Science topic

Delivery of Health Care - Science topic

Delivery of Health Care is the concept concerned with all aspects of providing and distributing health services to a patient population.
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During this time of intense pressure on general practices and local hospitals, could practitioner assistants (equivalent to F1 doctor qualification) and/or practice nurses be employed to contribute to the pharmacy environment with personal, social and therapeutic health management, including being qualified to prescribe some medications and thus be able to support pharmacists and to relieve some of the footfall in General Practices and Emergency Departments of their heavy workload?
The main hurdle to overcome would involve providing financial support to the chemist shops to enable this kind of employment. Also to consider would be the change in culture within the medical professions would be a paradigm shift in the inter professional roles that professionals play in the healthcare environment.
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Interesting question. Before I retired, I was a nurse practitioner (actually, advanced practitioner, but that was not a title that informed people very much about what I did) for bladder and bowel health.: (https://www.nhsemployers.org/articles/advanced-practice-and-enhanced-practice)
I used to carry out assessment and treatment, often after general practitioner (GP) referral, and would be involved in assessment and treatments that GPs felt that I would be more able to carry out than they (as generalists) could.
At the moment - probably owing to the legacy of COVID-19 - the local practices where I live seem to be very busy and use locums quite a lot.
So, I feel that to increase the clinical care available from pharmacies would be a very positive step. At the moment, practice nurses and pharmacists within the GP practices take on a lot more responsibility than they used to be given, including prescribing. And in the chemist shops, pharmacists now carry out vaccination.
I am not sure about the monetary perspective; would the NHS be able to employ these practitioners? I really don't know how this would work out or be allowed. There would also be the aspect of who were the nurses - for example - be managed. There would be the need for clinical supervision and support in the way that we had a (marvellous) manager, who was at one grade higher than we were, who we looked up to (in more ways than one). And she, likewise, had a manager and so it went up.
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While I am crossing two paths, such as medicine and technology, I see that there are often barriers to understanding the two, but I want to know from the researchers who deal with both what challenges still exist.
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I am not a researcher, but dealing with policy formulation and strategy design in the context of digital transformation of health systems. Among what I have observed almost consistently over time, there is a lot of naivety: on site of technocrats as it concerns the complexity and "maturity" of the health care delivery system, on side of health professionals the expectation, technology would fix their problems ..., compounded by a lack of patience of politicians, policy makers and the industry.
Understanding 'maturity' of health systems for applying digital technologies is a key factor for designing systems that work. See for example:
Carvalho, J. V., Rocha, Á., van de Wetering, R., & Abreu, A. (2019). A Maturity model for hospital information systems. Journal of Business Research, 94, 388–399. https://doi.org/10.1016/j.jbusres.2017.12.012
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This research is for my dissertation where I want to analyze VRET and explain why we should implement it more in healthcare.
I require data to analyze the same and explain further.
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Hola, estimado colega, saludos cordiales. Que bueno es encontrar personas que hagan psicoterapia y con las que se puede compartir. Trataré de responder, con mi modesta opinión, las tres preguntas implícitas en su escrito.
Cada día surgen en el mundo, más y nuevas técnicas de psicoterapia y una de ellas es a la que usted se ha adscrito. Sin importar la técnica de psicoterapia que un terapeuta aplique, siempre encontraremos un objetivo común, que no es otro que calmar o hacer desaparecer la ansiedad de nuestros casos. Cualquiera que sea el camino que siga, la escuela que siga, la corriente que siga, la técnica que siga, su objetivo va a ser siempre el mismo.
Además, nuestros pacientes acuden demandando ayuda porque se sienten agobiados por la ansiedad, que en su caso es paralizante y no les permite satisfacer las demandas de la vida, por tanto frente al miedo, aparecerán los mecanismos de evitación o enfrentamiento patológico a lo temido o a la situación que ocasiona miedo y frente a ese miedo, lo primero que harán es huir, huir de lo temido, en segundo lugar buscarán apoyo y en tercer lugar necesitan patológicamente también, reafirmación social, estas tres predisposiciones patológicas mantienen al sujeto atado a sus miedos, porque actúan como reforzadores negativos, que lo “calman por breve plazo”, para nuevamente aparecer la ansiedad o miedo que los mantiene sumergidos en su drama personal como un círculo vicioso.
Por otra parte, en la actualidad por vivir en un mundo tan convulso, donde los problemas superan a los tradicionalmente observados a lo largo de la historia, se aconseja para todos los psicoterapeutas, prepararse y conocer todas las escuelas de psicoterapia que han existido a lo largo de la historia de la humanidad, conocer, por su gran cantidad de técnicas, las más practicadas a lo largo de los años; se trata de que el profesional tenga una vasta formación en psicoterapia, que sea un experto conocedor de las estrategias en psicoterapia, recursos en psicoterapia y técnicas en psicoterapia, que sea un gran conocedor del manejo de los momentos en una psicoterapia y, por supuesto, que sea un gran conocedor de la técnica a la cual se adscribe. ¿Por qué?
Porque los problemas que se enfrentan hoy en la práctica médica psiquiátrica, nada tienen que ver con los problemas que se enfrentaban años atrás, desbordan la especialidad y desbordan, metafóricamente hablando, las ciencias médicas y, por tanto el abordaje que se exige hoy para el afrontamiento de fenómenos causales complejos, exige el uso de técnicas multimodales, abordarlo desde diferentes aristas, desde diferentes ángulos y, para no ser eclécticos en psicoterapia sino ser integrativos y manejar la conducta del paciente con la estrategia, método y técnica en psicoterapia que él necesita, debemos estar adscritos a una técnica en psicoterapia la cual debemos conocer hasta la saciedad y, por sobre todas las cosas, durante todo el proceso de tratamiento no podemos perder el basamento teórico de la técnica de psicoterapia que estoy aplicando (de donde viene el VRET y conocer las demás psicoterapias de la escuela conductista y neo conductista, cuáles son sus momentos, es decir no perder la razón que le da sustento a la técnica VRET por quien la aportó, bajo ningún concepto). Esto es lo que le permite ser integrativo en psicoterapia y darle a cada paciente lo que necesita y no caer en el eclecticismo de conveniencia tan frecuente en nuestros tiempos.
Muy mal el ejemplo desde mí, pero por ética no puedo hacerlo con otro. Por ejemplo, yo practico hace años una técnica cognitiva, publicada en Research Gate, sin perder el basamento teórico de esta psicoterapia, que es la elevación de la ansiedad hasta el máximo tolerable para el paciente, grupo, pareja, familia y, hasta que no vea que muchos han roto la barrera emotivo racional en el grupo, no comienzo con el manejo en la sesión de las tres predisposiciones que aparecen frente al miedo (la huida, la búsqueda de apoyo y la necesidad de reafirmación social o necesidad de reconocimiento social), ya una vez logrado un clima emocional donde muchos hayan hecho su experiencia emocional correctiva dentro de la sesión, comienzo a integrar técnicas, recursos y estrategias de otras psicoterapias y escuelas como la de Albert Ellis, del análisis transaccional de Eric Berne, de la neurolingüística, de Beck, la escuela Gestáltica, de la centrada en el cliente, entre muchas más, SIN PERDER EL BASAMENTO TEÓRICO DE LA PSICOTERAPIA DE MULTIEMPUJE QUE HAGO; para luego del cierre, hacer una relajación autógena de Shultz, de Jacobnson, una visualización curativa o una hipnosis ligera colectiva durante media hora, para calmar la ansiedad y que puedan continuar reflexionando y enfrentar el resto de las tareas del día. Como puedes apreciar, mi fuerte es la psicoterapia de multiempuje y en dependencia a lo que necesite cada uno, con lo que necesite cada persona en la psicoterapia es que hago valer como enfoque integrativo. No es lo que yo quiera que él vea, es lo que él necesita.
Como puedes apreciar, ahora estoy en condiciones de responder tu primera interrogante, aunque todas están parcialmente resueltas. Yo no diría que esa técnica está diseñada para utilizar como complemento y para ayudar a las personas que necesitan rehabilitación, sería una visión muy reduccionista, todo depende del ingenio del psicoterapeuta. Esta técnica como todas las que vienen de la escuela conductista, me recuerda a la desensibilización progresiva de Wolpe, al modelado de acercamiento gradual tan utilizado en psicoterapias para tratar disfunciones sexuales y los miedos en los niños; pero el alcance se hace mayor, en la medida que puedas verla como una modalidad de psicoterapia y, como en todas, dentro de las variables implicadas en el proceso, esta la personalidad del terapeuta, la suya (incluyo su conocimiento de psicoterapia), pues hacer psicoterapia es arte que no todos podemos hacer. En cuanto a si sirve solo para el trastorno de estrés postraumático y las fobias, nada más, lo pongo en duda, todo está en el conocimiento del terapeuta y de las habilidades que ha adquirido en el tiempo.
