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Muto M. [Cultivation of Cancer Medical Personnel Who Will Lead the Way in Advanced Cancer Treatment]. Gan To Kagaku Ryoho 2022; 49:620-623. [PMID: 35799384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Kyoto University has been promoting the"The 3rd Stage Cancer Professional Development Plan"in collaboration with Shiga University of Medical Science, Mie University, Osaka Medical and Pharmaceutical University, and Kyoto Pharmaceutical University. The theme of our plan is"Training of Cancer Professionals who will lead the way in advanced cancer treatment". As the distinctive educational programs, we have undertaken include: 1 )overseas training, 2 )a five-university collaborative short-term training program, 3 )a five-university collaborative medical forum, and 4 )an educational program of patient and public involvement. In the 3rd Stage of the program, 173 students have been accepted and 120 have obtained professional certifications as of the end of 2021. On the other hand, the 3rd Stage Cancer Professional Development Plan ended in FY2021, and it is difficult to continue the education of the students currently enrolled in the program. We sincerely hope that the sufficient budget will be allocated in FY2022 and beyond so that sustainable education can be implemented.
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Affiliation(s)
- Manabu Muto
- Dept. of Clinical Oncology, Kyoto University Hospital
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Abstract
BACKGROUND To evaluate the health status of healthcare workers (doctors and nurses) compared to those in the general population based on the National Health Insurance Service database and the cause of death data from Statistics Korea. METHODS The subjects of this study were 104,484 doctors and 220,310 nurses working in healthcare facilities from 2002 to 2017, and who had undergone at least one general medical examination. Based on the subject definition, the subject data were extracted from the National Health Insurance healthcare facility database and qualification database. We collected medical use details included in the research database, general medical examination results, medical history included in the health examination database, and additional data on the cause of death from the National Statistics database to analyze the main cause of death and mortality. RESULTS In terms of the major causes of death and mortality among healthcare workers, the mortality rate associated with intentional self-harm, injury, transportation accident, heart disease, addiction, and falling was significantly higher than that in the general population. Further, the prevalence of respiratory and gastrointestinal diseases was high. When analyzing the proportional mortality ratio (PMR) by cause of death for healthcare workers, the PMR values for death related to malignant neoplasm was the highest. In terms of diseases, both doctors and nurses had higher rates of infectious diseases such as maternal sepsis, rubella, and measles. CONCLUSION The health status of healthcare workers differs from that of the general population. Thus, it is important to consider the occupational characteristics of healthcare personnel. This study is unique in that it was conducted based on medical use indicators rather than survey data.
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Affiliation(s)
- Yoonhee Shin
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul, Korea
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Ui Jeong Kim
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Eun Jeong Choi
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyun Jin Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- National Academy of Medicine of Korea (NAMOK)
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
- National Academy of Medicine of Korea (NAMOK)
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Browne T, McKinney SH, Duck L, Blake EW, Baliko B, English S, Christopher R. Preparing Health Professions Students to Serve Southern Rural Communities in the Time of COVID-19 and Beyond: A Model for Interprofessional Online Telehealth Education. South Med J 2021; 114:665-667. [PMID: 34599348 PMCID: PMC8505031 DOI: 10.14423/smj.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 11/25/2022]
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4
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Kuehn BM. Increasing Burnout Could Have Dire Effects on the Cardiovascular Workforce After the Pandemic. Circulation 2021; 144:997-999. [PMID: 34543063 DOI: 10.1161/circulationaha.121.056977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wahezi SE, Kohan LR, Spektor B, Brancolini S, Emerick T, Fronterhouse JM, Luedi MM, Colon MA, Kitei PM, Anitescu M, Goeders NE, Patil S, Siddaiah H, Cornett EM, Urman RD, Kaye AD. Telemedicine and current clinical practice trends in the COVID-19 pandemic. Best Pract Res Clin Anaesthesiol 2021; 35:307-319. [PMID: 34511221 PMCID: PMC7667401 DOI: 10.1016/j.bpa.2020.11.005] [Citation(s) in RCA: 19] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/09/2020] [Indexed: 12/23/2022]
Abstract
Telemedicine is the medical practice of caring for and treating patients remotely. With the spread of the coronavirus disease-2019 (COVID-19) pandemic, telemedicine has become increasingly prevalent. Although telemedicine was already in practice before the 2020 pandemic, the internet, smartphones, computers, and video-conferencing tools have made telemedicine easily accessible and available to almost everyone. However, there are also new challenges that health care providers may not be prepared for, including treating and diagnosing patients without physical contact. Physician adoption also depends upon reimbursement and education to improve the telemedicine visits. We review current trends involving telemedicine, how pandemics such as COVID-19 affect the remote treatment of patients, and key concepts important to healthcare providers who practice telemedicine.
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Affiliation(s)
- Sayed E Wahezi
- Departments of Rehabilitation Medicine, Anesthesiology, and Orthopedic Surgery, Montefiore Medical Center, 1250 Waters Place, Bronx NY 10461, USA.
| | - Lynn R Kohan
- Department of Anesthesiology, University of Virginia, 545 Ray C Hunt Dr. Suite 3168, Charlottesville, VA, 22908, USA.
| | - Boris Spektor
- Department of Anesthesiology, Emory University School of Medicine, 1364 Clifton Road NE, 5th Floor Tower, T5L38, Atlanta, GA 30322, USA.
| | - Scott Brancolini
- Department of Anesthesiology and Pain Medicine, University of Pittsburgh Medical Center, 200 Delafield Road Medical Arts Building 200, Suite 2070, Pittsburgh, PA 15215, USA.
| | - Trent Emerick
- Department of Anesthesiology and Perioperative Medicine, Division of Chronic Pain, University of Pittsburgh Medical Center, Falk Medical Building - 6th floor, 3601 Fifth Avenue, Pittsburgh, PA 15213, USA.
| | - Jean M Fronterhouse
- Department of Psychiatry, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Markus M Luedi
- Department of Anesthesiology and Pain Therapy, Inselspital, Universitatsspital Bern, Switzerland.
| | - Marc A Colon
- Department of Psychiatry, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Paul M Kitei
- Department of Physical Medicine & Rehabilitation, Rothman Orthopaedic Institute and Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
| | - Magdalena Anitescu
- Department of Anesthesiology and Critical Care, University of Chicago, 5841 S Maryland Ave, MC 4028, Chicago, IL 60637, USA.
| | - Nicholas E Goeders
- Department of Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
| | - Shilpavedi Patil
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
| | - Harish Siddaiah
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
| | - Alan D Kaye
- Academic Affairs, LSU Health Shreveport, 1501 Kings Highway, Shreveport LA 71103, USA.
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Abstract
Amid the COVID-19 pandemic, women in medicine, including faculty, residents, medical students, and other health care workers (HCWs), are facing unparalleled challenges. The burdens of pandemic-associated increases in domestic and caregiving responsibilities, professional demands, health risks associated with contracting COVID-19, and the resulting psychosocial distress have exacerbated existing gender disparities at home, at work, and in academia. School and day care closures have created additional childcare needs, primarily for women, yet little support exists for parents and families. These increased childcare and domestic responsibilities have forced women HCWs, who make up the overwhelming majority of the workforce, to adapt their schedules and, in some cases, leave their jobs entirely. In this article, the authors detail how COVID-19 has exacerbated existing childcare accessibility and affordability issues as well as gender disparities. They argue that unless government and health care organization support for childcare increases, families, specifically women and children, will continue to suffer. Lack of access to affordable childcare can prevent HCWs from doing their jobs, including conducting and publishing academic scholarship. This poses incalculable risks to families, science, and society. COVID-19 should serve as a call to action to all sectors, including the government and health care organizations, to prioritize childcare provision and increase support for women HCWs, both now during the pandemic and going forward.
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Affiliation(s)
- Londyn J. Robinson
- L.J. Robinson was a fourth-year medical student, University of Minnesota Medical School, Minneapolis, Minnesota, at the time of writing. She is a first-year resident, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, now; ORCID: https://orcid.org/0000-0002-0961-4020
| | - Brianna J. Engelson
- B.J. Engelson is a second-year resident, Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota; ORCID: https://orcid.org/0000-0002-6877-520
| | - Sharonne N. Hayes
- S.N. Hayes is professor of medicine and cardiovascular diseases, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-3129-362X
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Abstract
Two new tools from the AHRQ help facilitate observational audits.
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Affiliation(s)
- Tracy A Ortelli
- Tracy A. Ortelli is executive vice president of teaching and learning innovation at Galen College of Nursing in Louisville, KY. She also coordinates Nursing Resources :
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Abstract
This cross-sectional study examines national trends in representativeness in select health care occupations by race/ethnicity and sex.
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Affiliation(s)
- Dan P. Ly
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles
- VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Anupam B. Jena
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Boston
- National Bureau of Economic Research, Cambridge, Massachusetts
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9
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Abstract
COVID-19 is a worldwide pandemic, with frontlines that look drastically different than in past conflicts: that is, women now make up a sizeable majority of the health care workforce. American women have a long history of helping in times of hardship, filling positions on the home front vacated by men who enlisted as soldiers during World War I and similarly serving in crucial roles on U.S. military bases, on farms, and in factories during World War II. The COVID-19 pandemic has represented a novel battleground, as the first in which women have taken center stage, not only in their roles as physicians, respiratory therapists, nurses, and the like, but also by serving in leadership positions and facilitating innovations in science, technology, and policy. Yet, the pandemic has exacerbated multiple pain points that have disproportionally impacted women in health care, including shortages in correctly sized personal protective equipment and uniforms, inadequate support for pregnant and breastfeeding providers, and challenges associated with work-life balance and obtaining childcare. While the pandemic has facilitated several positive advancements in addressing these challenges, there is still much work to be done for women to achieve equity and optimal support in their roles on the frontlines.
