The impact of the COVID-19 pandemic on Polish orthopedics, in particular on the level of stress among orthopedic surgeons and the education process

The Coronovirus Disease 2019 –(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20–60% (61,2% respondents), while the number of operations performed decreased by 60–100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0–5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p <0.001). The greatest increase in the level of stress was observed among orthopedists working in country hospitals (p = 0,03). In section Awareness 36,3% of respondents feel well or very well informed about the latest Covid-19 regulations. In addition, most doctors (82.6%) believe that the Polish health care system was not well prepared to fight the pandemic and that the regulations applied so far are not sufficient to effectively fight the pandemic (66.2%). The COVID-19 pandemic has impact on orthopedics departments in Poland and negatively affected the quality of training of orthopedic surgeons and the level of stress.

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Brazilian Primary and Secondary Public Oral Health Attention: Are Dentists Ready to Face the COVID-19 Pandemic?

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.342 ◽

2020 ◽

pp. 1-8

Author(s):

Anya P.G.F. Vieira-Meyer ◽

Maíra B. Coutinho ◽

Helena P.G. Santos ◽

Maria V. Saintrain ◽

George T. de M. Candeiro

Keyword(s):

Health Care ◽

Health Care System ◽

Personal Protective Equipment ◽

Dental Treatment ◽

Technological Development ◽

Protective Equipment ◽

Online Questionnaire ◽

Dental Procedures ◽

Secondary Health Care ◽

Care System

ABSTRACT Objective: To investigate knowledge and practice of Brazilian public primary and secondary health care dentists during the coronavirus disease (COVID-19) pandemic. Methods: An online questionnaire with sociodemographic and COVID-19 knowledge questions was used. Results: A total of 4048 dentists working in the Brazilian public primary and secondary health care system were investigated; 4024 (99.41%) believe that COVID-19 can be transmitted through dental procedures. A fair level of COVID-19 symptoms knowledge by these dentists was observed (3.76±1.27 of 6.00), as well as the skepticism in personal protective equipment (3382; 83.55%) and biosafety procedures (3278; 80.98%) used as an efficient form of COVID-19 transmission prevention. Country region, performance of social distancing, dental specialty, the use of personal protective equipment, and biosafety preventive measures influenced the likelihood of dentists to perform dental treatment, either elective or urgent, during the COVID-19 pandemic. Conclusion: The need of extra preventive barriers for dental treatment may bring an extra financial stress in the Brazilian public primary and secondary health care system, as well as in the patient-dentist relationship, which may have to be reframed. Internationally accepted public guideline policies regarding dental treatment safety, as well as the technological development of preventive tools, are needed to deal with the challenges brought by COVID-19.

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On the Horizon: Older Adults With Autism in a Changing Health Care Environment

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp3.sig15.4 ◽

2018 ◽

Vol 3 (15) ◽

pp. 4-14

Author(s):

Pamela A. Smith

Keyword(s):

Health Care ◽

Health Care System ◽

Practical Experience ◽

Health Care Environment ◽

Adults With Autism ◽

Number Of Patients ◽

Driven System ◽

The Impact ◽

Growing Population ◽

Care System

For many years, our health care system has been in a state of change, with most changes occurring as a result of economic issues and not clinical issues. Clinicians working in skilled nursing facilities (SNFs) have navigated a complex web of regulations and processes that are expected to change from a volume-driven system to a value-driven system. Such issues are challenging enough when clinicians are working with disorders with which they have received training and gained practical experience, but the growing population of residents in our facilities who are aging with autism will further complicate the SNF landscape. Because of the increases in prevalence of autism in the general population, the number of patients who will be entering our SNFs will only grow. New regulations and processes will require practice-based evidence and functional outcomes, data which do not exist with adults with autism. This article will discuss the impact of changes in our health care system, specifically in the SNF, and how these changes may impact the provision of care to a growing population of elders with autism.

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Palliative radiotherapy referrals in the last days of cancer patients' life: Could we do better?

