scholarly journals Waiting for Godot: A cross sectional survey based analysis of the hydroxychloroquine prophylaxis strategy against COVID-19 in India

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Merlin Moni ◽  
Thushara Madathil ◽  
Rahul Palabatla ◽  
Sabarish Balachandran ◽  
Fabia Edathadathil ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Research Policy ◽  
Tertiary Care ◽  
National Level ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Online Social Media ◽  
The Impact ◽  
Prophylaxis Strategy

Background: India currently has the second largest burden of infections due to COVID-19. Health Care Worker (HCW) shortages are endemic to Indian healthcare. It should therefore be a huge priority to protect this precious resource as a critical component of the systemic response to this pandemic. Advisories from the Indian Council of Medical Research (ICMR) have focused on using hydroxychloroquine prophylaxis against COVID-19 in at risk HCW. This prophylaxis strategy has no evidence. In further jeopardy there appear to insubstantial attempts to build this evidence as well. In this connection, we commissioned a survey within our Institution to estimate the penetration of hydroxychloroquine (HCQ) use and use this to statistically model the impact of current ongoing studies in India. We also briefly review the literature on HCQ prophylaxis for COVID-19. Design and methods: A structured survey designed using RedCAP application was disseminated among healthcare professionals employed at an academic referral tertiary care centre via online social media platforms. The survey was kept open for the entire month of June 2020. The survey was additionally used to statistically model the size of studies required to comprehensively address the efficacy of HCQ in this setting.Results: 522 responses were received, of which 4 were incomplete. The ICMR strategy of 4 or more doses of HCQ was complete only in 15% of HCW in our survey. The majority of respondents were doctors (238, 46%). Amongst all category of responders, only 12% (n=63) received the full course. A majority of those who initiated the chemoprophylaxis with HCQ turned out to be medical professionals (59/63) with neither nurse nor other categories of healthcare workers accessing the medication. The respondents of our institutional survey did not report any life-threatening side effects. Presuming efficacy as per ICMR modelling for new registry trial on the lines of the published case control study, equal allocation between cases and controls and assuming a RR of 1.3.6, the power of such a study would be very low for n=2000 for event rates from 2.5-12.5%. Conclusion: We report the low penetration of HCQ chemoprophylaxis among the healthcare workers of our institution.  We highlight the inherent drawbacks in the study design of current national COVID related trial based on the statistical modelling of our survey results and published literature, and thereby emphasis the need of evidence-based strategies contributing to research policy at national level.

scholarly journals Assessment of breakthrough infections among post-vaccinated healthcare workers in a Tertiary Dental Hospital in New Delhi, India

2021 ◽  
Author(s):  
Deepmala Maurya ◽  
Arundeep Kaur ◽  
Farrukh Faraz ◽  
Shruti Tandon ◽  
Anju Rana ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
National Level ◽  
New Delhi ◽  
Common Symptom ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Dental Hospital ◽  
The Impact ◽  
Body Ache

Background: COVID-19 vaccination in India has been rolled out on a national level, with healthcare workers (HCWs) becoming the first recipient of both Covishield and Covaxin. However, concerns over efficacy of vaccines have been much debated. This study highlights COVID-19 infections among vaccinated HCWs in a teaching dental hospital in Delhi, India. Methodology: This cross-sectional survey was conducted using a pretested, validated, self-instituted questionnaire assessing COVID-19 like symptoms and/or confirmed infections among partially or fully vaccinated HCWs (all faculty, staff and students) of the institute from 16th January to 31st July 2021. The number of infections was also matched with hospital records. Results: Out of 397 HCWs, 386 (97.2%) were vaccinated and 355 (89.4%) had received both doses. COVID-19 like symptoms appeared in 21 HCWs (5.4%) post any dose of vaccine. Symptomatic breakthrough infections >14 days after second dose occurred was seen in 16 HCWs (4.5%). Except one (required hospitalization), all other cases had mild infection. No significant difference was observed between Covishield and Covaxin. Most common symptom was fever and body ache. Conclusion: The study identifies the possibility of breakthrough infections among vaccinated HCWs, and ensures the impact of vaccination in limiting disease severity. The findings suggest that COVID-19 preventive measures should be continued even among vaccinated individuals.

scholarly journals Awareness Regarding Implant Supported Dental Prosthesis; A Survey In Tertiary Care Set Up

