Article in Russian | EMBASE | ID: covidwho-1822671

ABSTRACT

The aim of the study was to analyze the most significant studies representing the basic principles of diagnosis and treatment of patients with breast cancer (BC) during the CO VID -19 pandemic. Material and Methods. The search for relevant sources was carried out in PubMed, Cochrane Library, Web of Science systems, publications for 2019-2020 were studied, 48 of which were used to write this review. Results. During the CO VID -19 pandemic, it is necessary to suspend screening examinations for a certain period of time;patients with early and metastatic breast cancer should be transferred to outpatient treatment in the LU s located in their place of residence. Examinations and consultations of patients undergoing hormone therapy should be postponed or carried out using telemedicine technologies. Treatment of breast cancer patients during a pandemic should be carried out according to clinical guidelines and protocols, but minimizing the number of visits to the hospitals. Conclusion. The pandemic of the novel coronavirus infection (CO VID -19) is a serious problem for healthcare and professionals around the world. All treatment decisions must be based on risks and benefits in the context of each stage of the pandemic, on an individual basis and taking into account the preferences of patients.

5.
BJOG: An International Journal of Obstetrics and Gynaecology ; 129(6):837-838, 2022.
Article in English | EMBASE | ID: covidwho-1822043
6.
Jamia Open ; 5(2):7, 2022.
Article in English | Web of Science | ID: covidwho-1821749

ABSTRACT

Objective Evaluate an initiative to distribute video-enabled tablets and cell phones to individuals enrolled in Veterans Health Affairs supportive housing program during the COVID-19 pandemic. Materials and Methods In September 2020, individuals in the Veteran Health Affairs (VA) Housing and Urban Development-VA Supportive Housing (HUD-VASH) program were offered either a video-enabled tablet or cellphone to support their communication and health care engagement needs. We examined sociodemographic and clinical characteristics of device recipients, and compared engagement in in-person, telephone, and video-based visits (categorized as primary care, specialty care, rehabilitation, HUD-VASH, mental health care, and other) for 6 months prior to (March 1, 2020-August 31, 2020) and following (September 1, 2020-July 30, 2021) device receipt. Results In total, 5127 Veterans received either a tablet (n = 4454) or a cellphone (n = 673). Compared to the 6 months prior to device receipt, in the 6 months following receipt, in-person and video engagement increased by an average of 1.4 visits (8%) and 3.4 visits (125%), respectively, while telephone engagement decreased (-5.2 visits;-27%). Both tablet and cellphone recipients had increased in-person visits (+1.3 visits [8%] and +2.1 visits [13%], respectively);while tablet users had a substantially larger increase in video-based engagement (+3.2 visits [+110%] vs. +0.9 [+64%]). Similar trends were noted across all assessed types of care. Discussion Providing video-enabled devices to Veterans in a supportive housing program may facilitate engagement in health care. Conclusions and Relevance VA's device distribution program offers a model for expanding access to health-related technology and telemedicine to individuals in supportive housing programs. Lay Summary In September of 2020, the Veteran's Health Affairs (VA) initiated a program to distribute video-enabled tablets and cellphones to Veterans who were enrolled in the Housing and Urban Development-VA Supportive Housing (HUD-VASH) program. The goal of this program was to maintain communication and health care engagement during the pandemic. After receiving either a tablet or cellphone, we compared in-person, telephone, and video-based engagement among the 4454 tablet recipients and the 673 cellphone recipients. We found in the 6 months following receipt, that overall in-person and video engagement increased by an average of 1.4 visits (8%) and 3.4 visits (125%), while telephone engagement decreased (-5.2 visits;-27%). Both tablet and cellphone recipients had increased in-person visits (+1.3 visits [8%] and +2.1 visits [13%], respectively);while tablet users had a substantially larger increase in video-based engagement (+3.2 visits [+110%] vs. +0.9 [+64%]). This study suggests that providing video-enabled devices to Veterans in a supportive housing program may facilitate engagement in health care.

