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Oyama R, Endo M, Shimada E, Matsunobu T, Setsu N, Ishihara S, Kanahori M, Kawaguchi K, Hirose T, Nabeshima A, Fujiwara T, Yoshimoto M, Maekawa A, Hanada M, Yokoyama N, Matsumoto Y, Nakashima Y. Impact of COVID-19 pandemic on bone and soft tissue sarcoma patients' consultation and diagnosis. Sci Rep 2024; 14:20627. [PMID: 39232087 PMCID: PMC11374780 DOI: 10.1038/s41598-024-71830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/30/2024] [Indexed: 09/06/2024] Open
Abstract
The coronavirus disease (COVID-19) pandemic negatively affected the diagnosis and treatment of several cancer types. However, this pandemic's exact impact and extent on bone and soft tissue sarcomas need to be clarified. We aimed to investigate the effect of the COVID-19 pandemic and emergency declaration by the local government on consultation behavior and clinical stage at diagnosis of bone and soft tissue sarcoma. A total of 403 patients diagnosed with bone and soft tissue sarcoma who initially visited three sarcoma treatment hospitals between January 2018 and December 2021 were included. The monthly number of newly diagnosed soft tissue sarcoma patients was reduced by 25%, and the proportion of soft tissue patients with stage IV disease at diagnosis significantly increased by 9% during the COVID-19 pandemic compared to before the COVID-19 pandemic. Furthermore, the monthly number of new primary bone and soft tissue sarcoma patients significantly decreased by 43% during the state of emergency declaration. The COVID-19 pandemic had a negative impact on soft tissue sarcoma patients' consultation behavior and increased the proportion of advanced-stage patients at initial diagnosis. An emergency declaration by the local government also negatively affected primary bone and soft tissue sarcoma patients' consultation behavior.
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Affiliation(s)
- Ryunosuke Oyama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Eijiro Shimada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tomoya Matsunobu
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Nokitaka Setsu
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Shin Ishihara
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaya Kanahori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kengo Kawaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takeshi Hirose
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akira Nabeshima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masato Yoshimoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Akira Maekawa
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Masuo Hanada
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Nobuhiko Yokoyama
- Department of Orthopaedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Fukushima Medical University, Fukushima, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Chamla D, Iwu-Jaja C, Jaca A, Ndlambe AM, Buwa M, Idemili-Aronu N, Okeibunor J, Wiysonge CS, Gueye AS. The critical elements of the health system that could make for resilience in the World Health Organization African Region: a scoping review. PeerJ 2024; 12:e17869. [PMID: 39247547 PMCID: PMC11380474 DOI: 10.7717/peerj.17869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 07/15/2024] [Indexed: 09/10/2024] Open
Abstract
Background Unpredictable events, such as the outbreak of infectious diseases and humanitarian crises, are putting a strain on health care systems. As a result, African countries will need to prepare themselves with appropriate strategies to withstand such occurrences. Therefore, the purpose of this scoping review was to map available evidence about what type and what components of health systems are needed to help countries cope with health emergencies and to foster health system resilience in the WHO African Region. Methods A systematic search was performed independently in Scopus and PubMed electronic databases as well as grey literature. Studies were selected based on set eligibility criteria based on the Joanna Brigg's Institute (JBI) methodology for scoping reviews. The key findings were focused on health system resilience and were mapped based on the WHO's core health system components. Our data were tabulated, and a narrative synthesis was conducted. Results A total of 28 studies were included in this scoping review, mostly conducted in the WHO African Region and region of the Americas. Studies focused on a variety of strategies, such as the continuous delivery of essential services, the strengthening of the health workforce, including community health care workers, community engagement, the provision of protective mechanisms for the health workforce, and flexible leadership and governance measures. Conclusion Our findings suggest that strategies to improve health system resilience must include all areas of the healthcare delivery process, including primary care. A resilient health system should be ready for a crisis and have adaptable policies in place to offer adequate response at all levels, as well as post-recovery planning. Such health systems should also seek for continuous improvement. More research is needed to assess the efficacy of initiatives for improving health system resilience, particularly in vulnerable African health systems.
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Affiliation(s)
- Dick Chamla
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Chinwe Iwu-Jaja
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Asiphe Mavi Ndlambe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Muyunda Buwa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | | | - Joseph Okeibunor
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Charles Shey Wiysonge
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Abdou Salam Gueye
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
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Tchouaket EN, Kruglova K, Létourneau J, Bélanger E, Robins S, Jubinville M, El-Mousawi F, Shen S, Beogo I, Sia D. Factors influencing long-term care facility performance during the COVID-19 pandemic: a scoping review. BMC Health Serv Res 2024; 24:901. [PMID: 39113065 PMCID: PMC11304669 DOI: 10.1186/s12913-024-11331-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 07/19/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic wreaked havoc on long-term care facilities (LTCFs). Some LTCFs performed better than others at slowing COVID-19 transmission. Emerging literature has mostly described infection prevention and control strategies implemented by LTCFs during the pandemic. However, there is a need for a comprehensive review of factors that influenced the performance of LTCFs in containing COVID-19 spread to inform public health policy. OBJECTIVE To build on the existing literature, we conducted a scoping review of factors that influenced LTCF performance during the COVID-19 pandemic using a multidimensional conceptual framework of performance. METHODS We followed the Joanna Briggs Institute's methodology for scoping reviews. We queried CINAHL, MEDLINE (Ovid), CAIRN, Science Direct, Scopus, and Web of Science for peer-reviewed literature in English or French published between January 1st, 2020 and December 31st, 2021. Retrieved records were screened for context (COVID-19 pandemic), population (LTCFs), interest (internal and external factors that influenced LTCF performance), and outcomes (dimensions of performance: equity, accessibility, reactivity, safety, continuity, efficacy, viability, efficiency). Descriptive characteristics of included articles were summarized. Dimensions of performance as well as internal (e.g., facility characteristics) and external (e.g., visitors) factors identified to have influenced LTCF performance were presented. RESULTS We retained 140 articles of which 68% were classified as research articles, 47% originated in North America, and most covered a period between March and July 2020. The most frequent dimensions of performance were "efficacy" (75.7%) and "safety" (75.7%). The most common internal factors were "organizational context" (72.9%) and "human resources" (62.1%), and the most common external factors were "visitors" (27.1%) and "public health guidelines" (25.7%). CONCLUSIONS Our review contributes to a global interest in understanding the impact of the COVID-19 pandemic on vulnerable populations residing and working in LTCFs. Though a myriad of factors were reported, a lack of randomized controlled trials makes it impossible to establish causality between the identified factors and LTCF performance. The use of a multidimensional framework can be recommended to evaluate healthcare system performance not merely in terms of efficacy and safety, but alongside other critical dimensions such as efficiency and equity. TRIAL REGISTRATION Research Registry ID: researchregistry7026.
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Affiliation(s)
- Eric Nguemeleu Tchouaket
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada.
| | - Katya Kruglova
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Josiane Létourneau
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Emilie Bélanger
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Stephanie Robins
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Maripier Jubinville
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Fatima El-Mousawi
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Shiyang Shen
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de la Montagne, Montréal, QC, H3G 2M1, Canada
| | - Idrissa Beogo
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Drissa Sia
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
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Santhakumaran S, Baiad A, Ranjbari D, Correa JA, Chaudhry Z, Toffoli D. Impact of 5 waves of COVID-19 on pediatric ophthalmology. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00187-X. [PMID: 39106963 DOI: 10.1016/j.jcjo.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/05/2024] [Accepted: 06/16/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVE To characterize the impact of multiple waves of COVID-19 on pediatric ophthalmology at a tertiary care hospital. METHODS Medical records were reviewed from pediatric patients seen for ophthalmic emergencies at the Montreal Children's Hospital (Montreal, Canada) from 5 COVID-19 periods: March 13 to May 31, 2020; September 20, 2020, to February 21, 2021; March 21 to May 31, 2021; August 17 to November 5, 2021; and December 19, 2021, to January 25, 2022, as well as 2 pre-COVID time periods: March 13 to May 31, in 2018 and 2019). RESULTS There was a significant reduction in ophthalmic consultations when comparing pre-COVID to all 5 COVID waves (p < 0.0001). There was an increase in the average number of daily urgent (p = 0.01) ophthalmic consultations from waves 1 to 4. Mean household income of patients was not significantly different pre-COVID compared to during the 5 COVID waves (p = 0.96). The most common referral reason was ocular trauma (38.0% of cases). There was a non-significant trend demonstrating more infectious disease presentations during waves 3 to 5 (p = 0.07). There was no difference in symptom duration prior to presentation (p = 0.54); however, there was a difference in the time between emergency room and ophthalmology assessment in waves 3 and 4 compared with wave 5 (p = 0.003). CONCLUSION The number of pediatric ophthalmology consultations was less during the 5 COVID waves than pre-COVID. An increase in urgent pediatric ophthalmology consultations occurred as COVID-19 infection rates in Quebec decreased. Access to health care and time to care were preserved across waves compared with pre-pandemic.
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Affiliation(s)
| | - Abed Baiad
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Dorsai Ranjbari
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - José A Correa
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - Zoya Chaudhry
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, Canada
| | - Daniela Toffoli
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, Canada
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Piotrowski CC, Strong J, Giesbrecht A, Goldberg A, Kudar K, Pappas K, Rempel G. Coping With COVID-19: Perspectives of Caregivers of Children and Young People With Chronic Kidney Disease. Pediatr Transplant 2024; 28:e14823. [PMID: 39030950 DOI: 10.1111/petr.14823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/17/2024] [Accepted: 06/22/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Caregivers of children and young people with chronic kidney disease (CKD) face challenging circumstances on a daily basis; however, the difficulties they experienced during the COVID-19 pandemic, as well as potentially positive experiences, are not yet fully understood. The aim of this study was to explore the pandemic-related experiences of these caregivers. METHODS Twelve caregivers were recruited from a hospital-based pediatric renal program; eight families were posttransplant. Caregivers participated in virtual semistructured interviews conducted between March 2021 and November 2022. They provided responses to open-ended questions concerning how the pandemic affected their child with CKD, their family, and themselves. Interviews were transcribed and coded using thematic analysis. RESULTS Four main themes were identified: (1) Family Life, which included disruptions in routine, reduced social supports, and changes in the quality of family relationships; (2) Mental Health and Coping, which included increased anxiety and positive coping strategies; (3) Work and School Life, which included changes to work and school; and (4) Health and Health Care Systems, which included virtual health care and public health restrictions. CONCLUSIONS Despite facing profound challenges, caregivers identified both positive and negative aspects of their pandemic experiences. Their coping strategies highlighted individual and family resilience characteristics. Implications for health care providers, including future pandemic planning, support for the transition from in-person to virtual care, and strategies to better address barriers to resources for families of children with chronic kidney disease were discussed.
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Affiliation(s)
- Caroline C Piotrowski
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julie Strong
- HSC Children's Hospital of Winnipeg, Winnipeg, Manitoba, Canada
| | | | - Aviva Goldberg
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kira Kudar
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katerina Pappas
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gina Rempel
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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Khorram-Manesh A, Burkle FM, Goniewicz K. Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions. Osong Public Health Res Perspect 2024; 15:267-285. [PMID: 39039818 PMCID: PMC11391372 DOI: 10.24171/j.phrp.2023.0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/03/2024] [Indexed: 07/24/2024] Open
Abstract
The extensive history of pandemics has spanned many centuries, profoundly impacting societies, economies, and public health, and thereby shaping the course of history in various ways. Advances in medicine, science, and public health practices have played a pivotal role in mitigating the effects of pandemics over time. This review explores the scientific landscape of contemporary pandemics, examining their diverse and complex nature. It goes beyond the biological aspects of pandemics to consider socioeconomic, environmental, and technological factors. Through a scientific lens, this study aims to understand the complexities of pandemics and contribute to the expanding knowledge base that helps humanity strengthen its defenses against global health threats. By elucidating the enigmas of pandemics, the study hopes to foster a more resilient and prepared global health environment. Highlighting the importance of a multidisciplinary, cross-disciplinary, and transdisciplinary approach, this exploration emphasizes the critical need to integrate biological, socioeconomic, environmental, and technological domains to develop more robust defenses against these global health challenges.