2018 ◽  
Vol 08 (04) ◽  
pp. 250-253
Author(s):  
Anum Baqar ◽  
Saman Hakeem ◽  
Farnaz Ilyas ◽  
Abid Mohsin ◽  
Fatima Hassan ◽  
...  
Keyword(s):  
Dental Implant ◽  
Tertiary Care ◽  
Limiting Factor ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Dental Hospital ◽  
Set Up ◽  
Systemic Health ◽  
Implant Treatment

Objective: This research was aimed to assess the awareness and attitude regarding implant-retained prosthesis as the most advanced option for tooth replacement amongst residents of Karachi visiting tertiary care centre. Methodology: This cross-sectional survey was conducted in the department of Prosthodontics at Bahria University Dental Hospital, Karachi. Undertaking the demographic characteristics of patients, the objective was to determine the awareness and attitude toward implant supported prosthesis. Results: Amongst 380 responses retrieved, 9.8% of respondents were aware about the dental implant treatment. While correlating awareness with demographics features, awareness statistically increased with educational level (p= 0.00) and occupational category(p=0.01) of the participants. The friends and relative s(40.5%) were the main source of information regarding dental implant treatment modality. 54.1% were unwilling to undergo treatment with dental implant whereas high cost (55.2%)was the major limiting factor for implant treatment. 64.9% demanded dental insurance for getting the treatment. 45.9% had no knowledge regarding maintenance of implant supported prosthesis .73.0% had no idea regarding longevity of dental implant where as 86.5% were unaware of it’s impact on systemic health. Conclusion: The overall awareness regarding implant supported prosthesis was found to be minimal. This underlines the need of efforts and measures that should be made to raise the awareness and thus alter attitude towards dental implant therapy. Expensive rates (55.2%) was found to be the major limiting factor that should be relieved in the form of health insurance policies, especially in the developing countries like ours.

scholarly journals Towards more patient-centred endometriosis care: a cross-sectional survey using the ENDOCARE questionnaire

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
A M F Schreurs ◽  
M van Hoefen Wijsard ◽  
E A F Dancet ◽  
S Apers ◽  
W K H Kuchenbecker ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Diagnostic Delay ◽  
Care Centre ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Tertiary Centre ◽  
Validated Questionnaire ◽  
Physical Comfort ◽  
Patient Centredness

Abstract STUDY QUESTION What is the performance of the patient-centredness of endometriosis care in a secondary and a tertiary care setting and how can it be improved? SUMMARY ANSWER Overall, patient-centredness was comparable in the two endometriosis care centres, but differed regarding ‘physical comfort’ and ‘continuity and transition’; both centres can learn how to improve several of their targets from the other’s strengths. WHAT IS KNOWN ALREADY The ENDOCARE questionnaire (ECQ) is a validated questionnaire for assessing the important quality dimension ‘patient-centredness’. Patient-centredness is associated with quality of life, although this should be explored further by larger-scale studies. STUDY DESIGN, SIZE, DURATION A cross-sectional survey, relying on the ECQ, was performed (during 2015 and 2016) among 407 women with surgically diagnosed endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS This study was conducted in a secondary and a tertiary care centre in the Netherlands. A total of 209 Dutch-speaking women who had endometriosis surgery (2013–2014), completed the ECQ after a postal invitation and, if needed, postal reminders. The assessed outcomes were: overall patient-centredness, the patient-centredness for each of its 10 dimensions, and the patient-centred strengths and targets for improvement. Case-mix adjusted patient-centredness scores (PCS) were compared and strengths and targets for improvement were identified with a matrix modelling importance against experience. The need to improve the targets was quantified with quality impact indices. MAIN RESULTS AND THE ROLE OF CHANCE No difference was demonstrated between the overall PCS of the secondary and tertiary centres (respectively: 4.8 and 4.5; P = 0.15). No difference was found in PCS per dimension between the two clinics except for the secondary care centre performing better regarding ‘physical comfort’ (respectively: 4.5 and 3.0; P = 0.01) and ‘continuity and transition’ (respectively: 6.0 and 4.2; P = 0.01). The two centres had nine targets for improvement in common. The secondary and tertiary centres, respectively, had five and seven additional centre-specific targets for improvement. Cross-centre learning is encouraged as 9 out the 12 additional centre-specific targets were strengths in the other centre. The main improvement targets were being able to contact the centre in case of emergency (both centres), the involvement of a significant other (secondary centre), diagnostic delay (secondary centre), personal follow-up (tertiary centre) and disclosing the level of competence of healthcare providers (tertiary centre). LIMITATIONS, REASON FOR CAUTION Responders did not differ from non-responders in their stage of endometriosis, educational level, rating of endometriosis care and degree to which their complaints are suppressed. Endometriosis is a chronic condition and patient-centredness might be experienced differently at other points of the endometriosis care trajectory. WIDER IMPLICATION OF THE FINDINGS The ECQ is a useful tool to assess patient-centredness in both secondary and tertiary care centres. Further research should focus on how to improve endometriosis care. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used. V.M. and C.B.L. report grants from Guerbet, grants from Merck and grants from Ferring outside the submitted work. All authors declare that they have no competing interests concerning this publication.

