scholarly journals COVID-19 and Laparoscopic Surgery: Scoping Review of Current Literature and Local Expertise

10.2196/18928 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e18928 ◽  
Author(s):  
Robert Adrianus de Leeuw ◽  
Nicole Birgit Burger ◽  
Marcello Ceccaroni ◽  
Jian Zhang ◽  
Jurriaan Tuynman ◽  
...  
Keyword(s):  
Health Care ◽  
Laparoscopic Surgery ◽  
High Risk ◽  
Operating Room ◽  
Health Care Providers ◽  
Current Literature ◽  
Scoping Review ◽  
Open Surgery ◽  
Care Providers ◽  
Surgical Smoke

Background The current coronavirus disease (COVID-19) pandemic is holding the world in its grip. Epidemiologists have shown that the mortality risks are higher when the health care system is subjected to pressure from COVID-19. It is therefore of great importance to maintain the health of health care providers and prevent contamination. An important group who will be required to treat patients with COVID-19 are health care providers during semiacute surgery. There are concerns that laparoscopic surgery increases the risk of contamination more than open surgery; therefore, balancing the safety of health care providers with the benefit of laparoscopic surgery for the patient is vital. Objective We aimed to provide an overview of potential contamination routes and possible risks for health care providers; we also aimed to propose research questions based on current literature and expert opinions about performing laparoscopic surgery on patients with COVID-19. Methods We performed a scoping review, adding five additional questions concerning possible contaminating routes. A systematic search was performed on the PubMed, CINAHL, and Embase databases, adding results from gray literature as well. The search not only included COVID-19 but was extended to virus contamination in general. We excluded society and professional association statements about COVID-19 if they did not add new insights to the available literature. Results The initial search provided 2007 records, after which 267 full-text papers were considered. Finally, we used 84 papers, of which 14 discussed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eight papers discussed the added value of performing intubation in a low-pressure operating room, mainly based on the SARS outbreak experience in 2003. Thirteen papers elaborated on the risks of intubation for health care providers and SARS-CoV-2, and 19 papers discussed this situation with other viruses. They conclude that there is significant evidence that intubation and extubation is a high-risk aerosol-producing procedure. No papers were found on the risk of SARS-CoV-2 and surgical smoke, although 25 papers did provide conflicting evidence on the infection risk of human papillomavirus, hepatitis B, polio, and rabies. No papers were found discussing tissue extraction or the deflation risk of the pneumoperitoneum after laparoscopic surgery. Conclusions There seems to be consensus in the literature that intubation and extubation are high-risk procedures for health care providers and that maximum protective equipment is needed. On the other hand, minimal evidence is available of the actual risk of contamination of health care providers during laparoscopy itself, nor of operating room pressure, surgical smoke, tissue extraction, or CO2 deflation. However, new studies are being published daily from current experiences, and society statements are continuously updated. There seems to be no reason to abandon laparoscopic surgery in favor of open surgery. However, the risks should not be underestimated, surgery should be performed on patients with COVID-19 only when necessary, and health care providers should use logic and common sense to protect themselves and others by performing surgery in a safe and protected environment.

scholarly journals COVID-19 and Laparoscopic Surgery: Scoping Review of Current Literature and Local Expertise (Preprint)

2020 ◽  
Author(s):  
Robert Adrianus de Leeuw ◽  
Nicole Birgit Burger ◽  
Marcello Ceccaroni ◽  
Jian Zhang ◽  
Jurriaan Tuynman ◽  
...  
Keyword(s):  
Health Care ◽  
Laparoscopic Surgery ◽  
High Risk ◽  
Operating Room ◽  
Health Care Providers ◽  
Current Literature ◽  
Scoping Review ◽  
Open Surgery ◽  
Care Providers ◽  
Surgical Smoke