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Affiliation(s)
- Amir Khorram-Manesh
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Disaster Medicine, Gothenburg University, Gothenburg, Sweden
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Robitaille A, David PM, Collin J. Use of a "baby bottle" to allow a "better-than-nothing" death in older adults infected by COVID-19 in Quebec retirement homes - A case study. Soc Sci Med 2024; 359:117072. [PMID: 39326324 DOI: 10.1016/j.socscimed.2024.117072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 09/28/2024]
Abstract
The COVID-19 pandemic has brought to the forefront profound questions surrounding dying and the concept of a "good death". This qualitative case study, conducted in a health center in Quebec, Canada, severely affected by outbreaks during the pandemic's first wave, explores end-of-life care for older adults in retirement homes. Through thirty interviews with healthcare practitioners, researchers, and managers, we investigate the critical role of a pharmacological device referred to as the "baby bottle" in providing end-of-life care to older adults infected with COVID-19 in their homes. Drawing upon the boundary object framework, we examine the ambiguities surrounding the use of this device and explores its agency. In this unprecedented context, we argue that the device facilitated a form of death that could be described as "better than nothing", embodying practitioners' efforts to provide some dignity to the dying person, by minimally controlling the distress and ensuring a connection between the dying person and the care team. Additionally, it served as a means of coping with the pandemic's intolerable aspects, such as the exclusion of frail older adults for the supposed common good. This study raises questions about the legitimacy and normalization of such compensatory measure within under-resourced healthcare systems for older people experiencing a loss of autonomy.
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Heltveit-Olsen SR, Lunde L, Brænd AM, Spehar I, Høye S, Skoglund I, Sundvall PD, Fossum GH, Straand J, Risør MB. Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers. Scand J Prim Health Care 2024; 42:214-224. [PMID: 38214890 PMCID: PMC10851791 DOI: 10.1080/02813432.2023.2301562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses. DESIGN Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data. RESULTS Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality. CONCLUSIONS The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.
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Affiliation(s)
- Silje Rebekka Heltveit-Olsen
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lene Lunde
- Department of Public Health Science, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anja Maria Brænd
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ivan Spehar
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
- Institute of Psychology, Oslo New University College, Oslo, Norway
| | - Sigurd Høye
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ingmarie Skoglund
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden
| | - Pär-Daniel Sundvall
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, Sweden
| | - Guro Haugen Fossum
- Department of General Practice, The Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jørund Straand
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Mette Bech Risør
- Department of Public Health, The Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
- The General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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McSween-Cadieux E, Lane J, Hong QN, Houle AA, Lauzier-Jobin F, Saint-Pierre Mousset E, Prigent O, Ziam S, Poder T, Lesage A, Dagenais P. Production and use of rapid responses during the COVID-19 pandemic in Quebec (Canada): perspectives from evidence synthesis producers and decision makers. Health Res Policy Syst 2024; 22:22. [PMID: 38351054 PMCID: PMC10863098 DOI: 10.1186/s12961-024-01105-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has required evidence to be made available more rapidly than usual, in order to meet the needs of decision makers in a timely manner. These exceptional circumstances have caused significant challenges for organizations and teams responsible for evidence synthesis. They had to adapt to provide rapid responses to support decision-making. This study aimed to document (1) the challenges and adaptations made to produce rapid responses during the pandemic, (2) their perceived usefulness, reported use and factors influencing their use and (3) the methodological adaptations made to produce rapid responses. METHODS A qualitative study was conducted in 2021 with eight organizations in the health and social services system in Quebec (Canada), including three institutes with a provincial mandate. Data collection included focus groups (n = 9 groups in 8 organizations with 64 participants), interviews with decision makers (n = 12), and a document analysis of COVID-19 rapid responses (n = 128). A thematic analysis of qualitative data (objectives 1 and 2) and a descriptive analysis of documents (objective 3) were conducted. RESULTS The results highlight the teams and organizations' agility to deal with the many challenges encountered during the pandemic (e.g., increased their workloads, adoption of new technological tools or work processes, improved collaboration, development of scientific monitoring, adaptation of evidence synthesis methodologies and products). The challenge of balancing rigor and speed was reported by teams and organizations. When available at the right time, rapid responses have been reported as a useful tool for informing or justifying decisions in a context of uncertainty. Several factors that may influence their use were identified (e.g., clearly identify needs, interactions with producers, perceived rigor and credibility, precise and feasible recommendations). Certain trends in the methodological approaches used to speed up the evidence synthesis process were identified. CONCLUSIONS This study documented rapid responses producers' experiences during the COVID-19 pandemic in Quebec, and decision makers who requested, consulted, or used these products. Potential areas of improvements are identified such as reinforce coordination, improve communication loops, clarify guidelines or methodological benchmarks, and enhance utility of rapid response products for decision makers.
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Affiliation(s)
- Esther McSween-Cadieux
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada.
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada.
| | - Julie Lane
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Quan Nha Hong
- School of Rehabilitation, Université de Montréal, Montreal, Canada
| | - Andrée-Anne Houle
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
- Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - François Lauzier-Jobin
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Eliane Saint-Pierre Mousset
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Ollivier Prigent
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
| | - Saliha Ziam
- School of Business Administration, Université TÉLUQ, Montreal, Canada
| | - Thomas Poder
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), CIUSSS-de-l'Est-de-l'île-de-Montréal, Montreal, Canada
- Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, Canada
| | - Alain Lesage
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), CIUSSS-de-l'Est-de-l'île-de-Montréal, Montreal, Canada
| | - Pierre Dagenais
- Department of Medicine, Faculty of Medicine and Health Science, University of Sherbrooke, Sherbrooke, Canada
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10
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Guisado-Clavero M, Astier-Peña MP, Gómez-Bravo R, Ares-Blanco S. Open data for monitoring COVID-19 in Spain: Descriptive study. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:80-87. [PMID: 37088686 PMCID: PMC10073586 DOI: 10.1016/j.eimce.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 04/09/2023]
Abstract
BACKGROUND The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS All regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.
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Affiliation(s)
- Marina Guisado-Clavero
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria del área norte de la Comunidad de Madrid, Madrid, Spain
| | - María Pilar Astier-Peña
- Centro de Salud Univérsitas, Servicio Aragonés de Salud, Zaragoza, Spain; GdT de Seguridad del paciente de semFYC y del GdT de Calidad y Seguridad de WONCA, Zaragoza, Spain
| | - Raquel Gómez-Bravo
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and CognitiveSciences, Faculty of Humanities, Education, and Social Sciences, Universidad de Luxemburgo, Luxembourg, Luxembourg
| | - Sara Ares-Blanco
- Centro de Salud Federica Montseny, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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11
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Korab M, Kilpatrick K, Sarasua I. Exploring Frontline Shelter Staff Perspectives on the Healthcare Needs of Clients Experiencing Homelessness. J Community Health Nurs 2024; 41:30-43. [PMID: 37732740 DOI: 10.1080/07370016.2023.2256307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
PURPOSE To examine healthcare service development needs for persons experiencing homelessness from the perspective of frontline staff at a homeless shelter in Montreal, Quebec. DESIGN Qualitative descriptive design. METHODS Purposive sampling, semi-structured interviews with frontline shelter staff (n = 8), and thematic analysis. FINDINGS Themes included: 1) Challenges meeting healthcare service needs in a shelter environment. 2) Visions for improving healthcare services while accounting for health issues and barriers to care. 3) Participants' own knowledge gaps around health and healthcare services. CONCLUSIONS Future research should emphasize this group's crucial role in homelessness healthcare services development.
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Affiliation(s)
| | - Kelley Kilpatrick
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Irene Sarasua
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
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12
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Auger N, Bilodeau-Bertrand M, Ayoub A, Blackburn M, Potter BJ. Hospitalization and hospital mortality rates during the first and second waves of the COVID-19 pandemic in Quebec: interrupted time series and decomposition analysis. Public Health 2023; 225:28-34. [PMID: 37918174 DOI: 10.1016/j.puhe.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/17/2023] [Accepted: 09/19/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES We investigated hospitalization and hospital mortality rates by cause during the first year of the COVID-19 pandemic in Quebec, Canada. STUDY DESIGN Interrupted time series and decomposition analysis. METHODS We analyzed hospital mortality during the first (February 25-August 22, 2020) and second waves (August 23, 2020-March 31, 2021), compared with 2019. We identified the cause of death and examined trends using: 1) interrupted time series analysis; 2) log-binomial regression; and 3) decomposition of cause-specific mortality. RESULTS Hospitalization rates decreased; however, the proportion of deaths increased from 27.0 per 1000 in 2019 to 35.0 per 1000 in the first wave, for an excess of 8.0 deaths per 1000 admissions. COVID-19 was the cause of a third of excess deaths (2.6 per 1000). Other drivers of excess deaths included respiratory conditions (1.6 deaths per 1000), circulatory disorders (0.6 deaths per 1000), and cancer (0.9 deaths per 1000). COVID-19 was the cause of 58% of excess deaths in the second wave. Interrupted time series regression indicated that the proportion of deaths increased at the outset of the first wave but returned to prepandemic levels before increasing again in the second wave. Compared with 2019, the first wave was associated with 1.31 times (95% confidence interval [CI] 1.28-1.33) and the second wave with 1.17 times (95% CI 1.15-1.19) the risk of death during hospitalization. CONCLUSIONS The pandemic was associated with a greater risk of hospital mortality. Excess deaths were driven by COVID-19 but also other causes, including respiratory conditions, circulatory disorders, and cancer.
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Affiliation(s)
- N Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
| | | | - A Ayoub
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - M Blackburn
- Department of Community Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - B J Potter
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Division of Cardiology, Department of Medicine, University of Montreal Hospital Centre, Montreal, Quebec, Canada
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13
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Smits P, Cambourieu C, Ouimet M. Connections between health research systems and decision-making spaces: lessons from the COVID-19 pandemic in the province of Québec, Canada. Health Res Policy Syst 2023; 21:116. [PMID: 37919781 PMCID: PMC10621227 DOI: 10.1186/s12961-023-01053-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/23/2023] [Indexed: 11/04/2023] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic allowed for exceptional decision-making power to be placed in the hands of public health departments. Data and information were widely disseminated in the media and on websites. While the improvement of pandemic management is still a learning curve, the ecosystem perspective - that is, the interconnection of academic health research systems and decision-making spaces - has received little attention. In this commentary, we look at the mechanisms in place, or not, in Canada for ensuring decision-making spheres can "speak" to academic research systems. We look at the thick walls that are still in place between health research systems and decision-making spaces. More precisely, we discuss three organizational flaws that we identified in the evidence-informed decision-making ecosystem of Québec and, more broadly, Canada. We introduce some inspiring measures that other countries have implemented to better link evidence and public health decision-making during health crises. The observed flaws and options are related to the vitality of early information sharing relays, the cross-sectional capacity to issue opinions, and the collection and integration of hard and soft data.