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Affiliation(s)
- Loren Galler Rabinowitz
- L.G. Rabinowitz is a fellow, Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: http://orcid.org/0000-0002-6673-4096
| | - Danielle Galler Rabinowitz
- D.G. Rabinowitz is resident physician, Boston Combined Residency Program, Boston Children’s Hospital and Boston Medical Center, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-5437-5719
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Affiliation(s)
| | - Drew Weissman
- Department of Medicine, University of Pennsylvania, Philadelphia
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de Arriba-Fernández A, Molina-Cabrillana MJ, Serra Majem L. [Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic]. Rev Esp Quimioter 2021; 34:214-219. [PMID: 33829723 PMCID: PMC8179943 DOI: 10.37201/req/150.2020] [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] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/20/2021] [Accepted: 02/22/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.
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Affiliation(s)
- A de Arriba-Fernández
- Alejandro de Arriba-Fernández, Universidad de Las Palmas de Gran Canaria. Paseo Blas Cabrera Felipe "Físico", 310, Las Palmas Gran Canaria. Spain.
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Santabárbara J, Bueno-Notivol J, Lipnicki DM, Olaya B, Pérez-Moreno M, Gracia-García P, Idoiaga-Mondragon N, Ozamiz-Etxebarria N. Prevalence of anxiety in health care professionals during the COVID-19 pandemic: A rapid systematic review (on published articles in Medline) with meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2021; 107:110244. [PMID: 33453320 PMCID: PMC9188432 DOI: 10.1016/j.pnpbp.2021.110244] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 12/30/2022]
Abstract
During the COVID-19, healthcare workers are exposed to a higher risk of mental health problems, especially anxiety symptoms. The current work aims at contributing to an update of anxiety prevalence in this population by conducting a rapid systematic review and meta-analysis. Medline and Pubmed were searched for studies on the prevalence of anxiety in health care workers published from December 1, 2019 to September 15, 2020. In total, 71 studies were included in this study. The pooled prevalence of anxiety in healthcare workers was 25% (95% CI: 21%-29%), 27% in nurses (95% CI: 20%-34%), 17% in medical doctors (95% CI: 12%-22%) and 43% in frontline healthcare workers (95% CI: 25%-62%). Our results suggest that healthcare workers are experiencing significant levels of anxiety during the COVID-19 pandemic, especially those on the frontline and nurses. However, international longitudinal studies are needed to fully understand the impact of the pandemic on healthcare workers' mental health, especially those working at the frontline.
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Affiliation(s)
- Javier Santabárbara
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Juan Bueno-Notivol
- Psychiatry Service, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Medicine, Randwick, Australia
| | - Beatriz Olaya
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain.
| | | | - Patricia Gracia-García
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain; Psychiatry Service, Hospital Universitario Miguel Servet, Zaragoza, Spain; Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Nahia Idoiaga-Mondragon
- Department of Developmental and Educational Psychology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Naiara Ozamiz-Etxebarria
- Department of Developmental and Educational Psychology, University of the Basque Country UPV/EHU, Leioa, Spain
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Hordowicz M, Klimkiewicz A, Jarosz J, Wysocka M, Jastrzębska M. Knowledge, attitudes, and prescribing patterns of cannabis and cannabinoid-containing medicines among European healthcare workers: a systematic literature review. Drug Alcohol Depend 2021; 221:108652. [PMID: 33667785 DOI: 10.1016/j.drugalcdep.2021.108652] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/20/2021] [Accepted: 02/17/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Since the introduction of the National Medical Cannabis Programme in The Netherlands, many other countries in Europe have made medical cannabis (MC) and cannabis-based medicines (CBMs) available. However, each of them has implemented a unique legal framework and reimbursement strategy for these products. Therefore, it is vital to study healthcare professionals' knowledge level (HCP) and HCPs in-training regarding both medical uses and indications and understand their safety concerns and potential barriers for MC use in clinical practice. METHODS A comprehensive, systematic literature review was performed using PubMed/MEDLINE, EMBASE, and Google Scholar databases, as well as PsychINFO. Grey literature was also included. Due to the high diversity in the questionnaires used in the studies, a narrative synthesis was performed. RESULTS From 6995 studies retrieved, ten studies, all of them being quantitative survey-based studies, were included in the review. In most studies, the majority of participants were in favor of MC and CBMs use for medical reasons. Other common findings were: the necessity to provide additional training regarding medical applications of cannabinoids, lack of awareness about the legal status of and regulations regarding MC among both certified physicians, as well as prospective doctors and students of other medicals sciences (e.g., nursing, pharmacy). CONCLUSIONS For most European countries, we could not identify any studies evaluating HCPs' knowledge and attitudes towards medicinal cannabis. Therefore, similar investigations are highly encouraged. Available evidence demonstrates a need to provide medical training to the HCPs in Europe regarding medical applications of cannabinoids.
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Affiliation(s)
| | | | - Jerzy Jarosz
- Hospice of St. Christopher in Warsaw, Warsaw, Poland
| | - Maria Wysocka
- Hospice of St. Christopher in Warsaw, Warsaw, Poland; Medical University of Warsaw, Warsaw, Poland; Nowowiejski Hospital in Warsaw, Warsaw, Poland
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Weiss JJ, Attuquayefio TN, White EB, Li F, Herz RS, White TL, Campbell M, Geng B, Datta R, Wyllie AL, Grubaugh ND, Casanovas-Massana A, Muenker MC, Moore AJ, Handoko R, Iwasaki A, Martinello RA, Ko AI, Small DM, Farhadian SF. Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection. PLoS One 2021; 16:e0248025. [PMID: 33657167 PMCID: PMC7928484 DOI: 10.1371/journal.pone.0248025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/18/2021] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. METHODS AND FINDINGS We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV-2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). CONCLUSIONS In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.
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Affiliation(s)
- Julian J. Weiss
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Tuki N. Attuquayefio
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Elizabeth B. White
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Fangyong Li
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Rachel S. Herz
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Theresa L. White
- Department of Psychology, Le Moyne College, Syracuse, New York, United States of America
- SUNY Upstate Medical University, Syracuse, New York, United States of America
| | - Melissa Campbell
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
- Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Connecticut, United States of America
| | - Bertie Geng
- Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Rupak Datta
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Anne L. Wyllie
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Nathan D. Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Arnau Casanovas-Massana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - M. Catherine Muenker
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Adam J. Moore
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Ryan Handoko
- Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Akiko Iwasaki
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
| | - Richard A. Martinello
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Infection Prevention, Yale-New Haven Health, New Haven, Connecticut, United States of America
| | - Albert I. Ko
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Dana M. Small
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
| | - Shelli F. Farhadian
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, United States of America
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Alkurt G, Murt A, Aydin Z, Tatli O, Agaoglu NB, Irvem A, Aydin M, Karaali R, Gunes M, Yesilyurt B, Turkez H, Mardinoglu A, Doganay M, Basinoglu F, Seyahi N, Dinler Doganay G, Doganay HL. Seroprevalence of coronavirus disease 2019 (COVID-19) among health care workers from three pandemic hospitals of Turkey. PLoS One 2021; 16:e0247865. [PMID: 33657142 PMCID: PMC7928442 DOI: 10.1371/journal.pone.0247865] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/15/2021] [Indexed: 01/09/2023] Open
Abstract
COVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in "high risk" group had similar seropositivity rate with "no risk" group (2.9 vs 3.5 p = 0.7). These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.
