Decreased Medical Care During the COVID-19 Pandemic – A Comprehensive Analysis of Radiological Examinations

Objectives As a cross-section discipline within the hospital infrastructure, radiological departments might be able to provide important information regarding the impact of the COVID-19 pandemic on healthcare. The goal of this study was to quantify changes in medical care during the first wave of the pandemic using radiological examinations as a comprehensive surrogate marker and to determine potential future workload. Methods A retrospective analysis of all radiological examinations during the first wave of the pandemic was performed. The number of examinations was compared to time-matched control periods. Furthermore, an in-depth analysis of radiological examinations attributed to various medical specialties was conducted and postponed examinations were extrapolated to calculate additional workload in the near future. Results A total of 596,760 examinations were analyzed. Overall case volumes decreased by an average of 41 % during the shutdown compared to the control period. The most affected radiological modalities were sonography (–54 %), X-ray (–47 %) followed by MRI (–42 %). The most affected medical specialty was trauma and orthopedics (–60 % case volume) followed by general surgery (–49 %). Examination numbers increased during the post-shutdown period leading to a predicted additional workload of up to 22 %. Conclusion This study shows a marked decrease in radiological examinations in total and among several core medical specialties, indicating a significant reduction in medical care during the first COVID-19 shutdown. Key Points: Citation Format

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COVID-19 lock-down significantly reduced the number of surgical presentations in an emergency department

10.21203/rs.3.rs-81925/v1 ◽

2020 ◽

Author(s):

René Fahrner ◽

Stefan Bähler ◽

Gregor Lindner

Keyword(s):

Emergency Department ◽

Time Course ◽

Control Period ◽

Final Analysis ◽

Patient Characteristics ◽

Medical Specialty ◽

World Health ◽

Number Of Patients ◽

Health Organization ◽

The Impact

Abstract IntroductionCoronavirus disease 2019 (COVID-19) is an acute virus infection that was declared by the World Health Organization (WHO) as a pandemic. As a consequence, the Swiss government decreed a public lock-down to reduce and restrict further infections. The aim of this investigation was to provide the impact of the COVID-19 lock-down on the presentations of patients in an interdisciplinary emergency department (ED).Patients, Materials and MethodsA retrospective study was performed at an interdisciplinary Swiss ED during the lock-down period. All patients who presented to the ED were enrolled in this investigation and compared to a control cohort during the same time period in 2019. Data regarding patient characteristics, medical specialty, time course of presentations during the observation period, and outpatient or hospital admission were analyzed.ResultsIn total, 7,072 patients were included in the final analysis. During the lock-down period, the number of ED presentations significantly decreased by 29% in comparison to the control period in the previous year (p<0.0001). The analysis of the time course revealed that in each week, the number of patients was lower, with a 13% to 43% reduction. Irrespective of the medical specialty, the number of presentations decreased during the COVID-19 situation, whereas this decrease was higher in surgical diseases (31%, p<0.0001) than in non-surgical presentations (3.6%, p=0.4).DiscussionThe socio-economic lock-down impacted the number of presentations in an ED. Mainly, surgical diseases and injuries were affected in terms of a reduction of presentations during the COVID-19 lock-down period.

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Digital Subscription Systems in the Face of COVID-19 Crisis: The Case of ‘El Mundo’

Tripodos ◽

10.51698/tripodos.2020.47p87-102 ◽

2021 ◽

Vol 2 (47) ◽

pp. 87-102

Author(s):

Enrique Canovaca de la Fuente

Keyword(s):

Economic Recession ◽

Know How ◽

Key Points ◽

Depth Analysis ◽

The Face ◽

The Media ◽

Long Term Consequences ◽

Revenue Models ◽

The Impact

The aim of this article is to analyse the impact of COVID-19 on the income models of the Spanish general interest press through an in-depth analysis of the case of ‘El Mundo’. This article shows data about the decline in advertising, both in printed and digital formats, during the first quarter of 2020 and, more specifically, during March. It also reveals that the media platforms with a previously implemented subscription system have gained a significant number of new registrations. Not only is ‘El Mundo’ an example of this trend, but also other newspapers such as ‘Eldiario.es’, ‘Ara’, ‘La Razón’ or ‘La Voz de Galicia’. The reader becomes an alternative to lessen advertising losses at a time of global transformation of the industry towards reader-revenue models. Long-term consequences of a probable economic recession once the pandemic effects are reduced are also considered in the analysis. The article also outlines some key points to ensure the viability of newspaper publishers, such as investing in journalists with relevant sources or profiles that know how to manage new digital businesses. Keywords: COVID-19, press, business, subscriptions and advertising.