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Affiliation(s)
- Pernelle Smits
- Departement de Management, Université Laval, Québec, Canada.
| | | | - Mathieu Ouimet
- Departement de Sciences Politiques, Université Laval, Québec, Canada
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Gomes Chaves B, Alami H, Sonier-Ferguson B, Dugas EN. Assessing healthcare capacity crisis preparedness: development of an evaluation tool by a Canadian health authority. Front Public Health 2023; 11:1231738. [PMID: 37881342 PMCID: PMC10594116 DOI: 10.3389/fpubh.2023.1231738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/21/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction The COVID-19 pandemic presented health systems across the globe with unparalleled socio-political, ethical, scientific, and economic challenges. Despite the necessity for a unified, innovative, and effective response, many jurisdictions were unprepared to such a profound health crisis. This study aims to outline the creation of an evaluative tool designed to measure and evaluate the Vitalité Health Network's (New Brunswick, Canada) ability to manage health crises. Methods The methodology of this work was carried out in four stages: (1) construction of an evaluative framework; (2) validation of the framework; (3) construction of the evaluative tool for the Health Authority; and (4) evaluation of the capacity to manage a health crisis. Results The resulting evaluative tool incorporated 8 dimensions, 74 strategies, and 109 observable elements. The dimensions included: (1) clinical care management; (2) infection prevention and control; (3) governance and leadership; (4) human and logistic resources; (5) communication and technologies; (6) health research; (7) ethics and values; and (8) training. A Canadian Health Authority implemented the tool to support its future preparedness. Conclusion This study introduces a methodological strategy adopted by a Canadian health authority to evaluate its capacity in managing health crises. Notably, this study marks the first instance where a Canadian health authority has created a tool for emergency healthcare management, informed by literature in the field and their direct experience from handling the SARS-CoV-2 pandemic.
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Affiliation(s)
- Breitner Gomes Chaves
- Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Centre, Moncton, NB, Canada
| | - Hassane Alami
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada
| | | | - Erika N. Dugas
- Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Centre, Moncton, NB, Canada
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15
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Orhierhor M, Pringle W, Halperin D, Parsons J, Halperin SA, Bettinger JA. Lessons learned from the experiences and perspectives of frontline healthcare workers on the COVID-19 response: a qualitative descriptive study. BMC Health Serv Res 2023; 23:1074. [PMID: 37805603 PMCID: PMC10559616 DOI: 10.1186/s12913-023-10062-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, healthcare systems and healthcare workers (HCWs) faced significant demands and unique challenges. In this qualitative study, we explore the effects of the COVID-19 public health policies on British Columbia's frontline HCWs, describe what worked in the management of the pandemic, and elucidate the lessons learned that could be applied to future pandemic preparedness, recovery and response. METHODS This qualitative descriptive study is part of a larger, national multi-case study on pandemic policy communication and uptake. Semi-structured interviews were conducted from November 2020- June 2021 with fourteen HCWs working in long-term care (LTC), acute care and public health settings. Data were inductively coded, and analyzed following a resilience framework for public health emergency preparedness, which emphasizes the essential elements of a public health system, vital to all phases of health emergency management, readiness, response and recovery. RESULTS HCWs experienced confusion, frustration, uncertainty, anxiety, fatigue and stress, during the pandemic and detailed challenges that affected policy implementation. This included communication and coordination inconsistencies between the province and regional health authorities; lack of involvement of frontline staff in pandemic planning; inadequate training and support; inadequate personal protective equipment resource capacity and mobilization; and staffing shortages. HCWs recommended increased collaboration between frontline staff and policy makers, investment in preparing and practicing pandemic plans, and the need for training in emergency management and infection prevention and control. CONCLUSIONS Pandemic planning, response and recovery should include inputs from actors/key stakeholders at the provincial, regional and local levels, to facilitate better coordination, communication and outcomes. Also, given the critical roles of frontline HCWs in policy implementation, they should be adequately supported and consideration must be given to how they interpret and act on policies. Bi-directional communication channels should be incorporated between policymakers and frontline HCWs to verify the appropriate adoption of policies, reflective learning, and to ensure policy limitations are being communicated and acted upon by policy makers.
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Affiliation(s)
- Marian Orhierhor
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, A5-950 West 28th Street, Vancouver, BC, V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Wendy Pringle
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, A5-950 West 28th Street, Vancouver, BC, V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Donna Halperin
- Rankin School of Nursing, St. Francis Xavier University, 4130 University Ave, Antigonish, Nova Scotia, B2G 2W5, Canada
- Canadian Center for Vaccinology, Dalhousie University, IWK Health, Nova Scotia Health, Halifax, Nova Scotia, B3K 6R8, Canada
| | - Janet Parsons
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, M5B 1W8, Canada
- Department of Occupational Science & Occupational Therapy, Department of Physical Therapy, and the Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health, Nova Scotia Health, Halifax, Nova Scotia, B3K 6R8, Canada
- Departments of Pediatrics and Microbiology & Immunology, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, A5-950 West 28th Street, Vancouver, BC, V5Z 4H4, Canada.
- Department of Pediatrics, University of British Columbia, Vancouver, Canada.
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Knutsen Glette M, Ludlow K, Wiig S, Bates DW, Austin EE. Resilience perspective on healthcare professionals' adaptations to changes and challenges resulting from the COVID-19 pandemic: a meta-synthesis. BMJ Open 2023; 13:e071828. [PMID: 37730402 PMCID: PMC10514639 DOI: 10.1136/bmjopen-2023-071828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE To identify, review and synthesise qualitative literature on healthcare professionals' adaptations to changes and challenges resulting from the COVID-19 pandemic. DESIGN Systematic review with meta-synthesis. DATA SOURCES Academic Search Elite, CINAHL, MEDLINE, PubMed, Science Direct and Scopus. ELIGIBILITY CRITERIA Qualitative or mixed-methods studies published between 2019 and 2021 investigating healthcare professionals' adaptations to changes and challenges resulting from the COVID-19 pandemic. DATA EXTRACTION AND SYNTHESIS Data were extracted using a predesigned data extraction form that included details about publication (eg, authors, setting, participants, adaptations and outcomes). Data were analysed using thematic analysis. RESULTS Forty-seven studies were included. A range of adaptations crucial to maintaining healthcare delivery during the COVID-19 pandemic were found, including taking on new roles, conducting self and peer education and reorganising workspaces. Triggers for adaptations included unclear workflows, lack of guidelines, increased workload and transition to digital solutions. As challenges arose, many health professionals reported increased collaboration across wards, healthcare teams, hierarchies and healthcare services. CONCLUSION Healthcare professionals demonstrated significant adaptive capacity when faced with challenges imposed by the COVID-19 pandemic. Several adaptations were identified as beneficial for future organisational healthcare service changes, while others exposed weaknesses in healthcare system designs and capacity, leading to dysfunctional adaptations. Healthcare professionals' experiences working during the COVID-19 pandemic present a unique opportunity to learn how healthcare systems rapidly respond to changes, and how resilient healthcare services can be built globally.
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Affiliation(s)
- Malin Knutsen Glette
- SHARE-Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Kristiana Ludlow
- Centre for Health Services Research, The University of Queensland School of Psychology, Saint Lucia, Queensland, Australia
| | - Siri Wiig
- SHARE-Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - David Westfall Bates
- SHARE-Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Elizabeth E Austin
- Australian Institute of Health Innovation, Centre for Healthcare Resilience and Implementation Science, Macquarie University, Sydney, New South Wales, Australia
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Tan MZY, Prager G, McClelland A, Dark P. Healthcare resilience: a meta-narrative systematic review and synthesis of reviews. BMJ Open 2023; 13:e072136. [PMID: 37730383 PMCID: PMC10514640 DOI: 10.1136/bmjopen-2023-072136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building. DESIGN Systematic review and synthesis of reviews using a meta-narrative approach. SETTING Healthcare organisations and systems. PRIMARY AND SECONDARY OUTCOME MEASURES Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience. RESULTS The main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an 'all-hazards' approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework. CONCLUSION Resilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. PROSPERO REGISTRATION NUMBER CRD42022314729.
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Affiliation(s)
- Mark Z Y Tan
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
| | - Gabrielle Prager
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew McClelland
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
| | - Paul Dark
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
- Clinical Research Network, National Institute for Health and Care Research, London, UK
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18
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Srigley JA, Cheng B, Collet JC, Donovan Towell T, Han G, Keen D, Leung KW, Mori J, Ali RA. Barriers to infection prevention and control in long-term care/assisted living settings in British Columbia during the COVID-19 pandemic: a cross-sectional survey. Antimicrob Resist Infect Control 2023; 12:84. [PMID: 37649046 PMCID: PMC10469816 DOI: 10.1186/s13756-023-01292-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disproportionately impacted long-term care and assisted living (LTC/AL) facilities in Canada, where infection prevention and control (IPAC) programs had been suboptimal. We aimed to identify barriers affecting healthcare workers' (HCW) adherence to IPAC practices during the pandemic in British Columbia in LTC/AL compared to acute care settings. METHODS We conducted a web-based survey of direct care providers and IPAC professionals across BC from August to September 2021, focused on knowledge and attitudes toward IPAC within the context of the COVID-19 pandemic, and barriers that affected respondents' abilities to follow IPAC practices throughout the pandemic. RESULTS The final analysis included 896 acute care respondents and 441 from LTC/AL. More LTC/AL respondents reported experiencing the following barriers: following IPAC guidance was of lower priority compared to other tasks (29.1% vs. 14.7%, FDR = 0.001) and not their responsibility (28.0% vs. 11.2%, FDR = 0.001); limited supplies for personal protective equipment (PPE) (49.0% vs. 33.6%, FDR = 0.001), hand hygiene products (42.2% vs. 28.8%, FDR = 0.001), and cleaning/disinfection products (44.1% vs. 30.3%, FDR = 0.001); deficits in IPAC leadership support (46.2% vs. 38.9%, FDR = 0.012), IPAC education and training (46.9% vs. 32.0%, FDR = 0.001), and patient care knowledge for managing COVID-19 infections (46.6% vs. 36.0%, FDR = 0.001). CONCLUSIONS This survey found that barriers to HCWs' adherence to IPAC practices during the COVID-19 pandemic were different in LTC/AL settings compared to acute care. Improvement efforts should focus on strengthening IPAC programs in LTC/AL, particularly enhanced IPAC staffing/leadership, increased training and education, and improving access to PPE, hand hygiene, and cleaning products.
