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Milone V, Fusco A, De Feo A, Tatullo M. Clinical Impact of "Real World Data" and Blockchain on Public Health: A Scoping Review. Int J Environ Res Public Health 2024; 21:95. [PMID: 38248558 PMCID: PMC10815190 DOI: 10.3390/ijerph21010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
The digitisation of healthcare has allowed a significant rethinking of the previous clinical protocols, improving their interoperability through substantial standardisation. These technological advances have ensured that data are comparable, as they are obtained from 'reliable' and certified processes; however, there are billions of data that are neither structured nor quality-controlled. They are collectively referred to as 'Real World Data' (RWD). Blockchain (BC) is a procedure with specific characteristics and algorithms that ensure that the stored data cannot be tampered with. Nowadays, there is an increasing need to rethink blockchain in a one-health vision, making it more than just a 'repository' of data and information, but rather an active player in the process of data sharing. In this landscape, several scholars have analysed the potential benefits of BC in healthcare, focusing on the sharing and safety of clinical data and its contact tracing applications. There is limited research on this matter; moreover, there is a strategic interest in managing RWD in a reliable and comparable way, despite the lack of knowledge on this topic. Our work aims to analyse systematically the most impacting literature, highlighting the main aspects of BC within the context of the new digital healthcare, and speculating on the unexpressed potential of RWD.
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Affiliation(s)
- Virginia Milone
- Department of Economics, Management and Business Law, University of Bari “Aldo Moro”, P.ce Umberto I, 70121 Bari, Italy; (V.M.); (A.D.F.)
| | - Antonio Fusco
- Department of Economics, Management and Business Law, University of Bari “Aldo Moro”, P.ce Umberto I, 70121 Bari, Italy; (V.M.); (A.D.F.)
| | - Angelamaria De Feo
- Department of Economics, Management and Business Law, University of Bari “Aldo Moro”, P.ce Umberto I, 70121 Bari, Italy; (V.M.); (A.D.F.)
| | - Marco Tatullo
- Department of Translational Biomedicine and Neuroscience—DiBraiN, University of Bari “Aldo Moro”, P.ce G. Cesare, 70124 Bari, Italy
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2
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Magnasco L, Mikulska M, Sepulcri C, Ullah N, Giacobbe DR, Vena A, Di Pilato V, Willison E, Orsi A, Icardi G, Marchese A, Bassetti M. Frequency of Detection of Candida auris Colonization Outside a Highly Endemic Setting: What Is the Optimal Strategy for Screening of Carriage? J Fungi (Basel) 2023; 10:26. [PMID: 38248936 PMCID: PMC10817263 DOI: 10.3390/jof10010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/18/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
Candida auris outbreaks are increasingly frequent worldwide. In our 1000-bed hospital, an endemic transmission of C. auris was established in two of five intensive care units (ICUs). Aims of our study were to describe the occurrence of new cases of C. auris colonization and infection outside the endemic ICUs, in order to add evidence for future policies on screening in patients discharged as negative from an endemic setting, as well as to propose a new algorithm for screening of such high-risk patients. From 26 March 2021 to 26 January 2023, among 392 patients who were diagnosed as colonized or infected with C. auris in our hospital, 84 (21.4%) received the first diagnosis of colonization or infection outside the endemic ICUs. A total of 68 patients out of 84 (81.0%) had a history of prior admission to the endemic ICUs. All were screened and tested negative during their ICU stay with a median time from last screening to discharge of 3 days. In 57/68 (83.8%) of patients, C. auris was detected through screening performed after ICU discharge, and 90% had C. auris colonization detected within 9 days from ICU discharge. In 13 cases (13/57 screened, 22.8%), the first post-ICU discharge screening was negative. In those not screened, candidemia was the most frequent event of the first C. auris detection (6/11 patients not screened). In settings where the transmission of C. auris is limited to certain wards, we suggest screening both at discharge from the endemic ward(s) even in case of a recent negative result, and at least twice after admission to nonendemic settings.