BACKGROUND The current coronavirus disease (COVID-19) pandemic is holding the world in its grip. Epidemiologists have shown that the mortality risks are higher when the health care system is subjected to pressure from COVID-19. It is therefore of great importance to maintain the health of health care providers and prevent contamination. An important group who will be required to treat patients with COVID-19 are health care providers during semiacute surgery. There are concerns that laparoscopic surgery increases the risk of contamination more than open surgery; therefore, balancing the safety of health care providers with the benefit of laparoscopic surgery for the patient is vital. OBJECTIVE We aimed to provide an overview of potential contamination routes and possible risks for health care providers; we also aimed to propose research questions based on current literature and expert opinions about performing laparoscopic surgery on patients with COVID-19. METHODS We performed a scoping review, adding five additional questions concerning possible contaminating routes. A systematic search was performed on the PubMed, CINAHL, and Embase databases, adding results from gray literature as well. The search not only included COVID-19 but was extended to virus contamination in general. We excluded society and professional association statements about COVID-19 if they did not add new insights to the available literature. RESULTS The initial search provided 2007 records, after which 267 full-text papers were considered. Finally, we used 84 papers, of which 14 discussed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eight papers discussed the added value of performing intubation in a low-pressure operating room, mainly based on the SARS outbreak experience in 2003. Thirteen papers elaborated on the risks of intubation for health care providers and SARS-CoV-2, and 19 papers discussed this situation with other viruses. They conclude that there is significant evidence that intubation and extubation is a high-risk aerosol-producing procedure. No papers were found on the risk of SARS-CoV-2 and surgical smoke, although 25 papers did provide conflicting evidence on the infection risk of human papillomavirus, hepatitis B, polio, and rabies. No papers were found discussing tissue extraction or the deflation risk of the pneumoperitoneum after laparoscopic surgery. CONCLUSIONS There seems to be consensus in the literature that intubation and extubation are high-risk procedures for health care providers and that maximum protective equipment is needed. On the other hand, minimal evidence is available of the actual risk of contamination of health care providers during laparoscopy itself, nor of operating room pressure, surgical smoke, tissue extraction, or CO<sub>2</sub> deflation. However, new studies are being published daily from current experiences, and society statements are continuously updated. There seems to be no reason to abandon laparoscopic surgery in favor of open surgery. However, the risks should not be underestimated, surgery should be performed on patients with COVID-19 only when necessary, and health care providers should use logic and common sense to protect themselves and others by performing surgery in a safe and protected environment.

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

2018 ◽  
Vol 34 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Erin Relyea ◽  
Brooke MacDonald ◽  
Christina Cattaruzza ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Access To Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Scoping Review ◽  
End Of Life Care ◽  
Psychosocial Interventions ◽  
Life Care ◽  
Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

scholarly journals Health Education Serious Games Targeting Health Care Providers, Patients, and Public Health Users: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Nahid Sharifzadeh ◽  
Hadi Kharrazi ◽  
Elham Nazari ◽  
Hamed Tabesh ◽  
Maryam Edalati Khodabandeh ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Education ◽  
Health Care Providers ◽  
Scoping Review ◽  
Serious Games ◽  
Educational Games ◽  
Care Providers ◽  
Serious Educational Games

BACKGROUND Serious educational games have shown effectiveness in improving various health outcomes. Previous reviews of health education games have focused on specific diseases, certain medical subjects, fixed target groups, or limited outcomes of interest. Given the recent surge in health game studies, a scoping review of health education games is needed to provide an updated overview of various aspects of such serious games. OBJECTIVE This study aimed to conduct a scoping review of the design and evaluation of serious educational games for health targeting health care providers, patients, and public (health) users. METHODS We identified 2313 studies using a unique combination of keywords in the PubMed and ScienceDirect databases. A total of 161 studies were included in this review after removing duplicates (n=55) and excluding studies not meeting our inclusion criteria (1917 based on title and abstract and 180 after reviewing the full text). The results were stratified based on games targeting health care providers, patients, and public users. RESULTS Most health education games were developed and evaluated in America (82/161, 50.9%) and Europe (64/161, 39.8%), with a considerable number of studies published after 2012. We discovered 58.4% (94/161) of studies aiming to improve knowledge learning and 41.6% (67/161) to enhance skill development. The studies targeted various categories of end users: health care providers (42/161, 26.1%), patients (38/161, 23.6%), public users (75/161, 46.6%), and a mix of users (6/161, 3.7%). Among games targeting patients, only 13% (6/44) targeted a specific disease, whereas a growing majority targeted lifestyle behaviors, social interactions, cognition, and generic health issues (eg, safety and nutrition). Among 101 studies reporting gameplay specifications, the most common gameplay duration was 30 to 45 min. Of the 61 studies reporting game repetition, only 14% (9/61) of the games allowed the users to play the game with unlimited repetitions. From 32 studies that measured follow-up duration after the game intervention, only 1 study reported a 2-year postintervention follow-up. More than 57.7% (93/161) of the games did not have a multidisciplinary team to design, develop, or assess the game. CONCLUSIONS Serious games are increasingly used for health education targeting a variety of end users. This study offers an updated scoping review of the studies assessing the value of serious games in improving health education. The results showed a promising trend in diversifying the application of health education games that go beyond a specific medical condition. However, our findings indicate the need for health education game development and adoption in developing countries and the need to focus on multidisciplinary teamwork in designing effective health education games. Furthermore, future health games should expand the duration and repetition of games and increase the length of the follow-up assessments to provide evidence on long-term effectiveness.