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Affiliation(s)
- Jocelyn A Srigley
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
- Department of Pathology and Laboratory Medicine, BC Children's Hospital and BC Women's Hospital and Health Centre, 4500 Oak St, Room 2J3, Vancouver, BC, V6H 3N1, Canada.
| | - Brooke Cheng
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Jun Chen Collet
- Provincial Health Services Authority, 200-1333 W Broadway, Vancouver, BC, V6H 4C1, Canada
| | - Tara Donovan Towell
- Provincial Health Services Authority, 200-1333 W Broadway, Vancouver, BC, V6H 4C1, Canada
| | - Guanghong Han
- Provincial Health Services Authority, 200-1333 W Broadway, Vancouver, BC, V6H 4C1, Canada
| | - Dave Keen
- Fraser Health Authority, Suite 400, Central City Tower 13450 - 102nd Avenue, Surrey, BC, V3T 0H1, Canada
| | - Ka Wai Leung
- Provincial Health Services Authority, 200-1333 W Broadway, Vancouver, BC, V6H 4C1, Canada
| | - Julie Mori
- Interior Health Authority, 505 Doyle Ave, Kelowna, BC, V1Y 0C5, Canada
| | - R Ayesha Ali
- Department of Mathematics and Statistics, University of Guelph, 50 Stone Road East, Room 437 MacNaughton Building, Guelph, ON, N1G 2W1, Canada
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Najafi H, Kavosi Z, Rakhshan M, Karimi J, Marzale MA, Bijani M, Peyravi M. Exploring senior managers' experiences preparedness to respond to COVID-19: a qualitative study in Iran. BMC Health Serv Res 2023; 23:776. [PMID: 37474970 PMCID: PMC10360321 DOI: 10.1186/s12913-023-09764-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 06/29/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Epidemics caused by emerging respiratory viruses are challenging for the health system of most societies, and preparedness of the health system in responding to such epidemics is important. Therefore, the aim of this study was identifying different fields and key issues of the senior managers' experiences preparedness to respond to the COVID-19 epidemic from the Iranian senior managers' point of view. METHODS This is a qualitative descriptive study. Eighteen in-depth and semi-structured individual interviews were conducted for data collection. For this purpose, 18 senior managers with work experience in managing the COVID-19 crisis were enrolled in the study using purposive sampling. The collected data were analyzed according to Graneheim and Lundman's approach. RESULTS Analysis of the data resulted in the emergence of five themes and twelve sub-themes. The main themes and sub-themes included: (1) capacity improvement consisting of performance improvement and logistic improvement; (2) resource and infrastructure management including supply and support of human resources, infrastructure improvement, and supply of equipment; (3) an increase in epidemiology capacity including epidemiology improvement and emerging disease surveillance; (4) application of the principles of disaster and emergency management including intra- and extra-organizational interaction management, disaster risk management, and data management; and (5) society resilience increase including improving adaptation skill and maintaining health and social participation. CONCLUSION The results of this study present the key issues for the management of future emergency situations. Health system managers and policymakers in Iran and other countries should be aware of these key issues and apply them in practice to prepare the health systems to respond to next outbreaks. Indeed, the study results can help policymakers and health system managers to plan to achieve acceptable preparedness for the management of such outbreaks.
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Affiliation(s)
- Hojatolah Najafi
- Department of Health in Disasters and Emergencies, Health Human Resources Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jalal Karimi
- Department of Infection Disease, Faculty of Medicine, Fasa University of Medical Science, Fasa, Iran
| | - Milad Ahmadi Marzale
- Department of Health in Disasters and Emergencies, Health Human Resources Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mahmoudreza Peyravi
- Department of Health in Disasters and Emergencies, Health Human Resources Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Gautier L, Noda S, Chabrol F, David PM, Duhoux A, Hou R, Rosana de Araújo Oliveira S, Traverson L, Zinszer K, Ridde V. Hospital Governance During the COVID-19 Pandemic: A Multiple-Country Case Study. Health Syst Reform 2023; 9:2173551. [PMID: 37253204 DOI: 10.1080/23288604.2023.2173551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/24/2023] [Indexed: 06/01/2023] Open
Abstract
In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals' governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hospital cases from four countries on different continents: Brazil, Canada, France, and Japan. Our study examined how governance strategies (e.g., special task forces, communications management tools, etc.) were perceived by hospital staff. Key findings from a total of 177 qualitative interviews with diverse hospital stakeholders were analyzed using three categories drawn from the European Observatory on Health Systems and Policies framework on health systems resilience during the COVID-19 pandemic: 1) delivering a clear and timely COVID-19 response strategy; 2) coordinating effectively within (horizontally) and across (vertically) levels of decision-making; and 3) communicating clearly and transparently with the hospital's diverse stakeholders. Our study gleaned rich accounts for these three categories, highlighting significant variations across settings. These variations were primarily determined by the hospitals' environment prior to the COVID-19 crisis, namely whether there already existed a culture of managerial openness (including spaces for social interactions among hospital staff) and whether preparedness planning and training had been routinely integrated into their activities.
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Affiliation(s)
- Lara Gautier
- School of Public Health, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | - Shinichiro Noda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fanny Chabrol
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | | | - Arnaud Duhoux
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada
| | - Renyou Hou
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | | | - Lola Traverson
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
| | - Kate Zinszer
- School of Public Health, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | - Valéry Ridde
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
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Gabet M, Duhoux A, Ridde V, Zinszer K, Gautier L, David PM. How Did an Integrated Health and Social Services Center in the Quebec Province Respond to the COVID-19 Pandemic? A Qualitative Case Study. Health Syst Reform 2023; 9:2186824. [PMID: 37000982 DOI: 10.1080/23288604.2023.2186824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
During the first and second waves of the pandemic, Quebec was among the Canadian provinces with the highest COVID-19 mortality rates. Facing particularly large COVID-19 outbreaks in its facilities, an integrated health and social services center in the province of Quebec (Canada), developed resilience strategies. To explore these diverse responses to the crisis, we conducted a case study analysis of a Quebec integrated health and social services center, building on a conceptualization of resilience strategies using "configurations" of effects, strategies, and impacts. Qualitative data from 14 indepth interviews conducted in the summer and fall of 2020 with managers and frontline practitioners were analyzed through the lens of situations of "anticipation," "reaction," or "inaction." The findings were discussed in three results dissemination workshops, two with practitioners and one with managers, to discern lessons they learned. Three major configurations emerged: 1) reorganization of services and spaces to accommodate more COVID-19 patients; 2) management of contamination risks for patients and professionals; and 3) management of personal protective equipment (PPE), supplies, and medications. Within these configurations, the responses to the crisis were strongly shaped by the 2015 health care system reforms in Quebec and were constrained by organizational challenges that included a centralized model of governance, a history of substantial budget cuts to longterm care facilities, and a systematic lack of human resources.
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Vivion M, Jauvin N, Nicolakakis N, Pelletier M, Letellier MC, Biron C. Psychosocial Risks among Quebec Healthcare Workers during the COVID-19 Pandemic: A Social Media Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6116. [PMID: 37372703 DOI: 10.3390/ijerph20126116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/27/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
During the COVID-19 pandemic, healthcare workers (HCWs) were at high risk of exposure to the SARS-CoV-2 virus and to work-related psychosocial risks, such as high psychological demands, low social support at work and low recognition. Because these factors are known to be detrimental to health, their detection and mitigation was essential to protect the healthcare workforce during the pandemic, when this study was initiated. Therefore, using Facebook monitoring, this study aims to identify the psychosocial risk factors to which HCWs in Quebec, Canada reported being exposed at work during the first and second pandemic waves. In this study, HCWs mainly refer to nurses, respiratory therapists, beneficiary attendants and technicians (doctors, managers and heads of healthcare establishments were deemed to be less likely to have expressed work-related concerns on the social media platforms explored). A qualitative exploratory research based on passive analysis of Facebook pages from three different unions was conducted. For each Facebook page, automatic data extraction was followed by and completed through manual extraction. Posts and comments were submitted to undergo thematic content analysis allowing main coded themes to emerge based on known theoretical frameworks of the psychosocial work environment. In total, 3796 Facebook posts and comments were analyzed. HCWs reported a variety of psychosocial work exposures, the most recurrent of which were high workload (including high emotional demands), lack of recognition and perceived injustice, followed by low workplace social support and work-life conflicts. Social media monitoring was a useful approach for documenting the psychosocial work environment during the COVID-19 crisis and could be a useful means of identifying potential targets for preventive interventions in future sanitary crises or in a context of major reforms or restructuring.
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Affiliation(s)
- Maryline Vivion
- Department of Scientific Valorization and Quality, Institut National de Santé Publique du Québec (INSPQ), Quebec, QC G1V 5B3, Canada
- CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada
| | - Nathalie Jauvin
- Department of Environmental and Occupational Health and Toxicology, Institut National de Santé Publique du Québec (INSPQ), Quebec, QC G1V 5B3, Canada
| | - Nektaria Nicolakakis
- Department of Environmental and Occupational Health and Toxicology, Institut National de Santé Publique du Québec (INSPQ), Montreal, QC H2P 1E2, Canada
| | - Mariève Pelletier
- Guidance and Counseling School, Université Laval, Quebec, QC G1V 0A6, Canada
| | | | - Caroline Biron
- Department of Management, Faculty of Business & Administration, VITAM-Research Center for Sustainable Health, Université Laval, Quebec, QC G1V 0A6, Canada
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Côté-Corriveau G, Luu TM, Lewin A, Brousseau É, Ayoub A, Blaser C, Auger N. Hospitalization for child maltreatment and other types of injury during the COVID-19 pandemic. CHILD ABUSE & NEGLECT 2023; 140:106186. [PMID: 37060690 PMCID: PMC10080276 DOI: 10.1016/j.chiabu.2023.106186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/13/2023] [Accepted: 03/31/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The possibility that child maltreatment was misclassified as unintentional injury during the COVID-19 pandemic has not been evaluated. OBJECTIVE We assessed if child maltreatment hospitalizations changed during the pandemic, and if the change was accompanied by an increase in unintentional injuries. PARTICIPANTS AND SETTING This study included children aged 0-4 years who were admitted for maltreatment or unintentional injuries between April 2006 and March 2021 in hospitals of Quebec, Canada. METHODS We used interrupted time series regression to estimate the effect of the pandemic on hospitalization rates for maltreatment, compared with unintentional transport accidents, falls, and mechanical force injuries. We assessed if the change in maltreatment hospitalization was accompanied by an increase in specific types of unintentional injury. RESULTS Hospitalizations for child maltreatment decreased from 16.3 per 100,000 (95 % CI 9.1-23.4) the year before the pandemic to 13.2 per 100,000 (95 % CI 6.7-19.7) during the first lockdown. Hospitalizations for most types of unintentional injury also decreased, but injuries due to falls involving another person increased from 9.0 to 16.5 per 100,000. Hospitalization rates for maltreatment and unintentional injury remained low during the second lockdown, but mechanical force injuries involving another person increased from 3.8 to 8.1 per 100,000. CONCLUSIONS Hospitalizations for child maltreatment may have been misclassified as unintentional injuries involving another person during the pandemic. Children admitted for these types of unintentional injuries may benefit from closer assessment to rule out maltreatment.
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Affiliation(s)
- Gabriel Côté-Corriveau
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Hema-Quebec, Saint-Laurent, Quebec, Canada; Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Émilie Brousseau
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Aimina Ayoub
- Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Christine Blaser
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Nathalie Auger
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
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Gilbert JHV, Girard MA, Grymonpre RE, Mahler C, Maxwell B. The applicability of interprofessional education for collaborative people-centered practice and care to health plans and workforce issues: A thematic global case review. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2023; 36:67-75. [PMID: 38047334 DOI: 10.4103/efh.efh_459_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background This article focuses on a growing, global recognition of the importance of the field of interprofessional education for person-centered collaborative practice (IPECP) expressed through high-level policy and accreditation decisions/actions taking place in 5 countries. Policy decisions are used to motivate strategies related to IPECP that align with national health plans, and workforce issues. Methods Using a collective of representative stories from around the globe, a grouping of case studies were developed to illustrate different approaches and challenges to IPECP implementation. Results Institutions from countries of various income levels face many similar challenges in the execution, delivery, and sustainability of IPECP. All programs face issues of financing, of preparing faculty, of developing and organizing curricula, and of bridging between campus and community. Discussion Policies are being developed that promote a global approach to the inclusion of IPECP in the accreditation and regulation of postsecondary institutions and health service organizations, in keeping with WHO National Health Workforce Accounts. Policies developed promote and demonstrate the benefits of IPECP through remote emergency learning methods. The policies also build national systems for IPECP as an integral part of continuing professional development and lifelong learning. The organization of interprofessional research programs and the increasing publication of their results of such programs will lead to a clearer understanding of the efficacy of the field of IPECP. To ensure sustainability, stakeholders and policymakers should continue to foster policies that facilitate IPECP.
