scholarly journals COVD-04. REAL-WORLD PERSPECTIVES: TUMOR TREATING FIELDS (TTFIELDS) UTILITY TO OPTIMIZE TREATMENT OF PATIENTS WITH GLIOBLASTOMA (GBM) AMIDST COVID-19 PANDEMIC

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii21-ii22
Author(s):  
Peggy Frongillo ◽  
Melissa Shackelford ◽  
Lindsay Rain
Keyword(s):  
Electric Fields ◽  
Task Force ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Treatment Protocol ◽  
World Health ◽  
Treatment Access ◽  
Healthcare Teams ◽  
Tumor Treating Fields ◽  
The Impact

Abstract INTRODUCTION Due to the unprecedented, COVID-19 pandemic and resulting health/safety guidelines, rapid-adjustments to treatment plans for patients battling glioblastoma (GBM; debilitating, aggressive cancer) were critical. Tumor Treating Fields (TTFields; FDA-approved for GBM; antimitotic device) are alternating electric fields (200 kHz) delivered through scalp-placed transducer arrays to target rapidly dividing GBM cells. Visitor restrictions at cancer-centers and often overburdened healthcare teams provided obstacles to cancer therapy. Health and safety of patients/caregivers, healthcare providers (HCPs), and patient Device Support Specialists (DSS) were prioritized. We evaluated the impact of Novocure® (device manufacturer) implemented strategies on overcoming limitations/restrictions to treatment-access during COVID-19. TREATMENT/PROTOCOL TTFields (Optune) offers a viable noninvasive, built-in-care system for convenient at-home use. TTFields provides survival benefit with continuous, portable-usage and is tolerable (no-related systemic effects) without overall impact on quality-of-life (except itchy skin). Novocure adopted/amended protocols to meet health guidance/regulation (ie, World Health Organization, Centers for Disease Control and Prevention, local, hospital/clinic directives). PERSPECTIVES COVID-19 forced a change in treatment patterns imposed by quarantine limitations. This, coupled with the vulnerabilities of immunocompromised patients with GBM, necessitated new-access to TTFields. A COVID-19 task force was created to monitor developments, providing directives to minimize risks to patients/caregivers and employees. Hygiene-practices/full-personal protective equipment were applied for live patient-appointments with DSS. Virtual education appointments were executed to guide patients/caregivers through treatment-initiation. New, no-contact, monthly-usage data downloads were employed. Communication measures were implemented, informing HCPs of process changes impacting patients. To date, no observed differences were noted for virtual to non-virtual patient starts, demographics, time-to-start (42-days), treatment discontinuations, percentage continuing therapy (90%), and overall complaints. No new safety signals were observed utilizing new approaches. CONCLUSIONS TTFields care-delivery has been transformed during COVID-19 and preemptively in regards to other future access-limiting events, with adoption of virtual-platforms/protocols, resulting in enhanced access and education for patients/caregivers and healthcare teams.

Provision of the Continuum of Care to Noncommunicable Diseases Post-Floods in Kerala, India 2018

2021 ◽  
pp. 1-4
Author(s):  
Parasuraman Ganeshkumar ◽  
Rontgen Saigal ◽  
Bipin Gopal ◽  
Hari Shankar ◽  
Prabhdeep Kaur
Keyword(s):  
Disaster Response ◽  
Care Delivery ◽  
Treatment Protocol ◽  
Continuum Of Care ◽  
The State ◽  
Noncommunicable Disease ◽  
World Health ◽  
Guidance Document ◽  
Care Providers ◽  
The Continuum

Abstract Integrating noncommunicable disease (NCD) in health care delivery during emergency response posed a major challenge post-floods in Kerala. Kerala experienced an abnormally high rainfall during mid-2018 where more than 400 people lost their lives. State health officials and the Disaster Response Team were sensitized about the importance of including NCDs in the response action. More than 80% of patients with hypertension and diabetes were not under control in Kerala. Under the state NCD cell, an NCD expert group was consulted for drafting the treatment and referral strategies. Steps to tackle NCDs during the disaster response were formulated. The state NCD cell decided to integrate NCDs in the response measures. The technical guidance document by the World Health Organization South-East Asia Region was consulted to formulate actions. The activities were implemented in 6 steps: prioritizing of major NCDS, patient estimation and drug stock preparation, standard treatment protocol, mapping of referral facilities, public engagement, and daily reporting of NCD consultations. Prioritizing the continuum of care of NCDs during floods among the program managers and care providers was crucial. The health education and communication campaign was done to sensitize the known NCD patients to seek early care. Daily reporting of consultations was established.