scholarly journals Accelerating the Appropriate Adoption of Artificial Intelligence in Health Care: Protocol for a Multistepped Approach

10.2196/30940 ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. e30940
Author(s):  
David Wiljer ◽  
Mohammad Salhia ◽  
Elham Dolatabadi ◽  
Azra Dhalla ◽  
Caitlin Gillan ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Health Care Providers ◽  
Scoping Review ◽  
The United States ◽  
Data Driven ◽  
Data Sets ◽  
Health Providers ◽  
Care Providers ◽  
Environmental Scan

Background Significant investments and advances in health care technologies and practices have created a need for digital and data-literate health care providers. Artificial intelligence (AI) algorithms transform the analysis, diagnosis, and treatment of medical conditions. Complex and massive data sets are informing significant health care decisions and clinical practices. The ability to read, manage, and interpret large data sets to provide data-driven care and to protect patient privacy are increasingly critical skills for today’s health care providers. Objective The aim of this study is to accelerate the appropriate adoption of data-driven and AI-enhanced care by focusing on the mindsets, skillsets, and toolsets of point-of-care health providers and their leaders in the health system. Methods To accelerate the adoption of AI and the need for organizational change at a national level, our multistepped approach includes creating awareness and capacity building, learning through innovation and adoption, developing appropriate and strategic partnerships, and building effective knowledge exchange initiatives. Education interventions designed to adapt knowledge to the local context and address any challenges to knowledge use include engagement activities to increase awareness, educational curricula for health care providers and leaders, and the development of a coaching and practice-based innovation hub. Framed by the Knowledge-to-Action framework, we are currently in the knowledge creation stage to inform the curricula for each deliverable. An environmental scan and scoping review were conducted to understand the current state of AI education programs as reported in the academic literature. Results The environmental scan identified 24 AI-accredited programs specific to health providers, of which 11 were from the United States, 6 from Canada, 4 from the United Kingdom, and 3 from Asian countries. The most common curriculum topics across the environmental scan and scoping review included AI fundamentals, applications of AI, applied machine learning in health care, ethics, data science, and challenges to and opportunities for using AI. Conclusions Technologies are advancing more rapidly than organizations, and professionals can adopt and adapt to them. To help shape AI practices, health care providers must have the skills and abilities to initiate change and shape the future of their discipline and practices for advancing high-quality care within the digital ecosystem. International Registered Report Identifier (IRRID) PRR1-10.2196/30940

scholarly journals Worry from contracting COVID-19 infection and its stigma among Egyptian health care providers

2022 ◽  
Vol 97 (1) ◽  
Author(s):  
Doaa Mohamed Osman ◽  
Fatma R. Khalaf ◽  
Gellan K. Ahmed ◽  
Ahmed Y. Abdelbadee ◽  
Ahmed M. Abbas ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
High Risk ◽  
Health Care Providers ◽  
High Impact ◽  
Severe Illness ◽  
Care Providers ◽  
Internalized Shame ◽  
High Discrimination

Abstract Backgrounds Healthcare providers (HCPs) in COVID-19 epidemic face stressful workload of disease management, shortage of protective equipment and high risk of infection and mortality. These stressors affect greatly their mental health. The aim is to identify working conditions among Egyptian HCPs during COVID-19 epidemic as well as stigma and worry perceptions from contracting COVID-19 infection and their predictors. Methods A cross-sectional study was conducted among 565 HCPs. Data was collected through Google online self-administered questionnaire comprised seven parts: demographics characteristics, knowledge and attitude of COVID-19, working condition, worry of contracting COVID-19 at work, discrimination intention at work for COVID-19 patients, stigma assessment using impact stigma, and internalized shame scales. Results The vast majority of HCPs (94.7%) were worried from contracting COVID-19 at work. Risk factors for perceiving severe worry from contracting COVID-19 were expecting infection as a severe illness, believing that infection will not be successfully controlled, improbability to continue working during the pandemic even if in a well/fit health, high discrimination intention and impact stigma scales. Significantly high impact stigma scores were detected among those aged < 30 years, females, workers primarily in sites susceptible for contracting COVID-19 infection, those had severe worry from contracting infection at work, and high internalized shame scale. The risk factors for perceiving higher internalized shame scores were not having a previous experience in working during a pandemic, high discrimination intention towards COVID-19 patients and high impact stigma scale. Conclusions Considerable levels of worry and stigma were detected among Egyptian HCPs during COVID-19 outbreak. The psychological aspect of health care providers should not be overlooked during epidemic; appropriate institutional mental health support should be provided especially for young HCPs, those without previous work experience in epidemic and those who work in high-risk units. Raising the community awareness about contribution of HCPs in fighting the epidemic might decrease stigmatization action toward HCPs.

