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1.
Nursing Standard ; 35(7):67-69, 2020.
Article in English | ProQuest Central | ID: covidwho-2067177

ABSTRACT

Research released by NHS England shows that the overall death rate for people with diabetes doubled during the early stages of the COVID-19 pandemic.

2.
Int J Environ Res Public Health ; 19(19)2022 Sep 29.
Article in English | MEDLINE | ID: covidwho-2065968

ABSTRACT

BACKGROUND: Obesity is a major public health concern worldwide. Latin America has experienced rapid growth in obesity incidence during the last few decades. Driven by confinement measures, a telemedicine program was implemented in March 2020 to give continuity to obese patients' care through a weight loss program led by the endocrinology department in a tertiary care medical center in Latin America. OBJECTIVE: This study aimed to describe the clinical experience of using digital health for monitoring and attention of obese patients and description of weight change outcomes of these patients followed via telemedicine during March 2020-December 2020. METHODS: A retrospective cohort study was conducted including 202 patients. A Skillings-Mack test was performed to conduct a subgroup analysis of the medians of the weight over the follow-up period, and a mixed multiple linear regression model was performed to estimate the expected average change in weight over time Results: We observed good adherence to the program, represented by a weight loss of -4.1 kg at three months of follow-up, which was maintained even during the sixth month of follow-up. CONCLUSIONS: Digital Health strategies such as telemedicine can be a helpful tool for both patients and health care providers to support the continuity of care and showing satisfactory results in the management of obese patients.


Subject(s)
Obesity , Telemedicine , Humans , Latin America , Obesity/epidemiology , Obesity/therapy , Retrospective Studies , Telemedicine/methods , Tertiary Healthcare
3.
Current Issues in Pharmacy and Medical Sciences ; 35(2):75-79, 2022.
Article in English | EMBASE | ID: covidwho-2065356

ABSTRACT

The level of immunization of children and adolescents under the Protective Vaccination Program in Ukraine is lower than in Poland, and, due to the outbreak of the war in Ukraine, many people now live in conditions that are often unsanitary. Centers for refugees are also places of increased risk of outbreaks of infectious diseases. This risk is increased by the low percentage of the vaccinated, limited access to healthcare (including diagnostics) and overcrowding. The paper presents the state of vaccination in Ukraine against poliomyelitis, measles, diphtheria, tetanus and pertussis, the most important problems in the field of infectious diseases, as well as the resulting risks and the need to prevent them.

4.
Pharmaceutical Journal ; 308(7962), 2022.
Article in English | EMBASE | ID: covidwho-2065045
5.
Pharmaceutical Journal ; 308(7959), 2022.
Article in English | EMBASE | ID: covidwho-2065029
6.
Pharmaceutical Journal ; 308(7958), 2022.
Article in English | EMBASE | ID: covidwho-2065022
7.
Archives of Disease in Childhood ; 107(Supplement 2):A346-A347, 2022.
Article in English | EMBASE | ID: covidwho-2064041