Otro cuestionamiento es si esta técnica tiene sus contraindicaciones, yo soy del criterio que la práctica te enseña quien debe tratarse con esta técnica o no y, por lo general muchas técnicas tienen contraindicaciones, fíjate en la que hacemos en mi centro como tiene contraindicaciones, eso no demerita la técnica, todo lo contrario, la valoriza porque cuidas al paciente.
Por lo que dices, en el último párrafo, veo que has analizado como quieres introducirle una serie de técnicas que te garanticen una mayor resiliencia del sujeto; soy del criterio que toda psicoterapia habilita en resiliencia a toda persona. Sugiero valores el entrenamiento en habilidades sociales como el manejo de lo tácito y lo asertivo.
Hasta aquí mi respuesta, espero satisfacer tus expectativas y desearte éxitos profesionales. Intuyo que eres una persona joven, en franco proceso de desarrollo como psicoterapeuta, con muchas inquietudes y con una mente abierta al diálogo. Decirte que, en lo que te pueda ayudar, cuenta conmigo, es por eso, por lo que le está pasando, que en mi país se supervisa a diario al psicoterapeuta hasta que pueda correr solo.
TODA PSICOTERAPIA ES BUENA Y TODAS AYUDAN AL PACIENTE, SOLO DEPENDE DE SU BUENA PRÁCTICA, CONOCIMIENTO Y HABILIDADES DEL EQUIPO, HAY QUE RECORDAR QUE EN PSICOTERAPIA UNA PALABRA, BIEN O MAL DICHA, CURA O MATA.
Si en algo te ayudé, me sentiré satisfecho, saludos cordiales colega, continúa así.
Prof. Lajús.
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The mean time lag from clinical development to use of these agents was 11.13 years (range, 8.57 to 12.90 years) for biological drugs for rheumatoid arthritis in Brazil. How about other countries?
For more information, please see the paper below:
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Yes,sir it's true.
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Dears
How can we make the integral use of herbal or traditional medicines with conventional medicines to enhance the efficacy of the existing healthcare delivering systems?
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One helpful book in this field is PDR which has stated some herbal-drug interactions.
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healthcare response rate
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Global Overview of Response Rates in Patient and Health Care Professional Surveys in Surgery: A Systematic Review - PubMed (nih.gov)
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Dear All,
Any body have any idea about "Privacy Preserving on Healthcare IOT based system"
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Thank you
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I'm looking for papers and articles regarding the post-evaporation residue of healthcare disinfectants (based on CDC guideline: link below) like H2O2 or sodium hypochlorite. I'm also looking for the association of supposed residue to biofouling and biofilm formation.
I've read that H2O2 doesn't leave residue but they are mostly anecdotal.
Thanks!
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Maybe off your target - chlorhexidine oral use can discolor teeth -
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Hi, I am looking for surveys instruments to evaluate design of hospitals from a work environment perspective. Let me know if you have any tips.
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(PDF) Healthcare Evaluation (researchgate.net)
(PDF) Evaluation methods for hospital facilities (researchgate.net)
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SPSS or STATA? Python or R? Jamovi or JASP?
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R is a language, so you will find a lot of your early weeks (months!) spent learning how the language works and trying to remember your vocabulary. If you are also trying to learn data analysis at the same time, this results in constant interference between the task of language learning and the task of learning data analysis.
For these reasons I would recommend jamovi. The interface is transparently simple, and it encourages good data analysis habits. You can perform quite complex (and some very advanced) analyses in jamovi, and the library of modules is growing all the time.
For data manipulation and meta-data, Stata is remarkably powerful. Labelling variables, values, and datasets, merging, cleaning, consistency-checking are unrivalled. I know people who pre-process their data in Stata before moving it to R because of these strengths.
Both jamovi and Stata have excellent videos, and the Stata manuals are comprehensive, with every command illustrated with worked examples. You can learn a lot of stats from them!
One big plus to jamovi, of course, is that it's free!
Given that you are doing a masters, I would not recommend R. By the time you get up to speed, it may be time to go!
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We're working on a free program to support new projects that connect AI / ML with IoT and IoMT technologies to address current and future healthcare challenges
The idea is to find out what tools and platforms would be useful across different projects, and then integrate them into a shared "sandbox" that could save time for researchers, and make collaboration between project teams easier. Our long-term goals is to help accelerate development of advanced telehealth applications, in order to improve healthcare access and equity.
If you are or have been involved in related projects, we'd like to ask you a few question (on phone or via email) to get your feedback on the concept.
Send me a message if you'd be willing to correspond, and please refer us to others you think might be interested.
Thanks very much!
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Great point, Shafagat Mahmudova and great reference.
We are definitely envisioning this as a support for prototyping, or perhaps pre-prototyping, when you are just testing various approaches or various components of the idea. And it would be pre-patient, before we need to deal with privacy and consent issues.
We're assuming that, if you prove out some of your early architecture decisions and build out a business case, you will start to move towards a first-draft operational model. At that point, there will be a variety of options, both for a secure data platform as well as AI tool platform.
One strategy in accelerating innovation is to lower friction at very early stages, e.g. reduce the cost of trying something out. That's what we're imagining, and why we're asking for feedback. What specific features / functions would be useful at that stage?
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Dear all
Anyone idea about research topic on "Privacy preserving on Healthcare IOT based system"
OR
Privacy preserving on Healthcare Edge or Cloud IOT based system"
Actually , I want to do research or Phd in Privacy on IOT system
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Thank you
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I have requested the full text of the article: Whose decision is it anyway? A qualitative study of user participation and how clinicians deal with the patient perspective in mental healthcare. How long will it take before I get access?
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7 jours en moyenne
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I'm looking at conducting research around what influence healthcare staff wellbeing has on the quality of care service users receive. However, I'm unsure as to what test I would need to use?
So the research would need to look at the level of wellbeing healthcare staff have on different wards and then compare those results to the results on the quality of care patients receive on the same wards to identify any differences.
What test would I need to use?
Thank you in advance!
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Summary of application of different statistical tests is also attached
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What kinds of problems did healthcare workers experience using protective equipment during the COVID-19 outbreak?
What kind of problems did the healthcare professionals experience regarding the supply of materials during the treatment and care of the patient during the covid-19 outbreak?
Have nurses used innovative practices in care? Could you share the innovation examples in nursing used in this process?
During the COVID-19 epidemic, nurses working in a hospital setting may be physically, mentally, socially, ethically, etc. what kind of problems does he have?
We need your scientific research and help with the answers to these questions in order to share them with healthcare nurses.
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maybe "10.3389/fpubh.2021.793642" Dr.
kinds
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This article suggested weighted population density in some epidemiological studies.
Do you know in which type of study weighted is preferable? Should other population characteristics be weighted also? Such as gender ratio, population income... Also, some events, such as infectious disease and healthcare utilization, are strongly related to density.
Many thanks for considering my request.
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Suraj Kapoor , thanks Mr Kapoor. It is very interesting paper. However, they only say: "that is better sutied" without explanation, but providing great practical examples.
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The May 2022 issue of Canadian Healthcare Technology magazine has a feature report on the expansion of Electronic Health Record (EHR) systems to include genetic data. The article touches on a very important point in the first sentence, that a pan-[insert country here] EHR systems are mostly far off in many places, but in my view these would undoubtedly be beneficial to patients.
There is a regulatory and privacy landscape to navigate in different parts of the world, and a, sharing information between various states, provinces or regions, let alone hospitals within a single geography, is mostly a process covered in red tape and facilitated by the disappointingly familiar CNG tone of fax machines over a telephone line. Patient and clinician friendly processes and interfaces, along with built-in data standardization, a focus on computer-readable data capture, and interoperability are key to bringing genomic medicine into the digital age. The complexity and enormous potential of genetics and genomics in day-to-day clinical practice requires new approaches beyond pen/paper records and new technology beyond facsimile and traditional EHR systems to take us towards a better, healthier future. I would encourage you to read the article (linked below) and provide your thoughts on the subject.