scholarly journals Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19

2020 ◽  
pp. 07-19
Author(s):  
Hiba Takieddine ◽  
Samaa AL Tabbah
Keyword(s):  
Healthcare Providers ◽  
Well Being ◽  
World Health ◽  
Vulnerable Groups ◽  
Public Health Response ◽  
New Normal ◽  
The World ◽  
Health Organization ◽  
The Impact

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the world, inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, healthcare providers and people with underlying health conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused worldwide economic crisis, increased unemployment, and placed people under emotional and financial pressures. It affected people psychologically and mentally especially in terms of emotions and cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as increased alcohol and drug use. As part of its public health response, the World Health Organization (WHO) has worked with partners to develop a set of new guidelines and messages that can be used to prevent, manage, and support mental and psychological well-being in different vulnerable target groups during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will emerge and persist for months and years to come leading to long-term consequences. New lifestyles and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact of coronavirus pandemic on the psychological and mental health of people around the world especially vulnerable groups. It also presents the relevant intervention actions and recommendations to cope efficiently and effectively with the psychological short-term and long-term outcomes, mental changes, and the “New Normal” during and after COVID-19. Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

Introduction

ESC CardioMed ◽  
2018 ◽  
pp. 1927-1928
Author(s):  
Giuseppe Boriani
Keyword(s):  
Clinical Skills ◽  
Care Delivery ◽  
Scientific Evidence ◽  
Healthcare Providers ◽  
Cardiac Pacing ◽  
Daily Practice ◽  
Specific Patient ◽  
Current Prevalence ◽  
History Of ◽  
The Impact

The history of pacing for bradycardia started more than 50 years ago and in these five decades the technologically driven evolution of devices and tools has been complemented by the acquisition of important scientific evidence of benefit in specific patient settings. The current prevalence of bradyarrhythmias requiring permanent cardiac pacing therapy is not precisely known, but the progressive ageing of the population makes it necessary to improve knowledge of the impact of bradycardia on patients’ health, as well as to improve the implementation in daily practice of the most appropriate and evidence-based device treatments, with an adequate reorganization of care. Moreover, the impressive technological evolution that occurred in this field, as a result of extensive cooperation between physicians, scientists, engineers, manufacturers, regulatory agencies, and healthcare providers, led to the appearance of new requirements such as improved clinical skills, the need for continuous education on rapidly evolving technology, the assessment of treatment costs, the need for consensus guidelines, and the need for reorganization of care delivery including telemedicine for device follow-up.

scholarly journals Brazilian vascular surgeons experience during the coronavirus (COVID-19) pandemic

Vascular ◽  
2020 ◽  
pp. 170853812095496
Author(s):  
Rafael D Malgor ◽  
Marcone Lima Sobreira ◽  
Nicolas J Mouawad ◽  
Adam P Johnson ◽  
Max V Wohlauer ◽  
...  
Keyword(s):  
Social Media ◽  
Vascular Surgery ◽  
Task Force ◽  
Descriptive Analysis ◽  
Healthcare Providers ◽  
Coping Mechanisms ◽  
Cross Sectional ◽  
Brief Cope ◽  
Anxiety Levels ◽  
The Impact

