scholarly journals Orthopedic Department of Education Center and Service Provide During Coronavirus Disease-2019 Pandemic: An Experience from Single-Center Hospital

2021 ◽  
Vol 9 (B) ◽  
pp. 250-254
Author(s):  
Bagus Jati Nugroho ◽  
Bintang Soetjahjo ◽  
Udi Heru Nefihancoro ◽  
Rieva Ermawan ◽  
Rhyan Darma Saputra ◽  
...  
Keyword(s):  
Health Care Systems ◽  
Provincial Government ◽  
P Value ◽  
Emergency Rooms ◽  
Central Java ◽  
Digital Era ◽  
Orthopedic Department ◽  
Global Pandemic ◽  
Referral Hospitals ◽  
Care Systems

BACKGROUND: In the global pandemic of the 2019 coronavirus disease (COVID-19), many countries have reported a decrease in visits to hospitals, and health-care systems around the world are reshaping health protocols. Health service and education in orthopedics are also affected although not at the frontline in dealing COVID-19. METHODS: The data from this study collected from several official databases, including the Indonesian Ministry of Health, Central Java provincial government, general hospital, and orthopedic surgery cases. RESULTS: Pandemic COVID-19 started in March 2020 in Indonesia. Surakarta has become one of the epicenters. Health services in the orthopedic department also experienced a decrease cases on all divisions (outpatient clinics, emergency rooms, and inpatients). Mann–Whitney non-parametric comparative test showed significance result in p value operation of orthopedic cases and inpatients (p = 0.016 and p = 0.016; p < 0.05), meanwhile, outpatient visits did not show significance result with p = 0.0509 (p > 0.05). The decrease in the number of cases being treated in the orthopedic service also has an impact on education and training programs. The digital era is one of the choices in the field of education. However, digital resources cannot substitute for direct patient exposure. CONCLUSION: The average number of orthopedic patients during the pandemic period from January to December 2020 decreased compared to visits in the same period in 2019 so that orthopedic services at tertiary and academic referral hospitals experienced a significant decrease in cases. The education and services department must adapt to the policy on educational activities for residents and medical students. The education department and hospital institutions restructured and reorganized resident doctors to continue providing services. The digital era is an option that supports the education process during a pandemic.

scholarly journals Comprehensive Review of Cardiovascular Involvement in COVID-19

2021 ◽  
pp. e1-e19
Author(s):  
Ruff Joseph Macale Cajanding
Keyword(s):  
Cardiac Involvement ◽  
Health Care Systems ◽  
The Body ◽  
Cardiac Pathology ◽  
Current State ◽  
Global Pandemic ◽  
Cardiovascular Involvement ◽  
Disease Causation ◽  
Care Systems ◽  
Clinically Significant

COVID-19 has emerged as one of the most devastating and clinically significant infectious diseases of the last decade. It has reached global pandemic status at an unprecedented pace and has placed significant demands on health care systems worldwide. Although COVID-19 primarily affects the lungs, epidemiologic reports have shown that the disease affects other vital organs of the body, including the heart, vasculature, kidneys, brain, and the hematopoietic system. Of importance is the emerging awareness of the effects of COVID-19 on the cardiovascular system. The current state of knowledge regarding cardiac involvement in COVID-19 is presented in this article, with particular focus on the cardiovascular manifestations and complications of COVID-19 infection. The mechanistic insights of disease causation and the relevant pathophysiology involved in COVID-19 as they affect the heart are explored and described. Relevant practice essentials and clinical management implications for patients with COVID-19 with a cardiac pathology are presented in light of recent evidence.

The Untold Story: How the Health Care Systems in Developing Countries Contribute to Maternal Mortality

1992 ◽  
Vol 22 (3) ◽  
pp. 513-528 ◽  
Author(s):  
T. K. Sundari
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Care Systems ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Life Saving ◽  
Referral Hospitals ◽  
Care Systems

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.

scholarly journals About Psychological Adaptation of Medical Universities Students to the Process of Distance Learning During the Pandemic of the New Coronavirus Infection

2021 ◽  
pp. 133-144
Author(s):  
Dmitrii Valerievich Sudakov ◽  
Oleg Valerievich Sudakov ◽  
Natalia Vladimirovna Iakusheva ◽  
Artiom Nikolaevich Shevtsov ◽  
Evgenii Vladimirovich Belov
Keyword(s):  
Distance Learning ◽  
Learning Process ◽  
Psychological Health ◽  
Health Care Systems ◽  
Psychological Adaptation ◽  
Educational Process ◽  
Global Pandemic ◽  
Care Systems ◽  
Coronavirus Infection ◽  
Almost All