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e24008 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e24008-e24008

Author(s):

Leora Brazg Ferro ◽

Eliya Shachar ◽

Orit Gutfeld ◽

Ido Wolf ◽

Yasmin Natan Oz

Keyword(s):

Quality Of Life ◽

Health Care ◽

End Of Life ◽

Health Care System ◽

Treatment Plan ◽

Palliative Radiotherapy ◽

Palliative Radiation ◽

Number Of Patients ◽

Care System

e24008 Background: The role of active cancer therapy towards the end of life (EOL) is debatable and may even be considered harmful. While palliative radiotherapy may be highly effective in reducing cancer-related symptoms of advanced disease, the beneficial effects are usually at least 2-4 weeks from completion of treatment. Thus, radiotherapy administered at the end of life is often ineffective, and may actually impair quality of life and be associated with an unnecessary burden to the health care system. The universal Israeli health care system enables the administration of radiotherapy without financial or regulatory barriers, even at EOL. We aimed to assess the use radiotherapy towards EOL in a tertiary care Israeli cancer center. Methods: We retrospectively analyzed data of patients receiving palliative radiation and died within 30 days of their simulation from March 2019 until September 2020. Results: Out of approximately 2,000 patients treated with radiotherapy during the study period, 148 (8%) patients were referred for palliative radiation and died within 30 days of their simulation. The majority (88, 59.5%) were male, the median age was 67.3 years and the most common malignancies patients suffered from were lung cancer (49, 33.1%), gastrointestinal tumors (28, 18.9%), genito-urinary malignancies (23, 15.5%) or breast cancer (15, 10.1%). The median ECOG PS was 3. Nineteen patients (12.8%) did not initiate radiation treatment plan, 24 patients (16.2%) completed less than half of the planned treatment and 89 patients (60.1%) completed the entire duration of treatment. Of the patients who completed the planned therapy, 34 patients (38.2%) received a single fraction protocol. The majority of patients (89, 60.1%) were referred to the radiation unit by their treating medical oncologists or hemato-oncologist. None of the patients were referred by palliative care team members at our center. Most (105, 70.9%) received previous systemic therapies; but less than half (48, 45.7%) were under active treatments within a month prior to the radiation simulation. Conclusions: Relatively large number of patients with advanced malignancies are referred for futile palliative radiotherapy during the last 30 days of their life, thus impairing their quality of life and creating an unnecessary burden on public health services. These patients are often being referred by their treating oncologists who are familiar with their oncological history. These findings call for the implementation of collaborative multi-disciplinary teams, primarily directed at optimizing care at the end of life, setting achievable treatment goals, and improving quality of life.

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Quality of Life (QoL) among Health Care Workers with Diabetes Mellitus: A Literature Review

Clinics and Practice ◽

10.3390/clinpract11040096 ◽

2021 ◽

Vol 11 (4) ◽

pp. 801-826

Author(s):

Warda Alamri ◽

Aisha Alhofaian ◽

Nahed Mersal

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Health Care ◽

Literature Review ◽

Health Care System ◽

Health Care Workers ◽

Care Workers ◽

The Impact ◽

Care System

Objective: This scoping literature review explores the impact of diabetes mellitus (DM) on the health-related quality of life (HRQoL) of health care workers (HCWs). HCWs play a vital role in the global health care system, with the COVID-19 pandemic demonstrating their effectiveness and worth beyond any doubt. However, HCWs are among the most vulnerable members of the health care system because they are most susceptible to stress, exhaustion, and occupational health risks. Method: The review was conducted in 2021 and included articles published in English in the past five years that explore diabetic HCWs’ QoL and studies intended to assess the relationship between work stress and DM. In total, 27 relevant articles were found that satisfied the inclusion criteria and were critically and thematically analyzed. Results: Most DM studies have focused on the clinical management of patients, but researchers have paid little attention to the high-risk group of HCWs with diabetes. In addition to fulfilling their job mandate, HCWs are burdened with various sociological stressors that affect their QoL. Conclusion: This literature review suggests DM has a significant impact on QoL in the work–life context. However, there is limited evidence to demonstrate the impact of DM on the QoL of HCWs. Thus, further research is needed in this area to improve the provision of integrated care.

