The Effect of Telemedicine on Patients’ Compliance in Family Medicine Follow-ups in Qatar

Introduction: Telemedicine is the delivery of health care services to patients distantly. During the Coronavirus Disease 2019 (COVID-19) pandemic, telemedicine has become an essential implement in delivering healthcare services worldwide. Accordingly, in March 2020, the Primary Health Care Centers (PHCCs) in Qatar has started telephone consultation follow-up appointments in Family Medicine (FM) clinics instead of conventional consultation. Given the limited data about telephone consultations in Qatar, our aim of this study is to investigate the possible impact of telemedicine on chronic disease patients’ follow-up compliance. Methods: This study compares the compliance of adult patients with chronic diseases following-up within FM clinics in Qatar's PHCC through telephone consultations with a minimum of three telephone consultations ordered between April to November 2020, in comparison to the compliance of the same group of patients to their prior face-to-face follow-up consultations in FM clinics with a minimum of three face-to-face ordered follow up appointments between April to November 2019. A cross-sectional study will be carried out to investigate the effect of telephone consultation in PHCC on patients’ compliance with reference to conventional face-to-face consultation. Patients’ data will be received from Health Information Management in twenty-seven PHCCs in Qatar. Conclusion: Due to the limited studies on the effectiveness of telemedicine on patient compliance in FM follow-ups within Qatar's PHCC, comparing patients’ follow-up compliance with telephone consultations to their prior face-to-face consultations would be helpful in assessing patients’ quality of care delivering within FM clinics. With telecommunication being easily accessible and time-efficient, it is believed, when used correctly, it might improve compliance and adherence to the management prescribed by the physician and follow-up appointments in Qatar's PHCC. In addition, this study will help in providing recommendations that could guide the organization on forming policies to be applied in PHCCs after the resolution of the COVID-19 pandemic.

After one year of the COVID-19 pandemic and hundreds of suggested drugs, will cathepsin L inhibitors be the solution?

Cysteine cathepsins are defined as lysosomal enzymes that are members of the papain family. Cysteine cathepsins (Cts) prevalently exist in whole organisms, varying from prokaryotes to mammals, and possess greatly conserved cysteine residues in their active sites. Cts are engaged in the digestion of cellular proteins, activation of zymogens, and remodeling of the extracellular matrix (ECM). Host cells are entered by SARS-CoV-2 via endocytosis. Cathepsin L and phosphatidylinositol 3-phosphate 5-kinase are crucial in endocytosis by cleaving the spike protein, which permits viral membrane fusion with the endosomal membrane and succeeds in the release of the viral genome to the host cell. Therefore, inhibition of cathepsin L may be advantageous in terms of decreasing infection caused by SARS-CoV-2. Coordinate inhibition of multiple Cts and lysosomal function by different drugs and biological agents might be of value for some purposes, such as a parasite or viral infections and antineoplastic applications. Zn2+ deficiency or dysregulation leads to exaggerated cysteine cathepsin activity, increasing the autoimmune/inflammatory response. For this purpose, Zn2+ metal can be safely combined with a drug that increases the anti-proteolytic effect of endogenous Zn2+, lowering the excessive activity of some CysCts. Biguanide derivative complexes with Zn2+ have been found to be promising inhibitors of CysCts protease reactions. Molecular docking studies of cathepsin L inhibited by the metformin-Zn+2 complex have been performed, showing two strong key interactions (Cys-25&His-163) and an extra H-bond with Asp-163 compared to cocrystallized Zn+2 (PDB ID 4axl).

COVID-19 and the mental health of professionals in the health sector in the UAE: An analytical study

As the Covid-19 pandemic persists, the public health interventions reported that many individuals during this pandemic situation experience different circumstances that lead to their poor mental health performance, such as isolation stress, anxiety, depression, anger, confusion, and unemployment. The aim of this study is to examine the existing literature in a comprehensive manner and to explore the impact of COVID-19 on the mental health of UAE health workers. This study also examined the psychological factors that influence workers’ mental health due to the pandemic of COVID-19. An online questionnaire was administered to answer the research question. The results proved that the pandemic has affected both physical and mental health of UAE health workers. Consequently, the adoption of preventive actions at the governmental, organizational, and individual levels is highly recommended. In this research, the implementation of effective communication and the application of adequate psychological services have been suggested. To this end, the role of policy makers to be involved in placing governmental initiatives that prevent the spread of the virus and protect the mental health of workers has been highlighted.