ABSTRACT

Aims Many paediatric emergency departments (PED) reported an unexpected increase in attendances during summer 2021;most of these children were stated to have minor illnesses and were discharged with reassurance. The primary objective of our questionnaire was to obtain parental perspective of how changes to local acute paediatric healthcare services in response to Covid-19 had impacted upon accessing care for their children. Additional objectives aimed to identify if parents were more worried about their child's health in view of the pandemic, understand parents' ideas of how children should be assessed when unwell, and explore how parents felt remote consultations could be improved. Methods A questionnaire comprised of Likert scale, multiple choice and free-text questions was developed to explore the study aiSeveral iterations of the questionnaire were test-run with parents prior to roll-out. The project was registered with the Trust's Quality Improvement team. A total of 88 families presenting to the paediatric emergency department and local urgent treatment centres completed the questionnaire between 26th October and 31st December 2021. Excluded were families for whom a translator was needed for their medical assessment. A thematic analysis was performed using NVivo, and quantitative analysis performed using PRISM statistical software. Results 68.2% of parents had sought medical advice outside of the PED prior to presentation, either in the community and/or online. 20.5% of respondents sought healthcare input from two or more sources prior to attending PED. Figure 1 outlines the responses to Likert-scale questions. Statistical analysis of the responses in relation to of age of child, number of children in the family and whether English was the family's first language was performed. Confidence of phone/video assessments and English/non-English as first language approached statistical significance (p=0.059). No other comparisons were statistically significant. Analysis of free-text responses identified key themes regarding the parental expectation of how children should be reviewed when unwell, and how parents thought remote consultations can be improved. An outline of the identified themes and a selection of responses are outlined in Figure 2. Conclusion The questionnaire identified that parents had still been able to access healthcare during the pandemic when they felt their child was unwell. Parents reported concerns of their children becoming sick with Covid-19, but still felt confident managing minor illnesses at home. The increasing volume of remote assessments in primary care was a necessary adjustment during the pandemic which is likely to be embraced as a more permanent model of service. Many parents recognised the benefit of remote consultations for non-urgent issues. However, a key theme from the questionnaire was the lack of parental confidence in remote (particularly phone) consultations;parents were more likely to still seek a face-to-face assessment in PED if they felt they couldn't communicate their child's signs and symptoms over the phone. As local networks embrace a more remote model of working to deliver some urgency and emergency care it is necessary to identify the cohorts of patients who may still attend PED, and plan how better to provide clinical reviews for them in the community.

8.
American Journal of Transplantation ; 22(Supplement 3):609, 2022.
Article in English | EMBASE | ID: covidwho-2063467

ABSTRACT

Purpose: The COVID-19 pandemic affected many aspects of health care, including the provision of care in ambulatory care clinics, necessitating the utilization of telehealth. For example, we implemented phone clinics in our hospital to ease access to health care for liver transplant patients. This study aims to assess the impact of phone clinics on patients' perception, adherence to medication, and potential cost reduction. Method(s): This prospective observational study utilized validated questionnaires: the telehealth usability questionnaire (TUQ) and Morisky Medication Adherence Scale (MMAS-8), to assess patients' perception of telehealth and medication adherence, respectively. We included all liver transplant patients who received their care through phone clinics from June 1st, 2020, to December 31st, 2020. In addition, clinical outcomes were assessed, such as emergency room visits, development of biopsy-proven rejection, need for hospital admissions, and derangement of enzymes as secondary endpoints. Result(s): We had 422 patients served through phone clinics;416 met the inclusion criteria. The majority of patients were males (61.5%), lived outside Riyadh (63%), used 5-10 medications per day (71%), and were above the age of 60 years (43.7%). The average overall adherence scale was 7.2 (+/-0.91 SD), where 94.5% scored to have medium adherence (score of 6-8), followed by 5.5% with low adherence, while no one had high adherence score. Patients perception scores averages toward the utilization of phone clinic were: 1.5 (+/-0.76 SD) for the usefulness of telehealth, 1.4 (+/-0.7 SD) for the ease of use and learnability, 1.54 (+/-0.8 SD) for the interface quality, 1.45 (+/-0.8 SD) for the interaction quality, 2.07 (+/-1.17 SD) for the reliability, and 1.59 (+/-0.88 SD) for satisfaction and future use. The estimated average direct outof- pocket cost savings per patient was 703 SAR (187 USD) per person, with a total reduction of 292,630 SAR (78,033 USD) in all served patients. For clinical outcomes, 31 patients (7.45%) had emergency room visits three months after the phone clinic. Likewise, five patients (1.20%) developed a biopsy-proven rejection, 14 patients (3.36%) were admitted to hospitals, and 50 patients (12.01%) had derangements of enzymes requiring intervention during the specified period. Conclusion(s): Our results show that the utilization of phone clinics in the liver transplant settings was associated with a high satisfaction rate among the served patients with a medium score of medication adherence and potential cost reduction impact.