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Amendments to the Constitution of the Russian Federation: Dictated Necessity and Consequences in the Conditions of the Modern World

Prologue Law Journal ◽

10.21639/2313-6715.2021.2.7. ◽

2021 ◽

Author(s):

V.V. Chuksina ◽

◽

K.A. Mirvoda ◽

Keyword(s):

Health Care ◽

Medical Care ◽

Russian Federation ◽

Local Governments ◽

Health Care Systems ◽

Modern World ◽

Depth Analysis ◽

Care Systems ◽

The Russian Federation ◽

The Impact

The subject of this article is Law of the Russian Federation on Amendments to the Constitution of the Russian Federation (14.03.2020 No. 1-Federal Constitutional Law) «On improving the regulation of certain issues of the public power organization and functioning», namely, aspects of «coordination of health care» and «protection of the family, motherhood and childhood». The authors analyzed the issues of the medical care provision centralization, the impact of these amendments on the legal capacity of citizens. For a more in-depth analysis, the experience of foreign countries (Canada and Germany) was used. Despite the fact that the health care systems of the countries cited as an example differ in their essence and organization, nevertheless, they influence the formation of the availability of medicine for the population. As a result of the study of this experience, it was concluded that the delegation of freedom in the provision of medical care to lower levels of government allows to provide to the population affordable and high-quality medical care. It is noted that at present it is necessary to review the degree of participation of local governments in ensuring the availability of medical care in accordance with the federal law.

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Clinical approach to the diagnosis of skin disease

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0551 ◽

2020 ◽

pp. 5596-5601

Author(s):

Vanessa Venning

Keyword(s):

Skin Disease ◽

Diagnostic Process ◽

Clinical Approach ◽

History Taking ◽

Medical Specialties ◽

Key Points ◽

History Of ◽

The Impact ◽

Careful History

As in most medical specialties, the diagnosis of skin disease relies on careful history taking, and a thorough examination, supported in some cases by appropriate investigation. Astute physicians will also be aware that management outcomes are improved by taking account of the impact of skin disease on patients’ lives, whether through discomfort, disfigurement, or disability. This section, however, is chiefly concerned with aspects of history taking and examination that inform the diagnostic process. There are certain key points in the history of skin disease that should be specifically elicited. These should include a description of the events surrounding the onset of skin disease: when and where it started, and how it progressed.

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Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽

10.1024/0301-1526/a000771 ◽

2019 ◽

Vol 48 (3) ◽

pp. 262-269 ◽

Cited By ~ 3

Author(s):

Christian-Alexander Behrendt ◽

Tilo Kölbel ◽

Thea Schwaneberg ◽

Holger Diener ◽

Ralf Hohnhold ◽

...

Keyword(s):

Multidisciplinary Team ◽

Positive Impact ◽

Cross Sectional Study ◽

Invasive Treatment ◽

Cross Sectional ◽

Hospital Outcomes ◽

Vascular Intervention ◽

Medical Specialties ◽

Team Decision ◽

The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

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Computers in Medical Care: A Review

Methods of Information in Medicine ◽

10.1055/s-0038-1635328 ◽

1984 ◽

Vol 23 (02) ◽

pp. 63-74 ◽

Cited By ~ 5

Author(s):

Hans W. Gottinger

Keyword(s):

Resource Allocation ◽

Medical Care ◽

Hospital Care ◽

The Impact

SummaryThis survey provides an overview of major developments on the impact of computers in medical and hospital care over the last 25 years. Though the review emphasizes developments in the U. S. and their multi-faceted impacts upon resource allocation and regulation, a serious attempt is made to track those impacts being universally true in multinational environments.