Background The COVID-19 pandemic has made a significant impact on all spheres of society. The objective of this study was to examine the impact of COVID-19 on the practices, finances, and social aspects of Brazilian vascular surgeons’ lives. Methods This is a descriptive analysis of the responses from Brazilian vascular surgeons to the cross-sectional anonymous Society for Vascular Surgery Wellness Task Force Pandemic Practice, Anxiety, Coping, and Support Survey for Vascular Surgeons disseminated 14–24 April 2020. Survey dissemination in Brazil occurred mainly via the Brazilian Society of Angiology and Vascular Surgery (SBACV) and social media. The survey evaluated the impact of the COVID-19 pandemic on vascular surgeons’ lives by assessing COVID-19-related stressors, anxiety using theGeneral Anxiety Disorder (GAD)-7 scale, and coping strategies using the Brief Coping Orientation to Problems Experienced (Brief-COPE) inventory. Results A total of 452 responses were recorded from Brazil, with 335 (74%) respondents completing the entire survey. The majority of respondents were males ( N = 301, 67%) and practiced in an urban hospitals. The majority of respondents considered themselves at high risk to be infected with COVID-19 ( N = 251, 55.8%), and just over half the respondents noted that they had adequate PPE at their primary hospital ( N = 171, 54%). One hundred and nine (35%) surgeons confirmed that their hospitals followed professional surgical society guidelines for prioritizing surgeries during the pandemic. At the time of the survey, only 33 (10%) surgeons stated they have pre-operative testing of patients for COVID-19 available at their hospital. Academic vascular surgeons reported being redeployed more often to help with other non-vascular duties compared to community-based or solo practitioners (43% vs. 30% vs. 21% respectively, P = .01). Severe anxiety due to pandemic-related financial concerns was similar in those surgeons practicing solo compared to those in community- or academic-based/group practice (46% vs. 38% vs. 22%; P = .54). The respondents reported their anxiety levels as mild based on the stressors investigated instead of moderate-severe (54% vs. 46%; P = .04). Social media was utilized heavily during the pandemic, with video gatherings being the most commonly used tool (76%). Self-distraction (60%) and situational acceptance (81%) were the most frequently reported coping mechanisms used among Brazilian vascular surgeons. Conclusion The COVID pandemic has greatly affected healthcare providers around the world. At the time of this survey, Brazilian vascular surgeons are reporting low anxiety levels during this time and are using mostly active coping mechanisms.

scholarly journals A review on health-care acquired infections of the hospital staff during routine patient’s delivery service

2021 ◽  
Vol 25 (9) ◽  
pp. 1581-1586
Author(s):  
A.A. Enaigbe ◽  
C.C. Irodi
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Adverse Drug Events ◽  
Care Delivery ◽  
Educational Interventions ◽  
World Health ◽  
Infection Prevention And Control ◽  
Medical Attention ◽  
And Control ◽  
The Impact

The health-care acquired infections (HCAIs) occur world-wide among persons undergoing medical attention in health institutions and result in unexpected long-term stay, disability and financial loses. The most predominant infections are catheter associated urinary tract, central line associated, surgical site and ventilator associated pneumonia infections. The patients are prone to infections during hospitalization from varied environmental sources, hands of health-care professionals, medical equipment and other infected patients. The frequent factors affecting patients on admission are improper hand hygiene, contact with infected patients, adverse drug events and surgical complications. Patients under health-care delivery can acquire infection disseminated from food, water, aerosols and hospital wastes. The application of personal protective equipment, routine educational interventions are common approaches that can help stop HCAIs and save lives, decrease death rate and health delivery expenses. In buttressing this, the World Health Organization (WHO) enunciated guidelines to enhance hand washing practices, infection prevention and control programme, monitored use of antibiotics and its resistance. The other measures included global adoption of efficient surveillance system and the impact of relevant stakeholders in health sectors needed to prevent and control hospital acquired infections.

scholarly journals Otorhinolaryngology Out-Patient Practice in the “Post”-COVID-19 Era: Ensuring a Balance Between Service and Safety

2020 ◽  
Vol 35 (1) ◽  
pp. 6-29
Author(s):  
Jose Florencio Lapeña ◽  
Franco Louie Abes ◽  
Mark Anthony Gomez ◽  
Cesar Vincent Villafuerte ◽  
Rodante Roldan ◽  
...  
Keyword(s):  
Task Force ◽  
Care Delivery ◽  
Grey Literature ◽  
Relevant Literature ◽  
Neck Surgery ◽  
The Philippines ◽  
Data Sources ◽  
World Health ◽  
Patient Health ◽  
Health Organization