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Affiliation(s)
- Gizem Alkurt
- Genomic Laboratory (GLAB), Umraniye Teaching and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Murt
- Cerrahpasa Faculty of Medicine, Department of Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Zeki Aydin
- Department of Nephrology, Darica Farabi Teaching and Research Hospital, Kocaeli, Turkey
| | - Ozge Tatli
- Department of Molecular Biology and Genetics, Istanbul Technical University, Istanbul, Turkey
- Department of Molecular Biology and Genetics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nihat Bugra Agaoglu
- Genomic Laboratory (GLAB), Umraniye Teaching and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Arzu Irvem
- Department of Microbiology, Umraniye Teaching and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehtap Aydin
- Department of Infectious Disease, Umraniye Teaching and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ridvan Karaali
- Cerrahpasa Faculty of Medicine, Department of Infectious Disease, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mustafa Gunes
- Department of Urology, Darica Farabi Teaching and Research Hospital, Kocaeli, Turkey
| | | | - Hasan Turkez
- Faculty of Medicine, Department of Medical Biology, Ataturk University, Erzurum, Turkey
| | - Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
- Faculty of Dentistry, Centre for Host-Microbiome Interactions, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Mehmet Doganay
- Faculty of Medicine, Department of Infectious Diseases, Lokman Hekim University, Ankara, Turkey
| | - Filiz Basinoglu
- Department of Medical Biochemistry, Darica Farabi Teaching and Research Hospital, Kocaeli, Turkey
| | - Nurhan Seyahi
- Cerrahpasa Faculty of Medicine, Department of Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gizem Dinler Doganay
- Department of Molecular Biology and Genetics, Istanbul Technical University, Istanbul, Turkey
| | - Hamdi Levent Doganay
- Genomic Laboratory (GLAB), Umraniye Teaching and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Revollo B, Tebe C, Peñafiel J, Blanco I, Perez-Alvarez N, Lopez R, Rodriguez L, Ferrer J, Ricart P, Moret E, Tural C, Carreres A, Matllo J, Videla S, Clotet B, Llibre JM. Hydroxychloroquine pre-exposure prophylaxis for COVID-19 in healthcare workers. J Antimicrob Chemother 2021; 76:827-829. [PMID: 33219675 PMCID: PMC7717339 DOI: 10.1093/jac/dkaa477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Boris Revollo
- Division of Infectious Diseases and FLS Foundation for Fighting AIDS, Infectious Diseases and Promoting Health and Science, University Hospital Germans Trias, Badalona, Spain
| | - Cristian Tebe
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL)/University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Judith Peñafiel
- Biostatistics Unit, Bellvitge Biomedical Research Institute (IDIBELL)/University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ignacio Blanco
- Metropolitana Nord Laboratory, Institut Català de la Salut, Badalona, Spain
| | - Nuria Perez-Alvarez
- Division of Infectious Diseases and FLS Foundation for Fighting AIDS, Infectious Diseases and Promoting Health and Science, University Hospital Germans Trias, Badalona, Spain
- Statistics and Operations Research Department, Universitat Politècnica de Catalunya-Barcelona Tech, Barcelona, Spain
| | - Ruth Lopez
- Occupational Risk Prevention Unit, University Hospital Germans Trias, Badalona, Spain
| | - Laura Rodriguez
- Pulmonary Medicine, University Hospital Germans Trias, Badalona, Spain
| | - Josep Ferrer
- Internal Medicine Department, University Hospital Germans Trias, Badalona, Spain
| | - Pilar Ricart
- Intensive Care Unit Division, University Hospital Germans Trias, Badalona, Spain
| | - Enrique Moret
- Anaesthesiology Department, University Hospital Germans Trias, Badalona, Spain
| | - Cristina Tural
- Internal Medicine Department, University Hospital Germans Trias, Badalona, Spain
| | - Anna Carreres
- Emergency Department, University Hospital Germans Trias, Badalona, Spain
| | - Joan Matllo
- Occupational Risk Prevention Unit, University Hospital Germans Trias, Badalona, Spain
| | - Sebastià Videla
- Division of Infectious Diseases and FLS Foundation for Fighting AIDS, Infectious Diseases and Promoting Health and Science, University Hospital Germans Trias, Badalona, Spain
- Clinical Research Support Unit, Clinical Pharmacology Department, Bellvitge University Hospital/Bellvitge Biomedical Research Institute (IDIBELL)/University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Bonaventura Clotet
- Division of Infectious Diseases and FLS Foundation for Fighting AIDS, Infectious Diseases and Promoting Health and Science, University Hospital Germans Trias, Badalona, Spain
- Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josep M Llibre
- Division of Infectious Diseases and FLS Foundation for Fighting AIDS, Infectious Diseases and Promoting Health and Science, University Hospital Germans Trias, Badalona, Spain
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Ojo A, Guntuku SC, Zheng M, Beidas RS, Ranney ML. How Health Care Workers Wield Influence Through Twitter Hashtags: Retrospective Cross-sectional Study of the Gun Violence and COVID-19 Public Health Crises. JMIR Public Health Surveill 2021; 7:e24562. [PMID: 33315578 PMCID: PMC7790125 DOI: 10.2196/24562] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/12/2020] [Accepted: 12/12/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Twitter has emerged as a novel way for physicians to share ideas and advocate for policy change. #ThisIsOurLane (firearm injury) and #GetUsPPE (COVID-19) are examples of nationwide health care-led Twitter campaigns that went viral. Health care-initiated Twitter hashtags regarding major public health topics have gained national attention, but their content has not been systematically examined. OBJECTIVE We hypothesized that Twitter discourse on two epidemics (firearm injury and COVID-19) would differ between tweets with health care-initiated hashtags (#ThisIsOurLane and #GetUsPPE) versus those with non-health care-initiated hashtags (#GunViolence and #COVID19). METHODS Using natural language processing, we compared content, affect, and authorship of a random 1% of tweets using #ThisIsOurLane (Nov 2018-Oct 2019) and #GetUsPPE (March-May 2020), compared to #GunViolence and #COVID19 tweets, respectively. We extracted the relative frequency of single words and phrases and created two sets of features: (1) an open-vocabulary feature set to create 50 data-driven-determined word clusters to evaluate the content of tweets; and (2) a closed-vocabulary feature for psycholinguistic categorization among case and comparator tweets. In accordance with conventional linguistic analysis, we used a P<.001, after adjusting for multiple comparisons using the Bonferroni correction, to identify potentially meaningful correlations between language features and outcomes. RESULTS In total, 67% (n=4828) of #ThisIsOurLane tweets and 36.6% (n=7907) of #GetUsPPE tweets were authored by health care professionals, compared to 16% (n=1152) of #GunViolence and 9.8% (n=2117) of #COVID19 tweets. Tweets using #ThisIsOurLane and #GetUsPPE were more likely to contain health care-specific language; more language denoting positive emotions, affiliation, and group identity; and more action-oriented content compared to tweets with #GunViolence or #COVID19, respectively. CONCLUSIONS Tweets with health care-led hashtags expressed more positivity and more action-oriented language than the comparison hashtags. As social media is increasingly used for news discourse, public education, and grassroots organizing, the public health community can take advantage of social media's broad reach to amplify truthful, actionable messages around public health issues.
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Affiliation(s)
| | - Sharath Chandra Guntuku
- Penn Medicine Center for Digital Health, Philadelphia, PA, United States
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
| | - Margaret Zheng
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Rinad S Beidas
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Megan L Ranney
- Brown-Lifespan Center for Digital Health, Brown University, Providence, RI, United States
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Elbarbary NS, dos Santos TJ, de Beaufort C, Wiltshire E, Pulungan A, Scaramuzza AE. The Challenges of Managing Pediatric Diabetes and Other Endocrine Disorders During the COVID-19 Pandemic: Results From an International Cross-Sectional Electronic Survey. Front Endocrinol (Lausanne) 2021; 12:735554. [PMID: 34803908 PMCID: PMC8602836 DOI: 10.3389/fendo.2021.735554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/15/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Frequency, dimensions, management, and outcomes of the COVID-19 pandemic in children with endocrine disorders and diabetes were assessed. METHODS A cross-sectional electronic survey was distributed to the global network of endocrine societies. Respondents' professional and practice profiles, clinic sizes, their country of practice, and the impact of COVID-19 on endocrine diseases were investigated. RESULTS Respondents from 131 pediatric endocrine centers in 51 countries across all continents completed the survey. Routine check-ups and education were altered in most pediatric endocrine clinics. Over 20% of clinics experienced a shortage of critical medications or essential supplies. ICU treatment was required for patients with diabetes and COVID-19 in 21.2% of centers. In diabetes, 44% of respondents reported increased diabetic ketoacidosis episodes in newly diagnosed cases and 30% in established cases. Biopsychosocial and behavioral changes were explicitly reported to be occurring among pediatric patients with endocrine disorders. CONCLUSIONS This large global survey conducted during the COVID-19 pandemic highlights that diabetes is more challenging to manage than any other pediatric endocrine disorder, with an increased risk of morbidity. Psychological distress due to COVID-19 needs to be recognized and addressed. The importance of close contact with healthcare professionals should be emphasized, and medical supplies should be readily available to all patients.
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Affiliation(s)
- Nancy Samir Elbarbary
- Diabetes Unit, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tiago Jeronimo dos Santos
- Instituto Hispalense de Pediatría, Vithas Almería, Almería, Spain
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carine de Beaufort
- Diabetes & Endocrine Care Clinique Pédiatrique (DECCP), Clinique Pédiatrique/Centre Hospitalier (CH) de Luxembourg, Luxembourg, Luxembourg
- Department Pediatric Endocrinology, Free University Hospital Brussels, Brussels, Belgium
| | - Esko Wiltshire
- Department of Paediatrics and Child Health, University of Otago Wellington, Wellington, New Zealand
- Department of Child Health, Capital and Coast District Health Board, Wellington, New Zealand
| | - Aman Pulungan
- Child Health Department, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Andrea Enzo Scaramuzza
- Diabetes and Endocrinology & Nutrition, Division of Pediatrics, Azienda Socio Sanitaria Territoriale (ASST) Cremona, “Ospedale Maggiore di Cremona”, Cremona, Italy
- *Correspondence: Andrea Enzo Scaramuzza,
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20
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Maduke T, Dorroh J, Bhat A, Krvavac A, Regunath H. Are We Coping Well with COVID-19?: A Study on Its Psycho-Social Impact on Front-line Healthcare Workers. Mo Med 2021; 118:55-62. [PMID: 33551487 PMCID: PMC7861609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Global pandemics have a profound psycho-social impact on health systems and their impact on healthcare workers is under-reported. METHODS We performed a cross-sectional survey with 13 Likert-scale responses and some additional polar questions pertaining to dressing habits and learning in a university hospital in the midwest United States. Descriptive and analytical statistics were performed. RESULTS The 370 respondents (66.1% response rate, age 38.5±11.6 years; 64.9% female), included 102 supervising providers [96 (25.9%) physicians, 6 (1.6%) mid-level], 64 (17.3%) residents/fellows, 73 (19.7% nurses, 45 (12.2%) respiratory therapists, 31 (8.4%) therapy services and others: 12 (3.2%) case-managers, 4 (1.1%) dietitians, 39 (10.5%) unclassified]. Overall, 200 (54.1%) had increased anxiety, 115 (31.1%) felt overwhelmed, 159 (42.9%) had fear of death, and 281 (75.9%) changed dressing habits. Females were more anxious (70.7% vs. 56%, X2 (1, N=292)=5.953, p=0.015), overwhelmed (45.6% vs. 27.3%, X2 (1, N=273)=8.67, p=0.003) and suffered sleep disturbances (52% vs. 39%, X2 (1, N=312)=4.91, p=0.027). Administration was supportive; 243 (84.1%, N=289), 276 (74.5%) knew another co-worker with COVID-19, and only 93 (25.1%) felt healthcare employment was less favorable. Residents and fellows reported a negative impact on their training despite feeling supported by their program. CONCLUSION Despite belief of a supportive administration, over half of healthcare workers and learners reported increased anxiety, and nearly a third felt overwhelmed during this current pandemic.