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Affiliation(s)
- Laura Magnasco
- Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (L.M.); (D.R.G.); (A.V.); (M.B.)
| | - Malgorzata Mikulska
- Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (L.M.); (D.R.G.); (A.V.); (M.B.)
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
| | - Chiara Sepulcri
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
| | - Nadir Ullah
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
| | - Daniele Roberto Giacobbe
- Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (L.M.); (D.R.G.); (A.V.); (M.B.)
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
| | - Antonio Vena
- Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (L.M.); (D.R.G.); (A.V.); (M.B.)
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
| | - Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy; (V.D.P.); (A.M.)
- Microbiology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Edward Willison
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy; (V.D.P.); (A.M.)
- Microbiology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Andrea Orsi
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Giancarlo Icardi
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
- Hygiene Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Anna Marchese
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy; (V.D.P.); (A.M.)
- Microbiology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
| | - Matteo Bassetti
- Division of Infectious Diseases, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (L.M.); (D.R.G.); (A.V.); (M.B.)
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (C.S.); (N.U.); (A.O.); (G.I.)
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3
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Bhati D, Deogade MS, Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus 2023; 15:e47731. [PMID: 38021686 PMCID: PMC10676194 DOI: 10.7759/cureus.47731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
This comprehensive review delves into the critical role of effective hospital administration in shaping patient outcomes within the healthcare ecosystem. Exploration of key components, strategies, measurement methodologies, and future trends elucidates the multifaceted nature of hospital administration. Key findings underscore the profound impact of administrative decisions and practices on patient safety, satisfaction, and overall well-being. The review highlights the importance of patient-centred care and interdisciplinary collaboration for enhancing patient outcomes. It emphasises the significance of data-driven measurement and benchmarking, which are instrumental in assessing hospital performance and fostering continuous improvement. Looking ahead, emerging technologies, evolving healthcare policies, and persistent challenges are drivers of change in healthcare administration. However, amidst these transformations, the overarching message remains consistent: effective hospital administration is integral to improving patient outcomes. The conclusion calls for a collective commitment from healthcare leaders and policymakers to prioritise the development of capable administrators, invest in technology, promote value-based care, and address healthcare disparities. This collaborative effort ensures that the pursuit of better patient outcomes remains at the forefront of healthcare administration, ultimately shaping the future of healthcare for generations to come.
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Affiliation(s)
- Deepak Bhati
- Hospital Administration, School of Allied Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Meena S Deogade
- Ayurveda Pharmacology, All India Institute of Ayurveda, New Delhi, IND
| | - Deepika Kanyal
- Hospital Administration, School of Allied Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Donohue JF, Elborn JS, Lansberg P, Javed A, Tesfaye S, Rugo H, Duddi SRD, Jithoo N, Huang PH, Subramaniam K, Ramanjinappa N, Koltun A, Melamed S, Chan JCN. Bridging the "Know-Do" Gaps in Five Non-Communicable Diseases Using a Common Framework Driven by Implementation Science. J Healthc Leadersh 2023; 15:103-119. [PMID: 37416849 PMCID: PMC10320809 DOI: 10.2147/jhl.s394088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/12/2023] [Indexed: 07/08/2023] Open
Abstract
According to the United Nations High-Level Meeting 2018, five non-communicable diseases (NCDs) including cardiovascular diseases, chronic respiratory diseases, diabetes mellitus, cancer, and mental health conditions accounted for two-thirds of global deaths. These five NCDs share five common risk factors including tobacco use, unhealthy diets, physical inactivity, alcohol use, and air pollution. Low- and middle-income countries (LMICs) face larger burden of NCDs than high-income countries (HICs), due to differences in ecological, technological, socioeconomic and health system development. Based on high-level evidence albeit mainly from HICs, the burden caused by NCDs can be reduced by affordable medicines and best practices. However, "know-do" gaps, ie, gaps between what we know in science and what we do in practice, has limited the impact of these strategies, especially in LMICs. Implementation science advocates the use of robust methodologies to evaluate sustainable solutions in health, education and social care aimed at informing practice and policies. In this article, physician researchers with expertise in NCDs reviewed the common challenges shared by these five NCDs with different clinical courses. They explained the principles of implementation science and advocated the use of an evidence-based framework to implement solutions focusing on early detection, prevention and empowerment, supplemented by best practices in HICs and LMICs. These successful stories can be used to motivate policymakers, payors, providers, patients and public to co-design frameworks and implement context-relevant, multi-component, evidence-based practices. In pursuit of this goal, we propose partnership, leadership, and access to continuing care as the three pillars in developing roadmaps for addressing the multiple needs during the journey of a person with or at risk of these five NCDs. By transforming the ecosystem, raising awareness and aligning context-relevant practices and policies with ongoing evaluation, it is possible to make healthcare accessible, affordable and sustainable to reduce the burden of these five NCDs.