This work is devoted to some aspects of the psychological adaptation of students of a medical university to the distance learning process during a pandemic of a new coronavirus infection. The presented research is relevant for several reasons, the leading of which are: the ongoing reform of the education and health care systems in our country – both of which affect students of medical universities and various aspects of their educational activities, including their psychological adaptation to it; as well as the global pandemic of the new coronavirus infection COVID-19 that emerged in 2020, as a result of which, almost all scientists at various levels around the world were forced to switch to distance learning. The purpose of this work was to identify and analyze some elements of psychological adaptation of students directly to the distance learning process. The objects of the study were 200 men and women, students of the medical faculty. A certain interest in the study is also due to the fact that the same students were involved in it for 2 semesters (spring and autumn) of 2020. In order to track the development of their possible adaptation mechanisms to distance learning, the level of anxiety, both personal and situational, was determined; identified various depressive states; determined the reasons for the main fears and concerns, both directly to the period of an unfavorable epidemiological situation, and to the distance learning process itself. The main points of psychological adaptation were identified, with the identification of factors contributing to them. This work is of certain interest for all higher school teachers involved in the educational process with students, as well as for psychologists and all kinds of researchers dealing with the psychological health of students.

scholarly journals Knowledge and Attitude of Primary Care Physicians towards Palliative Care. Is it time for integration?

2021 ◽  
Author(s):  
Ameena Mohammed Al-Ansari ◽  
Wafaa Mostafa Abd-El-Gawad ◽  
Saleem Nawaf Suroor ◽  
Sobhi Mostafa AboSerea
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Health Care Systems ◽  
Knowledge Score ◽  
P Value ◽  
Care Services ◽  
Palliative Care Services ◽  
Care Systems ◽  
Knowledge And Attitude

Abstract Background Although the primary care physicians’ role in delivering the majority of care with high-quality service for patients under palliative care is unquestionable, it is not clear what their current level of knowledge and attitude toward palliative care is. Aim To recognize the primary care physicians’ knowledge and attitude toward palliative care in Kuwait. Design and Setting: National survey using stratified random sampling was performed. A total of 25 primary care clinics in Kuwait were selected and 284 primary care physicians were recruited. Method: Palliative Care Attitude and Knowledge questionnaire (PCAK) were distributed to them. Their attitude and knowledge were measured. predictors of better attitude were assessed. Results The response rate was 79.2%(n = 225). 53.3%(n = 120) of primary care physicians had an uncertain attitude towards palliative care while only 15(6.7%) had good knowledge. Only 5.7% and 25.5% reported excellent or very good experience in the management of pain and other symptoms respectively. Moreover, 141(62.7%) and 119(52.9%) were not familiar with palliative care services in their community or length and types of coverage under palliative care benefits. Less than 50% responded correctly to the questions regarding the proper management of catastrophic bleeding, opioid initiation, types, toxicity and its role in refractory dyspnea. Higher knowledge score was a positive predictor for more positive attitude scores (OR:1.088, 95% CI: 1.012–1.170,P value: 0.023). Conclusion The majority of primary care physicians had uncertain attitude and poor knowledge towards palliative care. Integrating palliative care into primary health care systems is urgently needed to alleviate the suffering of those patients.

scholarly journals Safely Administering Potential QTc Prolonging Therapy Across a Large Health Care System in the COVID-19 Era

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Moussa Saleh ◽  
James Gabriels ◽  
David Chang ◽  
Joanna Fishbein ◽  
Michael Qiu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Health Care Systems ◽  
Torsade De Pointes ◽  
Qt Prolongation ◽  
Hospitalized Patients ◽  
Simplified Approach ◽  
Global Pandemic ◽  
Care Systems

Background: The severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2) has resulted in a global pandemic. Hydroxychloroquine±azithromycin have been widely used to treat coronavirus disease 2019 (COVID-19) despite a paucity of evidence regarding efficacy. The incidence of torsade de pointes remains unknown. Widespread use of these medications forced overwhelmed health care systems to search for ways to effectively monitor these patients while simultaneously trying to minimize health care provider exposure and use of personal protective equipment. Methods: Patients with COVID-19 positive who received hydroxychloroquine±azithromycin across 13 hospitals between March 1 and April 15 were included in this study. A comprehensive search of the electronic medical records was performed using a proprietary python script to identify any mention of QT prolongation, ventricular tachy-arrhythmias and cardiac arrest. Results: The primary outcome of torsade de pointes was observed in 1 (0.015%) out of 6476 hospitalized patients with COVID-19 receiving hydroxychloroquine±azithromycin. Sixty-seven (1.03%) had hydroxychloroquine±azithromycin held or discontinued due to an average QT prolongation of 60.5±40.5 ms from a baseline QTc of 473.7±35.9 ms to a peak QTc of 532.6±31.6 ms. Of these patients, hydroxychloroquine±azithromycin were discontinued in 58 patients (86.6%), while one or more doses of therapy were held in the remaining nine (13.4%). A simplified approach to monitoring for QT prolongation and arrythmia was implemented on April 5. There were no deaths related to the medications with the simplified monitoring approach and health care provider exposure was reduced. Conclusions: The risk of torsade de pointes is low in hospitalized patients with COVID-19 receiving hydroxychloroquine±azithromycin therapy.