7.
Telemedicine and E-Health ; : 9, 2022.
Article in English | Web of Science | ID: covidwho-1821678

ABSTRACT

Introduction: Owing to the coronavirus disease 19 pandemic, the demand for telemedicine has increased. However, the awareness of and experience with telemedicine among the Korean population have not been investigated. Therefore, we examined Korean outpatients' experience with and awareness of telemedicine.Methods: From December 2020 to March 2021, we conducted a survey exploring the awareness of and experience with telemedicine of outpatients who were consecutively enrolled by family physicians from four hospitals. The participants completed questionnaires on sociodemographic characteristics and knowledge, experience, satisfaction, preference, and future considerations concerning telemedicine. We evaluated factors associated with satisfaction with telemedicine experiences using multivariate logistic regression analysis.Results: Among the 563 study participants, 364 participants had experience with telemedicine. More than 95% of the telemedicine visits were performed by telephone consultation, and the most common disease type for telemedicine visits was chronic diseases (67.5%). Overall, 82.4% of the participants were satisfied with telemedicine. More than 90% of the participants were satisfied with telemedicine in terms of saving time and money relative to hospital visits, no risk of infection, and convenience. According to the multivariate logistic regression analysis, adults aged >= 65 years (odds ratio [OR] 3.53, 95% confidence interval [CI] 1.44-8.68), residents of a metropolitan city (OR 6.8, 95% CI 1.41-32.55), and those with knowledge of telemedicine (OR 2.96, 95% CI 1.21-7.26) were more likely to be satisfied with their telemedicine experience, compared with their counterparts. For chronic diseases, participants with telemedicine experience were significantly more likely to prefer telemedicine for revisits, compared with those with no telemedicine experience. Nonetheless, most respondents recognized that telemedicine requires improvement.Conclusions: Most Korean outpatients showed high satisfaction with telemedicine. Telemedicine may be considered in various medical situations in the future. Therefore, building a practical system for telemedicine and changes in the medical environment are required.

8.
JTO Clinical and Research Reports ; : 100333, 2022.
Article in English | ScienceDirect | ID: covidwho-1821399

ABSTRACT

Introduction Telehealth is taking an increasingly important part of medicine. This practice change is being accelerated by the pandemic linked to COVID-19. Oncology is a medical specialty for which this paradigm shift is particularly significant. Methods We developed a survey aiming at evaluating the use of teleconsultation by physicians managing patients with lung cancer in France. The survey was available online from December 15, 2020 to February 10, 2021. Results Answers were obtained from 142 clinicians (73.9% pneumologists, 18.3% medical oncologists and 7.7% with another specialty), 129 (90.8%) of whom had already performed teleconsultation. Among those, 123 (95.3%) started after the COVID-19 pandemic. 72.9% had a moderate usage of this tool (<10 teleconsultations/month). The frequency of clinicians never using teleconsultation was higher in private practices (p=0.029). The two clinical situations for which teleconsultation was frequently used were visits during treatment without imaging assessment (53.5%), and post-treatment surveillance (80.3%). Depending on the type of treatment received, the frequency of teleconsultation was variable. Lung cancer subtype also impacted the clinician's practice. Indeed, 47.2% never proposed this tool for small-cell lung cancer. Teleconsultation was considered to be of no contribution, a moderate contribution, a significant contribution, or a revolution of the clinical practice for 14.1%, 66.2%, 10.6% and 2.1% of respondents. Participants expected to decrease, stabilize or increase their teleconsultation activity in 18.3%, 52.8% and 23.2% of cases. Conclusion Most thoracic oncologists in France are using teleconsultation, mostly as an additional tool that should not replace the doctor-patient in -person relationship.

