P071 SURGERY DURING COVID ERA - IMPACT IN ABDOMINAL WALL SURGERY - OUR EXPERIENCE

Aim “COVID pandemic created unprecedented challenges for actual health care systems with hundreds of surgeries suspended with impact in Abdominal Wall Surgery (AWS) and other benign diseases. With this in mind, we implemented new and dedicated clinical pathways to allow more patients to be operated in outpatient regime, so we could have more availability of beds, staff and resources for COVID assistance.” Material and Methods “A retrospective observational study was conducted using data since January 2018 to May 2021. Our Hospital and Surgical Department suffered great organizational changes, namely creation of: dedicated medical and staff teams for COVID + (C+) and COVID- (C-) patients; dedicated pathways in our operating rooms for C+ cases; and, ultimately, designed and implemented protocols and agreements to maintain our Department fully operational, with a secure shift from elective to outpatient surgeries.” Results “During the study, a global number of 2541 AWS were performed. In the era pre-COVID (2018 - February 2020), we performed 968 surgeries with an average number of 37,2 AWS/month. Despite COVID pandemic (march 2020 - may 2021), our department performed a total of 1573 AWS, with an average number of 112,4 AWS/month. In resume, during COVID era, we increased AWS by more than 300%.” Conclusions “This study found that, inner organizational adaptations and creation of dedicated protocols/clinical pathways can maintain surgical departments performance despite the stress and uncertainty of a pandemic like COVID-19 with a very positive impact on benign pathologies such as AWS.”

Pessimistic health and optimistic wealth distributions perceptions in Germany and the UK: evidence from an online-survey

Background Inequalities in health and wealth distributions are becoming pressing societal problems in many countries. How these inequalities are perceived and to what degree perceptions are aligned with actual distributions, is important for trust in public health services, social and economic policies, and policymakers. This study aims to assess perceived and desired levels of inequality in health and wealth in Germany and the UK. Methods The online-survey was filled out by 769 volunteers (322 from Germany, 447 from the UK), recruited from an existing commercial panel (Prolific Academic) or via Facebook advertisements in 2019. Perceived and ideal national health and wealth distributions were assessed and compared to actual health indicators (i.e. days absent from work, number of visits to general practitioners (GPs) and self-rated health), and actual wealth distributions with t-tests. Results A pronounced gap emerged between the estimated, ideal and actual inequality. Both samples strikingly underestimated the proportion of (very) good health in the national distribution by a factor of ~ 2.3 (participants estimated that 34% of the German and 36% of the UK population respectively are very healthy or healthy, while the actual proportion in the population was 75% in Germany and 84% in the UK, P < 0.001 for all). Moreover, actual health distributions were much closer to the desired than the perceived health distributions (78% of German and 72% of UK participants ideally being very healthy or healthy). A reversed pattern of results emerged for wealth in both samples, with wealth inequality being strikingly worse than desired and inequality being underestimated by a factor ~ 1.7 (P < 0.001 for all). Results were consistent across demographic groups. Conclusions Respondents in both Germany and the UK have profoundly negative misperceptions regarding the distribution of health, which contrasts with starkly positive misperceptions regarding the distribution of wealth, indicating that the public is healthier but poorer than they think. More importantly, from a public health perspective, a high level of consensus emerged, with both healthy and wealthy participants misperceiving health and wealth distributions.

Pharmacoeconomic Analysis of Biologics and Methotrexate for Rheumatoid Arthritis from the Standpoint of the Number Needed to Treat Concept under the Japanese Health Insurance System