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The impact of cultural factors on attachment dynamics: a view from Irish society

Attachment New Directions in Psychotherapy and Relational Psychoanalysis ◽

10.33212/att.v13n2.2019.207 ◽

2019 ◽

Vol 13 (2) ◽

pp. 207-223

Author(s):

Michael O’Toole

Keyword(s):

Significant Role ◽

Emotional Development ◽

Cultural Factors ◽

Seamus Heaney ◽

Irish Society ◽

Irish Context ◽

Key Points ◽

The Many ◽

The Impact ◽

The Relationship

In this article I examine aspects of the relationship between mothers and sons from an attachment perspective in an Irish context. Through the works of Irish writers such as Seamus Heaney, John McGahern, and Colm Tóibín, I focus on particular aspects of this relationship, which fails to support the developmental processes of separation and individuation in the many men who come to me for psychotherapy. I illustrate key points concerning this attachment dynamic through the use of clinical examples of my work with two men from my practice. While acknowledging that many other cultural factors play a significant role in the emotional development of children, integrating the work of our poets, novelists, and scholars with an attachment perspective

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The Catholic Diaspora—Experiences of Evacuation

10.1093/oso/9780198827023.003.0005 ◽

2018 ◽

Author(s):

Thomas Brodie

Keyword(s):

Urban Areas ◽

Religious Practice ◽

Catholic Clergy ◽

Profound Influence ◽

The Social ◽

Depth Analysis ◽

Nazi Era ◽

Mass Evacuation ◽

The Impact ◽

Pastoral Practice

This chapter analyses the impact exerted on the Catholic Church’s pastoral networks in Germany by the mass evacuation of laypeople from bombed urban areas as of 1941. Drawing on the voluminous correspondence of priests and curates despatched from the Rhineland and Westphalia to Saxony, Thuringia, Silesia, Austria, and elsewhere to minister to Catholic evacuees, this chapter provides in-depth analysis of the social and cultural histories of religious practice in wartime Germany. It demonstrates that the evacuation of laypeople—a topic long neglected within histories of wartime religious practice—exerted a profound influence on pastoral practice by the years 1943–5, placing unprecedented pressures on the Catholic clergy of the dioceses central to this study (Aachen, Cologne and Münster). This chapter therefore also casts new light on regionalism in Germany during the Nazi era.

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The Oxford Handbook of Adult Cognitive Disorders

10.1093/oxfordhb/9780190664121.001.0001 ◽

2019 ◽

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Neurodevelopmental Disorders ◽

Brain Aging ◽

Cognitive Disorders ◽

Diverse Range ◽

Medical Specialties ◽

Psychiatric Illnesses ◽

Medical Disorders ◽

The Impact

The prevalence of cognitive impairment caused by neurodegenerative diseases and other neurologic disorders associated with aging is expected to rise dramatically between now and year 2050, when the population of Americans aged 65 or older will nearly double. Cognitive impairment also commonly occurs in other neurologic conditions, as well as in non-neurologic medical disorders (and their treatments), idiopathic psychiatric illnesses, and adult neurodevelopmental disorders. Cognitive impairment can thus infiltrate all aspects of healthcare, making it necessary for clinicians and clinical researchers to have an integrated knowledge of the spectrum of adult cognitive disorders. The Oxford Handbook of Adult Cognitive Disorders is meant to serve as an up-to-date, scholarly, and comprehensive volume covering most diseases, conditions, and injuries resulting in impairments in cognitive function in adults. Topics covered include normal cognitive and brain aging, the impact of medical disorders (e.g., cardiovascular, liver, pulmonary) and psychiatric illnesses (e.g., depression and bipolar disorder) on cognitive function, adult neurodevelopmental disorders (e.g., Down Syndrome, Attention Deficit/Hyperactivity Disorder), as well as the various neurological conditions (e.g., Alzheimer’s disease, chronic traumatic encephalopathy, concussion). A section of the Handbook is also dedicated to unique perspectives and special considerations for the clinicians and clinical researchers, covering topics such as cognitive reserve, genetics, diversity, and neuroethics. The target audience of this Handbook includes: (1) clinicians, particularly psychologists, neuropsychologists, neurologists (including behavioral and cognitive neurologists), geriatricians, and psychiatrists (including neuropsychiatrists), who provide clinical care and management for adults with a diverse range of cognitive disorders; (2) clinical researchers who investigate cognitive outcomes and functioning in adult populations; and (3) graduate level students and post-doctoral trainees studying psychology, clinical neuroscience, and various medical specialties.

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