9.
Journal of Pediatric Surgery ; 2022.
Article in English | ScienceDirect | ID: covidwho-1821391

ABSTRACT

Background Telemedicine has played an increasingly important role in surgical care during the coronavirus disease 2019 (COVID-19) pandemic, yet little is known about its usage and correlation to cost both within and across surgical specialties during the pandemic. Study Design We collected data on telehealth encounters from April 2020 to June 2021 for all surgical specialties at a pediatric academic institution. The percent of total encounters that were telemedicine vs. in-person were analyzed over time. Data on charge and reimbursement were averaged for each encounter type, and the percent difference in average charge and reimbursement was calculated and compared between surgical specialties. Results Of the 147,007 surgical clinical visits identified, 6,566 encounters (4.5%) were telemedicine. Usage peaked in April and plateaued in June of 2020. The specialties with the highest total percentages of telemedicine visits were neurosurgery (23.2%) and cardiovascular-thoracic (11.9%). Orthopedics reported the lowest usage at 2%. Charges for in-person encounters were higher for nearly all specialties while reimbursements remained equal. Conclusion Our institutional trends reveal that conversion to telemedicine varied across surgical specialty during the COVID-19 pandemic. Charges for in-person encounters were higher than telehealth ones for nearly all specialties, but the reimbursements were fairly the same. Understanding trends in telemedicine volume instigated by and following the pandemic may better prepare pediatric institutions to navigate the accelerated adoption and influence policy changes. This is particularly relevant given the fluctuating impact of the pandemic on healthcare institutions as new strains of COVID-19 emerge. EVIDENCE LEVEL Level V

10.
Anesthesia and Analgesia ; 134(4 SUPPL):12-14, 2022.
Article in English | EMBASE | ID: covidwho-1820600

ABSTRACT

Background/Introduction: Amidst the COVID-19 pandemic, the sudden demand for virtual medical visits drove the drastic expansion of telemedicine across all medical specialties. Current literature demonstrates limited knowledge on the impact of telehealth on appointment adherence particularly in preoperative anesthesia evaluations. We hypothesized that there would be increased completion of preoperative anesthesia appointments in patients who received telemedicine visits. Methods: We performed a retrospective cohort study of adult patients at UCLA who received preoperative anesthesia evaluations by telemedicine or in-person within the Department of Anesthesiology and Perioperative Medicine from January to September 2021 and assessed appointment adherence. The primary outcome was incidence of appointment completion. The secondary outcomes included appointment no show and cancellations. Patient demographic characteristics including sex, age, ASA physical status class, race, ethnicity, primary language, interpreter service requested, patient travel distance to clinic, and insurance payor were also evaluated. Demographic characteristics, notably race and ethnicity, are presented as captured in the electronic health record and we recognize its limitations and inaccuracies in illustrating how people identify. Patient reported reasons for cancellations were also reviewed and categorized into thematic groups by two physicians. Statistical comparison was performed using independent samples t test, Pearson's chi-square, and Fischer's exact test. Results: Of 1332 patients included in this study, 956 patients received telehealth visits while 376 patients received in-person preoperative anesthesia evaluations. Compared to the in-person group, the telemedicine group had more appointment completions (81.38% vs 76.60%, p = 0.0493). There were fewer cancellations (12.55% vs 19.41%, p = 0.0029) and no statistical difference in appointment no-shows (6.07% vs 3.99%, p = 0.1337) in the telemedicine group (Figure 1). Compared to the in-person group, patients who received telemedicine evaluations were younger (55.81 ± 18.38 vs 65.97 ± 15.19, p < 0.001), less likely American Indian and Alaska Native (0.31% vs 1.60%, p = 0.0102), more likely of Hispanic or Latino ethnicity (16.63% vs 12.23%, p = 0.0453), required less interpreter services (4.18% vs 9.31%, p = 0.0003), had more private insurance coverage (53.45% vs 37.50%, p < 0.0001) and less Medicare coverage (37.03% vs 50.53%, p < 0.0001). Main reasons for cancellation included patient request, surgery rescheduled/cancelled/already completed, and change in method of appointment. Conclusions: In 2021, preoperative anesthesia evaluation completion was greater in patients who received telemedicine appointments compared to those who received in-person evaluations at UCLA. We also demonstrate potential shortcomings of telemedicine in serving patients who are older, require interpreter services, or are non-privately insured. Knowledge of these factors can provide feedback to improve access and equity to telehealth for patients from all backgrounds, particularly during the COVID pandemic as virtual evaluations increase. (Table Presented).