9.
Pharmaceutical Journal ; 307(7951), 2022.
Article in English | EMBASE | ID: covidwho-2064981
10.
Pharmaceutical Journal ; 306(7950), 2022.
Article in English | EMBASE | ID: covidwho-2064969
11.
Pharmaceutical Journal ; 306(7948), 2022.
Article in English | EMBASE | ID: covidwho-2064926
12.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P13, 2022.
Article in English | EMBASE | ID: covidwho-2064501

ABSTRACT

Introduction: Despite dramatic expansion of telehealth visits across health disciplines during the COVID-19 pandemic, little is known about attitudes toward telehealth offerings among patients affected by head and neck neoplasms. We investigate patient responses regarding their desire for telemedicine, personal attitudes, and barriers in availing telemedicine visits for head and neck oncology-related care. Method(s): Retrospective analyses of patient surveys prospectively administered between August and October 2021 to adult patients at a tertiary care head and neck oncology clinic. Level of interest in telemedicine appointments was the assessed primary outcome. Covariates including demographics, place of residence, primary neoplastic condition, speech/communication barriers, access to internet-enabled devices or reliable internet, personal preferences, and qualitative self-reporting of attitudes toward telemedicine were assessed for association with interest in telemedicine appointments. Result(s): Of 633 survey responses, 50.6% were male. More than 70% of surveyed patients were older than 56 years. Overall, 49.7% demonstrated interest in telehealth visits. Limitations in access to technology (17.7% [112 of 633 respondents]) and lack of reliable internet connection (13.74% [87 of 633 respondents]) were considered key barriers. Only 6% patients expressed concerns about missing key elements of care or quality of care delivered through telemedicine visits. Conclusion(s): Limited access to technology platforms and unreliable internet were key concerns for 1 in 2 patients considering telemedicine appointments for head and neck oncologic care. Understanding the needs and attitudes of specific patient populations may be important for organizations pivoting to telemedicine platforms for improving health care access. Key interventions to enhance participation in telemedicine- based care delivery could include identifying rural connectivity hubs and ensuring availability of connected devices through grant or device loan programs, and employing userfriendly technology platforms.

13.
Journal of Integrated Care ; 30(4):277-281, 2022.
Article in English | ProQuest Central | ID: covidwho-2063199

ABSTRACT

The proposed framework, being applied in Finland, acts as a set of standards to format data to allow it to move from one place to another (known as the “middle layer” in interoperable systems) bringing together different data elements to support a Virtual Care Operator model – an “information-focused approach to integration, coordination and continuity of care.” Domains in this model focus on technology, team organization, program support, integration of information systems, performance and quality, with maturity assessed on how well the model is enabling integration of service delivery around coordination of activities and other key issues like equity. Aird and colleagues present an implementation focused evaluation, using a multi-method approach to explore the roles and use of a new system of information exchange between one hospital and one long-term care home in Canada. Stamenova et al. evaluate a virtual visit program put in place to provide access to care during the COVID-19 pandemic using a convergent mixed-methods design which draws on usage data, surveys and interviews with patients and provider users of virtual care systems across different units within a hospital.

