scholarly journals The Impact of Coronavirus Disease 2019 on Trauma Patients and Orthopedic Trauma Operations at a Single Focused Training Center for Trauma in South Korea

2021 ◽  
Author(s):  
Wonseok Choi ◽  
Hanju Kim ◽  
Whee Sung Son ◽  
Seungyeob Sakong ◽  
Jun-Min Cho ◽  
...  
Keyword(s):  
South Korea ◽  
Trauma Patients ◽  
Orthopedic Trauma ◽  
Training Center ◽  
The Impact

scholarly journals Change in Orthopedic Trauma Practice under Strict Lockdown due to COVID-19 Pandemic

2021 ◽  
Vol 14 (1) ◽  
pp. 196-205
Author(s):  
Anas A.R. Altamimi ◽  
Ali A. Al-Omari ◽  
Saeed Al-Naser ◽  
Firas Al-Dabouby ◽  
Mahmoud Al-Balas ◽  
...  
Keyword(s):  
Response Rate ◽  
Legal Aspects ◽  
Trauma Patients ◽  
Orthopedic Trauma ◽  
University Hospitals ◽  
Cross Sectional ◽  
Femur Fractures ◽  
Orthopedic Surgeons ◽  
The Impact

Introduction: The COVID-19 pandemic has led to remarkable changes in several aspects of medical practice. Elective surgeries, including orthopedic surgery, were deferred worldwide, allowing hospitals to accommodate higher numbers of COVID-19 patients and reduce the possible risk of infection among healthcare workers. However, healthcare systems aimed to continue providing emergency services at similar standards. In this study, we aim to highlight the impact of lockdowns secondary to the pandemic on orthopedic trauma practice in a country that was described to have one of the strictest lockdowns worldwide. We aim to examine the trends of change in number and type of orthopedic trauma cases and the changes to decision making and patient care among orthopedic surgeons. Methods: This cross-sectional study is based on a survey that was designed and delivered to orthopedic surgeons from different health sectors i.e. governmental, military, private and university hospitals. The questionnaire was distributed through the official Jordan orthopedic association WhatsApp group by the end of the 4th week of strict lockdown. A total of 256 orthopedic surgeons were invited to participate and responses were limited to one per participant. 147 replies were received with a response rate of 57.4%. Data were analyzed using the Statistical Package for the Social Sciences Version 23 (SPSS Inc., Chicago, IL) statistical software. Results: A total of 147 surgeons participated in the study with a response rate of 57.4%. The mean age of the participants was 39.8 years, with the majority being between 30 and 40 years (n=70; 48%). There was a significant decline in the number of trauma cases admitted to the Emergency Departments (ER), especially cases with polytrauma. During this period, the most common reported fractures were proximal femur fractures (47.6%) followed by distal radius fracture (17%). 30% of participants used to perform more than 10 trauma operations per week. This percentage dropped to 7.5% during the pandemic lockdown. 25% did not operate at all during the lockdown period. Outpatients practice was significantly affected with almost 40% of orthopedic surgeons not managing any single patient. Regarding the use of Personal Protective Equipment (PPE), 85% of the surgeons used face masks and gloves only during their patient's encounter. Inside the operating room, only 9.5% of surgeons used fully protective PPEs. Regarding the changes in practice, 62% of surgeons reported an increased tendency toward non-operative management with a significant delay in follow up of patients. The use of telemedicine was effective in the management of less than 50% of patient encounters, according to our participants. Private practice respondents reported more than 50% drop in their income during the lockdown. Conclusion: Strict lockdown in Jordan led to significant changes to orthopedic trauma practice in terms of the number and type of cases. Emergency and outpatient services were similarly affected. Orthopedic surgeons developed a tendency towards more conservative management and less surgical treatment. There is a need for stricter implementation of guidelines regarding the use of PPE especially in the operating theatre. Telemedicine use in management and follow up of trauma patients needs further assessment in terms of its efficacy and efficiency to patients and to healthcare professionalswith regards to its medico-legal aspects.

scholarly journals Pediatric Orthopedic Trauma Care During the COVID-19 Pandemic: A Survey of the Pediatric Orthopedic Society of North America

2021 ◽  
pp. 155633162110560
Author(s):  
Mitchell A. Johnson ◽  
Theodore J. Ganley ◽  
Lindsay Crawford ◽  
Ishaan Swarup
Keyword(s):  
North America ◽  
Trauma Care ◽  
Care Delivery ◽  
Trauma Surgery ◽  
Trauma Patients ◽  
Orthopedic Trauma ◽  
Fracture Management ◽  
Pediatric Orthopedic ◽  
The Impact