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Affiliation(s)
- John H V Gilbert
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | | | | | - Cornelia Mahler
- Department of Nursing Sciences, University of Tübingen, Tübingen, Germany
| | - Barbara Maxwell
- Interprofessional Practice and Education Center, Indiana University, Indianapolis, Indiana, USA
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25
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Lugo-Radillo A, Mendoza-Cano O, Trujillo X, Huerta M, Ríos-Silva M, Guzmán-Esquivel J, Benites-Godínez V, Bricio-Barrios JA, Ríos-Bracamontes EF, Cárdenas-Rojas MI, Cárdenas Y, Murillo-Zamora E. Assessing the Burden of Dengue during the COVID-19 Pandemic in Mexico. Trop Med Infect Dis 2023; 8:tropicalmed8040232. [PMID: 37104357 PMCID: PMC10140831 DOI: 10.3390/tropicalmed8040232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
The transmission of the dengue virus in Mexico has historically been high, and its burden during the COVID-19 pandemic is currently not well understood. Our objective was to assess the burden of dengue-related disability-adjusted life years (DALYs) between 2020 and 2022. We conducted a cross-sectional analysis of databases resulting from an epidemiological surveillance of vector-borne diseases and computed DALYs using the protocol of the Global Burden of Disease (GBD) study 2019. Our results showed that there were 218,807 incident cases of dengue during the study period, resulting in 951 deaths. The calculated DALYs (and their 95% confidence intervals) were 8121 (7897-8396), 4733 (4661-4820), and 8461 (8344-8605) in 2020, 2021, and 2022, respectively. The DALY rates (per 100,000) were 6.5 (6.3-6.6), 3.8 (3.7-3.9), and 6.7 (6.6-6.8), respectively. The rates for 2020 and 2022 were similar to the historical mean (6.4, p = 0.884), whereas the rate for 2021 was lower than the mean. Premature mortality (years of life lost, YLL) contributed to 91% of the total burden. Our findings suggest that dengue fever remained a significant cause of disease burden during the COVID-19 pandemic, especially in terms of premature mortality.
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Affiliation(s)
- Agustin Lugo-Radillo
- CONACyT-Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juárez de Oaxaca, Ex Hacienda Aguilera S/N, Carr. a San Felipe del Agua, Oaxaca 68020, Mexico
| | - Oliver Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Coquimatlán 28400, Mexico
| | - Xóchitl Trujillo
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - Miguel Huerta
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - Mónica Ríos-Silva
- Centro Universitario de Investigaciones Biomédicas, CONACyT-Universidad de Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - José Guzmán-Esquivel
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Verónica Benites-Godínez
- Coordinación de Educación en Salud, Instituto Mexicano del Seguro Social, Calzada del Ejercito Nacional 14, Col. Fray Junípero Serra, Tepic 63160, Mexico
- Unidad Académica de Medicina, Universidad Autónoma de Nayarit, Ciudad de la Cultura "Amado Nervo", Tepic 63155, Mexico
| | | | - Eder Fernando Ríos-Bracamontes
- Departamento de Medicina Interna, Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Martha I Cárdenas-Rojas
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
| | - Yolitzy Cárdenas
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico
| | - Efrén Murillo-Zamora
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico
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Berniak-Woźny J, Rataj M. Towards Green and Sustainable Healthcare: A Literature Review and Research Agenda for Green Leadership in the Healthcare Sector. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:908. [PMID: 36673663 PMCID: PMC9858978 DOI: 10.3390/ijerph20020908] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
The health sector is one of the keys to sustainable development. Although it is directly related to only one Sustainable Development Goal (Goal 3, "Ensuring a healthy life and promoting well-being at all ages"), the sector itself, which aims to protect health, is paradoxically at the same time the main emitter of environmental pollutants that have a negative impact on health itself. Therefore, sustainability has become a key priority for health sector organizations, and leadership in this area is essential at all levels. Scientific research plays a particular role here, helping to more clearly define the links between environmental sustainability and the health effects of a polluted environment and climate change as well as indicating the direction of actions needed and disseminating good practices that can help accelerate the adoption of efforts towards climate neutrality and sustainable development of health sector organizations. The aim of this article is to present the current state of the art and future research scenarios in the field of green and sustainable healthcare through a literature review by using the Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) method to perform a bibliometric analysis of papers published in 2012-2022. The Web of Science Core Collection (WoSCC) database is used for this purpose. A total of 144 papers are included for analysis, categorized based on eight fields: author(s), title, year of publication, country, journal, scientific category, and number of citations. Based on the results, themes for future research on green leadership in the healthcare sector are identified and recommended.
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Affiliation(s)
- Justyna Berniak-Woźny
- Department of Management, University of Information Technology and Management, 35-225 Rzeszów, Poland
| | - Małgorzata Rataj
- Department of Cognitive Science and Mathematical Modeling, University of Information Technology and Management, 35-225 Rzeszow, Poland
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Myles S, Leslie K, Adams TL, Nelson S. Regulating in the public interest: Lessons learned during the COVID-19 pandemic. Healthc Manage Forum 2023; 36:36-41. [PMID: 35924971 PMCID: PMC9353312 DOI: 10.1177/08404704221112286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article has three aims. First, to reflect on how conceptualizations of the public interest may have shifted due to COVID-19. Second, to focus on the implications of regulatory responses for the health workforce and corresponding lessons as health leaders and systems transition from pandemic response to pandemic recovery. Third, to identify how these lessons lead to potential directions for future research, connecting regulation in a whole-of-systems approach to health system safety and health workforce capacity and sustainability. Pandemic regulatory responses highlighted both strengths and limitations of regulatory structures and frameworks. The COVID-19 pandemic may have introduced new considerations around regulating in the public interest, particularly as the impact of regulatory responses on the health workforce continues to be examined. Clearly articulating practitioner practice parameters, reducing barriers to practice, and working collaboratively with stakeholders were primary aspects of regulators' pandemic responses that impacted the health workforce.
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Affiliation(s)
- Sophia Myles
- University of Toronto, Toronto, Ontario, Canada
- Athabasca University, Athabasca, Alberta, Canada
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Through the looking glass: Confronting health care management's biggest challenges in the wake of a crisis. Health Care Manage Rev 2023; 48:185-196. [PMID: 36792956 PMCID: PMC9970016 DOI: 10.1097/hmr.0000000000000365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND The challenges brought on by the pandemic triggered a renewed scholarly focus on managing during crises. Now, 3 years on, having covered the initial crisis response, it is important to reevaluate what the crisis has taught us about health care management more generally. In particular, it is useful to consider the persistent challenges that continue to face health care organizations in the wake of a crisis. PURPOSE The present article aims to identify the biggest challenges that currently face health care managers in order to formulate a postcrisis research agenda. METHODOLOGY/APPROACH We employ an exploratory qualitative study, utilizing in-depth interviews with hospital executives and management to explore the persistent challenges facing managers in practice. RESULTS Our qualitative inquiry reveals three key challenges that extend beyond the crisis and are salient for health care managers and organizations in the years to come. Specifically, we identify the centrality of human resource constraints (amidst increasing demand), the necessity of collaboration (amidst competition), and a need to reconsider the approach to leadership (utility of humility). CONCLUSION We conclude by drawing upon relevant theories such as paradox theory to formulate a research agenda for health care management scholars that can support the creation of novel solutions and approaches to persistent challenges in practice. PRACTICE IMPLICATIONS We identify several implications for organizations and health systems, including the need to eliminate competition and the importance of building human resource management capacities within organizations. In highlighting areas for future research, we provide organizations and managers with useful and actionable insights to address their most persistent challenges in practice.
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29
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Jabakhanji SB, Lepinteur A, Menta G, Piper A, Vögele C. Sleep quality and the evolution of the COVID-19 pandemic in five European countries. PLoS One 2022; 17:e0278971. [PMID: 36576928 PMCID: PMC9797060 DOI: 10.1371/journal.pone.0278971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/28/2022] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic has led to lifestyle changes across Europe with a likely impact on sleep quality. This investigation considers sleep quality in relation to the evolution of the COVID-19 pandemic in five European countries. Using panel regressions and keeping policy responses to COVID-19 constant, we show that an increase in the four-week average daily COVID-19 deaths/100,000 inhabitants (our proxy for the evolution of the pandemic) significantly reduced sleep quality in France, Germany, Italy, Spain, and Sweden between April 2020 and June 2021. Our results are robust to a battery of sensitivity tests and are larger for women, parents and young adults. Additionally, we show that about half of the reduction in sleep quality caused by the evolution of the pandemic can be attributed to changes in lifestyles, worsened mental health and negative attitudes toward COVID-19 and its management (lower degree of confidence in government, greater fear of being infected). In contrast, changes in one's own infection-status from the SARS-CoV-2 virus or sleep duration are not significant mediators of the relationship between COVID-19-related deaths and sleep quality.
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Affiliation(s)
- Samira Barbara Jabakhanji
- Healthcare Outcomes Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | | | - Giorgia Menta
- Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg
| | - Alan Piper
- University of Leeds, Leeds, United Kingdom
| | - Claus Vögele
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
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30
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Macdonald LK, Glogauer M, Allison P, Quiñonez C, Madathil S, Rock LD. Canadian dental hygienists' experiences and perceptions of regulatory guidelines during the COVID-19 pandemic: a qualitative descriptive analysis. BMC Health Serv Res 2022; 22:1570. [PMID: 36550441 PMCID: PMC9773656 DOI: 10.1186/s12913-022-08925-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In Spring of 2020, due to the COVID-19 pandemic, Canadian provincial dental hygiene regulatory bodies implemented new practice guidelines. Reports of stress, anxiety and conflict experienced by dental hygienists have been linked to miscommunication between oral health regulators at this time. Limited data exists on the perceptions and experiences of dental hygienists navigating new guidelines for dental hygiene care during the pandemic. Therefore, the objective of our study was to explore via descriptive thematic analysis how dental hygienists experienced and perceived: i) dental hygiene practice during the COVID-19 pandemic, and ii) their regulatory body's COVID-19 guidelines. METHODS Participants were identified through provincial dental hygiene licensing bodies. Online bi-monthly questionnaires were administered to participants (n = 876) from December 2021 to January 2022. Two open-ended questions were asked in the questionnaire. A qualitative descriptive thematic analysis was applied to these two questions. RESULTS Major themes at baseline relayed challenges related to workplace compliance, patient treatment and communication of practice protocols. Across responses, hygienists confirmed conflicting messaging from regulators and guideline interpretations as stressors impacting their professional practice and satisfaction within the profession. Participant responses at endpoint cited increased satisfaction with regulatory guidelines as the pandemic evolved, yet inconsistencies in regulators' messaging was noted as a prevailing issue. CONCLUSION Inconsistent guideline messaging reflects an increased need for collaboration amongst oral health care regulators to streamline protocols for practice and reduce interprofessional conflict in pandemic circumstances. A national unified approach is warranted in establishing guidelines for dental hygiene practice in Canada.