11.
Asia Pacific Journal of Health Management ; 17(1):9, 2022.
Article in English | Web of Science | ID: covidwho-1820532

ABSTRACT

OBJECTIVE: As COVID-19 engulfed the world, people are shifting to a new way of life with social distancing and self isolation, especially in developing countries. In such a scenario, online retailing has gone through a sea change with a new wave of increased demand and where the healthcare sector has also adjusted with the augmented transition from physical shops to e-commerce. The current study aims to assess the adoption and usage intention of consumers towards telemedicine among people during pandemic times. METHOD: The adoption of telemedicine by consumers depends upon some factors such as reliability, affordability, convenience, authenticity, offers and discount;which could enhance the intention to adopt and continual use by consumers. A modified version of 'Technology Acceptance Model' is incorporated in this study to validate the concept of adoption of telemedicine in cities of North India. RESULTS: The study has found the positive and significant relationship between the factors of adoption and the intention to adopt telemedicine. Also, the 'Effect of COVID-19' plays a moderating role between the different factors of adoption and the intention to adopt telemedicine. CONCLUSION: The adoption of telemedicine by people is significantly associated with different internal and external factors. The intention to adopt telemedicine is the construct that strongly influences the actual usage of telemedicine in developing countries. The scope of this study is restricted to the Northern region of India. A future study can be undertaken in relation to the global perspective of consumers.

12.
Journal of Personalized Medicine ; 12(4):19, 2022.
Article in English | Web of Science | ID: covidwho-1820317

ABSTRACT

The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion in healthcare services, protect health professionals, and help them maintain satisfactory quality and safety of care. Remote monitoring platforms (RPM) emerged as potential solutions. In this study, we evaluate, from health professionals' perspectives, the capacity and contribution of two different digital platforms to maintain quality, safety, and patient engagement in care. A cross-sectional study was conducted using a survey in which a total of 491 health professionals participated. The results show that, in general, user perceptions of the quality and safety of care provided through the platforms were positive. The ease of access to health professionals' services in general and shorter waiting times for patients were the two main features that were highly appreciated by most participants. However, some problems were encountered during the use of these two platforms, such as a lack of training and/or direct support for users. To improve the two platforms and maximize their use, the areas for improvement and the issues identified should be addressed as part of a collaborative process involving health professionals and patients as well as health system leaders, decision-makers, and digital platform providers.

13.
Biomedicines ; 10(4):43, 2022.
Article in English | Web of Science | ID: covidwho-1820166

ABSTRACT

Background: COVID-19 pandemic has affected the physical health, psychological wellbeing, and mental health of the whole population. Young people are among those most at risk of developing mental health symptoms or disorders related to the pandemic. Purpose: the present narrative review is aimed at providing an updated overview of the current literature concerning the psychological impact of the SARS-CoV-2 infection but also of the COVID-19 outbreak, environmental restriction, and social distancing on mental health outcomes among the youth population aged between 15 and 25 years. Methods: in December 2021, an electronic search on this topic was performed on PubMed. Relevant publications from January 2020 until December 2021 were included. Findings: 53 cross-sectional studies, 26 longitudinal studies, 4 ecological studies, 1 qualitative study, and 1 systematic review were included. We found many methodological limitations in the studies included, especially poor choice of study samples and short follow-ups. Little literature was in support of a strong relationship between SARS-CoV-2 infection and consequences on youth mental health. On the contrary, many studies showed how extraordinary measures to limit the spread of the virus have impacted young people in terms of onset of new mental disorders and symptoms, suicidality, and access to emergency psychiatric services. Depressive and anxiety symptoms and disorders show the greatest increase in incidence, especially in girls and young women. Conclusions: it seems important to pay attention to the mental health of young people in relation to the consequences of the COVID-19 pandemic. However, studies with more robust methodologies and longer follow-ups are needed to establish precise indications for targeted interventions in this context.