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Affiliation(s)
| | | | | | - Afzal Javed
- Warwick Medical School, University of Warwick, Warwick, UK & Pakistan Psychiatric Research Centre, Coventry, UK
| | - Solomon Tesfaye
- Sheffield Teaching Hospitals and the University of Sheffield, Sheffield, UK
| | - Hope Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA
| | - Sita Ratna Devi Duddi
- International Alliance of Patients’ Organisations, London, United Kingdom
- DakshamA Health and Education, Delhi, India
| | | | | | | | | | | | | | - Juliana C N Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Regions of the People’s Republic of China
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5
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Livingston CJ, Gray M, LaForge K, Choo EK. A cross-sectional survey exploring clinician perceptions of a novel Medicaid back pain policy. J Complement Integr Med 2023; 20:438-446. [PMID: 36306465 DOI: 10.1515/jcim-2022-0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Oregon Medicaid (Oregon Health Plan, or OHP) implemented an innovative policy in 2016 that increased coverage of evidence-based non-pharmacologic therapies (NPT, including physical therapy, massage, chiropractic, and acupuncture) while restricting opioids, epidural steroid injections, and surgeries. The objective of this study was to compare the perspectives of clinicians who see back pain patients and can prescribe pharmacologic therapies and/or refer to NPTs and clinicians who directly provide NPT therapies affected by the policy. METHODS A cross-sectional online survey was administered to Oregon prescribing clinicians and NPT clinicians between December 2019 and February 2020. The survey was completed by 107 prescribing clinicians and 83 NPT clinicians. RESULTS Prescribing clinicians and NPT clinicians had only moderate levels of familiarity with core elements of the policy. Prescribing clinicians had higher levels of frustration caring for OHP patients with back pain than NPT clinicians (83 vs. 34%, p<0.001) and were less confident in their ability to provide effective care (73 vs. 85%, p = .025). Eighty-six percent of prescribing clinicians and 83% of NPT clinicians thought active NPT treatments were effective; 74 and 70% thought passive NPT treatments were effective. Forty percent of prescribing clinicians and 25% of NPT clinicians (p<0.001) thought medically-light therapies were effective, while 29% of prescribing clinicians and 10% of NPT clinicians thought medically-intensive treatments were effective (p=0.001). Prescribing clinicians thought increased access to NPTs improved outcomes, while opinions were less consistent on the impact of restricting opioid prescribing. CONCLUSIONS Prescribing clinicians and NPT clinicians had varying perspectives of a Medicaid coverage policy to increase evidence-based back pain care. Understanding these perspectives is important for contextualizing policy effectiveness.
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Affiliation(s)
| | | | | | - Esther K Choo
- Department of Emergency Medicine, Oregon Health & Science University, OR, USA
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6
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Affiliation(s)
- Yang Zou
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Watkinsville, GA, United States
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7
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Vieira Martins M, Karara N, Dembiński L, Jacot-Guillarmod M, Mazur A, Hadjipanayis A, Michaud PA. Adolescent pregnancy: An important issue for paediatricians and primary care providers-A position paper from the European academy of paediatrics. Front Pediatr 2023; 11:1119500. [PMID: 36824647 PMCID: PMC9941531 DOI: 10.3389/fped.2023.1119500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/06/2023] [Indexed: 02/10/2023] Open
Abstract
Adolescent pregnancy and childbearing, remain a widespread health-related problem with potential short and long-term consequences. Comprehensive social, economic, environmental, structural, and cultural factors heavily impact on adolescents' sexual and reproductive health and early pregnancy. Health professionals can play a pivotal role in the prevention of unplanned pregnancy. Improved access to family planning, sexuality education in schools, community-based interventions, and policies contribute greatly to reduce the risk of adolescent pregnancy and the adoption of respectful and responsible sexual behaviour. Additionally, health care professionals can support pregnant adolescents in making decisions under these circumstances and provide adequate health care. This review highlights actions that can guide healthcare professionals in empowering young adolescents to become more aware and capable of making informed decisions about their sexual life, health, and future.