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Affiliation(s)
- Lindsay K. Macdonald
- grid.55602.340000 0004 1936 8200Faculty of Dentistry, Dalhousie University, 5981 University Avenue, Room, Halifax, 5224 Canada
| | - Michael Glogauer
- grid.17063.330000 0001 2157 2938Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Paul Allison
- grid.14709.3b0000 0004 1936 8649Faculty of Dental Medicine & Oral Health Sciences, McGill University, Montreal, Canada
| | - Carlos Quiñonez
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Sreenath Madathil
- grid.14709.3b0000 0004 1936 8649Faculty of Dental Medicine & Oral Health Sciences, McGill University, Montreal, Canada
| | - Leigha D. Rock
- grid.55602.340000 0004 1936 8200Faculty of Dentistry, Dalhousie University, 5981 University Avenue, Room, Halifax, 5224 Canada ,grid.55602.340000 0004 1936 8200Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Canada
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31
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Saulnier DD, Duchenko A, Ottilie-Kovelman S, Tediosi F, Blanchet K. Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic. Int J Health Policy Manag 2022; 12:6659. [PMID: 37579465 PMCID: PMC10125099 DOI: 10.34172/ijhpm.2022.6659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/12/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Health challenges like coronavirus disease 2019 (COVID-19) are becoming increasingly complex, transnational, and unpredictable. Studying health system responses to the COVID-19 pandemic is an opportunity to enhance our understanding of health system resilience and establish a clearer link between theoretical concepts and practical ideas on how to build resilience. METHODS This narrative literature review aims to address four questions using a health system resilience framework: (i) What do we understand about the dimensions of resilience? (ii) What aspects of the resilience dimensions remain uncertain? (iii) What aspects of the resilience dimensions are missing from the COVID-19 discussions? and (iv) What has COVID-19 taught us about resilience that is missing from the framework? A scientific literature database search was conducted in December 2020 and in April 2022 to identify publications that discussed health system resilience in relation to COVID-19, excluding articles on psychological and other types of resilience. A total of 63 publications were included. RESULTS There is good understanding around information sharing, flexibility and good leadership, learning, maintaining essential services, and the need for legitimate, interdependent systems. Decision-making, localized trust, influences on interdependence, and transformation remain uncertain. Vertical interdependence, monitoring risks beyond the health system, and consequences of changes on the system were not discussed. Teamwork, actor legitimacy, values, inclusivity, trans-sectoral resilience, and the role of the private sector are identified as lessons from COVID-19 that should be further explored for health system resilience. CONCLUSION Knowledge of health system resilience has continued to cohere following the pandemic. The eventual consequences of system changes and the resilience of subsystems are underexplored. Through governance, the concept of health system resilience can be linked to wider issues raised by the pandemic, like inclusivity. Our findings show the utility of resilience theory for strengthening health systems for crises and the benefit of continuing to refine existing resilience theory.
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Affiliation(s)
- Dell D. Saulnier
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Duchenko
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Gagnon M, Perron A, Dufour C, Marcogliese E, Pariseau‐Legault P, Wright DK, Martin P, Carnevale FA. Blowing the whistle during the first wave of COVID-19: A case study of Quebec nurses. J Adv Nurs 2022; 78:4135-4149. [PMID: 35854677 PMCID: PMC9349867 DOI: 10.1111/jan.15365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 12/18/2022]
Abstract
The experiences of nurses who blew the whistle during the COVID-19 pandemic have exposed gaps and revealed an urgent need to revisit our understanding of whistleblowing. AIM The aim was to develop a better understanding of whistleblowing during a pandemic by using the experiences and lessons learned of Quebec nurses who blew the whistle during the first wave of COVID-19 as a case study. More specifically, to explore why and how nurses blew the whistle, what types of wrongdoing triggered their decision to do so and how context shaped the whistleblowing process as well as its consequences (including perceived consequences). DESIGN The study followed a single-case study design with three embedded units of analysis. METHODS We used content analysis to analyse 83 news stories and 597 forms posted on a whistleblowing online platform. We also conducted 15 semi-structured interviews with nurses and analysed this data using a thematic analysis approach. Finally, we triangulated the findings. RESULTS We identified five themes across the case study. (1) During the first wave of COVID-19, Quebec nurses experienced a shifting sense of loyalty and relationship to workplace culture. (2) They witnessed exceedingly high numbers of intersecting wrongdoings amplified by mismanagement and long-standing issues. (3) They reported a lack of trust and transparency; thus, a need for external whistleblowing. (4) They used whistleblowing to reclaim their rights (notably, the right to speak) and build collective solidarity. (5) Finally, they saw whistleblowing as an act of moral courage in the face of a system in crisis. Together, these themes elucidate why and how nurse whistleblowing is different in pandemic times. CONCLUSION Our findings offer a more nuanced understanding of nurse whistleblowing and address important gaps in knowledge. They also highlight the need to rethink external whistleblowing, develop whistleblowing tools and advocate for whistleblowing protection. IMPACT In many ways, the COVID-19 pandemic has challenged our foundational understanding of whistleblowing and, as a result, it has limited the usefulness of existing literature on the topic for reasons that will be brought to light in this paper. We believe that studying the uniqueness of whistleblowing during a pandemic can address this gap by describing why and how health care workers blow the whistle during a pandemic and situating this experience within a broader social, political, organizational context.
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Affiliation(s)
- Marilou Gagnon
- School of NursingUniversity of VictoriaVictoriaBritish ColumbiaCanada
| | - Amélie Perron
- School of NursingUniversity of OttawaOttawaOntarioCanada
| | - Caroline Dufour
- School of NursingUniversity of VictoriaVictoriaBritish ColumbiaCanada
| | | | | | - David Kenneth Wright
- Palliative Care and Nursing Ethics, Centre for Research on Health and NursingOttawaOntarioCanada
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Maziar P, Maher A, Alimohammadzadeh K, Jafari M, Hosseini SM. Identifying the preparedness components in COVID-19: Systematic literature review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:385. [PMID: 36618467 PMCID: PMC9818771 DOI: 10.4103/jehp.jehp_28_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/03/2022] [Indexed: 06/17/2023]
Abstract
In 2019, the COVID-19 pandemic posed a major challenge to the world. Since the world is constantly exposed to communicable diseases, comprehensive preparedness of countries is required. Therefore, the present systematic review is aimed at identifying the preparedness components in COVID-19. In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Science Direct, Iran Medex, Magiran, and Scientific Information Database were searched from 2019 to 2021 to identify preparedness components in COVID-19. Thematic content analysis method was employed for data analysis. Out of 11,126 journals retrieved from searches, 45 studies were included for data analysis. Based on the findings, the components of COVID-19 preparedness were identified and discussed in three categories: governance with three subcategories of characteristics, responsibilities, and rules and regulations; society with two subcategories of culture and resilience; and services with three subcategories of managed services, advanced technology, and prepared health services. Among these, the governance and its subcategories had the highest frequency in studies. Considering the need to prepare for the next pandemic, countries should create clear and coherent structures and responsibilities for crisis preparedness through legal mechanisms, strengthening the infrastructure of the health system, coordination between organizations through analysis and identification of stakeholders, culture building and attracting social participation, and service management for an effective response.
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Affiliation(s)
- Pooneh Maziar
- Ph.D. Student of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Maher
- Department of Health Policy, Economics and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khalil Alimohammadzadeh
- Department of Health Services Management, North Tehran Branch, Health Economics Policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Mehrnoosh Jafari
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Mojtaba Hosseini
- Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
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Sandhu HS, Smith RW, Jarvis T, O'Neill M, Di Ruggiero E, Schwartz R, Rosella LC, Allin S, Pinto AD. Early Impacts of the COVID-19 Pandemic on Public Health Systems and Practice in 3 Canadian Provinces From the Perspective of Public Health Leaders: A Qualitative Study. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:702-711. [PMID: 36027605 PMCID: PMC9528938 DOI: 10.1097/phh.0000000000001596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT The COVID-19 pandemic has impacted health systems worldwide. Studies to date have largely focused on the health care system with less attention to the impact on public health systems and practice. OBJECTIVE To describe the early impacts of COVID-19 on public health systems and practice in 3 Canadian provinces from the perspective of public health system leaders and synthesize lessons learned. DESIGN A qualitative study using semistructured virtual interviews with public health leaders between October 2020 and April 2021. The World Health Organization's essential public health operations framework guided data collection and analysis. SETTING This study involved the Canadian provinces of Alberta, Ontario, and Québec. These provinces were chosen for their large populations, relatively high COVID-19 burden, and variation in public health systems. PARTICIPANTS Public health leaders from Alberta (n = 21), Ontario (n = 18), and Québec (n = 19) in organizations with a primary mandate of stewardship and/or administration of essential public health operations (total n = 58). RESULTS We found that the COVID-19 pandemic led to intensified collaboration in public health systems and a change in workforce capacity to respond to the pandemic. This came with opportunities but also challenges of burnout and disruption of non-COVID-19 services. Information systems and digital technologies were increasingly used and there was greater proximity between public health leaders and other health system leaders. A renewed recognition for public health work was also highlighted. CONCLUSIONS The COVID-19 pandemic impacted several aspects of public health systems in the provinces studied. Our findings can help public health leaders and policy makers identify areas for further investment (eg, intersectoral collaboration, information systems) and develop plans to address challenges (eg, disrupted services, workforce burnout) that have surfaced.
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Affiliation(s)
- Harman S. Sandhu
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Robert W. Smith
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Tamika Jarvis
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Meghan O'Neill
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Robert Schwartz
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Laura C. Rosella
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Sara Allin
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Andrew D. Pinto
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
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Guisado-Clavero M, Astier-Peña MP, Gómez-Bravo R, Ares-Blanco S. [Open data for monitoring COVID-19 in Spain: descriptive study]. Enferm Infecc Microbiol Clin 2022; 42:S0213-005X(22)00191-4. [PMID: 36249470 PMCID: PMC9554340 DOI: 10.1016/j.eimc.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The indicators of the pandemic have been based on the total number of diagnosed cases of COVID-19, the number of people hospitalized or in intensive care units, and deaths from the infection. The aim of this study is to describe the available data on diagnostic tests, health service used for the diagnosis of COVID-19, case detection and monitoring. METHOD Descriptive study with review of official data available on the websites of the Spanish health councils corresponding to 17 Autonomous Communities, 2 Autonomous cities and the Ministry of Health. The variables collected refer to contact tracing, technics for diagnosis, use of health services and follow-up. RESULTS all regions of Spain show data on diagnosed cases of COVID-19 and deaths. Hospitalized cases and intensive care admissions are shown in all regions except the Balearic Islands. Diagnostic tests for COVID-19 have been registered in all regions except Madrid region and Extremadura, with scarcely information on what type of test has been performed (present in 7 CCAA), requesting service and study of contacts. CONCLUSIONS The information available on the official websites of the Health Departments of the different regions of Spain are heterogeneous. Data from the use of health service or workload in Primary Care, Emergency department or Out of hours services are almost non-existent.