14.
Telemedicine and E-Health ; : 22, 2022.
Article in English | Web of Science | ID: covidwho-1819772

ABSTRACT

Introduction: The COVID-19 pandemic ushered in a rapid, transformative adoption of telemedicine to maintain patient access to care. As clinicians made the shift from in-person to virtual practice, they faced a paucity of established and reliable clinical examination standards for virtual care settings. In this systematic review, we summarize the accuracy and reliability of virtual assessments compared with traditional in-person examination tools.Methods: We searched PubMed, Embase, Web of Science, and CINAHL from inception through September 2019 and included additional studies from handsearching of reference lists. We included studies that compared synchronous video (except allowing for audio-only modality for cardiopulmonary exams) with in-person clinical assessments of patients in various settings. We excluded behavioral health and dermatological assessments. Two investigators ed data using a predefined protocol.Results: A total of 64 studies were included and categorized into 5 clinical domains: neurological (N = 41), HEENT (head, eyes, ears, nose, and throat;N = 5), cardiopulmonary (N = 5), musculoskeletal (N = 8), and assessment of critically ill patients (N = 5). The cognitive assessment within the neurological exam was by far the most studied (N = 19) with the Mini-Mental Status Exam found to be highly reliable in multiple settings. Most studies showed relatively good reliability of the virtual assessment, although sample sizes were often small (<50 participants).Conclusions: Overall, virtual assessments performed similarly to in-person exam components for diagnostic accuracy but had a wide range of interrater reliability. The high heterogeneity in population, setting, and outcomes reported across studies render it difficult to draw broad conclusions on the most effective exam components to adopt into clinical practice. Further work is needed to identify virtual exam components that improve diagnostic accuracy.

15.
The Journal of Allergy and Clinical Immunology: In Practice ; 2022.
Article in English | ScienceDirect | ID: covidwho-1819517

ABSTRACT

Structured : Background Inconsistent and unequal access to medical care is an issue that predates the COVID19 pandemic, which only worsened the problem. Limited access to care from asthma specialists and other specialists treating comorbid diseases may adversely affect asthma. Objective The purpose of this review is to identify health disparities associated with access to care for asthma, and cost-effectiveness of therapies and interventions addressing this health disparity. Methods A narrative systematic review was undertaken using MeSH searches of English language articles published in CINAHL, Scopus or PubMed. Results 725 articles were identified. Barriers recognized from the literature included access to diagnostic spirometry, access to specialists, medication formulary restrictions and issues leading to medical non-adherence. Telemedicine, school-based health care interventions, digital applications and non-office based digital spirometry could be used to address these gaps in access to asthma care while potentially being cost-effective. Conclusion With the widespread adoption of telemedicine because of the pandemic, and adoption of other mobile services, we now have potential tools that can increase access to asthma care, which can help address this healthcare inequity. Evidence is limited, but favorable, that some of these tools may be cost-effective.

16.
Journal of Clinical and Diagnostic Research ; 16(4):LC21-LC26, 2022.
Article in English | EMBASE | ID: covidwho-1818675

ABSTRACT

Introduction: In this modern era of technology, Information and Communication Technology (ICT) has made a very big revolution. Telemedicine is an emerging concept in health care services in Kerala, its implementation has not been satisfactory and successful. It is cost effective and provides easy access to healthcare services for people anywhere and especially during pandemic situations like this. A study is required in the domain of awareness and skill of doctors to facilitate its adoption and implementation. There was an urgent need to devise means for patients to consult doctors during Coronavirus Disease 2019 (COVID-19) pandemic. Aim: To assess the level of awareness and skill among doctors practicing modern medicine during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted among 535 modern medicine doctors of Kerala from June 2020 to May 2021, using a structured self-administered questionnaire designed for the study. The total scores of awareness and skill calculated and categorised as poor, moderate, and good. Data was analysed by Statistical Package for the Social Sciences (SPSS) version 20.0 software by IBM. The Chi-square test/Fisher's-Exact test was used as test of significance. Results: Mean age of the study participants were 40.44±10.66 years, with majority 326 (60.94%) been females. Among the 535 doctors participated, 68.22% had moderate skill, 27.85% have good skill and only 3.92% have poor skill. Years of experience of doctors ranged from 1 to 48 with mean of 13.47±10.46 years. In majority, 431 (80.56%) of the participants, had moderate awareness about the telemedicine practice. Poor awareness was present in 19 (3.55%) doctors. 46.54% believes that specific software training is required for practicing telemedicine. Conclusion: The study showed that 15.89% had good awareness, while 80.56% of the participants had moderate awareness about the telemedicine. Only 27.85% of doctors had good skill, while 68.22% had moderate skill. Even though, awareness and skill of doctors practicing modern medicine are favourable, more webinars or workshops are needed to improve their knowledge.