scholarly journals Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034029
Author(s):  
Rachel Umoren ◽  
Veronica Chinyere Ezeaka ◽  
Ireti B Fajolu ◽  
Beatrice N Ezenwa ◽  
Patricia Akintan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Professional Training ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Secondary Outcome ◽  
Skills Acquisition ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Simulation Based

ObjectivesThe objective of this study was to explore the access to, and perceived utility of, various simulation modalities by in-service healthcare providers in a resource-scarce setting.SettingPaediatric training workshops at a national paediatric conference in Nigeria.ParticipantsAll 200 healthcare workers who attended the workshop sessions were eligible to participate. A total of 161 surveys were completed (response rate 81%).Primary and secondary outcome measuresA paper-based 25-item cross-sectional survey on simulation-based training (SBT) was administered to a convenience sample of healthcare workers from secondary and tertiary healthcare facilities.ResultsRespondents were mostly 31–40 years of age (79, 49%) and women (127, 79%). Consultant physicians (26, 16%) and nurses (56, 35%) were in both general (98, 61%) and subspecialty (56, 35%) practice. Most had 5–10 years of experience (62, 37%) in a tertiary care setting (72, 43%). Exposure to SBT varied by profession with physicians more likely to be exposed to manikin-based (29, 30% physicians vs 12, 19% nurses, p<0.001) or online training (7, 7% physician vs 3, 5% nurses, p<0.05). Despite perceived barriers to SBT, respondents thought that SBT should be expanded for continuing education (84, 88% physician vs 39, 63% nurses, p<0.001), teaching (73, 76% physicians vs 16, 26% nurses, p<0.001) and research (65, 68% physicians vs 14, 23% nurses, p<0.001). If facilities were available, nearly all respondents (92, 98% physicians; 52, 96% nurses) would recommend the use of online simulation for their centre.ConclusionsThe access of healthcare workers to SBT is limited in resource-scarce settings. While acknowledging the challenges, respondents identified many areas in which SBT may be useful, including skills acquisition, skills practice and communication training. Healthcare workers were open to the use of online SBT and expressed the need to expand SBT beyond the current scope for health professional training in Nigeria.

scholarly journals PRACTICES FOLLOWED DURING HOME QUARANTINE/ ISOLATION FOR COVID-19 PANDEMIC AMONG URBAN POPULATION OF ROHTAK, HARYANA

2020 ◽  
pp. 1-3
Author(s):  
B. M. Vashisht ◽  
Dhriti Bapna ◽  
Srishti Singh ◽  
Arup Saha ◽  
Manjeet Rathee ◽  
...  
Keyword(s):  
Urban Population ◽  
Tertiary Care ◽  
Structured Interview ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Microsoft Excel ◽  
Interview Schedule ◽  
Cross Sectional ◽  
Change Communication ◽  
Field Practice

Isolation is recommended for corona positive patients and their contacts are advised home quarantine. This study was planned to assess the practices followed during home quarantine/ isolation for COVID-19 pandemic among urban population in Rohtak, Haryana. A cross-sectional survey was conducted among 101 persons on home isolation or quarantine in urban field practice areas attached to the Department of Community Medicine of a tertiary care centre of Rohtak. A semi-structured interview schedule was used to obtain information from the participants through house to house visit. Data were analysed using Microsoft Excel version 2010 and Statistical Package for Social Sciences ver.24. 79.2% subjects on home quarantine/ isolation restricted their movement inside house. Face cover was used by 98% and correct hand washing technique was practised by 70.3% participants. Behaviour change communication activities need to be further strengthened to improve practices followed during home quarantine/ isolation.