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Affiliation(s)
- Tinashe Maduke
- Clinical Fellow, Department of Medicine, Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri-Columbia, (UMC), Columbia, Missouri
| | - James Dorroh
- Second-year Medical Student, Department of Medicine, UMC
| | | | - Armin Krvavac
- Assistant Professor, Department of Internal Medicine - Division of Pulmonary, Critical Care and Sleep Medicine, Saint Louis University, St. Louis, Missouri
| | - Hariharan Regunath
- Clinical Assistant Professor, Department of Medicine - Divisions of Pulmonary, Critical Care and Infectious Diseases-UMC
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21
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Duggal M, Dahiya N, Kankaria A, Chaudhary M, Bachani D. Restructuring the Healthcare System to Protect Healthcare Personnel Amidst the COVID-19 Pandemic. Front Public Health 2020; 8:588203. [PMID: 33363085 PMCID: PMC7759646 DOI: 10.3389/fpubh.2020.588203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/23/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
- Mona Duggal
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Neha Dahiya
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ankita Kankaria
- All India Institute of Medical Sciences, Bathinda (AIIMS Bathinda), Bhatinda, India
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Maggio LA, Willinsky JM, Costello JA, Skinner NA, Martin PC, Dawson JE. Integrating Wikipedia editing into health professions education: a curricular inventory and review of the literature. Perspect Med Educ 2020; 9:333-342. [PMID: 33030643 PMCID: PMC7718341 DOI: 10.1007/s40037-020-00620-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/12/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Wikipedia is an online encyclopedia read by millions seeking medical information. To provide health professions students with skills to critically assess, edit, and improve Wikipedia's medical content, a skillset aligned with evidence-based medicine (EBM), Wikipedia courses have been integrated into health professions schools' curriculum. This literature review and curricular inventory of Wikipedia educational initiatives provides an overview of current approaches and identifies directions for future initiatives and research. METHODS Five databases were searched for articles describing educational interventions to train health professional students to edit Wikipedia. Course dashboards, maintained by Wiki Education (Wiki Edu), were searched for curricular materials. From these sources, key details were extracted and synthesized, including student and instructor type, course content, educational methods, and student outcomes. RESULTS Six articles and 27 dashboards reported courses offered between 2015 and 2019. Courses were predominantly offered to medical and nursing students. Instructors delivered content via videos, live lectures, and online interactive modules. Course content included logistics of Wikipedia editing, EBM skills, and health literacy. All courses included assignments requiring students to edit Wikipedia independently or in groups. Limited details on assessment of student learning were available. DISCUSSION A small but growing number of schools are training health professions education students to improve Wikipedia's medical content. Course details are available on Wiki Edu dashboards and, to a lesser extent, in peer-reviewed publications. While more needs to be done in conducting and sharing assessment of student learning, integrating Wikipedia into health professions education has potential to facilitate learning of EBM and communication skills, improve Wikipedia's online content, and engage students with an autonomous environment while learning. Future considerations should include a thorough assessment of student learning and practices, a final review of student edits to ensure they follow Wikipedia's guidelines and are written in clear language, and improved sharing of teaching resources by instructors.
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Affiliation(s)
- Lauren A Maggio
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - John M Willinsky
- Graduate School of Education, Stanford University, Stanford University, Stanford, CA, USA
| | - Joseph A Costello
- Uniformed Services University of the Health Sciences in Bethesda, Bethesda, MD, USA
| | - Nadine A Skinner
- Graduate School of Education, Stanford University, Stanford University, Stanford, CA, USA
| | - Paolo C Martin
- Graduate School of Education, Stanford University, Stanford University, Stanford, CA, USA
| | - Jennifer E Dawson
- CHEO Research Institute, and the Wikipedian in Residence for Cochrane, Ottawa, Ontario, Canada
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Abstract
The duty to care for all patients is central to the health professions, but what happens when clinicians encounter patients who exhibit biased or discriminatory behaviors? While significant attention has focused on addressing clinician bias toward patients, incidents of patient bias toward clinicians also occur and are difficult to navigate.Clinicians anecdotally describe their experiences with patient bias, prejudice, and discrimination as profoundly painful and degrading. Though this phenomenon has not been rigorously studied, it is not unreasonable to postulate that the moral distress caused by patient bias may ultimately contribute to clinician burnout. Because women and minority clinicians are more likely to be targets of patient bias, this may worsen existing disparities for these groups and increase their risk for burnout. Biased behavior may also affect patient outcomes.Although some degree of ignoring derogatory comments is necessary to maintain professionalism and workflow, clinicians also have the right to a workplace free of mistreatment and abuse. How should clinicians reconcile the expectation to always "put patients first" with their basic right to be treated with dignity and respect? And how can health care organizations develop policies and training to mitigate the effects of these experiences?The authors discuss the ethical dilemmas associated with responding to prejudiced patients and then present a framework for clinicians to use when directly facing or witnessing biased behavior from patients. Finally, they describe strategies to address patient bias at the institutional level.
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Affiliation(s)
- Pooja Chandrashekar
- P. Chandrashekar is a second-year medical student, Harvard Medical School, Boston, Massachusetts
| | - Sachin H Jain
- S.H. Jain is adjunct professor of medicine, Stanford University School of Medicine, Palo Alto, California, and president and chief executive officer, SCAN Group and Health Plan, Long Beach, California
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Abstract
Suicide is a social evil that is considered to be a global epidemic. Mental healthcare professionals (MHP) (psychiatrists, clinical psychologists, psychiatric social work, etc.) are often involved as 'gatekeepers' in the management of suicidality and suicide prevention. Even though the risk of suicide in medical profession has received attention in research, there has been scarcity of literature related to the same in MHPs. They are not immune to the perils of psychological distress and its cascading consequences including suicide, contrary to the popular societal myths. The intrinsic and extrinsic pressures of the profession, persistent discourse in managing the psychological distress of others, professional burnout, self-stigma, societal apathy and easy access to psychotropics are certain factors making the MHPs more vulnerable. This disengagement and stress can contribute to depression, anxiety and complex trauma in the MHPs. The situation is furthermore compounded in developing countries with resource constraints, low MHP: patient ratio and inflexibility of work schedules. This makes tailored interventions, peer counselling, periodic mental health screenings and administrative understanding and accountability necessary at all levels. Keeping this in background, the review glances at the risk factors of suicide related to MHPs, highlights the problem statement and discusses the possible interventions.
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Affiliation(s)
- Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Prateek Varshney
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Bhavika Vajawat
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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25
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Abstract
The prevalence of harmful bias and discrimination within the health professions is staggering. Moreover, literature consistently demonstrates their persistence and their negative impact on patient care. Several professional codes of conduct for health professionals highlight the importance of addressing these forces in practice. However, despite this, these forces are often discussed as tangential within health professions curricula. This paper examines the prevalence of bias and discrimination, its effects on patient care and health professions trainees, and reviews the historical context of societal bias and discrimination within the health professions institution. The authors argue that addressing harmful bias and discrimination is the professional responsibility of every provider and essential to effective and equitable care.
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Affiliation(s)
- Camila M Mateo
- C.M. Mateo is associate director, anti-racism curriculum and faculty development and instructor of pediatrics, Harvard Medical School, and attending physician, Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - David R Williams
- D.R. Williams is the Florence Sprague Norman and Laura Stuart Norman professor of Public Health and chair, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and professor of African and African American studies, Harvard University, Cambridge, Massachusetts
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Peters VJT, Meijboom BR, Bunt JEH, Bok LA, van Steenbergen MW, de Winter JP, de Vries E. Providing person-centered care for patients with complex healthcare needs: A qualitative study. PLoS One 2020; 15:e0242418. [PMID: 33196659 PMCID: PMC7668580 DOI: 10.1371/journal.pone.0242418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022] Open
Abstract
Background People with chronic conditions have complex healthcare needs that lead to challenges for adequate healthcare provision. Current healthcare services do not always respond adequately to their needs. A modular perspective, in particular providing visualization of the modular service architecture, is promising for improving the responsiveness of healthcare services to the complex healthcare needs of people with chronic conditions. The modular service architecture provides a comprehensive representation of the components and modules of healthcare provision. In this study, we explore this further in a qualitative multiple case study on healthcare provision for children with Down syndrome in the Netherlands. Methods Data collection for four cases involved 53 semi-structured interviews with healthcare professionals and 21 semi-structured interviews with patients (the parents of children with Down syndrome as proxy). In addition, we gathered data by means of practice observations and analysis of relevant documents. The interviews were audio-recorded, transcribed verbatim and analyzed utilizing the Miles and Huberman approach. Results Our study shows that the perspectives on healthcare provision of professionals and patients differ substantially. The visualization of the modular service architecture that was based on the healthcare professionals’ perspective provided a complete representation of (para)medical outcomes relevant to the professionals’ own discipline. In contrast, the modular service architecture based on the patients’ perspective, which we define as a person-centered modular service architecture, provided a representation of the healthcare service that was primarily based on functional outcomes and the overall wellbeing of the patients. Conclusion Our study shows that visualization of the modular service architecture can be a useful tool to better address the complex needs and requirements of people with a chronic condition. We suggest that a person-centered modular service architecture that focuses on functional outcomes and overall wellbeing, enables increased responsiveness of healthcare services to people with complex healthcare needs and provision of truly person-centered care.