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Affiliation(s)
- Miguel Vieira Martins
- Young European Academy of Paediatrics, Brussels, Belgium.,Portuguese Society of Pediatrics/Sociedade Portuguesa de Pediatria-SPP, Lisbon, Portugal
| | - Nora Karara
- Young European Academy of Paediatrics, Brussels, Belgium.,Child and Youth Public Health Service, Berlin, Germany
| | - Lukasz Dembiński
- European Academy of Paediatrics, Brussels, Belgium.,Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | | | - Artur Mazur
- European Academy of Paediatrics, Brussels, Belgium.,Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Adamos Hadjipanayis
- European Academy of Paediatrics, Brussels, Belgium.,Medical School, European University of Cyprus, Nicosia, Cyprus
| | - Pierre-André Michaud
- European Academy of Paediatrics, Brussels, Belgium.,Faculty of Biology & Medicine, Lausanne University, Switzerland
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Patrascu R, Albai A, Braha A, Gaita L, Lazar S, Potre O, Timar B. Factors Influencing the Desirability, Acceptability, and Adherence of Patients with Diabetes to Telemedicine. Medicina (Kaunas) 2022; 58:medicina58080997. [PMID: 35893112 PMCID: PMC9331825 DOI: 10.3390/medicina58080997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Telemedicine solutions have proven their value and efficacy in augmenting diabetes care. In addition to the availability of tools needed to implement telemedicine solutions for patients with diabetes, the patients’ desirability, acceptance, and adherence represent major burdens in implementing them. The main aim of this research is to evaluate which factors are influencing the desirability, acceptance, and adherence of patients with diabetes to telemedicine interventions in diabetes care. Materials and Methods: QTelemeDiab, a previously validated instrument for assessing patients’ desirability, acceptance, and adherence to telemedicine in diabetes care, was used on 114 enrolled patients with diabetes mellitus, in parallel with demographic, socio-economic, disease history, and psychometric data from all patients. Results: Left-skewed score distributions were observed for the QTelemeDiab total score (median = 166; skewness = −1.738), as well as all its components, thus denoting a high desirability, acceptance, and adherence towards telemedicine use. The presence of severe depression was associated with significant decreases in the QTelemeDiab score (148 vs. 167; p < 0.001), as well as on the desirability sub-score (101 vs. 115; p < 0.001) and adherence sub-score (30 vs. 35; p < 0.001). The presence of severe anxiety was associated with significant decreases in QTelemeDiab score (150 vs. 166), as well as the desirability sub-score (104 vs. 114; p = 0.008) and adherence sub-score (30 vs. 34; p = 0.012). Conclusions: There is a high desirability, acceptance, and adherence to the use of telemedicine interventions in patients with diabetes, both in special and in normal epidemiological settings. The presence of severe anxiety decreases the patient’s desirability, acceptance, and adherence, while the presence of severe depression decreases the patient’s desirability and adherence to the use of telemedicine interventions in diabetes care.
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Affiliation(s)
- Raul Patrascu
- Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
| | - Alin Albai
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Correspondence: ; Tel.: +40-7214-35829
| | - Adina Braha
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Laura Gaita
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Sandra Lazar
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Ovidiu Potre
- First Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Bogdan Timar
- “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania; (A.B.); (L.G.); (B.T.)
- Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Torreggiani M, Chatrenet A, Fois A, Coindre JP, Crochette R, Sigogne M, Wacrenier S, Seret G, Mazé B, Lecointre L, Breuer C, Fessi H, Piccoli GB. Unmet needs for CKD care: from the general population to the CKD clinics-how many patients are we missing? Clin Kidney J 2021; 14:2246-2254. [PMID: 34804521 PMCID: PMC8598117 DOI: 10.1093/ckj/sfab055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction Prevalence of chronic kidney disease (CKD) varies around the world. Little is known about the discrepancy between the general population's needs and nephrology care offered. We aimed to contribute to filling this gap and propose a means to infer the number of patients needing follow-up. Methods All patients undergoing at least one nephrology consultation in 2019 were enrolled. We used the ratio between CKD Stages 3 and 4 reported in the literature, and considered that only 25–50% of CKD Stage 3 patients have progressive CKD, to hypothesize different scenarios to estimate the number of CKD Stage 3 patients still needing nephrology follow-up. Results The 1992 CKD patients were followed-up in our centre (56.93% males; age 66.71 ± 18.32 years; 16.82% Stage 1; 14.66% Stage 2; 39.46% Stage 3; 19.88% Stage 4; 7.68% Stage 5). The ratio between Stages 3 and 4 in population studies ranged from 7.72 to 51.29, being 1.98 in our centre. Hypothesizing that we followed-up 100, 70 or 50% of CKD Stage 4 patients, 528–2506 CKD Stage 3 patients in our area would need nephrology follow-up [1885–8946 per million population (p.m.p.)]. Three to 17 additional nephrologists p.m.p. would be necessary to fully cover the need for care. Conclusions The number of patients with CKD Stage 3 who would benefit from nephrology care is high. Considering that one patient-year of delay of dialysis could cover a nephrologist’s annual salary, interventions aimed to improve the care of advanced CKD may be economically sound.
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Affiliation(s)
- Massimo Torreggiani
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | - Antoine Chatrenet
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | - Antioco Fois
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | | | - Romain Crochette
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | - Mickael Sigogne
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | - Samuel Wacrenier
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | | | - Béatrice Mazé
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France
| | | | | | - Hafedh Fessi
- Department of Nephrology, Hospital Tenon, Paris, France
| | - Giorgina Barbara Piccoli
- Department of Nephrology and Dialysis, Centre Hospitalier Le Mans, Le Mans, France.,Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Torino, Italy
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Abstract
With the introduction of large-scale vaccination programmes against the coronavirus disease 2019 (COVID-19), the world has now begun to visualise a possible end to the ongoing pandemic. As with any vaccination programme, reports of side effects have begun to emerge in the wake of vaccinations. Initial reports were about mild side effects, such as local inflammation, pain, and fever. However, as a significant number of the population began to receive various COVID-19 vaccines, reports of various other moderate to severe side effects have now started to emerge. Although these side effects seem to be rare, the symptoms can be severe, and information and guidelines on how to manage them are scarce. In this case series, we discuss the incidence of widespread rashes that develop in some individuals after receiving COVID-19 vaccines by both AstraZeneca (AstraZeneca plc, Cambridge, UK) and Pfizer-BioNTech (Pfizer Inc., Brooklyn, NY; BioNTech SE, Mainz, Germany). The systemic skin reaction varied from maculopapular rashes to papules and patches that were widespread and not simply localised to the vaccine injection site. Further clinical information, awareness, and guidelines for practicing clinicians need to be exigently provided as vaccination programmes approach completion and the incidences of moderate to severe side effects of COVID-19 vaccination are becoming more apparent and pervasive.
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Affiliation(s)
- Mansoor Zafar
- Gastroenterology and Hepatology, Conquest Hospital, East Sussex Healthcare NHS Trust, St. Leonards-on-Sea, GBR
| | - Baby Ewnetu
- Acute Care Common Stem: Anaesthesia-General Internal Medicine-Emergency Medicine, Conquest Hospital, East Sussex Healthcare NHS Trust, St. Leonards-on-Sea, GBR
| | - Saif Ahmed
- General Internal Medicine, Conquest Hospital, East Sussex Healthcare NHS Trust, St. Leonards-on-Sea, GBR
| | - Uzair Iqbal
- Acute Medicine, General Internal Medicine, Conquest Hospital, East Sussex Healthcare NHS Trust, St. Leonards-on-Sea, GBR
| | - Mark Whitehead
- Gastroenterology, Conquest Hospital, East Sussex Healthcare NHS Trust, St. Leonards-on-Sea, GBR
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Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, Münter L. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Health 2021; 9:679397. [PMID: 34026720 PMCID: PMC8137852 DOI: 10.3389/fpubh.2021.679397] [Citation(s) in RCA: 194] [Impact Index Per Article: 64.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/12/2021] [Indexed: 12/27/2022] Open
Abstract
The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.