Objectives: To evaluate the cost-effectiveness of biologics and methotrexate (MTX) for rheumatoid arthritis (RA) using the number needed to treat (NNT) concept and total actual health care cost.Methods: This study included 121 RA patients with newly prescribed biologics and/or MTX between 2012 and 2017. The NNT was calculated based on the 24-week remission rate of Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) and Clinical Disease Activity Index (CDAI).Results: Remission rates were 76.4% for DAS28-ESR and 45.4% for CDAI in the biologics group and 63.6% and 24.2%, respectively, in the MTX group. The NNT was calculated as 6.4 and 4.2 in the biologics group and 34.2 and 35.2 in the MTX group, respectively. Mean total actual health care costs were 1,044,066 JPY (9,835 US$)/24 weeks per treated patient in the biologics group and 75,860 JPY (715 US$)/24 weeks in the MTX group. Although the effectiveness of biologics was superior to MTX from the standpoint of NNT, the mean total health care cost and mean cost per NNT were much higher in the biologics group.Conclusions: Cost-effectiveness is clearly higher for MTX than biologics from the standpoint of NNT and total actual health care cost under the Japanese health insurance system.

Corona crisis chronicle: Fang Fang's Wuhan Diary (2020) as an act of sousveillance

PurposeThis paper analyzes Fang Fang's 2020 Wuhan Diary‐Dispatches from a Quarantined City, to show how the author communicates the coronavirus crisis in Wuhan in a global information ecosystem. The success of the diary showcases how the actual health emergency has been transformed into a communication issue.Design/methodology/approachThis study is exploratory and qualitative in nature. The authors conducted a thematic analysis (TA) of Wuhan Diary, in which we decided to focus on the aspects of sousveillance and solidarity. For the purposes of our paper, we used the English translation of the text by Dr. Michael Berry.FindingsThe authors focus on two major themes in their exploration of the corona crisis as a global communication issue: sousveillance and solidarity. The authors argue that the diary's ways of seeing perform a version of “sousveillance” or “undersight” in juxtaposition to surveillance or “oversight” (Mann, 2017). Fang Fang calls for solidarity as an effective measure for individuals, communities and societies to contain the pandemic and a potential misinfodemic.Originality/valueSince Wuhan was the early epicenter of the COVID-19 pandemic, Wuhan Diary presents an unprecedented narrative account of life under quarantine that could function as a litmus test for other cities and countries. Fang Fang's diary provides a countermeasure to official accounts of the pandemic in Wuhan, which has resonated both with people in China and abroad.

Shedding Light on the Main Characteristics and Perspectives of Romanian Medicinal Oxygen Market

Medicinal oxygen plays an important role in healthcare, being essential for the existence and maintenance of the health of millions of people, who depend on medicinal oxygen every day, both in hospitals and at home. Medicinal oxygen is the primary treatment administrated to the majority of patients suffering from respiratory problems and low levels of oxygen in the blood, and in the context of the actual health crisis caused by the new COVID-19, the challenge is represented by increasing the supply of medicinal oxygen while reducing cost so that it is accessible where it is needed most, free at the point of use. It will take increased investment and commitment to put oxygen at the center of strategies for universal health coverage. In this context, it becomes essential to investigate the main characteristics of the Romanian market of medicinal oxygen, highlighting top key players, market development, key driving factors, types of products, market perspectives as well as shedding light on the segmentation of this particular market based on considerations regarding regions, hospital competence class and hospital specialization. Also, the research aims to explore the regional disparities in the decision of using O93%medicinal oxygen, revealing the main factors related to the usage of this type of product among Romanian public hospitals. The research relies on the first quantitative survey regarding medicinal oxygen usage among 121 public hospital units from a total of 461 public hospitals in 2018, which meet the specific requirements: includes the entire population according to the list published on the website of the Ministry of Health, is the most recent data and does not show repetition. The sampling was of probabilistic stage-type stratification, with the following sampling layers: hospital county distribution, hospital competence class officially assigned by the Ministry of Health and also area of residence (urban/rural). In order to analyze the main characteristics of the Romanian oxygen market, the following methods have been used: analysis of variance (ANOVA) together with Kruskal–Wallis, Pearson correlation coefficient as well as Goodman and Kruskal gamma, Kendall’s tau-b and Cramer’s V, as well as multilevel logistic regression analysis using hierarchical data (hospitals grouped in regions). The Romanian market of medicinal oxygen is rather an oligopoly market characterized by the existence of a small number of producers and two types of products currently used for the same medical purpose and having a substitutable character: medicinal oxygen O99.5%, and medicinal oxygen O93%. An overwhelming proportion of public hospitals agree that both types of medicinal oxygen serve the same therapeutic purpose. The Romanian market of medicinal oxygen highlighted a significant segmentation on considerations based on regions, hospital competence class and hospital specialization. Regarding the main perspectives, the Romanian market of medical oxygen keeps the growth trend registered globally, with development perspectives for competitors. Exploring the regional disparities in the decision of using O93 medicinal oxygen, the empirical results acknowledged the important role of unitary price, hospital capacity and the relevance of this product seen as a medicine. Medicinal oxygen is vital in sustaining life, proving its utility mainly in the context of the actual health crisis. In this context, the Romanian local market exhibits prospects for further development, being characterized by an important segmentation depending on regions, hospital competence class and hospital specialization.