Objective: To review available resources and provide evidence-based recommendations that may optimize otorhinolaryngologic out-patient health care delivery in the “post”-COVID-19 era while ensuring the safety of our patients, healthcare workers and staff. Data Sources: Relevant peer-reviewed journal articles; task force, organizational and institutional, government and non-government organization recommendations; published guidelines from medical, health-related, and scientific organizations. Methods: A comprehensive review of the literature on the COVID-19 pandemic as it pertained to “post”-COVID 19 out-patient otorhinolaryngologic practice was obtained from peer-reviewed articles, guidelines, recommendations, and statements that were identified through a structured search of the data sources for relevant literature utilizing MEDLINE (through PubMed and PubMed Central PMC), Google (and Google Scholar), HERDIN Plus, the World Health Organization (WHO) Global Health Library, and grey literature including social media (blogs, Twitter, LinkedIn, Facebook). In-patient management (including ORL surgical procedures such as tracheostomy) were excluded. Retrieved material was critically appraised and organized according to five discussion themes: physical office set-up, patient processing, personal protection, procedures, and prevention and health-promotion. Conclusion: These recommendations are consistent with the best available evidence to date, and are globally acceptable while being locally applicable. They address the concerns of otorhinolaryngologists and related specialists about resuming office practice during the “post”-COVID-19 period when strict quarantines are gradually lifted and a transition to the “new” normal is made despite the unavailability of a specific vaccine for SARS-CoV-2. While they target practice settings in the Philippines, they should be useful to ENT (ear, nose & throat) surgeons in other countries in ensuring a balance between service and safety as we continue to serve our patients during these challenging times. Keywords: COVID-19; SARS-CoV-2; otorhinolaryngology; otolaryngology head and neck surgery;ENT; out-patient practice; clinic practice.

ILSI Europe’s Food Allergy Task Force: From Defining the Hazard to Assessing the Risk from Food Allergens

2018 ◽  
Vol 101 (1) ◽  
pp. 91-95 ◽  
Author(s):  
René R W Crevel ◽  
Stefan Ronsmans ◽  
Cyril F M Marsaux ◽  
Diána Bánáti
Keyword(s):  
Risk Assessment ◽  
Food Allergy ◽  
Task Force ◽  
World Health ◽  
Health Concern ◽  
Food Allergies ◽  
Food Allergens ◽  
The European Union ◽  
Funded Project ◽  
The Impact

Abstract The International Life Sciences Institute (ILSI) Europe Food Allergy Task Force was founded in response to early public concerns about the growing impact of food allergies almost coincidentally with the publication of the 1995 Food and Agriculture Organization-World Health Organization Technical Consultation on Food Allergies. In line with ILSI principles aimed to foster collaboration between stakeholders to promote consensus on science-based approaches to food safety and nutrition, the task force has played a central role since then in the development of risk assessment for food allergens. This ranged from consideration of the criteria to be applied to identifying allergens of public health concern through methodologies to determine the relationship between dose and the proportion of allergic individuals reacting, as well as the nature of the observed responses. The task force also promoted the application of novel, probabilistic risk assessment methods to better delineate the impact of benchmarks, such as reference doses, and actively participated in major European food allergy projects, such as EUROPREVALL, the European Union (EU)-funded project “The prevalence, cost and basis of food allergy across Europe;” and iFAAM, “Integrated approaches to food allergen and allergy risk management,” also an EU-funded project. Over the years, the task force’s work has evolved as answers to initial questions raised further issues: Its current work program includes a review of analytical methods and how different ones can best be deployed given their strengths and limitations. Another activity, which has just commenced, aims to develop a framework for stakeholders to achieve consensus on acceptable risk.

scholarly journals Development of the Global Mycetoma Working Group

2020 ◽  
Author(s):  
Rita M Traxler ◽  
Karlyn D Beer ◽  
David D Blaney ◽  
Wendy W J van de Sande ◽  
Ahmed H Fahal ◽  
...  
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Working Group ◽  
Healthcare Providers ◽  
World Health ◽  
Public Health Professionals ◽  
The World ◽  
Treatment Research ◽  
Public Health Practitioners ◽  
The Impact

Abstract The Global Mycetoma Working Group (GMWG) was formed in January 2018 in response to the declaration of mycetoma as a neglected tropical disease (NTD) by the World Health Assembly. The aim of the working group is to connect experts and public health practitioners around the world to accelerate mycetoma prevention activities and reduce the impact of mycetoma on patients, healthcare providers and society in the endemic regions. The working group has made tangible contributions to mycetoma programming, awareness and coordination among scientists, clinicians and public health professionals. The group's connectivity has enabled rapid response and review of NTD documents in development, has created a network of public health professionals to provide regional mycetoma expertise and has enabled mycetoma to be represented within broader NTD organizations. The GMWG will continue to serve as a hub for networking and building collaborations for the advancement of mycetoma clinical management and treatment, research and public health programming.