14.
Journal of Integrated Care ; 30(4):413-433, 2022.
Article in English | ProQuest Central | ID: covidwho-2063196

ABSTRACT

Purpose>The purpose of this study is to understand virtual care use (e.g. telephone and video visits) during the COVID-19 pandemic across three hospital-based ambulatory clinics (i.e. mental health, renal and respiratory care) and to describe associated patient and provider experiences.Design/methodology/approach>A mixed-methods convergent study was conducted including quantitative electronic medical records data on virtual care use, electronic surveys assessing domains of experience (e.g. satisfaction, acceptance and technology use) among patient and providers and semi-structured interviews exploring the associated barriers and facilitators of virtual care adoption.Findings>Virtual care adoption rates and relative modality use (telephone vs video) varied across specialty clinics. Mental health clinics) showed the greatest use of virtual care and greater use of video over telephone, as compared to renal and respiratory care, where telephone was used almost exclusively. Patients and providers reported an overall good satisfaction and acceptance of virtual care (60–72%) across clinics, but commonly observed barriers (technical problems, behavioral adaptations needed and inequity) persisted. Good value propositions, tech support and the presence of early adopters who can support others in workflow re-design and highlight value propositions of virtual care were listed as adoption facilitators.Originality/value>The study provides a unique opportunity to compare the rate of virtual care adoption before and during the COVID-19 pandemic across distinct specialties that operate within the same organizational and political setting. This study showed that the nature of the condition (e.g. mental health conditions) and the characteristics of the users (e.g. younger patients) may drive models of care with higher rate of video use. Focusing on removing common barriers, like providing tech support and ensuring equitable access to patients, continues to be important even in the context of high virtual care adoption rates during the pandemic.

15.
U.S ; Pharmacist. 47(9):17-21, 2022.
Article in English | EMBASE | ID: covidwho-2058099

ABSTRACT

The National Institutes of Health defines health disparities as "differences in incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exist among specific population groups in the United States." There are measurable differences such as education, income, and location that tend to exist between races/ethnicities, sexual identities, and age groups associated with variations in health outcomes. Cardiovascular disease, COVID-19, cancer, and reproductive health are among the conditions that have been identified as having higher morbidity and mortality among women than men. Access to adequate healthcare, access to support services, or a female's genetic makeup further contribute to health disparities. Copyright © 2022, Jobson Publishing Corporation. All rights reserved.

16.
Investigative Ophthalmology and Visual Science ; 63(7):2660, 2022.
Article in English | EMBASE | ID: covidwho-2057966

ABSTRACT

Purpose : Older adults with combined hearing and vision loss (dual sensory loss/DSL) are a highly vulnerable population during the COVID-19 pandemic. Although around 1.1 million older Canadians live with DSL, data are scarce on how COVID-19 affected their access to healthcare during the pandemic. Therefore, the present study explored the impact of COVID-19 on healthcare access for older Canadians with DSL. Methods : We distributed an online survey for healthcare workers who provided services to older adults with DSL during the pandemic. Survey data were collected from 228 Canadian healthcare workers between August and November 2021. Content analysis was used to analyze open-ended qualitative data, whereas descriptive statistics were used for quantitative survey data using SPSS. Results : Almost all healthcare workers felt that COVID-19 has negatively affected their care delivery to older adults with DSL, especially due to physical distancing and use of Personal Protective Equipment. Moreover, those using telehealth with their older clients reported that COVID-19 related shift to telehealth appointments restricted access to healthcare for their clients. Most respondents (91%) felt that older adults with DSL found it difficult to follow pandemic-related physical distancing guidelines in a clinical or health system setting. While 69% of them believed that the health system was not adapted to match the needs of older adults living DSL, 71 % felt healthcare professionals are not adequately trained to meet the needs of this population in pandemic situations such as COVID-19. Conclusions : We concluded that the pandemic has negatively impacted healthcare services to older adults with DSL. The pandemic accentuated the need for equitable care for older adults with DSL, considering the unique challenges experienced by them and their healthcare providers. Our study findings underscored the need for training of healthcare professionals on the communication and accessibility needs of older adults living with DSL.