Background: The COVID-19 pandemic has dramatically altered the practice of pediatric orthopedic trauma surgery in both outpatient and inpatient settings. While significant declines in patient volume have been noted, the impact on surgeon decision-making is unclear. Purpose: We sought to investigate changes in pediatric orthopedic trauma care delivery as a result of COVID-19 and determine their implications for future orthopedic practice. Methods: An electronic survey was distributed to all members (N = 1515) of the Pediatric Orthopedic Society of North America (POSNA) in March to April 2021; only members who provided care for pediatric orthopedic trauma patients were asked to complete it. The survey included questions on hospital trauma call, inpatient care, outpatient clinic practice, and 3 unique fracture case scenarios. Results: A total of 147 pediatric orthopedic surgeons completed the survey, for a 9.7% response rate, with 134 (91%) taking trauma call at a hospital as part of their practice. Respondents reported significant differences across institutions regarding COVID-19 testing, hospital rounding, and employee COVID-19 screening. Changes in outpatient fracture management were observed, including a decreased number of follow-up visits for nondisplaced clavicle fractures, distal radius buckle fractures, and toddler’s fractures. Of respondents who changed their fracture follow-up schedules due to COVID-19, over 75% indicated that they would continue these outpatient treatment schedules after the pandemic. Conclusions: This survey found changes in pediatric orthopedic trauma care as a result of the COVID-19 pandemic. The use of telemedicine and abbreviated follow-up practices for common fracture types are likely to persist following the resolution of the COVID-19 pandemic.

Disability, Stigma, and Children's Developing Selves

2019 ◽  
Author(s):  
Misa Kayama ◽  
Wendy Haight ◽  
May-Lee Ku ◽  
Minhae Cho ◽  
Hee Yun Lee
Keyword(s):  
South Korea ◽  
Inclusive Education ◽  
Children With Disabilities ◽  
Cultural Psychology ◽  
Peer Group ◽  
Individual Development ◽  
Typically Developing ◽  
Everyday Lives ◽  
The Impact ◽  
The U.S

Stigmatization is part of the everyday lives of children with disabilities, their families, and their friends. Negative social encounters, even with perfect strangers, can dampen joyful occasions, add stress to challenging situations, and lead to social isolation. This book describes a program of research spanning a decade that seeks to understand disabilities in their developmental and cultural contexts. The authors are especially interested in understanding adults’ socialization practices that promise to reduce stigmatization in the next generation. Guided by developmental cultural psychology, including the concept of “universalism without uniformity,” the authors focus on the understandings and responses to disability and associated stigmatization of elementary-school educators practicing in Japan, South Korea, Taiwan, and the U.S. Educators from all four cultural groups expressed strikingly similar concerns about the impact of stigmatization on the emerging cultural self, both of children with disabilities and their typically developing peers. Educators also described culturally nuanced socialization goals and practices pertaining to inclusive education. In Japan, for instance, educators emphasized the importance of peer group belonging and strategies to support the participation of children with disabilities. In the U.S., educators placed relatively more emphasis on individual development and discussed strategies for the equitable treatment of children with disabilities. Educators in South Korea and Taiwan emphasized the cultivation of compassion in typically developing children. The understanding gained through examination of how diverse individuals address common challenges using cultural resources available in their everyday lives provides important lessons for strengthening theory, policy, and programs.

scholarly journals Retirement Age and Housing Consumption: The Case of South Korea

2021 ◽  
Vol 13 (3) ◽  
pp. 1286
Author(s):  
Chunil Kim ◽  
Hyobi Choi ◽  
Yeol Choi
Keyword(s):  
South Korea ◽  
Group Living ◽  
Peripheral Region ◽  
Housing Tenure ◽  
Housing Consumption ◽  
Household Expenditures ◽  
Housing Tenure Choice ◽  
Populated Region ◽  
The Impact ◽  
Real Assets

South Korea became an aging society in 2000 and will become a super-aged nation in 2026. The extended life expectancy and earlier retirement make workers’ preparation for retirement more difficult, and that hardship might lead to poorer living conditions after retirement. As annuity payments are, in general, not enough for retirees to maintain their previous standard of living after retirement, retired households would have to liquidate their financial and real assets to cover household expenditures. As housing takes the biggest share of households’ total assets in Korea, it seems to be natural for retirees to downsize their houses. However, there is no consensus in the housing literature on housing downsizing, and the debate is still ongoing. In order to understand whether or not housing downsizing by retirees occurs in Korea, this paper examines the impact of the timing of retirement on housing consumption using an econometric model of housing tenure choice and the consumption for housing. The results show that the early retirement group living in more populated region does not downsize the house, while the timing of retirement is negatively associated with housing consumption for the late retirement group living in the peripheral region.