scholarly journals Healthcare Workforce in Indonesia

2017 ◽  
Vol 12 (3) ◽  
pp. 32-40 ◽  
Author(s):  
Suryanto Suryanto ◽  
Malcolm Boyle ◽  
Virginia Plummer
Keyword(s):  
Rural Areas ◽  
Grey Literature ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
Healthcare Services ◽  
World Health ◽  
Health Service Provision ◽  
Ovid Medline ◽  
The World ◽  
The Impact

Introduction: Imbalanced distribution of healthcare providers between urban and rural areas is one of the difficulties facing health service provision in Indonesia. Several regulations have been made by the governmentto solve the problem. The objective of this paper is to describe the provision of human resources for healthcare services in Indonesia. Methodology: A review of medical related electronic databases, CINAHL and Ovid MEDLINE, was undertaken from their commencement date until the end of January 2017. The grey literature from the Indonesian government, the World Health Organisation and the World Bank websites was also searched. Results: There were 92 articles identified from the CINAHL and 222 articles from the Ovid MEDLINE databases. Five articles were included from the two databases and five documents from grey literature with ten articles to be reviewed.  Discussion: Nurses and midwives account for the largest proportion of healthcare providers in Indonesia. The ratio of healthcare providers in Indonesia is lower than the average of South-East Asian and other lower middle income countries. More than half of the healthcare providers in Indonesia provide care in community health centres. Several regulations have been proclaimed to improve the imbalanced proportion of healthcare providers across the country. Conclusion: Indonesia continues to develop strategies towards successful distribution of healthcare providers across the country. A study investigating the impact of the programs reducing the imbalanced distribution of healthcare providers on health outcomes is essential for Indonesia.

scholarly journals Impact of Immediate ART Initiation and Patient Health Expenditures: A Stepped-Wedge Randomised Trial

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J I Steinert ◽  
P Geldsetzer
Keyword(s):  
Healthcare Providers ◽  
Standard Of Care ◽  
Economic Benefits ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hiv Care ◽  
Stepped Wedge ◽  
Healthcare Expenditures ◽  
Art Initiation ◽  
The Impact

Abstract Background Healthcare expenditures for HIV care pose a major economic burden on households in sub-Saharan Africa. While immediate initiation of antiretroviral therapy (ART) for all HIV-positive patients has important health benefits, it is unknown how this profound change in HIV care provision will affect patients' healthcare expenditures. This study, therefore, aims to determine the causal impact of immediate ART initiation on patients' healthcare expenditures in Eswatini. Methods This stepped-wedge cluster-randomised controlled trial enrolled fourteen public-sector healthcare facilities in rural and semi-urban Eswatini. Facilities were randomly assigned to transition at one of seven time points from the standard of care (ART eligibility at CD4 counts of < 500 cells/mm3) to the immediate ART for all intervention (EAAA). The primary outcome was total patient-borne healthcare expenditures during the preceding 12 months. We used mixed-effects negative binomial regressions adjusted for secular trends and clustering at the facility level. Results 2261 participants were interviewed over the study period. Participants in the EAAA phase reported a 45% decrease (RR: 0.55, 95% CI: 0.39, 0.77, p < 0.001) in their total past-year healthcare expenditures compared to the standard-of-care phase. Patients' healthcare expenditures for private and traditional healthcare providers were 93% (RR 0.07, 95% CI: 0.01, 0.77, p < 0.001) lower in the EAAA than the standard of care phase. Self-reported health status was similar between study phases. Conclusions Despite a higher frequency of HIV care visits for newly initiated ART patients, immediate ART initiation lowered patients' healthcare expenditures because they sought less care from private and traditional healthcare providers. This study adds an important economic argument to the World Health Organisation's recommendation for countries to abolish CD4-count-based eligibility thresholds for ART. Key messages This is the first experimental study to examine the impact of immediate ART initiation on patients’ healthcare expenditures and thus obtain a causal estimate of the economic benefits of immediate ART. Immediate ART initiation in Eswatini reduced HIV patients’ healthcare expenditures, at least partially through decreasing care-seeking from traditional and private healthcare providers.

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