17.
Journal of Pediatric Gastroenterology and Nutrition ; 75(Supplement 1):S494-S495, 2022.
Article in English | EMBASE | ID: covidwho-2057944

ABSTRACT

Background: The utilization and reimbursement of technology-based health care services has drastically increased, especially in the era of COVID-19. However, they are not universally accessible and are disproportionately utilized, which can exacerbate already existing disparities Objective: To evaluate differences in technology-based health care usage in an academic pediatric gastroenterology practice based on demographic characteristics and the Area Deprivation Index (ADI), a validated composite index of socioeconomic status (SES). Design/Methods: We conducted a retrospective cohort study of new patients seen in the Pediatric Gastroenterology Clinic at the Children's Hospital Colorado for constipation from 1/1/2019-12/31/2020. Demographic variables and number of secure messages, telephone calls, telehealth visits, and emergency department (ED) visits for constipation were extracted for up to one year. We assigned each patient a state and national ADI based on home address. Univariate negative binomial regression models were used to determine significance. We also used a Poisson regression model to better understand the interplay between ED visits, technology-based health care usage, and SES. Result(s): 2087 patients were included in our study. The predicted mean number of patient-initiated secure messages (P=0.04) and phone calls (P=0.03) were significantly less in those with lower socioeconomic status (higher state ADI) (Figure 1). Socioeconomic status based on both state and national ADI did not significantly affect telehealth video usage. The predicted mean number of telehealth video visits and patient-initiated secure messages were significantly lower in Hispanic patients (P<0.001 and P<0.001), non-English speakers (P<0.001 and P<0.001), and those with government insurance (P=0.02 and P<0.001) (Table 1). The predicted mean number of patient-initiated phone calls was also significantly lower in Non-English speakers (P=0.02). The Poisson regression model showed that when the number of patient-initiated secure messages and telephone calls is small, lower SES is associated with more ED visits. As the number of patient-initiated secure messages and telephone calls increase, the extent of the positive association between low SES and ED visits attenuated gradually and eventually became negatively associated (P=0.04 and P=<0.001). This relationship was not significant for telehealth video visits. Conclusion(s): Patients with lower socioeconomic status, non-English speakers, and Hispanic patients utilize technology-based health care services significantly less. Thus, while technology-based health care services may help to increase access to care for some patients, it is important to minimize barriers and prevent the worsening of already-existing inequities in health care access. Improving access to secure messaging and telephone calls in patients with low SES may help to prevent constipation-related ED visits as well as reduce healthcare costs.

18.
J Gen Intern Med ; 2022 Sep 26.
Article in English | MEDLINE | ID: covidwho-2048509

ABSTRACT

BACKGROUND: Vaccination is a primary method of reducing the burden of influenza, yet uptake is neither optimal nor equitable. Single-tier, primary care-oriented health systems may have an advantage in the efficiency and equity of vaccination. OBJECTIVE: To assess the association of Veterans' Health Administration (VA) coverage with influenza vaccine uptake and disparities. DESIGN: Cross-sectional. PARTICIPANTS: Adult respondents to the 2019-2020 National Health Interview Survey. MAIN MEASURES: We examined influenza vaccination rates, and racial/ethnic and income-based vaccination disparities, among veterans with VA coverage, veterans without VA coverage, and adult non-veterans. We performed multivariable logistic regressions adjusted for demographics and self-reported health, with interaction terms to examine differential effects by race/ethnicity and income. KEY RESULTS: Our sample included n=2,277 veterans with VA coverage, n=2,821 veterans without VA coverage, and n=46,456 non-veterans. Veterans were more often White and male; among veterans, those with VA coverage had worse health and lower incomes. Veterans with VA coverage had a higher unadjusted vaccination rate (63.0%) than veterans without VA coverage (59.1%) and non-veterans (46.5%) (p<0.05 for each comparison). In our adjusted model, non-veterans were 11.4 percentage points (95% CI -14.3, -8.5) less likely than veterans with VA coverage to be vaccinated, and veterans without VA coverage were 6.7 percentage points (95% CI -10.3, -3.0) less likely to be vaccinated than those with VA coverage. VA coverage, compared with non-veteran status, was also associated with reduced racial/ethnic and income disparities in vaccination. CONCLUSIONS: VA coverage is associated with higher and more equitable influenza vaccination rates. A single-tier health system that emphasizes primary care may improve the uptake and equity of vaccination for influenza, and possibly other pathogens, like SARS-CoV2.