scholarly journals Waiting Times for Outpatient Treatment in Germany: New Experimental Evidence from Primary Data

2018 ◽  
Vol 238 (5) ◽  
pp. 375-394 ◽  
Author(s):  
Nils Heinrich ◽  
Ansgar Wübker ◽  
Christiane Wuckel
Keyword(s):  
Health Insurance ◽  
Outpatient Treatment ◽  
Health Care Systems ◽  
Waiting Times ◽  
Time Frame ◽  
Public Health Care ◽  
Primary Data ◽  
P Value ◽  
Before And After ◽  
Care Systems

Abstract Long waiting times are a common feature and a major concern in many public health care systems. They are often characterized as inefficient because they are a burden to patients without generating any gains for providers. There is an ongoing debate in Germany regarding the preferential treatment given to private health insurance (PHI) holders while statutory health insurance (SHI) holders face continuously increasing waiting times. In order to tackle this problem in the outpatient sector, Germany initiated a reform in 2015 which was aimed at providing SHI holders with appointments within an acceptable time frame. We exploit longitudinal experimental data to examine waiting times for six elective outpatient treatments in Germany for PHI and SHI holders before and after the reform. We find a considerable difference in waiting times favoring private patients. For SHI holders, waiting times remained stable over time (27.5 days in 2014, 30.7 days in 2016, Δ 3.2 days, p-value=0.889) while PHI holders experienced a significant improvement (13.5 days in 2014; 7.8 days in 2016; Δ 5.7 days, p-value=0.002). The results indicate that even after the reform there is still an unequal access to elective outpatient treatment depending on the patient’s insurance status.

scholarly journals Computational Analysis of Targeting SARS-CoV-2, Viral Entry Proteins ACE2 and TMPRSS2, and Interferon Genes by Host MicroRNAs

Genes ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 1354
Author(s):  
Jacob B. Pierce ◽  
Viorel Simion ◽  
Basak Icli ◽  
Daniel Pérez-Cremades ◽  
Henry S. Cheng ◽  
...  
Keyword(s):  
Viral Entry ◽  
Health Care Systems ◽  
Economic Recession ◽  
Local Health ◽  
Mirna Profiling ◽  
Global Pandemic ◽  
Local Health Care ◽  
Care Systems ◽  
Infected Cells ◽  
The Impact

Rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has led to a global pandemic, failures of local health care systems, and global economic recession. MicroRNAs (miRNAs) have recently emerged as important regulators of viral pathogenesis, particularly among RNA viruses, but the impact of host miRNAs on SARS-CoV-2 infectivity remains unknown. In this study, we utilize the combination of powerful bioinformatic prediction algorithms and miRNA profiling to predict endogenous host miRNAs that may play important roles in regulating SARS-CoV-2 infectivity. We provide a collection of high-probability miRNA binding sites within the SARS-CoV-2 genome as well as within mRNA transcripts of critical viral entry proteins ACE2 and TMPRSS2 and their upstream modulators, the interferons (IFN). By utilizing miRNA profiling datasets of SARS-CoV-2-resistant and -susceptible cell lines, we verify the biological plausibility of the predicted miRNA–target RNA interactions. Finally, we utilize miRNA profiling of SARS-CoV-2-infected cells to identify predicted miRNAs that are differentially regulated in infected cells. In particular, we identify predicted miRNA binders to SARS-CoV-2 ORFs (miR-23a (1ab), miR-29a, -29c (1ab, N), miR-151a, -151b (S), miR-4707-3p (S), miR-298 (5′-UTR), miR-7851-3p (5′-UTR), miR-8075 (5′-UTR)), ACE2 3′-UTR (miR-9-5p, miR-218-5p), TMPRSS2 3′-UTR (let-7d-5p, -7e-5p, miR-494-3p, miR-382-3p, miR-181c-5p), and IFN-α 3′-UTR (miR-361-5p, miR-410-3p). Overall, this study provides insight into potential novel regulatory mechanisms of SARS-CoV-2 by host miRNAs and lays the foundation for future investigation of these miRNAs as potential therapeutic targets or biomarkers.

scholarly journals COVID-19-Associated Coagulopathy: An Exacerbated Immunothrombosis Response