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Affiliation(s)
- Marina Guisado-Clavero
- Técnica de Salud de la Unidad Docente Multiprofesional de Atención Familiar y Comunitaria del área norte de la Comunidad de Madrid, España
| | - María Pilar Astier-Peña
- Médica de familia. Centro de Salud Universitas del Servicio Aragonés de Salud (Zaragoza, España). GdT de Seguridad del paciente de semFYC y del GdT de Calidad y Seguridad de WONCA, Zaragoza, España
| | - Raquel Gómez-Bravo
- Research Group Self-Regulation and Health. Institute for Health and Behaviour. Department of Behavioural and Cognitive, Sciences. Faculty of Humanities, Education, and Social Sciences, Universidad de Luxemburgo, Luxemburgo
| | - Sara Ares-Blanco
- Médica de familia. Centro de Salud Federica Montseny, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, España. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Sekhon H, Lavin P, Vacaflor B, Rigas C, Cinalioglu K, Su CL, Bodenstein K, Dikaios E, Goodman A, Raymond FC, Ibrahim M, Bein M, Gruber J, Se J, Sasi N, Walsh C, Nazar R, Hanganu C, Berkani S, Royal I, Schiavetto A, Looper K, Launay C, McDonald EG, Seitz D, Kumar S, Beauchet O, Khoury B, Bouchard S, Battistini B, Fallavollita P, Miresco M, Bruneau MA, Vahia I, Bukhari S, Rej S. Isolating together during COVID-19: Results from the Telehealth Intervention Program for older adults. Front Med (Lausanne) 2022; 9:948506. [PMID: 36304184 PMCID: PMC9592737 DOI: 10.3389/fmed.2022.948506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background A pressing challenge during the COVID-19 pandemic and beyond is to provide accessible and scalable mental health support to isolated older adults in the community. The Telehealth Intervention Program for Older Adults (TIP-OA) is a large-scale, volunteer-based, friendly telephone support program designed to address this unmet need. Methods A prospective cohort study of 112 TIP-OA participants aged ≥60 years old was conducted in Quebec, Canada (October 2020–June 2021). The intervention consisted of weekly friendly phone calls from trained volunteers. The primary outcome measures included changes in scores of stress, depression, anxiety, and fear surrounding COVID-19, assessed at baseline, 4 and 8-weeks. Additional subgroup analyses were performed with participants with higher baseline scores. Results The subgroup of participants with higher baseline depression scores (PHQ9 ≥10) had significant improvements in depression scores over the 8-week period measured [mean change score = −2.27 (±4.76), 95%CI (−3.719, −0.827), p = 0.003]. Similarly, participants with higher baseline anxiety scores (GAD7 ≥10) had an improvement over the same period, which, approached significance (p = 0.06). Moreover, despite peaks in the pandemic and related stressors, our study found no significant (p ≥ 0.09) increase in stress, depression, anxiety or fear of COVID-19 scores. Discussion This scalable, volunteer-based, friendly telephone intervention program was associated with decreased scores of depression and anxiety in older adults who reported higher scores at baseline (PHQ 9 ≥10 and GAD7 ≥10).
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Affiliation(s)
- Harmehr Sekhon
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada,McLean Hospital, Harvard Medical School, Boston, MA, United States,*Correspondence: Harmehr Sekhon
| | - Paola Lavin
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | - Blanca Vacaflor
- GeriPARTy Research Lab, Montreal, QC, Canada,Pierre-Boucher Hospital, Longueuil, QC, Canada
| | - Christina Rigas
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | - Karin Cinalioglu
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | | | - Katie Bodenstein
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | | | - Allana Goodman
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada
| | | | | | - Magnus Bein
- GeriPARTy Research Lab, Montreal, QC, Canada
| | | | - Jade Se
- GeriPARTy Research Lab, Montreal, QC, Canada
| | - Neeti Sasi
- GeriPARTy Research Lab, Montreal, QC, Canada
| | - Chesley Walsh
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | - Rim Nazar
- GeriPARTy Research Lab, Montreal, QC, Canada
| | - Cezara Hanganu
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | - Sonia Berkani
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada
| | - Isabelle Royal
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada
| | | | - Karl Looper
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada
| | - Cyrille Launay
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada
| | | | - Dallas Seitz
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Sanjeev Kumar
- Geriatric Clinical Research, The Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Olivier Beauchet
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada
| | - Bassam Khoury
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Stephane Bouchard
- Department of Psychoeducation and Psychology, Université du Quebec en Outaouais, Gatineau, QC, Canada
| | - Bruno Battistini
- Quebec Heart and Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada
| | - Pascal Fallavollita
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Marc Miresco
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Ipsit Vahia
- McLean Hospital, Harvard Medical School, Boston, MA, United States
| | - Syeda Bukhari
- Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
| | - Soham Rej
- Department of Psychiatry, McGill University, Montreal, QC, Canada,Jewish General Hospital/Lady Davis Institute, Montreal, QC, Canada,GeriPARTy Research Lab, Montreal, QC, Canada
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Endaryanto A, Dewi A, Kusbaryanto, Nugraha RA. Pediatric Residency Training amid the COVID-19 Pandemic: Exploring the Impact of Supervision and Clinical Practice Guidelines on Clinical and Financial Outcomes. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2495064. [PMID: 36148017 PMCID: PMC9489417 DOI: 10.1155/2022/2495064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
Objective This study is aimed at calculating the magnitude of the effect of clinical practice guidelines (CPG) and supervision in inhibiting the negative impact of the COVID-19 pandemic on clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents in academic medical center (AMC) hospitals during the COVID-19 pandemic. Methods The cohort retrospective study was conducted. This study collected patient data from pediatric residency programs. A research cohort consisted of non-COVID-19 pediatric patients at Dr. Soetomo General Academic Hospital. This study compared the subgroup of patients treated during the pandemic with those treated before the pandemic. The results were analyzed using SPSS 26.0 and Smart-PLS. Results There was a 41.4% decrease in pediatric inpatients during the pandemic with an increased severity level and complexity level, a reduction of 7.46% availability of supervisors, an increase of 0.4% in readmission < 30 days, an increase of 0.31% in-hospital mortality, an increase the total costs of care, and a decrease of insurance claim profit. CPG did not moderate the effect of the COVID-19 pandemic on the clinical outcomes (β = -0.006, P = 0.083) but moderated the financial outcomes (β = -0.022, P = 0.000), by reducing the total cost of care and increasing insurance claim profit. Supervision moderated the effect of the COVID-19 pandemic on the clinical outcomes (β = 0.040, P = 0.000) by increasing aLOS and on the financial outcomes (β = -0.031, P = 0.000) by reducing the total cost of care and increasing insurance claim profit. This study model had a 24.0% variance of explanatory power for clinical outcomes and 49.0% for financial outcomes. This study's structural model effectively predicted clinical outcomes (Q 2 = 0.238) and financial outcomes (Q 2 = 0.413). Conclusion Direct supervision inhibited the negative impact of the COVID-19 pandemic on both clinical and financial outcomes of non-COVID-19 inpatient care by pediatric residents, while CPG only inhibited the negative impact on financial outcomes. Implication of This Study. In a disaster, the availability of CPG and direct supervision makes AMC hospitals able to inhibit the negative impact of disasters on clinical and financial outcomes.
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Affiliation(s)
- Anang Endaryanto
- Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia
- Department of Child Health, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya 60285, Indonesia
| | - Arlina Dewi
- Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia
| | - Kusbaryanto
- Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya 60285, Indonesia
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Alami H, Lehoux P, Shaw SE, Papoutsi C, Rybczynska-Bunt S, Fortin JP. Virtual Care and the Inverse Care Law: Implications for Policy, Practice, Research, Public and Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710591. [PMID: 36078313 PMCID: PMC9518297 DOI: 10.3390/ijerph191710591] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 05/31/2023]
Abstract
Virtual care spread rapidly at the outbreak of the COVID-19 pandemic. Restricting in-person contact contributed to reducing the spread of infection and saved lives. However, the benefits of virtual care were not evenly distributed within and across social groups, and existing inequalities became exacerbated for those unable to fully access to, or benefit from virtual services. This "perspective" paper discusses the extent to which challenges in virtual care access and use in the context of COVID-19 follow the Inverse Care Law. The latter stipulates that the availability and quality of health care is inversely proportionate to the level of population health needs. We highlight the inequalities affecting some disadvantaged populations' access to, and use of public and private virtual care, and contrast this with a utopian vision of technology as the "solution to everything". In public and universal health systems, the Inverse Care Law may manifests itself in access issues, capacity, and/or lack of perceived benefit to use digital technologies, as well as in data poverty. For commercial "Direct-To-Consumer" services, all of the above may be encouraged via a consumerist (i.e., profit-oriented) approach, limited and episodic services, or the use of low direct cost platforms. With virtual care rapidly growing, we set out ways forward for policy, practice, and research to ensure virtual care benefits for everyone, which include: (1) pay more attention to "capabilities" supporting access and use of virtual care; (2) consider digital technologies as a basic human right that should be automatically taken into account, not only in health policies, but also in social policies; (3) take more seriously the impact of the digital economy on equity, notably through a greater state involvement in co-constructing "public health value" through innovation; and (4) reconsider the dominant digital innovation research paradigm to better recognize the contexts, factors, and conditions that influence access to and use of virtual care by different groups.
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Affiliation(s)
- Hassane Alami
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - Pascale Lehoux
- Center for Public Health Research and Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Sara E. Shaw
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - Chrysanthi Papoutsi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - Sarah Rybczynska-Bunt
- Community and Primary Care Research Group, Faculty of Health, Plymouth University, Plymouth PL6 8BX, UK
| | - Jean-Paul Fortin
- VITAM Research Centre on Sustainable Health, Faculty of Medicine, Laval University, Quebec, QC G1J 2G1, Canada
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Schiff M, Chow A, Noi GS. Riding the waves of the pandemic from West to East: The social workers' experience an International collaboration on study of social workers during COVID-19. SOCIAL WORK IN HEALTH CARE 2022; 61:185-198. [PMID: 35929856 DOI: 10.1080/00981389.2022.2108569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Miriam Schiff
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University, Israel
| | - Amy Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Goh Soon Noi
- Medical Social Services, Changi General Hospital, Singapore
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Phillips G, Kendino M, Brolan CE, Mitchell R, Herron LM, Kὃrver S, Sharma D, O'Reilly G, Poloniati P, Kafoa B, Cox M. Lessons from the frontline: Leadership and governance experiences in the COVID-19 pandemic response across the Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100518. [PMID: 35818573 PMCID: PMC9259208 DOI: 10.1016/j.lanwpc.2022.100518] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Background Universal access to safe, effective emergency care (EC) during the COVID-19 pandemic has illustrated its centrality to healthcare systems. The 'Leadership and Governance' building block provides policy, accountability and stewardship to health systems, and is essential to determining effectiveness of pandemic response. This study aimed to explore the experience of leadership and governance during the COVID-19 pandemic from frontline clinicians and stakeholders across the Pacific region. Methods Australian and Pacific researchers collaborated to conduct this large, qualitative research project in three phases between March 2020 and July 2021. Data was gathered from 116 Pacific regional participants through online support forums, in-depth interviews and focus groups. A phenomenological approach shaped inductive and deductive data analysis, within a previously identified Pacific EC systems building block framework. Findings Politics profoundly influenced pandemic response effectiveness, even at the clinical coalface. Experienced clinicians spoke authoritatively to decision-makers; focusing on safety, quality and service duty. Rapid adaptability, past surge event experience, team-focus and systems-thinking enabled EC leadership. Transparent communication, collaboration, mutual respect and trust created unity between frontline clinicians and 'top-level' administrators. Pacific cultural assets of relationship-building and community cohesion strengthened responses. Interpretation Effective governance occurs when political, administrative and clinical actors work collaboratively in relationships characterised by trust, transparency, altruism and evidence. Trained, supported EC leadership will enhance frontline service provision, health security preparedness and future Universal Health Coverage goals. Funding Epidemic Ethics/World Health Organization (WHO), Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.