17.
Cardiology Letters ; 30(5):238-245, 2022.
Article in Slovak | EMBASE | ID: covidwho-1818476

ABSTRACT

In 2020, the last periodic snapshot of the SLOVAKS registry, dedicated to the management of patients with ACS, took place in Slovakia. Results: 1450 patients were analyzed, with the proportion of STEMI representing 41.5%. Primary reperfusion therapy was performed in 89.1% of patients (pPCI 88.7%, fibrinolysis 0.4%). The median of total ischemic interval was 260 min, which was an insignificant prolongation compared to year 2015 (230.5 min) (p = 0.277). At the time of the COVID19 pandemic, the expected significant increase in the total ischemic interval was probably offset by the widespread use of the telemedicine communication platform STEMI, which led to a significant increase in the ability of EMS crews to provide STEMI ECG diagnostics in the field (38.8 vs. 61.4%), and increase primary transports to pPCI centers (48.45 vs. 62.2%). Of all pPCI cases, up to 37.4% were performed outside the recommended time limit (within 120 minutes of the ECG) and 63.5% outside the optimal time limit (within 90 minutes of the ECG). Patient hesitation (median of symptoms-ECG interval 150 min) and patient transport had a decisive share in unnecessary time losses, as up to 37.8% of STEMIs were transported to the primary PCI by secondary transport. STEMI hospitalization lethality was 4.5%. Conclusion: At the time of the COVID19 pandemic, the Slovak health care system maintained a high quality of management for patients with acute STEMI and there was no significant deterioration in the monitored quality parameters. Despite several positive trends (high concentration of emergency medical crews, unlimited availability of modern drugs, availability of invasive management 24/7, increased ability of emergency medical crews to provide ECG diagnostics of STEMI in the field) several deficiencies can be identified in the health care system. Above all, these are inappropriate time losses caused by patients, but also by the health care system due to unnecessary so-called secondary transports. A significant part of the patients met the indication for prehospital administration of fibrinolytics and so-called pharmacoinvasive procedure. The disappearance of this procedure from medical practice is medically unjustifiable. Fig. 8, Tab. 7, Ref. 12, on-line full text (Free, PDF) www.cardiologyletters.sk.

18.
BJGP Open ; 6(1):1-4, 2022.
Article in English | EMBASE | ID: covidwho-1818240

ABSTRACT

Introduction The COVID-19 pandemic has accelerated the widespread adoption of remote consultations in general practice in the UK;using telephones, video, or e-consults accompanied by a reduction in routine face-to-face consultations. These approaches allow for continued healthcare provision while reducing the risk of transmission of communicable infections. Telephone consultations have already been a staple within general practice for many years, despite a lack of high quality evidence supporting their use.1 Reported benefits include convenience for patients and cost savings.2 However, patients tend to disclose fewer medical issues on telephone calls than in face-to-face consultations.3 Similarly, video calls rely on high quality internet and patient ability to operate the required technology.4 Autism is a neurodevelopmental condition encompassing differences in social interaction, communication, and sensory perception.5 Differences occur in the use of verbal and non-verbal communication. Challenges can include situational mutism or reliance on augmentative and alternative communication (AAC) devices for individuals who are non-speaking. Autism is not synonymous with learning disability. In fact, the majority of autistic adults do not have a learning disability.6 Autism diagnoses have a prevalence of at least 1%,7 but autism is likely much more prevalent due to underrecognition and under-diagnosis.7 As such, autistic individuals are a patient group all primary care professionalsare likely to encounter on a regular or semi-regular basis. Autistic adults face increased barriers to accessing health care,5 and have higher mortality rates than the general population.5 Considering the needs of autistic patients in accessing primary health care is therefore vital if we are to embody the ethical tenets of beneficence and social justice. We write this article as neurodivergent doctors. SS is autistic and dyslexic. He is a GP speciality trainee with a parallel academic career. He has researched and published widely around the topic of neurodiversity, with particular interests in dyslexia, dyspraxia, and autism. He is currently the research lead for Autistic Doctors International. LJD is also a GP speciality trainee, with a background in academic research and public health. She is dyspraxic and has a specialist interest in supporting neurodivergent patients. MD is an autistic consultant anaesthetist and is the founder of Autistic Doctors International. Using a combination of the wider literature and our own experiences, both as clinicians and as patients, we explore the potential strengths and limitations of telemedicine in the context of autistic patients. We also propose some suggestions for increasing its accessibility.