The challenge of education and training in the COVID-19 National Emergency Hospital Wisma Atlet Kemayoran in Jakarta

Background The Corona virus disease 2019 (COVID-19) pandemic poses a risk of inequality between the number of prepared service staff and patients. Emergency hospitals, that do not have full-time employees due to the voluntary employment system, need to supervise the competence and knowledge of their staff, as they came with diverse backgrounds of knowledge and skill. The National Emergency Hospital Wisma Atlet Kemayoran, which can provide services for nearly 6000 COVID-19 patients, is required to be able to provide education and training continuously to improve the knowledge of its volunteers aiming to improve the quality of the care services. Methodology The present study is descriptive observational research to explore the challenge of education and training in the COVID-19 National Emergency Hospital Wisma Atlet Kemayoran in Jakarta. Results The COVID-19 health workers need to be equipped with sufficient knowledge about personal protective equipment (PPE), COVID-19 management, triage, admission, emergency and critical care for the COVID-19 patients. Supervision is needed to ensure that volunteers with various knowledge and skill backgrounds can collaboratively provide good services for the COVID-19 patients at all fronts. With frequent personnel changes, education and training on the same topic are always given repeatedly. To overcome this inefficiency, the Education and Training Department can film every practical skill related to health care service, and then create tutorial videos followed by small groups onsite skill station, when necessary. The hospital received enormous support from the governmental and non- governmental organizations to conduct education and training sessions on regular basis. Conclusions Education and training are very critical in the Emergency COVID-19 Hospital. The process has become a major challenge due to regular changes of staff. Information and communication technologies remain a more recommended alternative to the traditional onsite face-to-face method of education and training delivery as to prevent the spread of this virus. The training and education program in the National COVID-19 Emergency Hospital Wisma Atlet have received major supports from several Government agencies, and national private/non-government organizations. However, supports from International NGOs, international aid agencies, or humanitarian organizations, apart from the local professional organizations, which generally extend generous support need also to be explored.

Embracing Healthcare Delivery Challenges during a Pandemic. Review from a nodal designated COVID-19 center in Qatar

Hospitals and healthcare systems are instrumental in the formulation and delivery of a coordinated response to disaster management especially epidemics. In healthcare policy and strategy formation, there are only trade-offs, which with uncertainty are akin to gambles. National organizations play a key role in pandemics through the expression of physician motivation. Effective strategies can facilitate physician action through economies of scale that lower the costs for physicians to meet both community and patients' needs. Moreover, no matter how well clinicians are motivated and positioned to act, their collective actions are likely to fall short without complementary systems for population-based care that require the operational support of an organization. This review of institutional policy implementation and frameworks intends to highlight how a nodal-designated COVID-19 center in Qatar managed to control the menace by altering its procedural sets and work arrangements to augment an integrated, intrinsic response to a briskly emerging, conceivably complex situation. This outcome was achieved under the guidance of a national leadership team, effectively adapted to its specific challenges by building on current medical evidence, management routines, proficiencies, and health system capacity. This ambitious drive started with the cohesion of services and implementation of evidence-based protocols by assigning a physician-led team to research, strategize and organize improved patient flow and information by arranging analytical compliance and preparedness. Through these service approaches and ongoing efforts, HMGH has realized significant outcome improvements, such as increasing capacity building, reducing healthcare waste, and increasing patient satisfaction rates whilst successfully achieving significantly lower COVID-19 mortality both in terms of absolute numbers and as percent population compared to many developed countries in the world. The strategies outlined in this article might not be all-inclusive or fit other healthcare system models, but they generate a veritable interest to pursue and be subjected to further rigorous study.

Effects of the COVID-19 pandemic on perceived stress levels of employees working in private organizations during lockdown

Background Worldwide, office employees have experienced two novel phenomena during the COVID-19 pandemic and lockdown: working from home and reductions in their salaries. These phenomena have majorly impacted the lives of individuals as well as their families. The present study aims to measure the perceived stress levels among employees during the COVID-19 pandemic lockdown in Pakistan. Methodology A cross-sectional approach was used to collect data from a sample of 385 employees working in three different IT-oriented private organizations. A semi-structured, Likert-scale questionnaire was used, containing the 10-item inventory from the Perceived Stress Scale (PSS). A sociodemographic profile, working parameters, and frequency of PSS inventory were presented in the descriptive analysis. Binary logistic regression analysis was made to compare the stress levels of the two groups resulting from their workloads and reductions in salary. Results An elevated perceived stress level (50.9%) was observed among the employees, showing a significant relationship with salary reduction and home work engagement (p<0.005). A strong negative correlation was observed (-0.860) for the salary reduction with PSS. Conclusion Working from home and reductions in salary caused increased perceived stress levels of the employees working in private organizations. Salary reductions proved to be a strong stressor, causing economic disruption and inability to cope with financial burdens during the COVID-19 pandemic.