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Hi all, I'm doing fyp with the title of the determinant of healthcare expenditure in 2011-2020. Here are my variables: government financing, gdp, total population.
first model is: healthcare expendituret=B0+B1gov financingt + B2gdpt + B3populationt + et
second causal relationship model is healthcare expenditure per capitat= B0 + B1gdp per capitat +et
It is possible to use unit root test then ADRL for the first model and what test can use for the second model?
Thank you in advance for those reply me :)
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You should read the Global Burden of Disease articles on health care financing. Their appendices fully disclose their variables (& they've spent a lot of time & effort dettermining the best ones) and they provide their (sophisticated) statistical code. Lead author on most of that work is Joseph Dieleman or something like Global Burden of Disease Health Financing Collaborator Network. A full biblio of this work is at https://www.healthdata.org/about/joseph-dieleman if you click on the publications tab. The pubs are all open-access & most are on ResearchGate. :-)
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What are important factors affecting the selection of a destination country for job by a healthcare professional
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Hello. in my view, they are economic, social, technological, anthropological factors that, in a way, support the health professional in carrying out their activities.
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Hello Friends,
I have two topics in the area of research, any suggestion or feedback with your thoughts will be appreciated to help drive the success of my Doctoral research thesis. Both topics are from my real-life experience and want to pursue research to find a solution and help society.
I have shared the following two topics with my guide / Mentor for review.
1. Public Policy in Healthcare Management for better healthcare services to people using Technology (AI/ML) - overhead of medical treatment cost due to unwanted repetition of diagnostics, which affects the social determinant of health (SDoH) in a low-income patient ( lack of value-based).
OR
2. Smart Virtual Platform using Artificial Intelligence to Improve Motor-function of Stroke Survivors (Social Determinant of Health) using gamification.
Keywords: AI / ML, Public Policy, Healthcare, Remote care, Diagnostic services, PHC, SDoH, Treatment Cost, economics, Law, Digital Health / Telehealth / eHealth, Virtual Assistant, Chat-bot
Thank you and really appreciate any suggestions and help.
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your topics are very different ones... I think the 1st one is much more promising...I think getting some data would be way easier than the 2nd one..
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I'm trying to find good industry wide data on healthcare turnover (specifically nursing assistants) and how it accelerated during COVID-19. What resources are available? If you don't know specific healthcare data, I will also take general all industry wide acceleration information. Thank you in advance!
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Dear Ms. Thoebes!
You raised an important topic. I do really think that this problem needs a system perspective. So I searched for resources you might consider of value:
1) Davis, B., Bankhead-Kendall, B.K. & Dumas, R.P. A review of COVID-19’s impact on modern medical systems from a health organization management perspective. Health Technol. (2022). https://doi.org/10.1007/s12553-022-00660-z, Free access:
2) Hu, H., Wang, C., Lan, Y. et al. Nurses’ turnover intention, hope and career identity: the mediating role of job satisfaction. BMC Nurs 21, 43 (2022). https://doi.org/10.1186/s12912-022-00821-5, Open access:
3) Fronda, D. C., & Labrague, L. J. (2022).Turnover intention and coronaphobia among frontline nurses during the second surge of COVID-19: The mediating role of social support and coping skills. Journal of Nursing Management,1–10, Free access:
4) Mojgan Lotfi, Omid Zadi Akhuleh, Aysan Judi, Mohammadtaghi Khodayari,
Turnover intention among operating room nurses during the COVID-19 outbreak and its association with perceived safety climate, Perioperative Care and Operating Room Management, Volume 26, 2022, Free access:
Yours sincerely, Bulcsu Szekely
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I am trying to tweaking my machine learning model optimizer, and i would love to test that in healthcare domain space, especially for rare illnesses.
Thus, do any one knows any deidentified electronic health records for Epilepsy, Parkinson , or other rare diseases patients (maybe those who are treated with warfarin) ?
Please guide me how to get these datasets.
I already spoke with many research authors, but yet no responses.
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That's too painful.
The thing is that you understand their privacy concerns, and you have your procedures that you can assure your compliance to that.
But still its not easy to get those patient records.
I wrote this post after searching all the suggested resources, thought i really thank you for your care to respond.
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How to manage the space allocation i.e. office space for healthcare professional, new clinical programs within the limits of facilities that are already at capacity?
What are the processes in place to allocate space?
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Thank you for your feed back .
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Research: " Occupational Stress and Coping Strategies among healthcare employees: Where is the Role of Organizations?".
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please search in the database science direct or clinical keys using the key words
1.coping strategy
2.work place stress
3.healthy workplace
You will find the articles you need
Good luck
Orapan
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I am looking for examples where governments have deployed a business platform model approach that has the following characteristics:
- Government allocates a personal budget to the citizen, pending his situation and request procedure. Citizen is entitled to spend budget on their own preferred service, choosing the supplier of choice.
- Government assembles a marketplace with (trusted and verified) industry suppliers that cater for these services
- Government operates the platform where citizens can find the service they need and initiate the transaction. Upon transaction, money is transferred from the government to the supplier and the service commences.
This is quite common already for healthcare, employment or education services.
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اقتراح مشروع نقل حكومي تشاركي
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Please can you help me with West African countries with similar healthcare systems to Ghana?
What are the criteria?
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You may use the SWOT analysis, in line line with may thematic areas like available infrastructure, human recourse, available modern healthcare technologies, healthcare financing, competitive and comparative advantages and many others in relation to the other west African countries.
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Aim of qualitative research study is to elucidate the migratory push factors determining locally born and educated registered nurses to migrate from the only tertiary level hospital located in the small island, modern metropolitan capital city. in a country maintaining fairly stable economic and political conditions..
Undoubtedly, in consideration of globalization, an escalation in the number of native RNs migrating from a ''destination nation' for nursing migration, has grabbed the attention of healthcare systems stakeholders in the midst of the COVID-19 pandemic, there is no empirical evidence available to provide answers toward the planning and implementation of policies and strategies to stem the flow of these limited human healthcare resources' out of the nation's public healthcare system.
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Migration of labor like healthcare workers depends on several pull and push factors
Pull factors are better opportunities available at the destination sites for career advancement, better remuneration at the destination sites, job security at the pulling site, presence of high technology to make the work more fulfilling and enjoyable, adequate holiday periods for workers at the destination sites, higher and better pensions at the pulling sites and many others.
The push factors includes poor working environment, lack of technology, poor pension, absence of job security, comparatively low salaries etc. are but a few..
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Dear expert in this field,
Kindly, I would like to seek your opinion on the trend of healthcare policy decisions that are in line with the digitalization of global technology.
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I am going to publish a paper on CPD in healthcare.
Please let me know what journals you would consider?
Perhaps you have published some research already and have some experience.
Many thanks
Witold
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The most relevant I know of is Journal of Continuing Education in the Healthcare Professions.
If specific to medical setting, I might also consider European Journal of CME.
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I want to write my PhD thesis about the decision-making process in the digital transformation era (healthcare as an example). Will appreciate any help))
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Digital transformation in healthcare is a foundational component of a patient-centered approach to healthcare. It will assist healthcare providers in streamlining operations, understanding what patients need, building loyalty and trust, and providing a better user experience.
Telemedicine, AI-enabled medical equipment, and blockchain electronic health records are just a few real examples of how digital revolution in healthcare is totally transforming how we engage with health professionals and how our data is shared among providers.
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The evolution of Artificial Intelligence is influencing healthcare. With the production of applications such as AI-based biomedical applications, and medical AI systems, etc. Without a doubt, AI is having significant implications on healthcare.
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AI has been very impactful in the practice and delivery of healthcare, from triaging , checking patients vitals, in the consulting room, in interventions and follow up of the patients.
It has even gone beyond the typical healthcare delivery situations to purchasing, logistics management and accounting decision making processes in healthcare have been impacted by AI.
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Economics of healthcare and professional development are the keywords.
Can you please help to suggest other journals that would cover the scope, keywords, etc.
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The main ones (all of them indexed in Web of Science) could be
  • Health Economics
  • European Journal of Health Economics.
  • American Journal of Health Economics
  • Health Policy
  • Health Affairs
  • Health Economics Review
  • Health Economics Policy and Law
  • Applied Health Economics and Health Policy
You can even find articles on such a topic in journals of public health such as Gaceta Sanitaria, among many others.
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I'm looking for an interesting research topic or topics surrounding business management. Preferentially, any suggestions which have a focus on healthcare or renewable energy as these are interests of mine, but suggestions surrounding any discipline would be appreciated.
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To what extent 5G technology will affect e-commerce transactions?