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Affiliation(s)
- Vincent J. T. Peters
- Department of Management, Tilburg School of Economics and Management, Tilburg University, Tilburg, Noord-Brabant, The Netherlands
| | - Bert R. Meijboom
- Department of Management, Tilburg School of Economics and Management, Tilburg University, Tilburg, Noord-Brabant, The Netherlands
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, The Netherlands
- Department of Marketing, Innovation and Organization, Ghent University, Ghent, Belgium
- * E-mail:
| | - Jan Erik H. Bunt
- Department of Pediatrics, Elisabeth-Tweesteden Ziekenhuis, Tilburg, Noord-Brabant, The Netherlands
| | - Levinus A. Bok
- Department of Pediatrics, Máxima Medisch Centrum, Veldhoven, Noord-Brabant, The Netherlands
| | | | - J. Peter de Winter
- Department of Pediatrics, Spaarne Gasthuis, Haarlem, Noord-Holland, The Netherlands
| | - Esther de Vries
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, The Netherlands
- Department of Jeroen Bosch Academy Research, Jeroen Bosch Ziekenhuis, ‘s-Hertogenbosch, Noord-Brabant, The Netherlands
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27
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Regenauer KS, Myers B, Batchelder AW, Magidson JF. "That person stopped being human": Intersecting HIV and substance use stigma among patients and providers in South Africa. Drug Alcohol Depend 2020; 216:108322. [PMID: 33010712 PMCID: PMC7673102 DOI: 10.1016/j.drugalcdep.2020.108322] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND South Africa has the largest number of people living with HIV in the world. Concurrently, problematic alcohol and other drug use (AOD) is prevalent in the country and associated with poor HIV treatment outcomes. Further, the high rates of stigma surrounding HIV and AOD contribute to poor HIV outcomes. Yet, how HIV stigma and AOD stigma together may affect HIV care has not been extensively studied in this context. Thus, we explored HIV and AOD providers' and patients' experiences of HIV and AOD stigma. METHODS We conducted 30 semi-structured interviews with patients living with HIV who were struggling with HIV medication adherence and problematic AOD use (n = 19), and providers involved in HIV or AOD treatment (n = 11) in Cape Town, South Africa to assess how HIV and AOD stigmas manifest and relate to HIV care. FINDINGS Two main themes around the intersection of HIV and AOD and their related stigmas were identified: (1) how patients use AOD to cope with HIV stigma; and (2) enacted/ anticipated AOD stigma from HIV care providers, which acts as a barrier to HIV care. CONCLUSIONS Intersecting HIV and AOD stigmas exist at multiple levels and increase barriers to HIV care in this setting. Accordingly, it is important that future interventions address both these stigmas at multiple levels.
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Affiliation(s)
- Kristen S Regenauer
- Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD, 20740, USA.
| | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zyl Drive, Parow, 7505, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Abigail W Batchelder
- Department of Psychiatry, Massachusetts General Hospital/ Harvard Medical School, 1 Bowdoin Square, Boston, MA, 02114, USA
| | - Jessica F Magidson
- Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD, 20740, USA
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Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland SØ, Stroobants S, Van de Velde S, Vist GE. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res 2020; 293:113441. [PMID: 32898840 PMCID: PMC7462563 DOI: 10.1016/j.psychres.2020.113441] [Citation(s) in RCA: 447] [Impact Index Per Article: 111.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 12/20/2022]
Abstract
The covid-19 pandemic has heavily burdened healthcare systems throughout the world. We performed a rapid systematic review to identify, assess and summarize research on the mental health impact of the covid-19 pandemic on HCWs (healthcare workers). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence on 11 May and included 59 studies. Six reported on implementing interventions, but none reported on effects of the interventions. HCWs reported low interest in professional help, and greater reliance on social support and contact. Exposure to covid-19 was the most commonly reported correlate of mental health problems, followed by female gender, and worry about infection or about infecting others. Social support correlated with less mental health problems. HCWs reported anxiety, depression, sleep problems, and distress during the covid-19 pandemic. We assessed the certainty of the estimates of prevalence of these symptoms as very low using GRADE. Most studies did not report comparative data on mental health symptoms before the pandemic or in the general population. There seems to be a mismatch between risk factors for adverse mental health outcomes among HCWs in the current pandemic, their needs and preferences, and the individual psychopathology focus of current interventions.
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Affiliation(s)
| | | | | | | | | | - Synne Øien Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies, Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
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Antonelli M, Firenzuoli F, Salvarani C, Gensini GF, Donelli D. Reading and interpreting reviews for health professionals: a practical review. Intern Emerg Med 2020; 15:945-955. [PMID: 32281054 DOI: 10.1007/s11739-020-02334-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 01/08/2023]
Abstract
Literature reviews can be directly used by clinicians and other health professionals to support many decision-making processes. This review aims to offer health professionals an essential practical guide to critically evaluate and properly understand results of review articles published in the scientific literature. An evidence-based methodological review with step-by-step theoretical concepts and practical suggestions was developed. Key steps of this guide are: to consider the topic and the research question (a), to check the review type (b), to evaluate the methodology (with a keen focus on review guidelines, search strategy and study-selection process, evaluation of the quality and certainty of included evidence, and statistical analysis) (c), and to define the real impact of review results (d). This guide offers a description of essential and easy-to-apply key steps which can help health professionals to evaluate the reliability and implications of a literature review, and to select the latest high-quality scientific evidence to keep updated with.
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Affiliation(s)
- Michele Antonelli
- Terme di Monticelli, via Basse 5, Monticelli Terme, 43022, Parma, Italy.
- Department of Medicine and Surgery, University of Parma (UniPr), 43125, Parma, Italy.
- Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, 50139, Florence, Italy.
| | - Fabio Firenzuoli
- Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, 50139, Florence, Italy
| | - Carlo Salvarani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia (UniMoRe), 41125, Modena, Italy
- Azienda USL-IRCCS Di Reggio Emilia, 42122, Reggio Emilia, Italy
| | | | - Davide Donelli
- Terme di Monticelli, via Basse 5, Monticelli Terme, 43022, Parma, Italy
- Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, 50139, Florence, Italy
- Azienda USL-IRCCS Di Reggio Emilia, 42122, Reggio Emilia, Italy
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Affiliation(s)
- Diane M Gibson
- Marxe School of Public and International Affairs, Baruch College - City University of New York, New York, NY, USA.
| | - Jessica Greene
- Marxe School of Public and International Affairs, Baruch College - City University of New York, New York, NY, USA
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Wong KC, Han XA, Tay KS, Koh SB, Howe TS. The psychological impact on an orthopaedic outpatient setting in the early phase of the COVID-19 pandemic: a cross-sectional study. J Orthop Surg Res 2020; 15:322. [PMID: 32787965 PMCID: PMC7422671 DOI: 10.1186/s13018-020-01862-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND World Health Organization declared coronavirus disease-19 (COVID-19) a global pandemic on 11 March 2020, after the coronavirus claimed 4628 lives worldwide. Mental health challenges such as making impossible decisions and working under extreme pressures are expected to be faced by frontline healthcare workers who are directly involved in the care of COVID-19 patients. However, we question if significant stress levels might also be observed in a subspecialty musculoskeletal outpatient department, where staff are not first-line care providers of COVID-19 patients. We hypothesize that these healthcare workers also face significant psychological strain, and we aim to objectively determine the prevalence using a validated caregiver strain index. METHODS A cross-sectional study was conducted in outpatient musculoskeletal clinics in a tertiary hospital in Singapore. We collected basic demographic data and used a 13-question tool adapted from the validated Caregiver Strain Index (CSI) to measure psychological strain in these healthcare workers. Participants were divided into 2 groups depending on the level of strain experienced. RESULTS A total of 62 healthcare workers volunteered for this study. There were 32 participants (51.6%) who had 7 or more positive responses (group 1) and the remaining 30 participants (48.4%) were allocated to group 2. There were no significant differences between the two groups in terms of demographic data. "Work adjustments" (74.2%), "changes in personal plans" (72.6%), and finding it "confining" (72.6%) garnered the most positive responses in the questionnaire. On the other hand, "financial concerns" garnered the least positive responses (21.0%). CONCLUSION The protracted duration of the COVID-19 outbreak and its resultant prolonged adjustments can have unintended consequences of wearing down healthcare resources otherwise allocated to chronic and elective conditions. Countries should ensure that measures are put in place to safeguard the mental well-being of our healthcare workers to avoid needing another reactive strategy in this battle against COVID-19.
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Affiliation(s)
- Khai Cheong Wong
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
| | - Xinyun Audrey Han
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Kae Sian Tay
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Suang Bee Koh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Tet Sen Howe
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
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Markin NW, Cawcutt KA, Sayyed SH, Rupp ME, Lisco SJ. Transesophageal Echocardiography Probe Sheath to Decrease Provider and Environment Contamination. Anesthesiology 2020; 133:475-477. [PMID: 32358249 PMCID: PMC7223580 DOI: 10.1097/aln.0000000000003370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text.
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Affiliation(s)
| | - Kelly A. Cawcutt
- University of Nebraska Medical Center, Omaha, Nebraska (N.W.M.).
| | - Samer H. Sayyed
- University of Nebraska Medical Center, Omaha, Nebraska (N.W.M.).
| | - Mark E. Rupp
- University of Nebraska Medical Center, Omaha, Nebraska (N.W.M.).
| | - Steven J. Lisco
- University of Nebraska Medical Center, Omaha, Nebraska (N.W.M.).
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Delvigne A, Vandromme J. Assessment of environmental knowledge and needs among assisted reproductive technology professionals. J Assist Reprod Genet 2020; 37:2347-2355. [PMID: 32725308 DOI: 10.1007/s10815-020-01888-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/13/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Exposure to environmental contaminants is to be taken into account in preventive healthcare in general and particularly in the field of reproduction according to the increasing amount of evidence data being published. The aim of this study is to evaluate the practices and interest in and basic knowledge of environmental health, by the professionals of the ART process: doctor, embryologist, and nurses. METHODS Survey among 12 Belgian assisted reproductive technology (ART) centers. RESULTS The response rate was 67%: 43.5% of the ART professionals do bring up the topic of environmental contaminants with their patients, without significant differences among types of professionals. Ninety percent of respondents believe that it would be useful, and 63% mention their lack of knowledge and the absence of solutions (20.5%) to explain their inaction. Lack of knowledge is much greater for nurses respectively (85%) compared with doctors (52%) and biologists (54%). The most popular means toward improving their knowledge is scientific seminars (69%). The questionnaire to evaluate the health professional knowledge gives 56% of adequate replies. The topic concerning eating habits obtains a very bad score of knowledge. When looking at exposure to occupational risks, 75% of the answers were correct. CONCLUSIONS The place of ART before conception makes it an ideal entry point for the prevention of environmental hazards. This study corroborates the previous observations which underline the importance to reinforce the concepts of environmental health in the initial and continuous training of health professionals.