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Affiliation(s)
| | - John A Naslund
- Department of Global Health and Social Medicine and Harvard Medical School, Boston, MA, United States
| | | | - Shekhar Saxena
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, MA, United States
| | | | - Christoffel Grobler
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Lars Münter
- Danish Committtee for Health Education, Copenhagen, Denmark
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Abstract
In Dec 2019, a novel pathogen emerged, and within weeks, led to the emergence of the biggest global health crises seen to date. The virus called 'SARS-CoV-2', causes coronavirus disease which was named 'COVID-19' by the World Health Organization (WHO). The speedy spread of this infection globally became a source of public worry and several unknowns regarding this new pathogen created a state of panic. Mass media became the major source of information about the novel coronavirus. Much like the previous pandemics of SARS (2003), H1N1 (2009), and MERS (2012), the media significantly contributed to the COVID-19 infodemics. In this review, we analyze the role of mass media and public health communications from December 31, 2019 to July 15, 2020, and make scientific inferences. The COVID-19 pandemic highlights multiple social, cultural, and economic issues arising from the media's arguable role. The racial prejudices linked to the origin of the virus prevented collaborations among scientists to find a solution. Media coverage of coronavirus news during geographical lockdowns, extended quarantines, and financial and social hardships induced fear and caused psychological stress. Domestic and elderly abuse upsurged. The unscientific cures and unverified medicines endorsed by the politicians and fake doctors proved harmful. The media played a worldwide role in coronavirus disease tracking and updates through live updates dashboard. The media allowed for timely interventions by the Center For Disease Control And Prevention (CDC) and the World Health Organization (WHO), enabling a rapid and widespread reach of public health communications. We saw an upward trend for the promotion of health and hygiene practices worldwide by adaption of safe health practices such as increased hand washing, use of face coverings, and social distancing. Media reinforced illness-preventing guidelines daily, and people were encouraged to use telehealth to meet their healthcare needs. Mass media has an imperative role in today's world and it can provide a unified platform for all public health communications, comprehensive healthcare education guidelines, and robust social distancing strategies while still maintaining social connections. It can enable equal access to healthcare, end discrimination, and social stigmatization. The role of media and public health communications must be understood and explored further as they will be an essential tool for combating COVID-19 and future outbreaks.
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Affiliation(s)
- Ayesha Anwar
- Internal Medicine, Allama Iqbal Medical College/Jinnah Hospital, Lahore, PAK
| | - Meryem Malik
- Biotechnology, Harvard University, Cambridge, USA.,Psychiatry, Fatima Jinnah Medical University/Sir Ganga Ram Hospital, Lahore, PAK
| | | | - Anjum Anwar
- Anesthesia, University of Washington School of Medicine, Seattle, USA
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Godman B, Basu D, Pillay Y, Almeida PHRF, Mwita JC, Rwegerera GM, Anand Paramadhas BD, Tiroyakgosi C, Patrick O, Niba LL, Sefah I, Oluka M, Guantai AN, Kibuule D, Kalemeera F, Mubita M, Fadare J, Ogunleye OO, Rampamba EM, Wing J, Mueller D, Alfadl A, Amu AA, Matsebula Z, Kalungia AC, Zaranyika T, Masuka N, Wale J, Hill R, Kurdi A, Timoney A, Campbell S, Meyer JC. Ongoing and planned activities to improve the management of patients with Type 1 diabetes across Africa; implications for the future. Hosp Pract (1995) 2020; 48:51-67. [PMID: 32196395 DOI: 10.1080/21548331.2020.1745509] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 03/18/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Currently about 19 million people in Africa are known to be living with diabetes, mainly Type 2 diabetes (T2DM) (95%), estimated to grow to 47 million people by 2045. However, there are concerns with early diagnosis of patients with Type 1 diabetes (T1DM) as often patients present late with complications. There are also challenges with access and affordability of insulin, monitoring equipment and test strips with typically high patient co-payments, which can be catastrophic for