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I am working on a data mining project and would like to portray the correlation between healthcare expenditure by country and the population's life expectancy/general health and am having trouble finding sizeable data sets.
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Healthcare expenditures: http://wdi.worldbank.org/table/2.12
Here's the full list of indicators: http://wdi.worldbank.org/table
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The ideal is to have both functioning well, but in many medium to low resource countries, this has become an Either/Or decision for Health Administrators.
Primary Health care to reduce the burden of disease and complications of disease and thus reduce the need for specialized care and it's cost.
Specialised care follows all the latest trends and innovations, but usually are very costly. Costs are likely to come down over time, though.
So FOMO medicine: Specialised....
or Affordable rimary Health Care....?
What is your view?
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The concept of PHC is to provide comprehensive package of health care services in the form of preventive, promotive, curative, rehabilitative, emergency, palliative, responsive, sensitive to the need of people. Now universal health care to everyone everywhere which should be accessible, available, acceptable & affordable. Through this wide network including ASHAs , interface with community & political will can make it possible.
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Operations research techniques are used widely in the scientific literature to support decision-making problems in healthcare. However, such methods are rarely applied in practice? What are the obstacles? What could be the solution?
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Indeed, operations research (OR) and management science (MS) methods are not consistently used in practice for healthcare management decision-making. A report published by National Academy of Engineering and Institute of Medicine (Reid et al, 2005) states in an unusually blunt way, “In fact, relatively few health care professionals or administrators are equipped to think analytically about health care delivery as a system or to appreciate the relevance of engineering tools. Even fewer are equipped to work with engineers to apply these tools.”
Thus, it is often difficult for many administrators to appreciate the role of MS and OR methodology in the healthcare delivery process. A wide gap exists between the OR and MS publications that urge the use of this methodology in healthcare settings but provide few or no practical examples, and the publications with examples that are too specialized and complex for digesting by a typical hospital administrator. This gap is probably one of the reasons why too many administrators still have a vague idea of the practical value of healthcare OR and MS methodology. Many of them simply do not see ‘what’s in it for me’.
On the other hand, OR and MS professionals/engineers do not always have enough knowledge of healthcare or the role of physicians in making not only clinical but also management decisions. Healthcare has a culture of rigid division of labor. This functional division does not effectively support the methodology that crosses the functional areas, especially if it assumes significant change in traditional relationships.
Nonetheless, to address the challenge of transforming the system of care delivery in practice, some leading healthcare organizations have adopted this area as a strategic priority. For example, the Mayo Clinic, one of the largest integrated medical centers in the USA, has defined the Science of Healthcare Delivery as one of its four strategic directions. The others are Quality, Individualized Medicine, and Integration (Fowler et al, 2011). The Mayo Clinic has also created the Center for the Science of Healthcare Delivery, a new initiative that will focus on creating improved approaches to how healthcare is delivered (Mayo Clinic, 2011).
The bottom line: physicians and healthcare administrators are not supposed to have the knowledge of the OR/MS methods. They are too busy with other problems. Rather, they are supposed to understand why traditional management approaches and education guess are usually not accurate, short-lived or unsustainable; which quantitative technique is more appropriate for addressing a particular managerial problem; what can be expected from a particular technique and what are its strengths and limitations. For example, is queuing analytic theory (QAT) or discrete event simulation (DES) appropriate methodology for addressing a particular problem? What are the caveats in Linear Optimization for staffing and scheduling? What technique is the most appropriate for making a particular forecast type and why? What is the best approach to the fair cost (savings) allocation? And so on…Collaboration and trust between the healthcare/physicians leaders and OR/MS professionals is the key to progress in this area.
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I am currently preparing to interview some marginalized women in an African country on their experiences with the maternal healthcare system. I would be grateful to get some suggestions.
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Very interesting concept. James J.Mckenna is right. Certain points can be added.
1.Are they aware of available health care services in area ?
2. Whether these services are accessible?
3. What's the attitude of health care providers towards them?
4. Are the health care services affordable?
5. What's their perception regarding health seeking behaviour behaviour?
6. Who influence the decision making about the services?
7. What are the efforts/steps initiated by the government?
8. Is there any reluctance on the part of service providers to visit these areas?
9. Are there some incentives/ schemes,like JSY, JSSK available from government to them?
10. What are the factors affecting to seek the MCH services?
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The military, both serving and veterans and their spouses and families, can have needs that may be different from civilian patients. There is a covenant between the NHS and Armed Forces. Are healthcare staff aware of the covenant?
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If the gap between medical resources is widened, I think it is an issue that should be paid attention to.
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I am comparing the global prevalence in intestinal carriage of drug resistant E. coli between community and healthcare settings. I found that the global pooled prevalence in feacal ESBL E.coli carriage in healthcare settings as 21.1% ( 95%CI, 19.1-23.2%) while the prevalence in the community was 17.6% (95%CI, 15.3-19.8%). Can we say the prevalence in healthcare settings was higher than in the community? Note, the 95%CI s ovelap!
If not how shall I compare/describe these
two findings?
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I don’t think it can, because it may exist selection bias.These are 2 samples with different attributes.I suggest you consider DID analysis.
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Updated very Recent Examples of AI tools in Healthcare
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For my Doctoral thesis, I am framing a quantitative questionnaire tool to collect healthcare seeking behavior of vulnerable tribal peoples. The content of questionnaire were synthesized from literature review and a qualitative interview like IDI and FGD will be done to explore more possible categories of specific questions.
I need to validate my tool.
So, what validity and reliability test should be good enough to call my tool a validated one?
Will Face and content validity and internal consistency reliability test suffice my tool validation?
Thank you!
Jyoti
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The surveys are validated by providing pieces of evidence of face and content validity before the survey is administered. After the administration of the survey, internal consistency reliability can be used, and make sure you have 5-10 responses per question in the survey (this is a well know practice followed).
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I am looking for an emulator for an IoT healthcare application, does anyone has an idea for help ?
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Dear Salama,
Look over the data below. It may help to focus the thoughts:
Which is the best IoT application for healthcare?
A remote patient monitoring system is one of the best IoT healthcare applications used widely across the globe. IoT based remote patient monitoring system is an extension of medical systems, where a patient’s vitals can be monitored remotely.
IoT Healthcare Applications and Benefits - Contus Blog
Which is IoT based healthcare system for monitoring all body parameters?
This is IOT based HealthCare System for monitoring all the body parameters like Heartbeat ,ECG,BP etc. We have developed Mobile app also. This is IOT based HealthCare System for monitoring all the body parameters like Heartbeat ,ECG,BP etc. We have developed Mobile app also.
IOT Based Health Care System - Arduino Project Hub
Why does every IoT project need an intelligent device simulator?
Every IoT project needs an intelligent device simulator. As the project moves forward, simulator becomes complex to maintain and orchestrate - taking the precious resources and focus away from developing the core IoT platform. IoTIFY eases the life of developer and testers by providing simulation as a service.
IoTIFY - cloud based IoT simulator and IoT testing platform | IoTIFY is ...
How does the Internet of things work in healthcare?
Telemedicine can be considered a “primitive” form of an Internet of Things in healthcare example. With IoT, a patient can be observed and in some cases treated remotely through video cameras and other electronic actuators.
How IoT Works in Healthcare?
IoT in Healthcare: Benefits, Use Cases, Challenges [Guide]
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I am looking for an IoT healthcare dataset to conduct analysis and visualization, it's extremely hard to find one in internet. Does anyone please have something about that that can share it with me?
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It will be a great opportunity to share thoughts and research findings on aging and elderly smart healthcare.
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Ali Mansour Al-madani Alhassan Alharbi @Zeyad Abdulhameed Ahmed
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successful healthcare organisations always owners a strong health care information system, so to build a robust health care information system , structured approach should be used, which structured approach do you recommend to use to built a robust health care information system in health care organization?
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The first step to improving the quality of care at your organization is to analyze your existing data to understand where opportunities exist. You should analyze both your patient population and your organizational operations to identify areas for improvement.Once you’ve analyzed your patient population data to understand their risk and studied your practice operations to identify areas for improvement, it’s time to prioritize those areas and set goals. If you need some help, there are several health organizations with established quality and consistency measures that could guide your goal-setting process. Then Improve Access to Care,Focus on Patient Engagement should be compulsory for batter health,
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Quantum computing provides the benefits of speeding up traditional computing systems. I am interested in broad challenges that should be addressed for the implementation of healthcare services.