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Affiliation(s)
| | - Jean Vandromme
- Department of Obstetrics and Gynecology, CHU Saint Pierre, Brussels, Belgium
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Pattison RJ, Esteban JP, Sempokuya T, Kewcharoen J, Kalathil S, Kuwada SK. Nonalcoholic Fatty Liver Disease: An Important Consideration for Primary Care Providers in Hawai'i. Hawaii J Health Soc Welf 2020; 79:180-186. [PMID: 32524096 PMCID: PMC7281344] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. NAFLD is a broad term for both non-alcoholic fatty liver (NAFL), which describes simple fatty liver without inflammation, and non-alcoholic steatohepatitis (NASH), the more severe phenotype with hepatocellular inflammation. The population of Hawai'i is particularly vulnerable to the NAFLD and obesity epidemics due to its large proportions of high-risk ethnic minorities exposed to varying degrees of westernization. Unfortunately, primary care providers (PCPs) often face a lack of awareness on the diagnosis and disease spectrum of NAFLD. Early initiation of treatment for NAFLD is crucial to slow its progression and prevent liver-related morbidity and mortality. This review aims to raise awareness for NAFLD among PCPs in Hawai'i by summarizing the disease's epidemiology, diagnosis, and treatment. The diagnostic workup of NAFLD in the primary care setting involves exclusion of other liver disease etiologies and staging assessment of fibrosis and steatosis through non-invasive means such as serum biomarkers or elastography. Patients with overt signs and symptoms of cirrhosis or a high likelihood of advanced hepatic fibrosis should be referred to liver disease specialists. The role of PCPs in NAFLD management involves facilitating weight loss through therapeutic lifestyle modifications and treatment of comorbid cardiovascular conditions. Evidence-based pharmacologic therapies for NAFLD are available, such as vitamin E and pioglitazone, with more currently in development.
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Affiliation(s)
- Robert J. Pattison
- Internal Medicine Residency Program, John A. Burns School of Medicine University of Hawai‘i, Honolulu, HI (RJP, JK)
| | | | | | - Jakrin Kewcharoen
- Internal Medicine Residency Program, John A. Burns School of Medicine University of Hawai‘i, Honolulu, HI (RJP, JK)
| | | | - Scott K. Kuwada
- John A. Burns School of Medicine University of Hawai‘i, Honolulu, HI (SKK)
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35
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Burrell L. The Future of Health Care and the Importance of the Nuclear Medicine Technologist. J Nucl Med Technol 2020; 48:84S-85S. [PMID: 32605964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
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Warne-Griggs M, Brandt L, Hoffman K, Greever-Rice T, Mutrux ER. Building Regional Expertise: Perspectives from Show-Me ECHO Participants. Mo Med 2020; 117:222-227. [PMID: 32636554 PMCID: PMC7302021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article highlights four primary care providers that practice in underserved areas in Missouri. Show-Me ECHO (Extension for Community Healthcare Outcomes) provides colleagues opportunities for consultation and Continuing Medical Education (CME) around particular conditions. Through their participation, these providers have 1) enhanced their comfort and skill in diagnosis and treatment, 2) become important regional resources for patients and other providers, and 3) improved access to specialty services in their community.
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Affiliation(s)
| | - Lea Brandt
- Associate Professional Practice Professor, University of Missouri-Columbia, Columbia, Missouri
| | - Kimberly Hoffman
- Professor Emerita, Family and Community Medicine, University of Missouri-Columbia, Columbia, Missouri
| | - Tracy Greever-Rice
- Director, Center for Health Policy, Assistant Research Professor, University of Missouri-Columbia, Columbia
| | - E Rachel Mutrux
- Senior Program Director, Missouri Telehealth Network, Director, Show-Me ECHO, State Director, Heartland Telehealth Resource Center, University of Missouri-Columbia, Columbia, Missouri
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37
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Lambooij MS, Veldwijk J, van Gils PF, Suijkerbuijk AWM, Struijs JN. Trading patients' choice in providers for quality of maternity care? A discrete choice experiment amongst pregnant women. PLoS One 2020; 15:e0232098. [PMID: 32330182 PMCID: PMC7182251 DOI: 10.1371/journal.pone.0232098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 04/07/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The introduction of bundled payment for maternity care, aimed at improving the quality of maternity care, may affect pregnant women's choice in providers of maternity care. This paper describes a Dutch study which examined pregnant women's preferences when choosing a maternity care provider. The study focused on factors that enhance the quality of maternity care versus (restricted) provider choice. METHODS A discrete choice experiment was conducted amongst 611 pregnant women living in the Netherlands using an online questionnaire. The data were analysed with Latent Class Analyses. The outcome measure consisted of stated preferences in the discrete choice experiment. Included factors were: information exchange by care providers through electronic medical records, information provided by midwife, information provided by friends, freedom to choose maternity care provider and travel distance. RESULTS Four different preference structures were found. In two of those structures, respondents found aspects of the maternity care related to quality of care more important than being able to choose a provider (provider choice). In the two other preference structures, respondents found provider choice more important than aspects related to quality of maternity care. CONCLUSIONS In a country with presumed high-quality maternity care like the Netherlands, about half of pregnant women prefer being able to choose their maternity care provider over organisational factors that might imply better quality of care. A comparable amount of women find quality-related aspects most important when choosing a maternity care provider and are willing to accept limitations in their choice of provider. These insights are relevant for policy makers in order to be able to design a bundled payment model which justify the preferences of all pregnant women.
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Affiliation(s)
- Mattijs S. Lambooij
- Centre of Food, National Institute for Public Health and the Environment, Prevention and Health care (VPZ), Bilthoven, the Netherlands
| | - Jorien Veldwijk
- Erasmus Choice Modelling Center (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Paul F. van Gils
- Centre of Food, National Institute for Public Health and the Environment, Prevention and Health care (VPZ), Bilthoven, the Netherlands
| | - Anita W. M. Suijkerbuijk
- Centre of Food, National Institute for Public Health and the Environment, Prevention and Health care (VPZ), Bilthoven, the Netherlands
| | - Jeroen N. Struijs
- Centre of Food, National Institute for Public Health and the Environment, Prevention and Health care (VPZ), Bilthoven, the Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center Campus The Hague, Leiden, the Netherlands
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Azadmanjir Z, Jazayeri SB, Habibi Arejan R, Ghodsi Z, Sharif-Alhoseini M, Kheiri G, Zendehdel K, Safdarian M, Sadeghian F, Khazaeipour Z, Naghdi K, Arab Kheradmand J, Saadat S, Pirnejad H, Fazel MR, Fakharian E, Mohammadzadeh M, Sadeghi-Naini M, Saberi H, Derakhshan P, Sabour H, Benzel EC, Oreilly G, Noonan V, Vaccaro AR, Emami-Razavi SH, Rahimi-Movaghar V. The data set development for the National Spinal Cord Injury Registry of Iran (NSCIR-IR): progress toward improving the quality of care. Spinal Cord Ser Cases 2020; 6:17. [PMID: 32210224 PMCID: PMC7093542 DOI: 10.1038/s41394-020-0265-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/29/2020] [Accepted: 02/29/2020] [Indexed: 12/17/2022] Open
Abstract
STUDY DESIGN Descriptive study. OBJECTIVES The aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR). SETTING SCI community in Iran. METHODS The NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry. RESULTS The final version of the data set was composed of 376 data elements including sociodemographic, hospital admission, injury incidence, prehospital procedures, emergency department visit, medical history, vertebral injury, spinal cord injury details, interventions, complications, and discharge data. It also includes 163 components of the International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) and 65 data elements related to quality of life, pressure ulcers, pain, and spasticity. CONCLUSION The NSCIR-IR data set was developed in order to meet the quality improvement objectives of the registry. The process was centered around choosing the data elements assessing care provided to individuals in the acute and chronic phases of SCI in hospital settings. The International Spinal Cord Injury Data Set was selected as a basic framework, helped by comparison with data from other countries. Expert panel modifications facilitated the implementation of the registry process with the current clinical workflow in hospitals.
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Affiliation(s)
- Zahra Azadmanjir
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behzad Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Urology, University of Florida, Jacksonville, FL, USA
| | - Roya Habibi Arejan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Kheiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Student's Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Sadeghian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Center for Health Related Social and Behavioral Science Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Khazaeipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Soheil Saadat
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibollah Pirnejad
- Health Information Technology Department, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Esmail Fakharian
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Mohsen Sadeghi-Naini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Houshang Saberi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Derakhshan
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Sabour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Gerard Oreilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vanessa Noonan
- Rick Hansen Institute, University of British Columbia, Vancouver, BC, Canada
| | - Alexander R Vaccaro
- Department of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - Seyed Hassan Emami-Razavi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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McSharry J, Byrne M, Casey B, Dinneen SF, Fredrix M, Hynes L, Lake AJ, Morrissey E. Behaviour change in diabetes: behavioural science advancements to support the use of theory. Diabet Med 2020; 37:455-463. [PMID: 31797455 DOI: 10.1111/dme.14198] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 12/18/2022]
Abstract
Behaviour is central to the management of diabetes, both for people living with diabetes and for healthcare professionals delivering evidence-based care. This review outlines the evolution of behavioural science and the application of theoretical models in diabetes care over the past 25 years. There has been a particular advancement in the development of tools and techniques to support researchers, healthcare professionals and policymakers in taking a theory-based approach, and to enhance the development, reporting and replication of successful interventions. Systematic guidance, theoretical frameworks and lists of behavioural techniques provide the tools to specify target behaviours, identify why ideal behaviours are not implemented, systematically develop theory-based interventions, describe intervention content using shared terminology, and evaluate their effects. Several examples from a range of diabetes-related behaviours (clinic attendance, self-monitoring of blood glucose, retinal screening, setting collaborative goals in diabetes) and populations (people with type 1 and type 2 diabetes, healthcare professionals) illustrate the potential for these approaches to be widely translated into diabetes care. The behavioural science approaches outlined in this review give healthcare professionals, researchers and policymakers the tools to deliver care and design interventions with an evidence-based understanding of behaviour. The challenge for the next 25 years is to refine the tools to increase their use and advocate for the role of theoretical models and behavioural science in the commissioning, funding and delivery of diabetes care.