Projecting the long-term benefits of single pill combination therapy for patients with hypertension in five countries

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Borghi ◽  
J.G Wang ◽  
A.V Rodionov ◽  
M Rosas ◽  
I.S Sohn ◽  
...  
Keyword(s):  
Combination Therapy ◽  
South Korea ◽  
Health Outcomes ◽  
Clinical Outcomes ◽  
Funding Source ◽  
Combination Therapies ◽  
Private Company ◽  
Treatment Pathways ◽  
Single Pill ◽  
The Impact

Abstract Background It is well established that single pill combination (SPC) therapies have the potential to improve patient adherence versus multi-pill regimens, thereby improving blood pressure control and clinical outcomes in populations with hypertension. Purpose To develop a microsimulation model, capturing different treatment pathways, to project the impact on clinical outcomes of using single pill combination therapies for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico). Methods The model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices [CTP], single drug with dosage titration first then sequential addition of other agents [start low and go slow, SLGS], free choice combination with multiple pills [FCC] and combination therapy in the form of a single pill [SPC]. Model inputs were derived from Global Burden of Disease 2017 dataset, including demographics, health status/risk factors, transition probabilities and treatment attributes/healthcare utilization, and the model incorporated real-world challenges to healthcare delivery such as access to care, SBP measurement error, adherence and therapeutic inertia. Simulated outcomes of mortality, incidence of chronic kidney disease (CKD), stroke and ischemic heart disease (IHD), and disability-adjusted life years (DALYs) due to these conditions were estimated for population of 1,000,000 simulated patients for each treatment pathway and country. Results SPC therapy was projected to improve health outcomes over SLGS, FCC and CTP over 10 years in all five countries. SPC was forecast to reduce mortality by 5.4% (Italy), 4.9% (Russia), 4.5% (China), 2.3% (South Korea) and 3.6% (Mexico) versus CTP and showed greater projected reductions in mortality than SLGS and FCC. DALYs were projected to be reduced with SPC therapy by between 5.7% (Italy) and 2.2% (South Korea) compared with CTP and reductions in the incidence of clinical events were also projected with SPC therapy, with decreases in the range of 11.5% (Italy) to 4.9% (South Korea) versus CTP. Conclusions Ten-year projections of clinical outcomes associated with different anti-hypertensive treatment pathways in five countries indicated that both combination therapies (FCC and SPC) are likely to reduce the disease burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Sanofi, Gentilly, France

scholarly journals Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Francois-Xavier Ageron ◽  
Timothy J. Coats ◽  
Vincent Darioli ◽  
Ian Roberts
Keyword(s):  
Tranexamic Acid ◽  
Acid Treatment ◽  
Injury Severity ◽  
External Validation ◽  
Research Network ◽  
Brier Score ◽  
Trauma Patients ◽  
Using Data ◽  
The Uk ◽  
The Impact

Abstract Background Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death from bleeding. Methods We conducted an external validation of the BATT score using data from the UK Trauma Audit Research Network (TARN) from 1st January 2017 to 31st December 2018. We evaluated the impact of tranexamic acid treatment thresholds in trauma patients. Results We included 104,862 trauma patients with an injury severity score of 9 or above. Tranexamic acid was administered to 9915 (9%) patients. Of these 5185 (52%) received prehospital tranexamic acid. The BATT score had good accuracy (Brier score = 6%) and good discrimination (C-statistic 0.90; 95% CI 0.89–0.91). Calibration in the large showed no substantial difference between predicted and observed death due to bleeding (1.15% versus 1.16%, P = 0.81). Pre-hospital tranexamic acid treatment of trauma patients with a BATT score of 2 or more would avoid 210 bleeding deaths by treating 61,598 patients instead of avoiding 55 deaths by treating 9915 as currently. Conclusion The BATT score identifies trauma patient at risk of significant haemorrhage. A score of 2 or more would be an appropriate threshold for pre-hospital tranexamic acid treatment.

Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow

2021 ◽  
pp. 084653712110238
Author(s):  
Francesco Macri ◽  
Bonnie T. Niu ◽  
Shannon Erdelyi ◽  
John R. Mayo ◽  
Faisal Khosa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Major Trauma ◽  
Patient Flow ◽  
Interrupted Time Series ◽  
Trauma Patients ◽  
Linear Regression Models ◽  
High Acuity ◽  
Time Series Approach ◽  
Comparison Series ◽  
The Impact

Purpose: Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital. Methods: Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint. Results: During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern. Conclusions: At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.

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