Association of Parvovirus B19 with Rheumatic Diseases

Human parvovirus B19 infections are well reported to be associated with different autoimmune disorders. They can either mimic or trigger autoimmune diseases, such as systemic lupus erythematous (SLE), rheumatoid arthritis (RA), and vasculitis. A lack of awareness about this infection can result in delays in diagnosis and poor care. In this review, the basic biology and clinical aspects of the parvovirus, human immune response, and the pathogenesis in the rheumatic diseases are discussed.

Compassion Versus Care in Healthcare Institutions: What’s the Difference?

In February 2013, the Francis Report outlined what it described as ‘systematic failings’ at Mid Staffordshire NHS Foundation Trust resulting in the death and suffering of many patients through neglect (in the UK context, hospitals can apply to gain foundation trust status. Foundation trust hospitals are part of the National Health Service (NHS) but are not directed by central government and have greater freedom to decide the way services are delivered. They adhere to core NHS principles of free medical treatment based on need and not the ability to pay.) A lack of compassion, particularly among nursing staff, was identified as one of the contributing factors to poor care. The NHS was founded on the core value of compassion that today is one of six values all NHS staff are expected to demonstrate. Frequently invoked as a means to ensuring good patient care, it is a concept that is contested by a number of writers who argue that such moral emotions are not only unnecessary but dangerous. The purpose of this work is to explore the difference between compassion and care (but not medical treatment) in the context of the NHS. The paper draws on the work of Anca Gheaus, who argues there is a distinction to be made between the two and that while it is possible to be compassionate towards everybody, the ability to care, is limited to fewer people and is a more intense and engaged activity. Regarded as the founding myth of the NHS, the work also draws on the parable of the Good Samaritan to make the distinction between the two concepts more visible, and argues the roles played by the Good Samaritan and the innkeeper, remain relevant to the workings of today’s healthcare system. It also reflects on the need for kindness within the system.

An update to remedial avenues for complaints about poor care in the NHS

As an institution, the NHS is liable to respond and act on any concerns or complaints against the services it provides. NHS organisations should provide Patient Advice and Liaison Services as a first point of contact for patients, carers and/or relatives. Complaints raised by patients or their representatives should be investigated in an open, evidence-based way, aiming to resolve the issue to the fullest satisfaction of the complainant within an agreed time frame, while maintaining strict confidentiality. Complainants should be safeguarded and supported with appropriate advice. If a satisfactory resolution is not provided within 6 months, the complainant has the right to escalate the issue to the Parliamentary and Health Service Ombudsman. With this in mind, the aim of this article is to provide an overview for NHS staff regarding the avenues available for complainants.

The COVID-19 pandemic should be last orders for poor care of people with neurodevelopmental disorders

Summary We explore whether the needs of individuals with neurodevelopment disorders have been overlooked during the coronavirus disease 2019 (COVID-19) pandemic and set out the issues that need to be considered in response to future health crises and pandemics.

Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal

Background Respectful maternal and newborn care (RMNC) is an important component of high-quality care but progress is impeded by critical measurement gaps for women and newborns. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study was an observational study with mixed methods assessing measurement validity for coverage and quality of maternal and newborn indicators. This paper reports results regarding the measurement of respectful care for women and newborns. Methods At one EN-BIRTH study site in Pokhara, Nepal, we included additional questions during exit-survey interviews with women about their experiences (July 2017–July 2018). The questionnaire was based on seven mistreatment typologies: Physical; Sexual; or Verbal abuse; Stigma/discrimination; Failure to meet professional standards of care; Poor rapport between women and providers; and Health care denied due to inability to pay. We calculated associations between these typologies and potential determinants of health – ethnicity, age, sex, mode of birth – as possible predictors for reporting poor care. Results Among 4296 women interviewed, none reported physical, sexual, or verbal abuse. 15.7% of women were dissatisfied with privacy, and 13.0% of women reported their birth experience did not meet their religious and cultural needs. In descriptive analysis, adjusted odds ratios and multivariate analysis showed primiparous women were less likely to report respectful care (β = 0.23, p-value < 0.0001). Women from Madeshi (a disadvantaged ethnic group) were more likely to report poor care (β = − 0.34; p-value 0.037) than women identifying as Chettri/Brahmin. Women who had caesarean section were less likely to report poor care during childbirth (β = − 0.42; p-value < 0.0001) than women with a vaginal birth. However, babies born by caesarean had a 98% decrease in the odds (aOR = 0.02, 95% CI, 0.01–0.05) of receiving skin-to-skin contact than those with vaginal births. Conclusions Measurement of respectful care at exit interview after hospital birth is challenging, and women generally reported 100% respectful care for themselves and their baby. Specific questions, with stratification by mode of birth, women’s age and ethnicity, are important to identify those mistreated during care and to prioritise action. More research is needed to develop evidence-based measures to track experience of care, including zero separation for the mother-newborn pair, and to improve monitoring.

J’accuse: difference between the two Covid-19 episodes in Italy, what is the cause?

Background: The COVID-19 pandemic appears to have struck Italy in two waves.Objective: To analyse the differences between the first (W1) and the second wave (W2).Methods: Our analysis was based on weekly data retrieved from the Official Bulletin of the Italian Civil Protection Department from 1 March 2020 to 21 January 2021.Results: W1 lasted about 23 weeks, from March to 15 August 2020. W2 started on 16 August and was still underway on 21 January 2021.W2 is much more severe than W1 in terms of positive cases and deaths, and its decay is much slower.We have identified at least six different causes of these differences: the colder season, the impact of seasonalinfluenza, viral mutation, the lack of a plan to tackle viral resurgence, poor care of elderly people, and lack of oralhygiene as an important preventive measure. Moreover, in an attempt to give the best possible informationthrough the media, the experts have instead caused feelings of uncertainty and fear.Conclusions: There are several reasons for the differences between W1 and W2: the start of the colder seasonduring W2, poor care of elderly people, the delay in providing seasonal influenza vaccination, the lack of anational plan against COVID-19 resurgence, confusion over the lockdown measures, lack of information aboutoral hygiene, and confusing information given through the media.