Impact of the COVID-19 pandemic on the utilisation of health services at public hospitals in Yemen: a retrospective comparative study

BackgroundThe COVID-19 pandemic has led to a global crisis, creating an unprecedented situation, which has taken the world by storm, overshadowing on all life’ aspects and having a significant impact on the health systems of most countries. In this study, the delivery of health services is investigated both before and during the outbreak of the COVID-19 pandemic at public hospitals in Yemen to assess the impact of COVID-19 on the utilisation of health services.MethodData collected from 127 hospitals in Yemen were reviewed using the DHIS2 system. The data represented 3 months before the outbreak of COVID-19 between January and March 2020 and during the outbreak of COVID-19 outbreak between April and June 2020. The results were then compared with the same period in 2019. The utilisation pattern of healthcare services during the period of investigation was compiled and analysed by applying a generalised estimating equation (GEE) to examine the effects of the COVID-19 outbreak in Yemen. The data collected from the targeted hospitals included information related to consultations, surgeries, deliveries, C-sections and penta-3rd dose immunisation.ResultsThe trendline of health services used during the pandemic showed a gradual decline beginning from April 2020 for consultations, surgeries and penta-3rd dose utilisation. The GEE model revealed a significant effect (p<0.05) during the outbreak compared with preoutbreak in the consultation services (B=−1,343.9; 95% CI −1,767.2 to −920.6; χ2=38.718), surgeries (B=−54.98; 95% CI −79.13 to −30.83, χ2=19.911) and penta-3rd dose (B=−24.47; 95% CI −30.56 to −18.38 and χ2=62.010). As for deliveries and C-sections, the results were shown to be statistically non-significant.ConclusionThe impact of COVID-19 on continuity of health services delivery in Yemen has been distinct and profound, where the study revealed that the number of the consultations, surgeries and number of vaccinated children have been declined during the COVID-19 pandemic, likely due to the partially lockdown measures taken and fear of being infected. However, the deliveries and C-section services remained nearly in the same level and did not affect by the COVID-19 pandemic.

Podcast Media in Consultation Services to Develop Academic Stress Prevention Skills

The rapid digitization of education in a pandemic has an impact on academic stress conditions. Counsellors have not implemented various innovative media but need relevant and millennial media to support consulting services with podcasts. This article aims to analyze the feasibility of podcast media in consulting services to develop academic stress prevention skills. Research and development limited to five stages help know the feasibility of podcasts as support for consulting services, especially academic stress prevention skills. The data analyzed the feasibility questionnaire instrument through expert validators, media, and practitioners (counsellors) quantitatively with percentages and inter-rater analysis. The results of the research show that podcast media is quite relevant to use in consulting services. The relevance and accuracy of podcast media can adjust to the content of the supporting material. Prevention of academic stress isn’t only with knowledge but skills to cope with academic stress in all conditions, especially in pandemic and post-pandemic situations. Professional and millennial counsellors can develop skills in the use of podcast media in consulting services. Can use Podcast media directly in consulting services. Recordings of podcast results can be used indirectly in consulting services or group guidance services, group counselling, individual counselling, and classical guidance as a follow-up.

Construction and Application of an Intelligent Response System for COVID-19 Voice Consultation in China: A Retrospective Study

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has led to tremendous individuals visit medical institutions for healthcare services. Public gatherings and close contact in clinics and emergency departments may increase the exposure and cross-infection of COVID-19.Objectives: The purpose of this study was to develop and deploy an intelligent response system for COVID-19 voice consultation, to provide suggestions of response measures based on actual information of users, and screen COVID-19 suspected cases.Methods: Based on the requirements analysis of business, user, and function, the physical architecture, system architecture, and core algorithms are designed and implemented. The system operation process is designed according to guidance documents of the National Health Commission and the actual experience of prevention, diagnosis and treatment of COVID-19. Both qualitative (system construction) and quantitative (system application) data from the real-world healthcare service of the system were retrospectively collected and analyzed.Results: The system realizes the functions, such as remote deployment and operations, fast operation procedure adjustment, and multi-dimensional statistical report capability. The performance of the machine-learning model used to develop the system is better than others, with the lowest Character Error Rate (CER) 8.13%. As of September 24, 2020, the system has received 12,264 times incoming calls and provided a total of 11,788 COVID-19-related consultation services for the public. Approximately 85.2% of the users are from Henan Province and followed by Beijing (2.5%). Of all the incoming calls, China Mobile contributes the largest proportion (66%), while China Unicom and China Telecom are accounted for 23% and 11%. For the time that users access the system, there is a peak period in the morning (08:00–10:00) and afternoon (14:00–16:00), respectively.Conclusions: The intelligent response system has achieved appreciable practical implementation effects. Our findings reveal that the provision of inquiry services through an intelligent voice consultation system may play a role in optimizing the allocation of healthcare resources, improving the efficiency of medical services, saving medical expenses, and protecting vulnerable groups.