Pediatric emergency department utilisation during Ramadan: a retrospective cross-sectional study

2020 ◽  
pp. archdischild-2020-319173
Author(s):  
Rasha D Sawaya ◽  
Cynthia Wakil ◽  
Sami Shayya ◽  
Moustafa Al Hariri ◽  
Alik Dakessian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Pediatric Emergency ◽  
Cross Sectional Study ◽  
Peak Time ◽  
Work Efficiency ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
The Impact

ObjectiveTo investigate the impact of Ramadan on patient characteristics, diagnoses and metrics in the paediatric emergency department (PED).DesignRetrospective cross-sectional study.SettingPED of a tertiary care centre in Lebanon.PatientsAll paediatric patients.ExposureRamadan (June 2016 and 2017) versus the months before and after Ramadan (non-Ramadan).Main outcome measuresPatient and illness characteristics and PED metrics including peak patient load; presentation timings; length of stay; and times to order tests, receive samples and report results.ResultsWe included 5711 patients with mean age of 6.1±5.3 years and 55.4% males. The number of daily visits was 28.3±6.5 during Ramadan versus 31.5±7.3 during non-Ramadan (p=0.004). The peak time of visits ranged from 18:00 to 22:00 during non-Ramadan versus from 22:00 to 02:00 during Ramadan. During Ramadan, there were significantly more gastrointestinal (GI) and trauma-related complaints (39.0% vs 35.4%, p=0.01 and 2.9% vs 1.8%, p=0.005). The Ramadan group had faster work efficiency measures such as times to order tests (21.1±21.3 vs 24.3±28.1 min, p<0.0001) and to collect samples (50.7±44.5 vs 54.8±42.6 min, p=0.03).ConclusionsRamadan changes presentation patterns, with fewer daily visits and a later peak time of visits. Ramadan also affects illness presentation patterns with more GI and trauma cases. Fasting times during Ramadan did not affect staff work efficiency. These findings could help EDs structure their staffing to optimise resource allocation during Ramadan.

scholarly journals The magnitude and determinants of violence against healthcare workers in Pakistan

2020 ◽  
Vol 5 (4) ◽  
pp. e002112 ◽  
Author(s):  
Shiraz Shaikh ◽  
Lubna Ansari Baig ◽  
Ibrahim Hashmi ◽  
Mirwais Khan ◽  
Seemin Jamali ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Health Workers ◽  
Physical Violence ◽  
Tertiary Care ◽  
Emergency Vehicle ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Levels Of Care ◽  
Different Types ◽  
Verbal Violence

ObjectivesTo determine the magnitude and determinants of violence against healthcare workers (HCWs) and to identify the predominant types and causes of violence experienced by them.MethodologyA cross-sectional survey based on structured questionnaire adopted from previous surveys and qualitative data was conducted in 4 large cities and 12 districts in 3 provinces of Pakistan. The survey covered 8579 from all cadres of HCWs, including doctors, nurses, technicians, support staff, ambulance workers, vaccinators, lady health visitors, midwives and lady health workers (LHWs). The predictors of overall violence experienced, physical violence experienced and verbal violence experienced were separately analysed for tertiary care hospitals, secondary care hospitals, primary care hospitals and field-level HCWs. Logistic regression was used to compute adjusted ORs with 95% CIs for the association of different factors with the violence experienced.ResultsMore than one-third (38.4%) reported having experienced any form of violence in the last 6 months. Verbal violence was the most commonly experienced form (33.9%), followed by physical violence (6.6%). The main reasons for physical violence were death of patients (17.6%), serious condition of patients (16.6%) and delay in care (13.4%). Among the different types of field HCWs, emergency vehicle operators were significantly more likely to experience verbal violence compared with LHWs (adjusted OR=1.97; 95% CI 1.31 to 2.94; p=0.001). Among hospital HCWs, those working in private hospitals were significantly less likely to experience physical violence (adjusted OR=0.52; 95% CI 0.38 to 0.71; p=0.001) and verbal violence (adjusted OR=0.57; 95% CI 0.48 to 0.68; p=0.001).ConclusionViolence against HCWs exists in various forms among all cadres and at different levels of care. The gaps in capacity, resources and policies are evident. Specific strategies need to be adopted for different types of HCWs to protect them against violence.*The study was conducted under the framework of ICRC’s Healthcare in Danger Initiative for protection of healthcare against Violence

scholarly journals Depression, Anxiety and Stress among Nurses Working in a Tertiary Care Centre in Southern India