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Thank you Vadym for the answer, it was helpful. I could see all the use cases that you have shared relate to enhancing computational speed in healthcare. What could be some possible scenarios where this implementation could be challenging?
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Traditionally patients in South Africa, particularly in rural areas retain their own clinical record, often in an exercise book or similar. Healthcare staff also record the history of a particular visit often in a register
Has that changed over recent years?
Do the nurses keep and record of each patient in a register?
Do they record clinical information and treatment given?
What happens to that information?
I have searched the literature without success
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Depending on the measure, data can be collected from different sources, including medical records, patient surveys, and administrative databases used to pay bills or to manage care
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All the countries across the globe have reconstructed the healthcare system responding to the COVID-19 pandemic. Many high quality systems were failed to contain the infection and to deliver adequate treatment.
Which might be a good model for healthcare now and future? Should we focus on primary healthcare or secondary and tertiary one? How to harmonize them to prevent and contain future disasters?
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A health disaster of this kind of pandemic Primary Health care system may not directly control the disaster without the required medical infrastructure. But it is inevitable to maintain all three levels based on the population size. Alongside it is also important a parallel Medical Research and Development in the Pharma sector. So budgets need to be categorized and disbursed accordingly as a proportion to GDP. In countries where GDP growth is slow and low requirements have to be met by external assistance to develop facilities. So the role of local government to global involvement has become the need of such situations.
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There is a trend on applying federated learning in healthcare domain. What the potentials and challenges in your opinion?
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Dear Anran, the following recent papers may help you:
Xu J, Glicksberg BS, Su C, et al. Federated Learning for Healthcare Informatics. J Healthc Inform Res 2021;5:1-19. https://link.springer.com/content/pdf/10.1007/s41666-020-00082-4.pdf
Ng D, Lan X, Yao MM, Chan WP, Feng M. Federated learning: a collaborative effort to achieve better medical imaging models for individual sites that have small labelled datasets. Quant Imaging Med Surg 2021;11(2):852-857. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779924/pdf/qims-11-02-852.pdf
Liu JC, Goetz J, Sen S, Tewari A. Learning From Others Without Sacrificing Privacy: Simulation Comparing Centralized and Federated Machine Learning on Mobile Health Data. JMIR Mhealth Uhealth 2021;9(3):e23728. https://mhealth.jmir.org/2021/3/e23728/PDF
Dou Q, So TY, Jiang M, et al. Federated deep learning for detecting COVID-19 lung abnormalities in CT: a privacy-preserving multinational validation study. NPJ Digit Med 2021;4(1):60. https://www.nature.com/articles/s41746-021-00431-6.pdf
Vaid A, Jaladanki SK, Xu J, et al. Federated Learning of Electronic Health Records to Improve Mortality Prediction in Hospitalized Patients With COVID-19: Machine Learning Approach. JMIR Med Inform 2021;9(1):e24207. https://medinform.jmir.org/2021/1/e24207/PDF
Qian F, Zhang A. The value of federated learning during and post-COVID-19. Int J Qual Health Care. 2021;33(1):mzab010. https://academic.oup.com/intqhc/article/33/1/mzab010/6128587
Best wishes from Germany, Martin
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With the ever increasing potential of using Big Data in Healthcare in India, this discussion is aimed at sharing your experiences and challenges in publishing from large clinical datasets in Medicine.
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Lisbeth Bang Thank you for your comment. We have progressed far beyond in domains like finance and social media when it comes to handling voluminous loads of data. In healthcare however we are now realizing the potential of mining large datasets generated over the years. We will learn a lot for sure as we explore this path for generating insights to help increase the efficiency of health care delivery in different geographies. As
George Stoica
mentioned, we are getting better and better at mining information and this will become the NEW NORMAL for us healthcare practitioners.
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Innovation in Health Care Sector through the use of Telemedicine. This interview (link below) was done 4 years ago on Citizen National TV where I predicted that Telemedicine is the future. The year 2020 has proven this. Healthcare is now offered remotely by the use of I.T.
We have seen the rise in the use of Tele-Health solution to provide health care service remotely to the patients. However, one may argue with regards to the ethical dilemmas while providing healthcare services.
Here is the link to the interview: https://www.youtube.com/watch?v=gLd8xJGN4Dc
Lets discuss!
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Yes Samuel. Also, HIPPA protects patients rights.
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Does anyone have a Healthcare Accessibility survey questionnaire? Or know where to find one
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Approximately 15-20% of waste generated by the healthcare sector is considered hazardous material that may be infectious, toxic, or radioactive.
I am working on circular economy solutions to deal with non-hazardous and hazardous (if any) healthcare waste generation. Is there any suggestion or perspective?
Your comments are highly acknowledged.
Regards,
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I think that healthcare waste are big concern due to their negative effect. Genially, Health care waste contain may types as illustrated below:
  • Infectious waste: waste contaminated with blood and other bodily fluids (e.g. from discarded diagnostic samples),cultures and stocks of infectious agents from laboratory work (e.g. waste from autopsies and infected animals from laboratories), or waste from patients with infections (e.g. swabs, bandages and disposable medical devices).
  • Pathological waste: human tissues, organs or fluids, body parts and contaminated animal carcasses.
  • Sharps waste: syringes, needles, disposable scalpels and blades, etc.
  • Chemical waste: for example solvents and reagents used for laboratory preparations, disinfectants, sterilant and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries.
  • Pharmaceutical waste: expired, unused and contaminated drugs and vaccines;
  • Cytotoxic waste: waste containing substances with genotoxic properties (i.e. highly hazardous substances that are, mutagenic, teratogenic or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites.
  • Radioactive waste: such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials; and
  • Non-hazardous or general waste: waste that does not pose any particular biological, chemical, radioactive or physical hazard.
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Dear Researchers
I am preparing to conduct a healthcare survey focused on slum dwellers.
I am looking for advise on key indicators to assess and sample surveys if already used in past.
Could you please share your insights, feedback and suggestions.
Thanks for your support.
Best regards
Vikrant
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Questionnaires require a full fledged preparation. It should include questions related to socio-economic and demographic dimensions of selected sample, then health profiles, health care preferences and lists are wide. It depends on your objectives of the study.
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Changes in policies specific to healthcare is the need of the hour, how government's have changed or changing policies that effects citizens directly.