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Affiliation(s)
- Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Kὃrver
- Australasian College for Emergency Medicine, Melbourne, Australia
| | - Deepak Sharma
- Emergency Department, Colonial War Memorial Hospital, Suva, Fiji
| | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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Said Abasse K, Toulouse Fournier A, Paquet C, Côté A, Smith PY, Bergeron F, Archambault P. Collaborative Writing Applications in Support of Knowledge Translation and Management during Pandemics: A Scoping Review. Int J Med Inform 2022; 165:104814. [DOI: 10.1016/j.ijmedinf.2022.104814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/17/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
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Affiliation(s)
- Kimberlyn McGrail
- School of Population and Public Health, University of British Columbia, Vancouver, BC
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Mundae R, Velez A, Sodhi GS, Belin PJ, Kohler JM, Ryan EH, Tang PH. Trends in the Clinical Presentation of Primary Rhegmatogenous Retinal Detachments During the First Year of the COVID-19 Pandemic. Am J Ophthalmol 2022; 237:49-57. [PMID: 34801509 PMCID: PMC8603252 DOI: 10.1016/j.ajo.2021.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/02/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the effect of 1 full year of the coronavirus disease 2019 (COVID-19) pandemic on clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). Design Single-center, retrospective observational cohort study. Methods Patients were divided into 2 cohorts: consecutive patients treated for primary RRD during the COVID-19 pandemic (March 9, 2020, to March 7, 2021; pandemic cohort) and patients treated during the corresponding time in previous year (March 11, 2019, to March 8, 2020; control cohort). Main outcome measures: Proportion of patients presenting with macula-involving (mac-off) or macula-sparring (mac-on) RRD. Results A total of 952 patients in the pandemic cohort and 872 patients in the control cohort were included. Demographic factors were similar. Compared with the control cohort, a significantly greater number of pandemic cohort patients presented with mac-off RRDs ([60.92%] pandemic, [48.17%] control, P = .0001) and primary proliferative vitreoretinopathy ([15.53%] pandemic, [6.9%] control, P = .0001). Pandemic cohort patients (10.81%) had significantly higher rates of lost to follow-up compared with the control cohort (4.43%; P = .0001). Patients new to our clinic demonstrated a significant increase in mac-off RRDs in the pandemic cohort (65.35%) compared with the control cohort (50.40%; P = .0001). Pandemic cohort patients showed worse median final best-corrected visual acuity (0.30 logarithm of the minimum angle of resolution) compared with the control cohort (0.18 logarithm of the minimum angle of resolution; P = .0001). Conclusions Patients with primary RRD during the first year of the COVID-19 pandemic were more likely to have mac-off disease, present with primary proliferative vitreoretinopathy, be lost to follow-up, and have worse final best-corrected visual acuity outcomes.
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Pongou R, Ahinkorah BO, Mabeu MC, Agarwal A, Maltais S, Yaya S. Examining the association between reported COVID-19 symptoms and testing for COVID-19 in Canada: a cross-sectional survey. BMJ Open 2022; 12:e056229. [PMID: 35246421 PMCID: PMC8918074 DOI: 10.1136/bmjopen-2021-056229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Studies on the management of the COVID-19 pandemic through testing have been conducted in countries that have been hardest hit by this pandemic. Considering the importance of testing in containing the spread of COVID-19, it is useful to have evidence on continuing COVID-19 testing even in countries where the prevalence of COVID-19 is relatively low. We, therefore, examined the association between reported COVID-19 symptoms and testing for COVID-19 in Canada. DESIGN AND SETTINGS We conducted an online survey using the SurveyMonkey platform between July and October 2020 across Canada. PARTICIPANTS A nationally representative sample size of 2790 adult individuals was used. RESULTS Our findings show that respondents who reported that they and/or members of their households had COVID-19 symptoms were more likely to test for COVID-19 (adjusted OR, aOR 1.91; 95% CI 1.32 to 2.76) as compared with those who did not report COVID-19 symptoms. The likelihood of testing for COVID-19 was lower among male respondents compared with females (aOR 0.69; 95% CI 0.49 to 0.96), respondents aged 65-84 compared with those aged 18-44 (aOR 0.62; 95% CI 0.42 to 0.93), and respondents in British Columbia compared with those residing in Quebec. Higher odds of testing for COVID-19 were found among respondents who lived in Alberta compared with those who lived in Quebec (aOR 0.42; 95% CI 0.23 to 0.75) and respondents who had postgraduate education compared with those with high school or less education (aOR 1.84; 95% CI 1.01 to 3.36). The association between reported COVID-19 symptoms and testing for COVID-19 was statistically significant among female respondents (aOR 1.52; 95% CI 1.81 to 3.52) but not among male respondents. CONCLUSIONS In conclusion, this study provides evidence in support of the hypothesis that there is significant association between reported COVID-19 symptoms and COVID-19 testing among adult Canadians. The study highlights the need for the Canadian government to prioritise subpopulations (ie, males, those aged 65-85, and those with high school or less education) that have lower likelihood of seeking COVID-19 testing to get tested when they have symptoms.
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Affiliation(s)
- Roland Pongou
- Department of Economics, University of Ottawa, Ottawa, Ontario, Canada
- Center for African Studies, Harvard University, Cambridge, MA, USA
| | | | | | - Arunika Agarwal
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Stephanie Maltais
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Malmgren Fänge A, Christensen J, Backhouse T, Kenkmann A, Killett A, Fisher O, Chiatti C, Lethin C. Care Home and Home Care Staff's Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom. Healthcare (Basel) 2022; 10:306. [PMID: 35206920 PMCID: PMC8872186 DOI: 10.3390/healthcare10020306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 7 October 2020 and 17 December 2010: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices.
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Affiliation(s)
- Agneta Malmgren Fänge
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (A.M.F.); (C.L.)
| | - Jonas Christensen
- Department of Social Work, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
| | - Tamara Backhouse
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Andrea Kenkmann
- Center for Aging, Catholic University of Applied Sciences Munich, 836 71 Benediktbeuern, Germany;
| | - Anne Killett
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Oliver Fisher
- Department of Economics and Social Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy;
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, 60124 Ancona, Italy
| | | | - Connie Lethin
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (A.M.F.); (C.L.)
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Buchy P, Buisson Y, Cintra O, Dwyer DE, Nissen M, Ortiz de Lejarazu R, Petersen E. COVID-19 pandemic: lessons learned from more than a century of pandemics and current vaccine development for pandemic control. Int J Infect Dis 2021; 112:300-317. [PMID: 34563707 PMCID: PMC8459551 DOI: 10.1016/j.ijid.2021.09.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 01/04/2023] Open
Abstract
Pandemic dynamics and health care responses are markedly different during the COVID-19 pandemic than in earlier outbreaks. Compared with established infectious disease such as influenza, we currently know relatively little about the origin, reservoir, cross-species transmission and evolution of SARS-CoV-2. Health care services, drug availability, laboratory testing, research capacity and global governance are more advanced than during 20th century pandemics, although COVID-19 has highlighted significant gaps. The risk of zoonotic transmission and an associated new pandemic is rising substantially. COVID-19 vaccine development has been done at unprecedented speed, with the usual sequential steps done in parallel. The pandemic has illustrated the feasibility of this approach and the benefits of a globally coordinated response and infrastructure. Some of the COVID-19 vaccines recently developed or currently in development might offer flexibility or sufficiently broad protection to swiftly respond to antigenic drift or emergence of new coronaviruses. Yet many challenges remain, including the large-scale production of sufficient quantity of vaccines, delivery of vaccines to all countries and ensuring vaccination of relevant age groups. This wide vaccine technology approach will be best employed in tandem with active surveillance for emerging variants or new pathogens using antigen mapping, metagenomics and next generation sequencing.
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Affiliation(s)
| | | | | | - Dominic E Dwyer
- New South Wales Health Pathology - Institute of Clinical Pathology and Medical Research, Westmead Hospital, New South Wales, Australia.
| | - Michael Nissen
- Consultant in Infectious Diseases, University of Queensland, Brisbane, Australia.
| | - Raul Ortiz de Lejarazu
- Scientific Advisor & Emeritus director at Valladolid NIC (National Influenza Centre) Spain, School of Medicine, Avd Ramón y Cajal s/n 47005 Valladolid, Spain.
| | - Eskild Petersen
- European Society for Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Department of Molecular Medicine, The University of Pavia, Pavia, Italy; Department of Clinical, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Alami H, Lehoux P, Attieh R, Fortin JP, Fleet R, Niang M, Offredo K, Rouquet R, Ag Ahmed MA, Ly BA. A “Not So Quiet” Revolution: Systemic Benefits and Challenges of Telehealth in the Context of COVID-19 in Quebec (Canada). Front Digit Health 2021. [DOI: 10.3389/fdgth.2021.721898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic has had a major impact on health and social service systems (HSSS) worldwide. It has put tremendous pressure on these systems, threatening access, continuity, and the quality of patient care and services. In Quebec (Canada), the delivery of care and services has radically changed in a short period of time. During the pandemic, telehealth has been widely deployed and used, notwithstanding the decades-long challenges of integrating this service modality into the Quebec HSSS. Adopting a narrative-integrative approach, this article describes and discusses Quebec's experience with the deployment and utilization of telehealth in the context of COVID-19. Firstly, we introduced the achievements and benefits made with the use of telehealth. Secondly, we discussed the challenges and concerns that were revealed or accentuated by the sanitary crisis, such as: (1) training and information; (2) professional and organizational issues; (3) quality of services and patient satisfaction; (4) cost, remuneration, and funding; (5) technology and infrastructure; (6) the emergence of private telehealth platforms in a public HSSS; (7) digital divide and equity; and (8) legal and regulatory issues. Finally, the article presents recommendations to guide future research, policies and actions for a successful integration of telehealth in the Quebec HSSS as well as in jurisdictions and countries facing comparable challenges.
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Gontariuk M, Krafft T, Rehbock C, Townend D, Van der Auwermeulen L, Pilot E. The European Union and Public Health Emergencies: Expert Opinions on the Management of the First Wave of the COVID-19 Pandemic and Suggestions for Future Emergencies. Front Public Health 2021; 9:698995. [PMID: 34490183 PMCID: PMC8417533 DOI: 10.3389/fpubh.2021.698995] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The first wave of the coronavirus SARS-COV-2 pandemic has revealed a fragmented governance within the European Union (EU) to tackle public health emergencies. This qualitative study aims: 1) to understand the current EU position within the field of public health emergencies taking the case of the COVID-19 as an example by comparing and contrasting experiences from EU institutions and experts from various EU Member States at the beginning of the pandemic; and, 2) to identify and to formulate future EU pandemic strategies and actions based on experts' opinions. Methods: Eighteen semi-structured interviews were conducted with public health experts from various European Member States and European Commission officials from May 2020 until August 2020. The transcripts were analyzed by Thematic Content Analysis (TCA), mainly a manifest content analysis. Results: This study demonstrated that the limited EU mandate in health hinders proper actions to prevent and tackle infectious disease outbreaks, such as the COVID-19 pandemic. The results showed that this limitation significantly impacted the ECDC, as the Member States' competence did not allow the agency to have more capacity. The European Commission has fulfilled its role of coordinating and supporting the Member States by facilitating networks and information exchange. However, EU intra- and inter-communication need further improvement. Although diverse EU instruments and mechanisms were found valid, their implementation needed to be faster and more efficient. The results pointed out that underlying political challenges in EU decision-making regarding health emergencies hinder the aligned response. It was stated that the Member States were not prepared, and due to the restriction of their mandate, EU institutions could not enforce binding guidelines. Additionally, the study explored future EU pandemic strategies and actions. Both, EU institutions and national experts suggested similar and clear recommendations regarding the ECDC, the investment, and future harmonized preparedness tools. Conclusion: The complex politics of public health at the EU level have led to the fragmentation of its governance for effective pandemic responses. This ongoing pandemic has shed light on the fragility of the political and structural systems in Europe in public health emergencies. Health should be of high importance in the political agenda, and robust health reforms at the local, regional, national, and EU levels are highly recommended.
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Affiliation(s)
- Marie Gontariuk
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Thomas Krafft
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Cassandra Rehbock
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - David Townend
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | | | - Eva Pilot
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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