families. These challenges negatively impact on the quality of care of patients with T1DM increasing morbidity and mortality. There are also issues of patient education and psychosocial support adversely affecting patients' quality of life. These challenges need to be debated and potential future activities discussed to improve the future care of patients with T1DM across Africa. METHODOLOGY Documentation of the current situation across Africa for patients with T1DM including the epidemiology, economics, and available treatments within public healthcare systems as well as ongoing activities to improve their future care. Subsequently, provide guidance to all key stakeholder groups going forward utilizing input from senior-level government, academic and other professionals from across Africa. RESULTS Whilst prevalence rates for T1DM are considerably lower than T2DM, there are concerns with late diagnosis as well as the routine provision of insulin and monitoring equipment across Africa. High patient co-payments exacerbate the situation. However, there are ongoing developments to address the multiple challenges including the instigation of universal health care and partnerships with non-governmental organizations, patient organizations, and pharmaceutical companies. Their impact though remains to be seen. In the meantime, a range of activities has been documented for all key stakeholder groups to improve future care. CONCLUSION There are concerns with the management of patients with T1DM across Africa. A number of activities has been suggested to address this and will be monitored.
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Affiliation(s)
- Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge , Stockholm, Sweden
- Health Economics Centre, University of Liverpool Management School , Liverpool, UK
| | - Debashis Basu
- Department of Public Health Medicine, Steve Biko Academic Hospital and the University of Pretoria , Pretoria, South Africa
| | - Yogan Pillay
- National Department of Health, Pretoria, South Africa
| | - Paulo H R F Almeida
- School of Pharmacy, Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais (UFMG) , Belo Horizonte, Brazil
- Departamento de Gestão e Incorporação de Tecnologias e Inovação em Saúde, Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde, Ministry of Health , Brasília, Brazil
| | - Julius C Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana , Gaborone, Botswana
| | - Godfrey Mutashambara Rwegerera
- Faculty of Medicine, Department of Internal Medicine, University of Botswana and Department of Medicine, Princess Marina Hospital , Gaborone, Botswana
| | - Bene D Anand Paramadhas
- Department of Pharmacy, Central Medical Stores, Ministry of Health and Wellness , Gaborone, Botswana
| | - Celda Tiroyakgosi
- Botswana Essential Drugs Action Program, Ministry of Health and Wellness , Gaborone, Botswana
| | - Okwen Patrick
- Effective Basic Services (Ebase) Africa , Bamenda, Africa
- Adelaide University , Adelaide, Australia
| | - Loveline Lum Niba
- Effective Basic Services (Ebase) Africa , Bamenda, Africa
- Department of Public Health, University of Bamenda , Bambili, Cameroon
| | - Israel Sefah
- Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service , Keta, Ghana; Department of Pharmacy Practice, School of Pharmacy, University of Health and Allied Sciences, Ghana
| | - Margaret Oluka
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi , Nairobi, Kenya
| | - Anastasia N Guantai
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi , Nairobi, Kenya
| | - Dan Kibuule
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia
| | - Francis Kalemeera
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia
| | - Mwangana Mubita
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University , Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital , Ado-Ekiti, Nigeria
| | - Olayinka O Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine , Ikeja, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital , Ikeja, Nigeria
| | - Enos M Rampamba
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa
- Department of Health, Tshilidzini Hospital, Department of Pharmacy , Shayandima, South Africa
| | - Jeffrey Wing
- Charlotte Maxeke Medical Research Cluster , Johannesburg, South Africa
| | - Debjani Mueller
- Department of Public Health Medicine, Steve Biko Academic Hospital and the University of Pretoria , Pretoria, South Africa
- Charlotte Maxeke Medical Research Cluster , Johannesburg, South Africa
| | - Abubakr Alfadl
- National Medicines Board, Federal Ministry of Health , Khartoum, Sudan
- Unaizah College of Pharmacy, Qassim University , Unaizah, Saudi Arabia