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Interesting question.. many policy changes introduce to monetize the economy and safeguard jobs. Warm regards
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Aside from the socioeconomic factors, already discussed at length in the media, are there other factors that may increase the susceptibility of the BAME community to severe complications and death from COVID 19 infectionA marked increase of non-Caucasian ethnicities has been observed of healthcare workers who have succumbed fatally to the COVID 19 virus.A second genetic factor could be considered regarding skin colour and melanin content. Skin type influences vitamin D levels where darker skin has greater amounts of melanin, which competes for UVB photons with 7-dehydrocholesterol (vitamin D making substrate). Several epidemiological studies link higher susceptibility to immune mediated disorders with vitamin D deficiency.The non-skeletal effects of vitamin D have been of increasing interest with regard to its association with several diseases and, in particular, its role in regulating the immune system at the cellular level. 1,25-dihydoxyvitamin D3, the active form of vitamin D, has a physiological role in immunomodulation targeting several cells of the immune system and is a key factor linking innate and adaptive immunity and both are compromised with vitamin D deficiency. Hypovitaminosis D is associated with several immune and autoimmune disorders in addition to the classical association with osteomalacia.Several immune cells have the cellular ability to convert 25-hydroxyvitamin D to active 1,25-duhydroxyvitamin D, which promote responses to pathogens in macrophages. Another antimicrobial response is in regulating the maturation of antigen-presenting dendritic cells and this pathway controls T-lymphocyte function. T cells also responds directly to activated vitamin D. Another immunomodulatory function is that cells of the immune system express vitamin D-activating enzymes also enabling the conversion of vitamin D into its active form.The amount of UV exposure is related to the global UV index is also associated with vitamin D synthesis in skin and thus undergoes activation via a binding protein in the liver and kidney. As higher levels of melanin inhibit vitamin D synthesis from UV exposure and the currently low UV index in the UK, this may influence the demographic findings of healthcare workers that have succumbed to the virus.Vitamin D insufficiency or deficiency is associated with regulation of insulin secretion and glucose levels. Deficiency also causes the inflammation associated with adipose metabolic diseases, such as obesity, multiple sclerosis, diabetes, and fatty liver.The vitamin D receptor is expressed in adipose tissue and the vitamin itself is stored there. It is suggested that vitamin D exerts antiadipogenic influence on some preadipocytes and regulates the expression of adipocyte transcription factors, such as, PPARγ, C/EBPα, and LPL. Obesity has also been a factor associated with more severe disease and death from COVID 19 infection.Having already established that genetic factors determining skin colour may influence disease outcomes to COVID 19 infection, it should also be considered that genetic differences in vitamin D receptor genes (VDR), such as, polymorphisms occur frequently in might influence disease outcomes. Vitamin D receptor (VDR) polymorphisms also alter vitamin D levels and can influence disease but is not necessarily a factor differentiating between different ethnic groups.Located on chromosome 12q13.11 in humans, the VDR gene consists of eleven exons. Several polymorphisms of the VDR gene have been identified, but four single-nucleotide polymorphisms (SNPs) of this gene are the ones that have been most studied, namely, BsmI (rs1544410), ApaI (rs7975232), TaqI (T> C; rs731236), and FokI (C> T; rs2228570, formerly known as rs10735810).Another factor in this discussion is that the marked increase of non-Caucasian ethnicities has been observed of healthcare workers who have succumbed fatally to the COVID 19 virus may be related to hypertensive drug treatment regimens, as there is a difference, according to the treatment British Hypertension Society recommendations, for combining blood pressure lowering drugs for different ages and ethnicity, where black patients and older patients tend to be treated with diuretics and calcium channel blockers whereas the younger or non-black patients receive ACEI/ARB and Beta blockers.In a retrospective study in Hubei province in China, COVID 19 patients, admitted to 9 hospitals in a multi centre study, between December 31st and February 29th 2020. 1128 hospitalised adult patients with hypertension and diagnosed with COVID 19 were included in the study. There were 188 patients taking ACEI/ARB and 940 not taking ACEI/ARB with a median age of 64 years.ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB non-users (ACEI/ARB group versus the non-ACEI/ARB group (3.7% vs. 9.8%; P = 0.01)).References
  • Hewison M. Vitamin D and immune function: an overview. Proc Nutr Soc. 2012;71(1):50–61. doi:10.1017/S0029665111001650
  • Hewison M. Vitamin D and the immune system: new perspectives on an old theme.Endocrinol Metab Clin North Am. 2010;39(2):365–379. doi:10.1016/j.ecl.2010.02.010
  • Glass D, Lens M, Swaminathan R, Spector TD, Bataille V. Pigmentation and vitamin D metabolism in Caucasians: low vitamin D serum levels in fair skin types in the UK. PLoS One. 2009;4(8):e6477. Published 2009 Aug 3. doi:10.1371/journal.pone.0006477
  • Clemens TL, Adams JS, Henderson SL, Holick MF. Increased skin pigment reduces the capacity of skin to synthesise vitamin D3. Lancet. 1982;1(8263):74–76. doi:10.1016/s0140-6736(82)90214-8
  • Jones P, Lucock M, Chaplin G, et al. Distribution of variants in multiple vitamin D-related loci (DHCR7/NADSYN1, GC, CYP2R1, CYP11A1, CYP24A1, VDR, RXRα and RXRγ) vary between European, East-Asian and Sub-Saharan African-ancestry populations. Genes Nutr. 2020;15(1):5. Published 2020 Mar 13. doi:10.1186/s12263-020-00663-3
  • Rockell JE, Skeaff CM, Williams SM, Green TJ. Association between quantitative measures of skin color and plasma 25-hydroxyvitamin D.Osteoporos Int. 2008;19(11):1639–1642. doi:10.1007/s00198-008-0620-4
  • Miao Z, Wang S, Wang Y, et al. A Potential Linking between Vitamin D and Adipose Metabolic Disorders. Can J Gastroenterol Hepatol. 2020;2020:2656321. Published 2020 Feb 18. doi:10.1155/2020/2656321
  • Valdivielso JM, Fernandez E. Vitamin D receptor polymorphisms and diseases.Clin Chim Acta. 2006;371(1-2):1‐12. doi:10.1016/j.cca.2006.02.016
Transcription FactorsGlassAntimicrobialsGreen IT
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I am conducting research for a Health Psychology MSc. My chosen topic is to explore racial healthcare experience disparities, and healthcare inequalities, in the maternal/perinatal period. I am trying to find an appropriate health psychological theories that can be applied to these to help underpin my research and interview schedule.
Thank you.
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This article may be
Exploring the Group Prenatal Care Model: A Critical Review of the Literature useful.published J perinatal education 2012
ALSO
THIS ARTICLE RELATE 2019
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I am looking for constructs, measurement, scales and item to assess a users privacy and security concern regarding personal health information. More specific in the context in use of smart wearables/ smart healthcare technologies. Thank you
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HIPAA Compliance
Let us help you protect the privacy and security of your patients information
HIPAA Compliance Training Manuals, Documentation, and More (oshamanual.com)
Updated December 09, 2020 The Health Insurance Portability and Accountability Act (HIPAA) and the HIPAA Privacy Rule set the standard for protecting sensitive patient data by creating the standards for the electronic exchange, privacy, and security of patient medical information by those in the health care industry.
What Is the HIPAA Law and Privacy Rule?
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Processes required to manage an effective health care organization.
Focusing on U.S. health care delivery systems, how to manage in health care organizations including management processes organizational structures and types of governance and management issues of U.S.-based health care delivery systems.
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Indeed, a lack of awareness about management science (MS) and operations management (OM) principles is one of the root causes of inferior healthcare leaders' management decisions for delivery of care, such as new/old lines of service, staffing and scheduling, financial and equipment allocation, bed capacity, etc.
Traditional OM is based on past experience, intuition, educated guesses, simple linear projections with the average values of input variables. In contrast, management science is based on comparative outcomes of validated simulation models of organizations' functioning and their operations. Traditional management does not have a proper means to take into account the inevitable process variability, uncertainty, scale, and interconnections that are critical for making sustainable and justified managerial decisions. The fundamentals of management science for healthcare organizations have been developed. They play a role of the laws of physics in natural sciences. While the laws of physics cannot be violated, management science principles can and are frequently violated. Unfortunately, many organizations pay a heavy price for doing so. Thus, the problem is not a lack of knowledge of the MS fundamentals and methods. The problem is a dearth of the practical application of this knowledge in the real hospital and clinic settings.
You may find useful, e.g. the following resources for details:
1. Kolker, A. Springer_Briefs series in Healthcare Management & Economics "Healthcare Management Engineering: What Does This Fancy Term Really Mean? The Use of Operations Management in Healthcare Settings". NY, 2012
2. Hopp, W., & Lovejoy, W. (2013). Hospital operations: Principles of high efficiency health care. New York: FT Press.
3. Reid, P., Compton, W, Grossman, J., Fanjiang, G., Eds., (2005). Building A Better Delivery System: A new Engineering / Healthcare Partnership. National Academy of Engineering and Institute of Medicine. Washington, DC. The National Academy Press
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Any of you use/develop software to make easier in OSCE exam?
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Yes, we use Maxinity Maxexam, means examiners can record their scores electronically. Big advantage is that psychometric data analysis is readily available: helps convince the regulators that you are doing the right thing!
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As always happens, healthcare professionals have been immediately involved in the infectious diseases, dentists are often in the first line, as they work in close contact with patients, moreover the dental workers are the most exposed to to the danger of being infected by COVID-19 significantly more than medical caretakers and general physicians.
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In our country the criteria for vaccine distribution is not as per compulsion. All those who want to get the vaccine can register themselves and get vaccinated. Those who are not willing to take it are totally free from not taking it and are not under any compulsion.
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In the 4 largest EMERGE healthcare database networks where investigators have evaluated 106,000 plus genomes of schizophrenic patients found that obesity has protective or relatively less chance of genetic risk penetration for schizophrenic process.
Their study is published in recent issue of Am J Psychiatry 2019, October.
My question is how does obesity influences the polygenic risk and pleiotropy for the vulnerability of schizophrenia?
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Possibly a Darwinian process
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AI is using in every sector now a days. Please state your view about pros and cons of using AI in health sector.
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There are several articles and reports about this subject. I suggest you start by putting "advantages and disadvantages of AI in healthcare" into your browser. You'll find information that goes back a couple of years. There also are multiple uses of AI in healthcare. Importantly, each individual one has pros and cons.
One example would be decision support software. On the one hand such software can help increase the accuracy of diagnoses and treatment plans for clinicians. On the other hand, one has to avoid discrimination against certain types of patients and patients whose manifestations of a disease are not "typical."
