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2021 ◽  
pp. archdischild-2021-321884
Author(s):  
Smita Dick ◽  
Clare MacRae ◽  
Claire McFaul ◽  
Usman Rasul ◽  
Philip Wilson ◽  
...  

BackgroundAdmission rates are rising despite no change to burden of illness, and interventions to reduce unscheduled admission to hospital safely may be justified.ObjectiveTo systematically examine admission prevention strategies and report long-term follow-up of admission prevention initiatives.Data sourcesMEDLINE, Embase, OVID SP, PsychINFO, Science Citation Index Expanded/ISI Web of Science, The Cochrane Library from inception to time of writing. Reference lists were hand searched.Study eligibility criteriaRandomised controlled trials and before-and-after studies.ParticipantsIndividuals aged <18 years.Study appraisal and synthesis methodsStudies were independently screened by two reviewers with final screening by a third. Data extraction and the Critical Appraisals Skills Programme checklist completion (for risk of bias assessment) were performed by one reviewer and checked by a second.ResultsTwenty-eight studies were included of whom 24 were before-and-after studies and 4 were studies comparing outcomes between non-randomised groups. Interventions included referral pathways, staff reconfiguration, new healthcare facilities and telemedicine. The strongest evidence for admission prevention was seen in asthma-specific referral pathways (n=6) showing 34% (95% CI 28 to 39) reduction, but with evidence of publication bias. Other pathways showed inconsistent results or were insufficient for wider interpretation. Staffing reconfiguration showed reduced admissions in two studies, and shorter length of stay in one. Short stay admission units reduced admissions in three studies.Conclusions and implicationsThere is little robust evidence to support interventions aimed at preventing paediatric admissions and further research is needed.


2021 ◽  
Vol 12 (5) ◽  
pp. 1394-1412
Author(s):  
Abdul Samad ◽  
Salman Bashir Memon ◽  
Ayaz Ali Maitlo

Though workplace incivility is a negative behavioral phenomenon that has infiltrated almost every sector, yet, less investigated in the healthcare sector. The healthcare sector is the backbone for economic and well-being for any nation and mainly composed of nurses. Turnover among nurses is a serious challenge to public healthcare facilities in terms of management, financing, and service quality. Based on the COR theory, this study capitalizes investigation on the effects of incivility on turnover intention through burnout and occupational stress. Simple random sampling was deployed on a sample of 265 nurses from 24 public hospitals of Sindh in Pakistan. Data analysis through partial least square and results revealed that workplace incivility has insignificant relation with turnover intention. Whereas, incivility has a significant indirect relationship with turnover intention through burnout and occupational stress. This study suggests that emotional and occupational depletion in public healthcare is high due to incivility at the workplace. Thus, HR managers must devise policies to practice civil behavior to curtail turnover intention problem among nurses. Besides practical benefits, some limitations with potential future research directions are discussed in the end.


Author(s):  
Tambe Sagar B ◽  
◽  
Patil Kunal A ◽  
Bhavare Pankaj C ◽  
Kendre Govind L ◽  
...  

Today good healthcare facilities and awareness of need of good healthcare is increasing in India. But as awareness increases it also strains the current healthcare infrastructure as patient expects more secured treatment round the clock. So there arises a need of remote assessment of patient health all the time using IoT devices. But these devices also need to be monitored by health worker in a hospital. Due to human interaction with theses IoT devices it may give rise to errors as human decisions can be late as a human health worker cannot look at the devices 24X7. So, to remove dependence of human decision-making technologies such as WBAN, cloud and machine learning has to be utilized together to make heath decision of a patient with less human interaction. So, we are designing a project where healthcare of a patient can be monitored extensively using WBAN. In first part of our project, we design a IoT device using Arduino and ESP8266 Wi-Fi module. The sensors connected to the Arduino will be pulse sensor, temperature sensor etc. The sensors will transfer data from patient to a server using ESP8266 and Wi-Fi called as WBAN network. The server will then apply SVM machine learning algorithm on the sensor readings and classify in two categories safe and unsafe. Custom made training dataset will be used to train the SVM. If unsafe readings are found the sensor will send a message to concerned doctor and upload readings to the cloud. The doctor on receiving alert can see the readings on the android app designed for the project and take a decision on the condition of the patient. For the project we are using Google Cloud Platform as our cloud provider which is free for use. Thus, by using our project a doctor can monitor his patient remotely from anywhere and the system will help in making decisions on the behalf of the doctor.