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Affiliation(s)
- J McSharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - M Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - B Casey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | - S F Dinneen
- School of Medicine, National University of Ireland, Galway, Ireland
- Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland
| | - M Fredrix
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands
| | - L Hynes
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | - A J Lake
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - E Morrissey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
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Gandrup J, Li J, Izadi Z, Gianfrancesco M, Ellingsen T, Yazdany J, Schmajuk G. Three Quality Improvement Initiatives and Performance of Rheumatoid Arthritis Disease Activity Measures in Electronic Health Records: Results From an Interrupted Time Series Study. Arthritis Care Res (Hoboken) 2020; 72:283-291. [PMID: 30740931 PMCID: PMC6689446 DOI: 10.1002/acr.23848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/05/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Applying treat-to-target strategies in the care of patients with rheumatoid arthritis (RA) is critical for improving outcomes, yet electronic health records (EHRs) have few features to facilitate this goal. We undertook this study to evaluate the effect of 3 health information technology (health-IT) initiatives on the performance of RA disease activity measures and outcomes in an academic rheumatology clinic. METHODS We implemented the 3 following initiatives designed to facilitate performance of the Clinical Disease Activity Index (CDAI): an EHR flowsheet to input scores, peer performance reports, and an EHR SmartForm including a CDAI calculator. We performed an interrupted time-series trial to assess effects on the proportion of RA visits with a documented CDAI. Mean CDAI scores before and after the last initiative were compared using t-tests. Additionally, we measured physician satisfaction with the initiatives. RESULTS We included data from 995 patients with 8,040 encounters between 2012 and 2017. Over this period, electronic capture of CDAI scores increased from 0% to 64%. Performance remained stable after peer reporting and the SmartForm were introduced. We observed no meaningful changes in disease activity levels. However, physician satisfaction increased after SmartForm implementation. CONCLUSION Modifications to the EHR, provider culture, and clinical workflows effectively improved capture of RA disease activity scores and physician satisfaction, but parallel gains in disease activity levels were missing. This study illustrates how a series of health-IT initiatives can evolve to enable sustained changes in practice. However, capture of RA outcomes alone may not be sufficient to improve levels of disease activity without a comprehensive treat-to-target program.
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Affiliation(s)
| | - Jing Li
- University of California, San Francisco
| | | | | | | | | | - Gabriela Schmajuk
- University of California and the Veterans Affairs Medical Center, San Francisco
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Keane JM, Franklin NF, Vaughan B. Simulation to educate healthcare providers working within residential age care settings: A scoping review. Nurse Educ Today 2020; 85:104228. [PMID: 31765870 DOI: 10.1016/j.nedt.2019.104228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/10/2019] [Revised: 08/18/2019] [Accepted: 09/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Simulation is used widely in health education to develop healthcare providers' knowledge and skills. The use of simulation however, as an educational strategy among aged care worker is not well understood. OBJECTIVES This review sought to describe studies where simulation is used to educate healthcare providers working within aged care settings; describe the method and structure used in simulations in residential aged care; the key learning outcomes for the participants in this setting; and identify any gaps in the current literature to illuminate future research opportunities. DESIGN The review follows the Joanna Briggs Institute Scoping Review methodology and utilises the PRISMA-ScR Checklist. Searches of CINAHL Complete, PubMed and Scopus databases were completed using the search terms "Simulation" AND "training" AND "Aged Care" OR "Elderly" OR "Older People". Inclusion criteria were peer-reviewed, English, full-text articles published from database inception to July 2018. RESULTS Twenty studies were included in this review. Studies differed in their methodology, sample size and participants and their findings varied significantly. Fourteen studies originated from the United States of America, five from Canada, and one from Taiwan. Studies were published between 1977 and July 2018. Clinical topics used in simulation were aggression and violence; dementia; aging; death and dying; range of motion exercises; person-centred care; sepsis; and dressing residents. Simulation types were role play, simulated patients, and mannequins. Debrief was described in less than a third of studies. Just over half of the studies evaluated participant outcomes. DISCUSSION/CONCLUSION This study demonstrated a large paucity of evidence utilising simulation for training within aged care settings. It highlights the need for future research in this area where simulation could be utilised to meet the unique learning needs of nurses working in aged care.
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Affiliation(s)
- Johanna M Keane
- The University of Melbourne, Department of Medical Education, Parkville Campus, Parkville, Victoria 3010, Australia.
| | - Natasha F Franklin
- The University of South Australia, School of Nursing & Midwifery, Frome Street, Adelaide, South Australia, 5001, Australia.
| | - Brett Vaughan
- The University of Melbourne, Department of Medical Education, Medical Building, Parkville Campus, Parkville, Victoria, 3010, Australia.
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Best M, Leget C, Goodhead A, Paal P. An EAPC white paper on multi-disciplinary education for spiritual care in palliative care. BMC Palliat Care 2020; 19:9. [PMID: 31941486 PMCID: PMC6964109 DOI: 10.1186/s12904-019-0508-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The EAPC White Paper addresses the issue of spiritual care education for all palliative care professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and education; as well as national and local curricula development groups. METHODS Early in 2018, preliminary draft paper was written by members of the European Association for Palliative Care (EAPC) spiritual care reference group inviting comment on the four core elements of spiritual care education as outlined by Gamondi et al. (2013) in their paper on palliative care core competencies. The preliminary draft paper was circulated to experts from the EAPC spiritual care reference group for feedback. At the second stage feedback was incorporated into a second draft paper and experts and representatives of national palliative care organizations were invited to provide feedback and suggest revisions. The final version incorporated the subsequent criticism and as a result, the Gamondi framework was explored and critically revised leading to updated suggestions for spiritual care education in palliative care. RESULTS The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care. The revised spiritual care education competencies for all palliative care providers are accompanied by the best practice models and research evidence, at the same time being sensitive towards different development stages of the palliative care services across the European region. CONCLUSIONS Better education can help the healthcare practitioner to avoid being distracted by their own fears, prejudices, and restraints and attend to the patient and his/her family. This EAPC white paper encourages and facilitates high quality, multi-disciplinary, academically and financially accessible spiritual care education to all palliative care staff.
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Affiliation(s)
- Megan Best
- Senior Lecturer, Institute for Ethics and Society, University of Notre Dame, Fremantle, Australia
- Post-doctoral research fellow, PoCoG and Sydney Health Ethics, University of Sydney, PO Box, 944, Broadway NSW 2007, Sydney, Australia
| | - Carlo Leget
- Professor in Care Ethics at the University of Humanistic Studies, Kromme Nieuwegracht 29, Utrecht, 3512 HD The Netherlands
| | - Andrew Goodhead
- Spiritual Care Lead, St Christopher’s Hospice, 51/59 Lawrie Park Road, London, Sydenham SE26 6DZ UK
| | - Piret Paal
- Researcher at the Palliative Care Research Hub, Institute of Nursing Science and Practice, Paracelsus Medical Private University, Strubergasse 21, 5020 Salzburg, Austria
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Coates D, Clerke T. Training Interventions to Equip Health Care Professionals With Shared Decision-Making Skills: A Systematic Scoping Review. J Contin Educ Health Prof 2020; 40:100-119. [PMID: 32433322 DOI: 10.1097/ceh.0000000000000289] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION To support the development, implementation, and evaluation of shared decision-making (SDM) training programs, this article maps the relevant evidence in terms of training program design and content as well as evaluation outcomes. METHOD A systematic scoping review methodology was used. To identify studies, the databases PubMed, Medline, and CINAHL were searched from 2009 to 2019, and reference lists of included studies were examined. After removal of duplicates, 1367 articles were screened for inclusion. To be included, studies were to be published in peer-reviewed journals, and should not merely be descriptive but report on evaluation outcomes. Articles were reviewed for inclusion by both authors, and data were extracted using a purposely designed data charting form implemented using REDCap. RESULTS The review identified 49 studies evaluating 36 unique SDM training programs. There was considerable variation in terms of program design and duration. Most programs included an overview of SDM theories and key competencies, as well as SDM skill development through role plays. Few programs provided training in reflective practice, in identifying and working with patients' individually preferred decision-making style, or in relation to SDM in a context of medical uncertainty or ambiguity. Most programs were evaluated descriptively, mostly using mixed methods, and there were 18 randomized controlled trials, showing that training was feasible, well received, and improved participants' knowledge and skills, but was limited in its impact on patients. DISCUSSION Although there is limited capacity to comment on which types of training programs are most effective, overall training was feasible, well received, and improved participants' knowledge and skills.