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There are lots of misinformation in the area of clinical coding, and this has been affecting effective medical research and efficient healthcare system. Many hospitals are using provisional diagnosis as the diagnosis to code, after the discharge of patients from the hospital. This has raised many questions and I will appreciate the experts to bring in their suggestions here.
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By definition, the two variants are different. Provisional diagnosis (or tentative diagnosis) is based upon the availability of sources of information, but subject to change. As the course of patient care progresses, and more facts emerge, the provisional diagnosis is changed to reveal the present reality. And the provisional diagnosis may change to become the final diagnosis and it is coded accordingly.
on the other hand, the Principal diagnosis (Main Diagnosis) is the condition established after careful study, to be chiefly responsible for occasioning the admission of patient to the hospital for care. During a given episode of care, it is possible that a patient is treated for just a single condition or multiple diagnoses. In a situation where you have multiple conditions, the attending physician has the duty to determine which of these is the principal diagnosis. Criteria like how much of hospital resources was consumed, the length of stay, and the severity of the condition are used to choose which of the multiple diagnoses qualifies to be the principal diagnoses.
Therefore, for coding purposes, the discharge summary written and duly authenticated by the attending physician is consulted by the coder (please note that coding is done after the patient might have been discharged via the different modes of disposition). Where you have a single condition identified, as provisional, and no new facts emerge until the patient is discharged, that same condition will be assigned the ICD code. But if there is a change, the amended condition recorded by the attending physician is coded. In a situation where there are multiple diagnosis, the physician must indicate the one that qualifies to be principal, and the other are indicated either as secondary diagnoses or complications (whichever be the case). The coder assigns the ICD-10 codes to all the diagnoses as indicated. Where there is not enough information, the coder shall prepare a physician query (in line with policy of the facility), requesting for further details that will aid in identifying the diagnoses rightly and in assigning correct codes to them.
Finally, to directly answer the question, both the provisional or the principal diagnoses can have ICD-10 codes assigned.
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hai, all
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Hi Sunil,
you can select your favorite topic by look in Healthfinder.gov.
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Which methods does they suggest to ease the burden and stress as a teamwork?
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I would like to assume that frontline workers dealing with the COVID - 19 pandemic would have been given access to mental health resources. However, it not there are several ways this can be achieved - (e.g., individual vs group basis). It might make sense to begin forming a group (lead by a mental health professional) where workers can share stories with one another. This would help provide an "outlet" for those needing one, as well as hear how others are coping, which they may find helpful. In addition to providing support, this group can also help identify individuals who would need more intensive therapy/counseling that can be provided individually.
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There are a number of ICT applications in health care practice today ( hospitals, polyclinics, general practice, nursing, public health etc.). Evaluation and improvement of such application is needed - first of all due to new knowledge in medicine and healthcare practice, and new demands for improving health of population. Digitalization of health care offer a number of possibilities, and what to do with such data is issue the health professional know best. "Nothing should be done for us without us" is a statement or the reason that health professional should be empowered to participate in development (evaluation and improvement) ICT applications for health care.
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Dear Josipa Kern,
The area “ICT applications for Health Care” is of great importance for the future. This research paper provides a broad analysis of various problems in this area:
Laura Kurtinaityte: E-HEALTH – THE USAGE OF ICT DEVELOPING HEALTH CARE SYSTEM: MULTIPLE-CASE STUDY OF EUROPEAN COUTRIES DENMARK AND LITHUANIA; Dissertation, University Halmstad, 2007
Best regards
Anatol Badach
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I am looking at the following factors:
How seriously they take healthcare?
What factors affect their behavior like severity or cost, etc?
Also, other parameters that help in deciding the patient's mindset.
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You can check with the MIMIC-IV dataset.
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I've encountered a curious gap in the literature that I would love professional help to address! My Professors and I were discussing the need to identify American-based literature (if I can find any) on adversarial relationships and/or professional conflict between clinicians and their management in a healthcare organisation (such as a hospital). The issue is frequently discussed in other contexts (UK, Europe, Australia, New Zealand, etc) however, I've been searching high and low...I couldn't find much.
Is there genuinely little writing on this topic, or am I looking in the wrong places? Is there a term I'm missing? I would love your guidance.
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Perhaps the term "clinicians" has another synonymous. Key words are important for "search strategy" while searching for gab and finding publication. There are plenty of systematic review papers, I recommend to look at their "search strategy" used and if you need further assistance please feel free to contact me. I will be delighted to help.
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I am conducting a research on burnout of Healthcare professions during COVID 19 pandemic period. I also want to find out coping strategies adopted by them to overcome burnout. Therefore, need help to know and get if there is any standardized questionnaire related to coping strategies for overcoming burnout among healthcare professional.
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Shilpi Saraswat I'm also looking for a questionnaire on Physicians burnout. Can anyone help ?
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I want to have an idea about the current issues and future challenges of AI in the medical area. For that, I need some technical suggestions on the following questions:
1. How can we combine Big Data Analytics and Machine Learning techniques specifically for healthcare systems?
2. What can we achieve in the above case?
Thanks for your help!
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The recent trend & focus is on statistical approaches of Machine Learning towards data from industry, sciences, medical, business and politics etc.
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I'm planning to adopted a standard questionnaire to conduct a survey that will measure the perception and attitude of healthcare professionals on investment and access to loans in the pharmaceutical industry of a developing country.
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I'm sure it will, thank you Florencia Maldia
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COVID-19: July 13, 2020: Is the high rate among Healthcare Workers due to Breach in Protocol, Lack of PPE, or Home Contact with Relatives and Friends?
Cases & Deaths among USA Healthcare Personnel
Data were collected from USA 2,577,636 people, but healthcare personnel status was only available for 557,437 (21.6%) people. For the 98,150 cases of COVID-19 among USA healthcare personnel, death status was only available for 64,968 (66.2%).
USA CASES AMONG Healthcare Personnel 98,150 ; DEATHS AMONG USA Healthcare Personnel ; 521 (July 13, 2020 from the CDC Reports.)