Author(s):  
Ar. Safeer Ahmad

Patient is the most important stakeholder of any healthcare facilities. Gone are the days when we used to design a healthcare setup based on our perception of what the patient could expect. Now we are living in a competitive environment where the patients’ expectation should not be guessed but have to offer the patient room as a space that let the patient customize as per their comfort during the stay in the facility. In a Healthcare facility designing, an Inpatient unit is very crucial because its physical infrastructure & built environment not only affect patients’ recovery but also Healthcare staff & facility outcome. IoT enabled healthcare facility helps the doctors to be more watchful of the patients’ activity and how their body responds to based on the data collected. However, integration of IoT in a healthcare facility is proving to be equally challenging. This paper shall cover overview of the technical considerations of planning and designing of Patient Room Unit in context of future emerging trends as well as implementation of IoT and patients experience. The Methodology shall be engagement of various techniques to gather information of healthcare facilities through observation, Literature review of published journals, academic papers, also Data collection in this qualitative study and basic concept background are investigated through online media and observation to work for qualitative analysis.


2021 ◽  
Vol 9 ◽  
Author(s):  
Qunfang Hu ◽  
Lei He ◽  
Ying Zhang

To prevent the spread of coronavirus disease 2019 (COVID-19), stringent quarantine measures have been implemented so that healthy people and virus carriers have isolated themselves in the same community owing to the limit capacity of healthcare facilities. With the exponential growth of the infected population, the residential environment is contaminated by fomites from the infected residents and consequently threating the health of susceptible residents. Till now, little has been acknowledged on this indirect transmission route and its role on community transmission. Here we address the impact of self-isolated virus carriers on the residential environment and elucidate the potential transmission pathways via contaminated environment in communities. We urge further investigation on the superspreading cases in communities and hope to arouse the attention to evaluate the potential risk of indirect transmission route as well as the corresponding control measures.


2021 ◽  
Author(s):  
Garrett A. Cavaliere ◽  
Reem Alfalasi ◽  
Gregory N. Jasani ◽  
Gregory R. Ciottone ◽  
Benjamin J. Lawner

2021 ◽  
Author(s):  
Neha Awasthi ◽  
Monika Chaudhary

Abstract Universal Health Coverage, as a milestone of Sustainable Development Goal − 3 has its own predefined limitations for a resource constraint economy. Underdeveloped and developing nations are not in a position to provide critical and crucial health services to all its citizens and those who remain uncovered are likely to face financial hardships. Division of limited resources is never easy andchoosing which services to offer and to whom in order to benefit the weaker sections becomes a complex choice. This study examines, that despite the availability of health systems and insurance schemes, does a vulnerable sections of the societyremains unprotected against Catastrophic Health Expenditure. Is catastrophic health expenditure leading to impoverishment in urban poor of Jaipur city? Primary data was collected from 426 households of urban slums of Jaipur City. It was found that of all the households, 8.1 percent households incurred Catastrophic Health Expenditure. The mean excess of expenditure over the defined threshold (i.e. 40 percent of non-subsistence household expenditure) was 33 percent for households which incurred Catastrophic Health Expenditure. There was a significant association between increased health expenditure and curtailment in expenditure on food and clothing by households, p < 0.0001 and p < 0.05 respectively. There was a significant rise in impoverishment in urban slums because of out of pocket expenditures on health. There was an absolute 1 percent rise (2.8 percent to 3.8 percent) in poverty on the basis of National Poverty Line and 2.6 percent (37.1 percent to 39.7 percent) when International Poverty Line estimates were taken. Increase in normalized mean positive poverty gap from 29.8 percent to 45.3 percent, indicates the deepening of poverty among existing poor. The result indicates massive discrepancy in estimates of poverty 2.8 percent on National poverty standards and 37.1 percent on International poverty standards. Poverty ratio, as low as 2.8 percent among urban slum (the acknowledged poorer section) based on National Poverty Line indicates need of developing a sensitive poverty standards. Urban slum dwellers of Jaipur are forced to spend more on day-to-day household items because of higher cost of living of the city. This led to an underestimation of the number of poor on National poverty line basis. Lack of considerations of regional variables and factors while designing health schemes is evident. This raises an argument in favor of recognizing local factors while designing the social insurance schemes. Evidence based selection of healthcare delivery system - assurance, insurance or mixed is required. The approach must enable the Government to control quality and cost of the healthcare at the same time. In the present scenario, assurance (healthcare services by Public Healthcare Facilities) approach may not only improve the accessibility but also will control the cost of healthcare for the entire population. In place of putting two parallel systems insurance or assurance, the Government should focus to invest funds and efforts in one system. To strengthen the assurance of public health care ‘Right based approach to Health’ may be adopted.This will result in long term protection of its citizens.


2021 ◽  
Vol 8 ◽  
Author(s):  
C. Roland Ghareeb ◽  
Bharadwaja S. T. Peddinti ◽  
Samantha C. Kisthardt ◽  
Frank Scholle ◽  
Richard J. Spontak ◽  
...  