2020 ◽  
Vol 26 ◽  
pp. 107602962094329 ◽  
Author(s):  
Apoorva Jayarangaiah ◽  
Pramod Theetha Kariyanna ◽  
Xiaoyi Chen ◽  
Amog Jayarangaiah ◽  
Abhishek Kumar
Keyword(s):  
Immune System ◽  
Health Care Systems ◽  
Therapeutic Strategies ◽  
Innate Immune ◽  
The Novel ◽  
Cytokine Release ◽  
Global Pandemic ◽  
Care Systems ◽  
Underlying Mechanisms ◽  
D Dimer

Since the onset of the global pandemic in early 2020, coronavirus disease 2019 (COVID-19) has posed a multitude of challenges to health care systems worldwide. In order to combat these challenges and devise appropriate therapeutic strategies, it becomes of paramount importance to elucidate the pathophysiology of this illness. Coronavirus disease 2019, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), is characterized by a dysregulated immune system and hypercoagulability. COVID-associated coagulopathy (CAC) was recognized based on profound d-dimer elevations and evidence of microthrombi and macrothrombi, both in venous and arterial systems. The underlying mechanisms associated with CAC have been suggested, but not clearly defined. The model of immunothrombosis illustrates the elaborate crosstalk between the innate immune system and coagulation. The rendering of a procoagulant state in COVID-19 involves the interplay of many innate immune pathways. The SARS-CoV2 virus can directly infect immune and endothelial cells, leading to endothelial injury and dysregulation of the immune system. Activated leukocytes potentiate a procoagulant state via release of intravascular tissue factor, platelet activation, NETosis, and inhibition of anticoagulant mechanisms. Additional pathways of specific relevance in CAC include cytokine release and complement activation. All these mechanisms have recently been reported in COVID-19. Immunothrombosis provides a comprehensive perspective of the several synergistic pathways pertinent to the pathogenesis of CAC.

Kebijakan Ekonomi Di Masa Pandemi Covid-19

2021 ◽  
Vol 1 (2) ◽  
pp. 134-145
Author(s):  
Nur Afni
Keyword(s):  
Health Workers ◽  
Health Care Systems ◽  
Public Awareness ◽  
World Health ◽  
Medium Term ◽  
Global Pandemic ◽  
Care Systems ◽  
The Government ◽  
Health Organization ◽  
Taking Action

COVID-19 discovered a global pandemic that gave rise to the emergence of various groups, especially the public. Inaugurated by the World Health Organization as a global pandemic, the management of COVID-19 is a challenge for countries with limited energy sources and health care systems. Citizens' understanding continues to grow along with the number of positive problems and deaths due to COVID-19 which continues to grow in a relatively short time. The ability of each country to adapt to the existing conditions during efficient and anticipatory implementation varies greatly. The policy finds an early ground that must be tested in order to be able to tackle these cases successfully. Anticipatory policy decisions related to efforts to prevent the spread of COVID-19, take action against infected patients, protect health workers, and control public awareness are carefully considered. For this reason, the Government is trying to schedule a New Normal policy so that the economic impact of the pandemic does not create a sustainable crisis. This policy is linked to planning where the Government has established programs, as well as major projects in the 2020-2024 National Medium-Term Development Plan (RPJMN). The government needs to review the medium-term plan considering that in 2020 all programs that are trying to focus on taking action against Covid-19. The government has 3 alternatives in the medium term, whether it is always quality, making moderate improvements, or changing it with a new plan with assumptions made from the Covid-19 pandemic and the consequences that accompany it.

scholarly journals Drug Shortage and Critical Medication Inventory Management at a Children's Hospital During the COVID-19 Pandemic

2021 ◽  
Vol 26 (1) ◽  
pp. 21-25
Author(s):  
Jeffrey D. Moss ◽  
Hayden T. Schwenk ◽  
Michael Chen ◽  
Shabnam Gaskari
Keyword(s):  
Inventory Management ◽  
Health Care Systems ◽  
Hospital Data ◽  
Drug Shortage ◽  
Children's Hospital ◽  
Drug List ◽  
Global Pandemic ◽  
Children’S Hospital ◽  
Care Systems ◽  
Input Variables

Drug shortages have significantly affected the ability to provide care at pediatric institutions, particularly in the inpatient and critical care settings. The coronavirus disease 2019 (COVID-19) pandemic highlighted additional challenges with drug supply chains. A working group consisting of pharmacy management, clinical pharmacists, and pharmacy buyers met regularly at the beginning of the COVID-19 pandemic. In collaboration with medical staff leadership and the Pharmacy and Therapeutics Committee, we developed a pediatric critical drug list to track essential medications for targeted monitoring. We created an inventory model with easily modifiable input variables related to patient and hospital data. This model was aligned across affiliate health care systems to increase transparency of our hospital's surge capacity for managing patients with COVID-19. Here, we share our framework for modeling drug inventory management at a freestanding children's hospital during a global pandemic.

Sign in / Sign up

Export Citation Format

Share Document