Content Analysis of the Free COVID-19 Telephone Consultations Available during the First Wave of the Pandemic in Japan

This cross-sectional study aimed to (1) describe the unclassified contents of telephone consultation services provided by a public health center during the first wave of COVID-19 in Japan and (2) examine whether the contents required assistance from public health nurses (PHNs). We analyzed a total of 207 calls in which the purpose of the call was unclassified into pre-set categories. PHNs transcribed the exact text of the consultation conversations recorded from 25 March to 20 April 2020 in City A. Approximately half of the calls were from residents. Seven categories were extracted through a qualitative content analysis. The most common topic was infection control measures, where the presence of COVID-19 infection was assumed (n = 62); the second most common was extreme anxiety and fear of infection (n = 50). Questions about the COVID-19 response system (n = 30), discrimination and misunderstandings about COVID-19 (n = 24), and response measures for COVID-19 outbreaks within organizations (n = 18) were also included. The unclassified consultations included various topics, several of which required the expertise of a PHN. Each local government should consider sharing and task-shifting telephone consultation services among PHNs and other staff to reduce their burden and allow them to concentrate on conducting infection control more effectively.

Integrating Telemedicine in Assisting Poison Center Service: Line Application

Objective: To characterize Line, a mobile chat application, usage in Ramathibodi Poison Center (RPC) for further improvement of toxicological consultation services. Materials and Methods: Retrospective data were retrieved from Line messages together with concurrently recorded cases in the RPC database for six months, between November 16, 2018 and May 15, 2019. Time of consultation, time to response, types of toxins, reasons for consultation, and delivered content were recorded. Results: Over six months, 12,686 consultations were made via the hotline with 1,181 cases that used Line as an adjunct with 1,301 conversations. Median response time was three minutes. The most common poisonings were pesticides with 525 contacts (40.4%), followed by pharmaceutical agents and animal toxins. Most requests were for treatment suggestions with 731 contacts (56.2%), followed by notifying case progression and substance or animal identification. Among 1,030 files sent by consultees, the most common were photos of substances and animals for identification. Among 997 responses, most RPC staff used Line as an adjunct for treatment suggestions at 659 times (66.1%), followed by substance or animal identification and providing diagnoses. Overall, 602 protocols were delivered. Conclusion: Ten percent of all consultations were accompanied by Line usage. Most contacts were about pesticides and for appropriate treatment. RPC also used Line to effectively deliver diagnoses and treatment and increase coverage nationally. Keywords: Telemedicine, Line, Application, Poison center

Beyond Services in the United States of America: Fulbright U.S. Scholar Experience in Vietnam

Purpose: This article addresses my experience as a speech-language pathologist in a cultural exchange and global outreach program in Vietnam. The importance and various types of cultural exchange and global outreach programs available through the U.S. Department of State, the current status of educational speech-language pathology programs in Vietnam, and a brief introduction of the country as well as its unique cultural characteristics are also discussed. Conclusions: As a Fulbright U.S. scholar, I resided 6 months in Hue, Vietnam, to provide education and consultation services to children who needed speech-language pathology services and their families. The speech pathology profession in Vietnam is significantly underdeveloped. However, several international nongovernmental organizations and foreign universities have assisted Vietnam in developing speech pathology and audiology professions. Among many opportunities to serve the needs of speech pathology and audiology preprofessional education and service delivery in Vietnam, one of the most prestigious opportunities is the Fulbright U.S. Scholar Program. It is my hope that my personal and professional experiences can encourage fellow speech-language pathology and audiology professors and practitioners to apply for a Fulbright scholarship to pursue a rich volunteer experience in a foreign country as well as to improve their cultural competency upon return to their own academic institutions.

Response to Expanding Video Consultation Services at Pace and Scale in Scotland During the COVID-19 Pandemic: National Mixed Methods Case Study (Preprint)

UNSTRUCTURED Please see attached letter in response to a recently published article.

Call to action: empowering patients and families to initiate clinical ethics consultations

Clinical ethics consultations exist to support patients, families and clinicians who are facing ethical or moral challenges related to patient care. They provide a forum for open communication, where all stakeholders are encouraged to express their concerns and articulate their viewpoints. Ethics consultations can be requested by patients, caregivers or members of a patient’s clinical or supportive team. Although patients and by extension their families (especially in cases of decisional incapacity) are the common denominators in most ethics consultations, these constituents are the least likely to request them. At many healthcare organisations in the USA, ethics consultations are overwhelmingly requested by physicians and other clinicians. We believe it is vital that healthcare institutions bridge the knowledge gaps and power imbalances over access to ethics consultation services through augmented policies, procedures and infrastructure. With enhanced education and support, patients and families may use ethics consultation to elevate their voices and prioritise their unique characteristics and preferences in the delivery of their healthcare. Empowering patients and families to request ethics consultation can only strengthen the patient/family–clinician relationship, enhance the shared decision-making model of care and ultimately lead to improved patient-centred care.