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Implementation of Fiber to the Home (FTTH)-based Technologies: Opening a New Dimension for Health Care Industry in India

International Journal of Engineering and Advanced Technology - Regular Issue ◽

10.35940/ijeat.f9091.088619 ◽

2019 ◽

Vol 8 (6) ◽

pp. 5004-5009

Keyword(s):

Health Care ◽

Health Care System ◽

Quality Of Health Care ◽

Healthcare Sector ◽

Equation Modeling ◽

Fiber To The Home ◽

Indian Health ◽

The Impact ◽

Care System

Fiber to the home is a useful technology which is used by different industries including healthcare. Though it is expensive that is why it is difficult to implement worldwide but still it proves essential tools in the healthcare sector. It is a helpful tool in different health care purpose such as monitoring, sending fast and effective information, enhancing the quality of health care, providing E-health solutions, telemedicine, tele-surgery, health education and many more. In this paper we are trying to find out the scope, opportunities and difficulties of fiber to home in Indian health care system and the impact of FTTH on enhancing efficiencies of Health-Care system and quality service delivery. For measuring the impact of FTTH, Structural Equation Modeling (SEM) has been used as a statistical tool in this study. It is found that the growing demand of health care need requires fast and effective health care which is only possible by having high speed network facilities. So if Indian health care system is able to implement FTTH, then they can reach every people and can enhance the quality of health care.

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Ensuring quality of dermatologic care in the US health care system

Archives of Dermatology ◽

10.1001/archderm.133.11.1355 ◽

1997 ◽

Vol 133 (11) ◽

pp. 1355-1357 ◽

Cited By ~ 1

Author(s):

M. L. Johnson

Keyword(s):

Health Care ◽

Health Care System ◽

The Us ◽

Care System

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Assisting People With Their Living, Not Their Dying: Health Professionals’ Perspectives of Palliative Care and Opioids in ILD

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211018664 ◽

2021 ◽

pp. 104990912110186

Author(s):

Lauren Russo ◽

Karen Willis ◽

Natasha Smallwood

Keyword(s):

Quality Of Life ◽

Health Care ◽

Palliative Care ◽

Health Care System ◽

Therapeutic Relationships ◽

Specialist Palliative Care ◽

Cross Sectional ◽

Symptom Palliation ◽

Care System

Objectives: Interstitial lung disease (ILD) is a debilitating and life-limiting condition, requiring multi-disciplinary care. While guidelines recommend early specialist palliative care referral to improve symptoms and quality of life, few patients access such care towards the end-of-life. This study aimed to explore clinicians’ perspectives regarding specialist palliative care and opioids to understand barriers to optimal care and guide clinical practice improvement initiatives. Methods: A cross-sectional, exploratory, qualitative study was undertaken with Australian respiratory clinicians caring for people with ILD (n = 17). In-depth, semi-structured interviews were audio-recorded, transcribed verbatim and coded. Thematic analysis was undertaken to extrapolate recurring ideas from the data. Results: Four themes were identified: 1) understanding how to improve patient care and support, 2) the need to dispel stigmatized beliefs and misconceptions, 3) the importance of trusted relationships and good communication and 4) the challenges of navigating the health-care system. Participants discussed the need to implement early specialist palliative care and symptom palliation to alleviate symptoms, provide emotional support and augment quality of life. Participants described challenges accessing palliative care and opioids due to stigmatized beliefs amongst patients and clinicians and difficulties navigating the health-care system. Trusted therapeutic relationships with patients and strong inter-disciplinary partnerships with collaborative education and communication were perceived to improve patients’ access to symptom palliation. Conclusion: Specialist palliative care and opioids were believed to improve patients’ quality of life, however, many barriers can make accessing such care challenging. To address these issues, multi-disciplinary collaboration, high-quality communication and trusted therapeutic relationships are crucial throughout the ILD illness journey.

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