The dual threats posed by the COVID-19 pandemic and hospital-acquired infections (HAIs) have emphasized the urgent need for self-disinfecting materials for infection control. Despite their highly potent antimicrobial activity, the adoption of photoactive materials to reduce infection transmission in hospitals and related healthcare facilities has been severely hampered by the lack of scalable and cost-effective manufacturing, in which case high-volume production methods for fabricating aPDI-based materials are needed. To address this issue here, we examined the antimicrobial efficacy of a simple bicomponent spray coating composed of the commercially-available UV-photocrosslinkable polymer N-methyl-4(4'-formyl-styryl)pyridinium methosulfate acetal poly(vinyl alcohol) (SbQ-PVA) and one of three aPDI photosensitizers (PSs): zinc-tetra(4-N-methylpyridyl)porphine (ZnTMPyP4+), methylene blue (MB), and Rose Bengal (RB). We applied these photodynamic coatings, collectively termed SbQ-PVA/PS, to a variety of commercially available materials. Scanning electron microscopy (SEM) and time-of-flight secondary ion mass spectrometry (ToF-SIMS) confirmed the successful application of the coatings, while inductively coupled plasma-optical emission spectroscopy (ICP-OES) revealed a photosensitizer loading of 0.09-0.78 nmol PS/mg material. The antimicrobial efficacy of the coated materials was evaluated against methicillin-susceptible Staphylococcus aureus ATCC-29213 and human coronavirus strain HCoV-229E. Upon illumination with visible light (60 min, 400-700 nm, 65 ± 5 mW/cm2), the coated materials inactivated S. aureus by 97-99.999% and HCoV-229E by 92-99.999%, depending on the material and PS employed. Photobleaching studies employing HCoV-229E demonstrated detection limit inactivation (99.999%) even after exposure for 4 weeks to indoor ambient room lighting. Taken together, these results demonstrate the potential for photodynamic SbQ-PVA/PS coatings to be universally applied to a wide range of materials for effectively reducing pathogen transmission.


2021 ◽  
Author(s):  
Jin Xu ◽  
Guang Duan ◽  
Xiujun Lu ◽  
Yan Zhou ◽  
C.B Sivaparthipan ◽  
...  

Abstract The causes of diverse, high realization percentages are the Hospital Sewage, and no appropriate therapy for contaminant elimination has been examined. These pollutants and their complicated properties are immune to the laboratory's wastewater treatment plant (WWTPs). In other sentences, certain dynamic chemicals cannot be eliminated by traditional therapy. Environmental chemical contaminants can pose significant threats to global water supplies. In recent times, the wastewater created from medical services, healthcare facilities and laboratories has become more involved with the atmosphere researchers. A Sustainable Control Strategy for Detecting Activated Toxins (SCS-DAT) model is proposed in this research. For three things - traditional drainage features, major priority drug products, and microbiota studies - this analysis picked several multi-speciality facilities with non-identical pre-treatments. The research review assesses innovative processes' effectiveness for disposing of these three components from treated wastewater before being released into a hazardous water Sewage treatment plant (STP). Regarding the test findings, these two procedures effectively lowered the standard and medication variable of direct and indirect approaches in two out of three treatment methods, MBR and CW, excluding microbe restoration, by following stages. These two substances were found. The results showed 100% ibuprofen, carbamazepine, and frusemide reduction, while CW suggested that ofloxacin was 100% eliminated. The medicines' degradation demonstrated two accelerated oxidation variations, ozonation (O3) and peroxisome (O3-H2O2). pH, O3 availability, time of touch and H2O2 quantities are the main operating variables in AOP. Centred on medicinal products efficacy, traditional O3 treatment is more effective than integrating O3- H2O2 therapy. Therefore, the study proved that MBR combined with ozone proven an ideal technology for the chemical treatment of treated wastewater among several innovations.


Author(s):  
Sawad Aseel Bin ◽  
Turkistani Fatema

The World Health Organization (WHO) declared the pandemic status of coronavirus disease of 2019 (COVID-19). The necessity for social distancing has prompted states to make policy changes. These policy changes are in line with the policies and recommendations set by the WHO, the Centers for Disease and Control Prevention (CDC), the United States Department of Health and Human Services (HHS), the Centers for Medicare and Medical Services (CMS), the Kaiser Permanente, the National Institutes of Health (NIH), the United States Food and Drug Administration (FDA), and the American Medical Association (AMA). The aim of this study is to discuss and analyze the effectiveness of many organizations in responding to the COVID-19 crisis. Three processes were involved in conducting the narrative review: (1) a search was conducted through the websites of eight organizations (CDC, HHS, CMS, Kaiser Permanente, NIH, WHO, FDA, and AMA), (2) Selection of relevant information related to the responses taken by the eight organizations between January 21, 2020 and April 24, 2020 were included, (3) the information selected from the websites of the eight organizations were recorded, summarized, and integrated in this paper.COVID-19 is a health problem that needs to be approached in a collaborative manner. All eight organizations that have taken action against the further spread of the virus. The different policy changes and/or recommendations from the eight organizations have one common ground and that is the necessity for social distancing. To prevent overcrowding in hospitals and in other healthcare facilities, the organizations have decided to expand telehealth coverage. In Conclusions Health-related and policy-issuing organizations provided policies that are aligned with one another in order to contain the spread of COVID-19.


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