19.
Clinical Practice in Pediatric Psychology ; 10(3):233-240, 2022.
Article in English | APA PsycInfo | ID: covidwho-2050277

ABSTRACT

Objective: The ethical imperative to work with the parents, caregivers, and guardians (hereafter, parents) of pediatric patients has been highlighted. However, parents continue to be underserved in pediatric health care settings. The syndemics of COVID-19 and mental health further magnified health disparities and the differential impacts of social determinants of health on the wellbeing of those from minority or disadvantaged backgrounds. Therefore, dedicated efforts to developing holistic, culturally responsive, accessible, and effective interventions that meet the needs of the child and parents have never been more needed. Methods: Papers highlighting the role of pediatric psychology in working with parents while also emphasizing issues of diversity, equity, inclusion and access in screening and interventions were solicited and considered for this issue. Results: This Special Issue includes 11 articles highlighting efforts to (a) support parents' unmet needs in medical subspecialty settings, (b) utilize a diversity, equity, and inclusion (DEI) framework to develop and adapt interventions specifically designed to support these populations;and (c) improve access to behavioral health for vulnerable populations through different modes of care. This issue also includes a commentary outlining advocacy actions which can be taken by pediatric psychologists working with the families of transgender and gender diverse youth, with implications for advocating across populations. Conclusions: This issue highlights opportunities for pediatric psychologists to collectively and individually better support families and close health equity gaps through clinical and research avenues, as well as through opportunities for advocacy. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Implications for Impact Statement-The aim of this special issue is to further highlight the ethical imperative that exists for mental health providers in pediatric settings to address the mental health needs of parents, caregivers, and guardians, with an emphasis on diversity, access, equity, and inclusion. Pediatric psychologists can and should utilize existing skills to help all families reach their fullest potential through their involvement in research, clinical services, and advocacy efforts, with articles in this offering examples for implementation models. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

20.
Handbook of rural, remote, and very remote mental health ; : 191-215, 2021.
Article in English | APA PsycInfo | ID: covidwho-2048165

ABSTRACT

There is a growing burden of disease nationally and internationally from mental illness, both as a stand-alone problem and also comorbid with the growing epidemic of chronic, non-communicable diseases. The advent of the COVID-19 pandemic in early 2020 and ongoing climate change sequelae have exacerbated these mental health risks exponentially, creating massive service delivery dilemmas globally. In many countries, people in regional and particularly rural and remote areas, bear a greater disease burden from mental health conditions, due largely to the unique stressors inherent in rural life and inequitable access to appropriate services. This chapter canvases these issues and includes a brief discussion of optimally integrated care, risk factors and needs specific to rural people, the impact of Indigeneity, the role of socioeconomic factors in general and mental health, and inequity of access to primary mental healthcare services. These factors are illustrated by focusing on Australia as a case study, exemplifying both generic characteristics and those unique to that country that are relevant to service delivery in rural areas. The chapter was accepted for publication prior to Australia's worst bushfires on record (in the summer of 2019-2020), subsequent floods in early 2020, and the advent of the COVID-19 pandemic in February-March 2020 (ongoing). Most of the highlighted factors, however, remain the same -albeit greatly exacerbated by these extraordinary events. Information is provided in relation to the distribution of four relevant mental health specialties, with recommendations made-specific to Australia and also in the global context-with regard to optimally integrated primary mental health care.Across the settled world, there is a huge need to systematically roll-out integrated mental health services, using a number of modalities, to meet rural need. It is recommended that changes include: interprofessional education to facilitate team-based care;co-location of multidisciplinary primary healthcare teams;development and integration of culturally appropriate health services for Indigenous clients;mapping of required services in regional, rural, and remote areas;and optimal and strategic use of available funding and telehealth options. It is also strongly recommended that integration of lifestyle interventions be included in all mental health treatment, to facilitate optimal outcomes. These initiatives are now particularly pertinent, given the post-COVID "mental health pandemic" predicted by health experts globally. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

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