2020 ◽  
pp. 147-152
Author(s):  
D. Mohan Kishore ◽  
N. K. Manjunath ◽  
Kashinath Metri ◽  
Natesh Babu ◽  
Basavaraj Angadi
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Tertiary Care ◽  
Health Problems ◽  
Mental Health Issue ◽  
Care Centre ◽  
Cross Sectional Survey ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Nursing Professionals

Purpose: Nursing professionals have to meet huge expectations on one side and cope with the demanding situations on the other side. The purpose of the present study was to evaluate the prevalence of depression, anxiety, and stress among nurses working at a tertiary care centre in South India. Design: Cross-sectional survey design. Methods: 387 female nursing professionals aged 20-50 years, working at a tertiary care centre for a minimum of two years, voluntarily participated in the study. Individuals with a history of psychiatric illness, major health problems, or those on sleep medication were excluded. Anxiety, depression, and stress levels were assessed by administering the DASS 21 questionnaire. Descriptive statistics and percentages were calculated using Microsoft Excel. Findings: The results showed prevalence of: Anxiety (63.3%); depression (56.05%); and stress (36.17%) in those who participated in the survey. Anxiety was highest, followed by depression, and lastly, stress. Conclusions: Work-related anxiety is the commonest mental health issue reported by professional nurses, followed by depression and stress. Yoga-based intervention would be efficacious if implemented within hospitals both to prevent and manage mental health problems associated with the nursing profession.

scholarly journals Healthcare workers’ perspectives on coronavirus testing availability: a cross sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Byhoff ◽  
Jessica K. Paulus ◽  
Rubeen Guardado ◽  
Julia Zubiago ◽  
Alysse G. Wurcel
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Full Time ◽  
Patient Support ◽  
Hospital Workers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Employees ◽  
The Impact

Abstract Background Studies on the impact of the novel SARS-CoV-2 virus (COVID) for healthcare workers (HCWs) rarely include the full spectrum of hospital workers, including less visible patient support roles. In the early days of the pandemic, COVID testing was preferentially available to HCWs. The objective of this study was to understand how individual experiences for all HCWs during the pandemic were associated with perceptions of access to, and receipt of COVID testing . Methods All hospital employees (n = 6736) in a single academic medical center in Boston, Massachusetts were invited to participate in a cross-sectional survey regarding perceived access to, and receipt of COVID testing during the first wave of the pandemic (March – August 2020). Responses were linked to human resources data. Log binomial univariate and multivariable models were used to estimate associations between individual and employment variables and COVID testing. Results A total of 2543 employees responded to the survey (38 %). The mean age was 40 years (± 14). Respondents were female (76 %), white (55 %), worked as nurses (27 %), administrators (22 %) and patient support roles (22 %); 56 % of respondents wanted COVID testing. Age (RR 0.91, CI 0.88–0.93), full time status (RR 0.85, CI 0.79–0.92), employment tenure (RR 0.96, CI 0.94–0.98), changes in quality of life (RR 0.94, CI 0.91–0.96), changes in job duties (RR 1.19, CI 1.03–1.37), and worry about enough paid sick leave (RR 1.21, CI 1.12–1.30) were associated with interest in testing. Administrators (RR 0.64, CI 0.58–0.72) and patient support staff (RR 0.85, CI 0.78–0.92) were less likely than nurses to want testing. Age (RR 1.04, CI 1.01–1.07), material hardships (RR 0.87, CI 0.79–0.96), and employer sponsored insurance (RR 1.10, CI 1.00-1.22) were associated with receiving a COVID test. Among all employees, only administrative/facilities staff were less likely to receive COVID testing (RR 0.69, CI 0.59–0.79). Conclusions This study adds to our understanding of how hospital employees view availability of COVID testing. Hazard pay or other supports for hospital workers may increase COVID testing rates. These findings may be applicable to perceived barriers towards vaccination receipt.

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