19.
Signals ; 3(1):40, 2022.
Article in English | ProQuest Central | ID: covidwho-1818197

ABSTRACT

The development of mobile health for epilepsy has grown in the last years, bringing new applications (apps) to the market and improving already existing ones. In this systematic review, we analyse the scope of mobile apps for seizure detection and epilepsy self-management, with two research questions in mind: what are the characteristics of current solutions and do they meet users’ requirements? What should be considered when designing mobile health for epilepsy? We used PRISMA methodology to search within App Store and Google Play Store from February to April of 2021, reaching 55 potential apps. A more thorough analysis regarding particular features was performed on 26 of those apps. The content of these apps was evaluated in five categories, regarding if there was personalisable content;features related to medication management;what aspects of seizure log were present;what type of communication prevailed;and if there was any content related to seizure alarm or seizure action plans. Moreover, the 26 apps were evaluated through using MARS by six raters, including two neurologists. The analysis of MARS categories was performed for the top and bottom apps, to understand the core differences. Overall, the lowest MARS scores were related to engagement and information, which play a big part in long-term use, and previous studies raised the concern of assuring continuous use, especially in younger audiences. With that in mind, we identified conceptual improvement points, which were divided in three main topics: customisation, simplicity and healthcare connection. Moreover, we summarised some ideas to improve m-health apps catered around long-term adherence. We hope this work contributes to a better understanding of the current scope in mobile epilepsy management, endorsing healthcare professionals and developers to provide off-the-shelf solutions that engage patients and allows them to better manage their condition.

20.
International Journal of Environmental Research and Public Health ; 19(9), 2022.
Article in English | EMBASE | ID: covidwho-1818146

ABSTRACT

During the recent COVID-19 pandemic, healthcare providers have been encouraged to increase their use of telemedicine and to adopt telemedicine platforms for the majority of their clients who have chronic illnesses. Due to the outbreak itself, almost all countries worldwide were placed under emergency lockdowns. In this paper, we reviewed the literature regarding the use of telemedicine during the COVID-19 pandemic. Consequentially, we identified the adoption of telemedicine in various countries worldwide and evaluated their future steps in order to increase the adoption of e-health technologies. As a result of COVID-19, the e-health agenda, especially telemedicine, has been accelerated in several countries. COVID-19 is affecting individuals’ daily lives and has created major difficulties in the management of healthcare facilities for both infected and non-infected patients. A large portion of the rapid increase in the use of telemedicine can be attributed to evidence from previous pandemics as well as progress made by the field in response to COVID-19, especially in industrialized countries. A lack of effective treatment, large numbers of unvaccinated individuals, as well as social distancing and lockdown measures suggest telemedicine is the safest and most appropriate way of working with patients and doctors. In spite of this willingness, a large number of barriers need to be overcome in order for the telemedicine system to function properly and effectively throughout countries. In order for telemedicine to be sustainable and beneficial beyond the pandemic, several technical, educational, infrastructure, legal, and economic issues must be addressed and solved.

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