Ensuring reliable operation and efficient service of heading and winning machines for potash ore extraction

Introduction. The article considers the organization of heading and winning machines’ maintenance in the mines of the Upper Kama potash salt deposit highlighting the potential of maintenance and repair according to the actual health of mining machines. Research methodology. The methodological foundations are presented of collecting and processing the data on Ural heading and winning machines failure statistics in the Upper Kama potash salt deposit. It is indicated that monitoring systems implemented in mining machine since 2013 made it possible to quickly track and record data on operating modes and downtime causes. Results. Research revealed that the greatest number of Ural heading and winning machines emergency failures is due to mining technology violation, as well as untimely or poor quality repairs. Breakdowns of swing and distributing reduction gears of planetary actuators, reduction gears of berm bodies and hydraulic systems units are most common. Ural mining machines’ repair cycle is presented. Even complex current and overhauls of heading and winning machines are often carried out by miners who directly operate the machines. Summary. Statistical data storage on failures and corresponding diagnostic parameters limit of heading and winning machines makes it possible to predict the time of equipment failure with a high degree of probability. The more standardized the potash mining machine operation and repair conditions are, the more accurate the remaining life forecast of the residual resource is.

A New Perspective for Prevention and to Cure COVID-19 Patients: Encouraging Medical Teams to Contact Healed People Treated with Chlorine Dioxide in Solution (CDS)

This article is written to encourage medical teams from all over the world to contact the patients already treated with this soluble gas. To contact also their medical teams accompanying the study cases as to verify the actual health conditions of patients. Finally, the invitation is to question whether CDS should be tried in their respective local healthcare environments.

Perception against COVID-19 Threat Affecting the Behavior of Indonesia People Three Months after the Outbreak

BACKGROUND: In Indonesia, a new behavior has been introduced in the community to prevent COVID-19 transmission following 3 months of the COVID-19 outbreak. The Ministry of Health, Republic of Indonesia, names this new concept as “the adaptation of new behavior.” However, preventive measures and health protocols encouraged by the government have not yet yielded a significant impact on reducing the COVID-19 positivity rate. This unsuccessful outcome indicates that infective circulation is still occurring caused by incompliant to the health protocol. AIM: This study aimed to measure community perceptions against COVID-19 at the individual level. METHODS: A cross-sectional study with a total of 1687 respondents was performed. Questionnaires distributed thru sharing online links which contain questions on perception of vulnerability and severity of COVID-19. Chi-square test used in analysis to determine the difference in perception with respondents’ behavior. RESULTS: A total of 81.7% of respondents who had a perception of “susceptible to contract” performed behavior suited to recommendations and 81.2% study population had a perception of “COVID-19 is severe” executed behavior suited to the recommendation. CONCLUSION: This study demonstrated the establishment of government recommendations for COVID-19 infection did not guarantee the actual health practice/behavior in the community. The existing misconception of the perspective of seriousness/severity and susceptibility would prevent the country from flattening the curve.