| | - Adefolarin A Amu
- Eswatini Medical Christian University , Swazi Plaza, Kingdom of Eswatini
| | | | | | - Trust Zaranyika
- Department Of Medicine, University of Zimbabwe College of Health Sciences , Harare, Zimbabwe
| | - Nyasha Masuka
- Independent Health Systems Consultant , Harare, Zimbabwe
| | - Janney Wale
- Independent Consumer Advocate , Brunswick, Australia
| | - Ruaraidh Hill
- Liverpool Reviews and Implementation Group, Whelan Building, University of Liverpool , Liverpool, UK
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK
- Department of Pharmacology, College of Pharmacy, Hawler Medical University , Erbil, Iraq
| | - Angela Timoney
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK
- NHS Lothian Director of Pharmacy, NHS Lothian , Edinburgh, UK
| | - Stephen Campbell
- Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester , Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester , Manchester, UK
| | - Johanna C Meyer
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa
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Hochdorn A, Faleiros VP, Valerio P, Vitelli R. Narratives of Transgender People Detained in Prison: The Role Played by the Utterances "Not" (as a Feeling of Hetero- and Auto-rejection) and "Exist" (as a Feeling of Hetero- and Auto-acceptance) for the Construction of a Discursive Self. A Suggestion of Goals and Strategies for Psychological Counseling. Front Psychol 2018; 8:2367. [PMID: 29387034 PMCID: PMC5776140 DOI: 10.3389/fpsyg.2017.02367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/27/2017] [Indexed: 11/13/2022] Open
Abstract
Purpose: Understanding how transgender people, who committed criminal offenses and are detained in prison, produce a narrative representation of self within different prison contexts. More specifically, this study has been based on two sub-aims: On a paradigmatic level, it has been aimed at critically investigating how the discursive positioning among the Self and the Other might promote the internalization of positive and/or negative attitudes toward the self. On a pragmatic level, it intends to offer some suggestions for goals and strategies of psychological counseling with these inmates inside such highly institutionalized contexts. Method and Materials: In total, 23 in-depth interviews were conducted with transgender women detained in either female or male prison contexts in Italy and Brazil. The lexical, semantic, and semiotic structure of the transcribed interviews has been investigated by adopting the quali-quantitative software Iramuteq for performing statistical text-mining analysis. Frequency, correspondences, and distribution of the most representative utterances across the corpus of data have been accessed and critically analyzed. Results: The findings showed that transgender inmates in Brazil made repeated use of the adverb "not," while the verb "exist" became the most representative word for the Italian sample. In Brazil, indeed, transgender women assumed masculine-driven behavior due to a common imprisonment with cis-gender men. On the contrary, transgender women in Italy are detained in protected sections, where they are allowed to wear female clothing and continue hormonal treatments. Surprisingly, transgender inmates in Italy suffered more violence in a female sector when compared to exclusively male jails. Conclusions: Transgender people represent a challenge for prison administration because it is not clear in which penitentiary context they should be detained. They should receive special attentions in order to face their special needs, which are radically different when compared to other typologies of inmates. Within penitentiary contexts, psychological counseling with transgender women should pay a special attention to the several psycho-social dimensions of this existential condition. In particular, psychological counselors should consider its inner complex articulation within different social, cultural and normative contexts.
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Affiliation(s)
- Alexander Hochdorn
- Post-graduation Program in Psychology, Catholic University of Brasília, Brasília, Brazil
| | - Vicente P Faleiros
- Post-graduation Program in Psychology, Catholic University of Brasília, Brasília, Brazil
| | - Paolo Valerio
- Department of Neuroscience and Reproductive and Dental Sciences, University of Naples Federico II, Napoli, Italy
| | - Roberto Vitelli
- Department of Neuroscience and Reproductive and Dental Sciences, University of Naples Federico II, Napoli, Italy
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