scholarly journals Understanding physical literacy in the context of health: a rapid scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Katie Cornish ◽  
Gloria Fox ◽  
Trina Fyfe ◽  
Erica Koopmans ◽  
Anne Pousette ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Scoping Review ◽  
Health Indicators ◽  
Rapid Review ◽  
Original Research ◽  
Care Providers ◽  
Physical Literacy ◽  
The Relationship

Abstract Background Physical literacy is a multidimensional concept that describes a holistic foundation for physical activity engagement. Understanding the utilization and effectiveness of physical literacy in the context of health and the health care setting will support clinical and population health programming. The purpose of this rapid scoping review was to: 1) map the conceptualization of physical literacy as it relates to health; 2) identify and describe the utilization of physical literacy in the context of health and engagement of health care providers; and 3) better understand the relationship between physical literacy, physical activity, and health. Methods Following established scoping review methods adapted for a rapid review approach, we searched electronic databases Medline OVID, CINAHL Ebsco, PsycInfo Ebsco, Web of Science ISI, and ERIC Ebsco from conception until September 2019. Tabulation coding was used to identify the key themes across included articles and synthesize findings. The review follows an integrated knowledge translation approach based on a partnership between the health system, community organizations, and researchers. Results Following removal of duplicates, our search identified 475 articles for title and abstract screening. After full text review, 17 articles were included (12 original research papers and five conceptual or review papers). There was near consensus among included papers with 16 of 17 using the Whiteheadian definition of physical literacy. There was limited involvement of health care providers in the concept of physical literacy. Physical literacy was connected to the following health indicators: BMI and body weight, waist circumference, cardiorespiratory fitness, physical activity, and sedentary behaviour. The primary demographic focus of included studies was children and there was a conceptual focus on the physical domain of physical literacy. Conclusions Despite growing popularity, the empirical evidence base linking physical literacy and health outcomes is limited and the relationship remains theoretical. Physical literacy may present a novel and holistic framework for health-enhancing physical activity interventions that consider factors vital to sustained participation in physical activity across the life course. Future work should continue to explore the nature and direction of the relationship between physical activity and physical literacy to identify appropriate focused approaches for health promotion.

scholarly journals They Say, “If You Don’t Relax…You’re Going to Make Something Bad Happen”: Women’s Emotion Management During Medically High-Risk Pregnancy

2019 ◽  
Vol 44 (1) ◽  
pp. 117-129 ◽  
Author(s):  
Judith L. M. McCoyd ◽  
Laura Curran ◽  
Shari Munch
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Providers ◽  
Emotional Labor ◽  
Emotional Reactions ◽  
Emotion Management ◽  
High Risk Pregnancy ◽  
Care Providers ◽  
Risk Pregnancy ◽  
And Coping

Little is known about how women with medically high-risk pregnancy manage their emotions while worried about their pregnancies. This study aimed to phenomenologically explore 16 hospitalized women’s emotional reactions and coping during medically high-risk pregnancy with a focus on how emotion management techniques were utilized and what rationales women used for employing them, along with their interpretations of health care providers’ and family members’ advice regarding emotional expression. Respondents universally feared that experienced stress and the resulting distress (negative emotions such as anxiety, sadness, and anger) could harm their fetus. They experienced double binds including believing they must “be positive” to enhance fetal health, despite anxiety and sadness; feeling responsible for housework yet being told not to do it; and needing medical treatments they feared would harm their fetus. In attempting to avoid tears and fears, they expended tremendous energy, leaving themselves depleted and less able to cope. Ubiquitous “think positive” messages amplify women’s sense of failure when distress due to the medically high-risk pregnancy spills over. With little attention to women’s emotional experiences, even to the point of complimenting them as “good incubators,” health care providers may unintentionally shift emotional labor onto vulnerable women. Understanding women’s needs for assistance with emotion management during medically high-risk pregnancy provides important guidance for development of best practices for this population.

scholarly journals The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review

2017 ◽  
Vol 65 (11) ◽  
pp. 517-526 ◽  
Author(s):  
Kevin Bree ◽  
Spencer Barnhill ◽  
William Rundell
Keyword(s):  
Operating Room ◽  
Health Care Providers ◽  
Responsibility To Protect ◽  
Care Providers ◽  
Operating Room Personnel ◽  
Surgical Smoke ◽  
The United Kingdom ◽  
Smoke Evacuation ◽  
Harmful Effects

A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.

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