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Affiliation(s)
- Dominiek Coates
- Dr. Coates: Senior Research Fellow, University of Technology Sydney, Faculty of Health, Sydney, Australia.Clerke: Project Officer, Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), Sydney, Australia
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Adubato S. Back to the Future of Healthcare: Defining a New Normal, in the Wake of COVID-19. MD Advis 2020; 13:8-10. [PMID: 33352014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Luciano MG, Batzdorf U, Kula RW, Rocque BG, Maher CO, Heiss J, Martin BA, Bolognese PA, Ashley-Koch A, Limbrick D, Poppe DJ, Esposito KM, Odenkirchen J, Esterlitz JR, Ala’i S, Joseph K, Feldman RS, Riddle R. Development of Common Data Elements for Use in Chiari Malformation Type I Clinical Research: An NIH/NINDS Project. Neurosurgery 2019; 85:854-860. [PMID: 30690581 PMCID: PMC7054710 DOI: 10.1093/neuros/nyy475] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Indexed: 12/28/2022] Open
Abstract
The management of Chiari I malformation (CMI) is controversial because treatment methods vary and treatment decisions rest on incomplete understanding of its complex symptom patterns, etiologies, and natural history. Validity of studies that attempt to compare treatment of CMI has been limited because of variable terminology and methods used to describe study subjects. The goal of this project was to standardize terminology and methods by developing a comprehensive set of Common Data Elements (CDEs), data definitions, case report forms (CRFs), and outcome measure recommendations for use in CMI clinical research, as part of the CDE project at the National Institute of Neurological Disorders and Stroke (NINDS) of the US National Institutes of Health. A working group, comprising over 30 experts, developed and identified CDEs, template CRFs, data dictionaries, and guidelines to aid investigators starting and conducting CMI clinical research studies. The recommendations were compiled, internally reviewed, and posted online for external public comment. In October 2016, version 1.0 of the CMI CDE recommendations became available on the NINDS CDE website. The recommendations span these domains: Core Demographics/Epidemiology; Presentation/Symptoms; Co-Morbidities/Genetics; Imaging; Treatment; and Outcome. Widespread use of CDEs could facilitate CMI clinical research trial design, data sharing, retrospective analyses, and consistent data sharing between CMI investigators around the world. Updating of CDEs will be necessary to keep them relevant and applicable to evolving research goals for understanding CMI and its treatment.
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Affiliation(s)
- Mark G Luciano
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - Ulrich Batzdorf
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California
| | - Roger W Kula
- Chiari Neurosurgical Center at Neurological Surgery, P.C., Lake Success, New York
| | - Brandon G Rocque
- Department of Neurosurgery, University of Alabama, Birmingham, Alabama
| | - Cormac O Maher
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - John Heiss
- Division of Intramural Research, National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Bryn A Martin
- Department of Biological Engineering, University of Idaho, Moscow, Idaho
| | - Paolo A Bolognese
- Chiari Neurosurgical Center at Neurological Surgery, P.C., Lake Success, New York
| | | | - David Limbrick
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Joanne Odenkirchen
- Division of Neuroscience, National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | | | | | | | | | - Robert Riddle
- Division of Neuroscience, National Institutes of Health/National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
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Affiliation(s)
- Jason T Eberl
- Saint Louis University, 3545 Lafayette Ave., Salus 527, St. Louis, MO, 63104, USA.
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Lind JD, Fickel J, Cotner BA, Katzburg JR, Cowper-Ripley D, Fleming M, Ong MK, Bergman AA, Bradley SE, Tubbesing SA. Implementing Geographic Information Systems (GIS) into VHA Home Based Primary Care. Geriatr Nurs 2019; 41:282-289. [PMID: 31757414 DOI: 10.1016/j.gerinurse.2019.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/24/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 11/18/2022]
Abstract
The Veteran's Health Administration (VHA) Home Based Primary Care (HBPC) program provides comprehensive in-home primary care services to elderly Veterans with complex chronic medical conditions. Nurses have prominent roles in HBPC including as program leaders, primary care providers and nurses who make home visits. Delivery of primary care services to patients in their homes can be challenging due to travel distances, difficult terrain, traffic, and adverse weather. Mapmaking with geographic information systems (GIS) can support optimization of resource utilization, travel efficiency, program capacity, and management during normal operations, and patient safety during disasters. This paper reports on the feasibility, acceptability and outcomes of an initiative to implement GIS mapmaking in VHA HBPC programs. A mixed method evaluation assessed extent of adoption and identified facilitators and barriers to uptake. Results indicate that GIS mapping in VHA HBPC is feasible and can increase effectiveness and efficiency of VHA HBPC nurses.
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Affiliation(s)
- Jason D Lind
- James A. Haley Veterans' Hospital and Clinics, Research and Development Service, 8900 Grand Oak Circle (151R), Tampa, FL 33637-1022, United States.
| | - Jacqueline Fickel
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Bridget A Cotner
- James A. Haley Veterans' Hospital and Clinics, Research and Development Service, 8900 Grand Oak Circle (151R), Tampa, FL 33637-1022, United States
| | - Judith R Katzburg
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Diane Cowper-Ripley
- North Florida/South Georgia Veterans Health System, Center of Innovation, Gainesville, FL, United States; VA Office of Rural Health, GeoSpatial Outcomes Division, Gainesville, FL, United States
| | - Marguerite Fleming
- VA Office of Reporting, Analytics, Performance, Improvement, and Deployment, Center for Innovation and Analytics, Washington, D.C., United States
| | - Michael K Ong
- University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA, United States; Division of Hospital Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Alicia A Bergman
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Sarah E Bradley
- James A. Haley Veterans' Hospital and Clinics, Research and Development Service, 8900 Grand Oak Circle (151R), Tampa, FL 33637-1022, United States
| | - Sarah A Tubbesing
- Home Based Primary Care Program, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA, United States
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Alexander M, Alexander J, Arora M, Slocum C, Middleton J. A bellweather for climate change and disability: educational needs of rehabilitation professionals regarding disaster management and spinal cord injuries. Spinal Cord Ser Cases 2019; 5:94. [PMID: 31754472 PMCID: PMC6858313 DOI: 10.1038/s41394-019-0239-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 10/17/2019] [Accepted: 10/23/2019] [Indexed: 11/09/2022] Open
Abstract
Study design Cross-sectional survey. Objective Persons with disabilities are disproportionately impacted by extreme weather disasters and climate change. Individuals with spinal cord injury (SCI) are especially at risk due to inability to control their body temperature and mobility concerns. We surveyed rehabilitation professionals in the field of SCI to determine their experiences, concerns and educational needs regarding natural disasters, climate change and sustainability and the effects on their clientele. Setting Online survey available to an international cohort. Methods The survey was developed by the authors and conducted in 2019. It was distributed amongst various international health care organizations whose members care for persons with SCI. Descriptive statistics and chi-square test for association were performed using Microsoft Excel 2016. Results Of 125 respondents, 50% were from Europe, 18% from North America, and 18% from Asia; 74% were physicians and 13% physical therapists. In total 57.6% believed climate change had impacted their client's health and well-being. Respondents from North America were significantly less likely to report climate change had an impact on their patient's health than those from Asia or Europe (p < 0.01). In total 82.5% of respondents thought professionals should be concerned with sustainability and 85.5% were interested in further education. Conclusions Most respondents acknowledged a need for more information related to the disasters, climate change, and disability. Results underscore the need for further research, professional, and consumer education.
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Affiliation(s)
- Marcalee Alexander
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham School of Medicine, Birmingham, AL USA
- Department of Physical Medicine and Rehabilitation, Harvard School of Medicine, Spaulding Rehabilitation Hospital, Charlestown, MA USA
- Telerehabilitation International, Birmingham, AL USA
| | | | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Chloe Slocum
- Department of Physical Medicine and Rehabilitation, Harvard School of Medicine, Spaulding Rehabilitation Hospital, Charlestown, MA USA
| | - James Middleton
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
- State Spinal Cord Injury Service, NSW Agency for Clinical Innovation, Sydney, NSW Australia
- NSW Spinal Outreach Service, Royal Rehab, Sydney, NSW Australia
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Huang J, Pacheco Barzallo D, Rubinelli S, Münzel N, Brach M, Gemperli A. What influences the use of professional home care for individuals with spinal cord injury? A cross-sectional study on family caregivers. Spinal Cord 2019; 57:924-932. [PMID: 31127196 PMCID: PMC6892416 DOI: 10.1038/s41393-019-0296-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVE The objective of this study is to identify what characteristics of the family caregivers influenced the use of professional home care for persons with SCI in Switzerland. SETTING Community setting, nationwide in Switzerland. METHODS Questionnaires were filled out by the adult family caregivers of persons with SCI. Influence of characteristics of the caregivers was analyzed with regression models, adjusting for the characteristics of the person with SCI. Logistic regression was used for whether professional home care was used. Poisson regression was applied for the absolute and relative amount of professional home care. RESULTS In total, 717 family caregivers participated in the study (31% response rate). Among the participants, 33% hired professional home care for 10 h per week on average. The level of dependency of the persons with SCI had a significant influence on the utilization of care. The availability and proximity of the primary family caregiver, namely being spouse and cohabiting, reduced the amount of services used, whereas caregivers who worked full time employed more services. Higher levels of education and income increased the use of professional home care. Compared with their reference groups, caregivers with older age and those with a migratory background used comparable or larger absolute amount of professional services, which, however, represented a smaller proportion of total hours of care. CONCLUSIONS Adequate support requires consideration of the characteristics of both the caregiver and of the person with SCI. The needs of family caregivers should also be assessed systematically in the needs assessment.
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Affiliation(s)
- Jianan Huang
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Diana Pacheco Barzallo
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | | | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland.
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
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Abstract
Health systems today have increasing opportunities and imperatives to conduct delivery science, which is applied research that evaluates clinical or organizational practices that systems can implement or encourage. Examples include research on eliminating racial/ethnic disparities in hypertension management and on identifying the types of patients who can successfully use video visits. Clinical leaders and researchers often face barriers to delivery science, including limited funding, insufficient leadership support, lack of engagement between operational and research leaders, limited pools of research expertise, and lack of pathways to identify and develop ideas. We describe five key strategies we employed to address these barriers and develop a portfolio of delivery science programs in Kaiser Permanente Northern California. This portfolio now includes small and medium-sized grant programs, training programs for postdoctoral research fellows and experienced physician researchers, and a dedicated team that partners with clinicians to develop high-priority ideas and conduct small projects. Most of our approaches are consistent with frameworks used to develop delivery science by other health systems; some are innovative. Most of these strategies are adaptable by other health systems prepared to make long-range organizational commitments to mechanisms that foster partnerships between clinical leaders and researchers.
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Affiliation(s)
- Tracy A Lieu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
- The Permanente Medical Group, Oakland, CA, USA.
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