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I published this in JAMA Ophthalmology today, it might help with protection to protect the eyes with PPE:
Comment Journal of the American Medical Association Ophthalmology September 19, 2020 Eye Protection as an Essential Part of PPE. Gary Ordog, MD, DABEM, DABMT | County of Los Angeles, Department of Health Services, (retired) Thank you for the informative study. First, in response to a previous question, the methodology is stated to include direct questioning about eyeglasses, also in my experience, the direct questioning of patients upon hospital admission includes the use of eyeglasses, dentures, prostheses, pacemakers, etc. which would make this information readily available on admission documents. So this set of data seems plausible. The validity of matching of the experimental with the control group is more questionable. Nevertheless, the results show a very strong association in the protective action of eyeglasses against SARS-CoV-2, and in conclusion would support the use of eye protection in PPE use. The preferred PPE should have eye protection that prevents "touching" and direct air flow to the eyes. Also, there may be other confounding variables that are causing this strong association, for example: 'further investigation could show that eyeglass users frequently clean the glasses with sterilizing wipe, thus presenting a chemical shield to the virus.' Again, thank you for your work, and as usual, further study is required. Stay safe with eye protection. CONFLICT OF INTEREST: None Reported Brief Report September 16, 2020 Association of Daily Wear of Eyeglasses With Susceptibility to Coronavirus Disease 2019 Infection Weibiao Zeng, MS1; Xiaolin Wang, MS2; Junyu Li, MS3; et alYong Yang, MS2; Xingting Qiu, MS4; Pinhong Song, MS2; Jianjun Xu, MD, PhD1; Yiping Wei, MD, PhD1 Author Affiliations Article Information JAMA Ophthalmol. Published online September 16, 2020. doi:10.1001/jamaophthalmol.2020.3906 COVID-19 Resource Center editorial comment icon Editorial Comment Key Points Question What is the association between the daily wear of eyeglasses and susceptibility to coronavirus disease 2019 (COVID-19)? Findings In this cohort of 276 patients hospitalized with COVID-19 in Suizhou, China, the proportion of daily wearers of eyeglasses was lower than that of the local population (5.8% vs 31.5%). Meaning These findings suggest that daily wearers of eyeglasses may be less likely to be infected with COVID-19. Abstract Importance The proportion of daily wearers of eyeglasses among patients with coronavirus disease 2019 (COVID-19) is small, and the association between daily wear of eyeglasses and COVID-19 susceptibility has not been reported. Objective To study the association between the daily wearing of eyeglasses and the susceptibility to COVID-19. Design, Setting, and Participants This cohort study enrolled all inpatients with COVID-19 in Suizhou Zengdu Hospital, Suizhou, China, a designated hospital for COVID-19 treatment in the area, from January 27 to March 13, 2020. COVID-19 was diagnosed according to the fifth edition of Chinese COVID-19 diagnostic guidelines. The proportion of persons with myopia who wore eyeglasses in Hubei province was based on data from a previous study. Exposures Daily wearing of eyeglasses for more than 8 hours. Main Outcomes and Measures The main outcomes were the proportions of daily wearers of eyeglasses among patients admitted to the hospital with COVID-19 and among the local population. Data on exposure history, clinical symptoms, underlying diseases, duration of wearing glasses, and myopia status and the proportion of people with myopia who wore eyeglasses in Hubei province were collected. People who wore glasses for more than 8 hours a day were defined as long-term wearers. Results A total of 276 patients with COVID-19 were enrolled. Of these, 155 (56.2%) were male, and the median age was 51 (interquartile range, 41-58) years. All those who wore glasses for more than 8 hours a day had myopia and included 16 of 276 patients (5.8%; 95% CI, 3.04%-8.55%). The proportion of people with myopia in Hubei province, based on a previous study, was 31.5%, which was much higher than the proportion of patients with COVID-19 who had myopia in this sample. Conclusions and Relevance In this cohort study of patients hospitalized with COVID-19 in Suizhou, China, the proportion of inpatients with COVID-19 who wore glasses for extended daily periods (>8 h/d) was smaller than that in the general population, suggesting that daily wearers of eyeglasses may be less susceptible to COVID-19. Introduction Coronavirus disease 2019 (COVID-19), the pathogen of which is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly infectious disease that broke out in Wuhan, China, in December 2019 and has spread to more than 200 countries.1 COVID-19 has been proven to be transmitted mainly through droplets and contact.2 The eye is also considered an important route of infection. According to reports published in recent years, the prevalence of myopia in China is now more than 80% of the population. Wearing of eyeglasses is common among Chinese individuals of all ages.3 However, since the outbreak of COVID-19 in Wuhan in December 2019, we observed that few patients with eyeglasses were admitted in the hospital ward. Therefore, we collected information on the wearing of eyeglasses from all inpatients with COVID-19 as part of their medical history and used the data to examine the association between wearing eyeglasses and COVID-19 infection. Methods This cohort study was approved by the ethics committee of Suizhou Zengdu Hospital, Suizhou, China, and followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. Patients signed written informed consent and were not provided with any incentive or compensation to participate in the study. The study enrolled patients admitted to the hospital from January 27 to March 13, 2020, with the admission criteria of a diagnosis of COVID-19. The diagnostics and clinical classification of COVID-19 were based on the fifth edition of Chinese COVID-19 diagnostic guidelines.4 Throat swab samples were obtained from patients at admission and tested using real-time reverse transcriptase–polymerase chain reaction assays to identify COVID-19 infection. Patients were specifically asked about the reason they wore eyeglasses, the length of time that they wore eyeglasses during daily activities, and whether they wore contact lenses or had ever undergone refractive surgery. This information was recorded by the patients’ treating physicians while taking their medical history, starting February 4, 2020. Information on exposure history and clinical symptoms was extracted from the medical records. People who wore eyeglasses for more than 8 hours a day were defined as long-term wearers, and these people were considered to wear eyeglasses when socializing. To estimate the population myopia rate, we extracted data from the Research on Chinese Student Physique and Health Study,5 which recorded data from a survey about the physical and health status of Chinese students, organized by state educational institutions and the Ministry of Health of China in 1985. We used descriptive statistics to characterize the study sample. Results As shown in the Table, a total of 276 patients with COVID-19 were enrolled in the study. The median age was 51 (interquartile range, 41-58) years; 155 patients (56.2%) were male and 121 (43.8%) were female. Most patients with COVID-19 were moderately ill, with 14 (5.1%) severely ill. Common symptoms were fever (227 [82.2%]), cough (218 [79.0%]), and fatigue (141 [51.1%]). Underlying disease was present in 88 patients (31.9%), with hypertension the most common, accounting for 47 (17.0%) of all admitted patients. Thirty patients with COVID-19 wore eyeglasses (10.9%), including 16 cases of myopia and 14 cases of presbyopia. None of the patients in this study wore contact lenses or underwent refractive surgery. All 16 patients with COVID-19 who wore glasses for more than 8 hours per day had myopia, accounting for 5.8% (95% CI, 3.0%-8.6%), and the median age was 33 years. Their symptoms, underlying disease, and COVID-19 severity were not significantly different from those of other patients. The results from previous research5 showed that the mean rate of myopia among students aged 7 to 22 years in Hubei province was 31.5%. By 2020, these students were aged 42 to 57 years, which is close to the median age of our patients with COVID-19. The myopia rate of 31.5% is higher than the 5.8% among our patients with COVID-19. Discussion At the time of writing, this study was the only research, to our knowledge, to assess the association between wearing eyeglasses and COVID-19 infection. Our main finding was that patients with COVID-19 who wear eyeglasses for an extended period (>8 h/d) every day were relatively uncommon, which could be preliminary evidence that daily wearers of eyeglasses are less susceptible to COVID-19. Considering the prevalence of COVID-19, conducting a sample survey among the local population would have been difficult. Instead, we used data from a previous survey for approximate reference and comparison, although the age, region, and educational level of the students in that survey had some differences compared with our study population. We hypothesized that eyeglasses prevent or discourage wearers from touching their eyes, thus avoiding transferring the virus from the hands to the eyes.6 Studies have shown that normal people will involuntarily touch their eyes about 10 times per hour.7 Eyes usually lack protection, and an abundance of the SARS-CoV-2 receptor angiotensin-converting enzyme 2 has been found on the ocular surface,8 through which SARS-CoV-2 can enter the human body. SARS-CoV-2 may also be transported to the nasal and nasopharyngeal mucosa through continuous tear irrigation of the lacrimal duct, causing respiratory infection.9 According to available statistics, nearly 1% to 12% of patients with COVID-19 have ocular manifestations,10,11 SARS-CoV-2 was detected in tears or the conjunctival sacs of patients with COVID-19,12 and some ophthalmologists were reported to be infected during routine treatment.13 Therefore, the eyes are considered an important channel for SARS-CoV-2 to enter the human body.11 For daily wearers of eyeglasses, who usually wear eyeglasses on social occasions, wearing eyeglasses may become a protective factor, reducing the risk of virus transfer to the eyes and leading to long-term daily wearers of eyeglasses being rarely infected with COVID-19. Presently, many COVID-19 guidelines state the need to pay attention to preventing infections through the eyes,14 but most people only focus on wearing masks and home isolation, ignoring recommendations such as washing hands frequently and avoiding touching the eyes with the hands.15 The results of this study can be used as evidence of the importance of these 2 recommendations. Limitations Our study had some notable limitations. First, it was a single-center study with a small sample size. The numbers of patients who wear eyeglasses and long-term wearers were limited, which limits the extension of the results to a larger population, so our results need to be verified by large-sample multicenter studies. Second, the proportion of wearers of eyeglasses was based on data from previous literature and was not calculated from current local populations. Third, the myopia rate obtained in previous studies included a small number of people with myopia who did not wear eyeglasses. Information on these people was lacking and partly affected the integrity and validity of our data. Fourth, none of our research participants wore contact lenses, so the association between wearing contact lenses and susceptibility to COVID-19 remains to be studied. In addition, further studies are needed to clarify the reasons that wearing eyeglasses may decrease susceptibility to COVID-19. Conclusions Our study found that the proportion of inpatients with COVID-19 who wear eyeglasses for extended daily periods was lower than that of the general population, suggesting that daily wear of eyeglasses is associated with less susceptibility to COVID-19 infection. These findings suggest that the eye may be an important infection route for COVID-19, and more attention should be paid to preventive measures such as frequent hand washing and avoiding touching the eyes. Back to top Article Information Accepted for Publication: July 28, 2020. Corresponding Author: Yiping Wei, MD, PhD (weiyip2000@hotmail.com), and Jianjun Xu, MD, PhD (xujianjun3526@163.com), Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, 1 Min De Road, Nanchang 330006, China. Published Online: September 16, 2020. doi:10.1001/jamaophthalmol.2020.3906 Author Contributions: Drs Wei and Xu had full access to the study data and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Xu, Yiping. Acquisition, analysis, or interpretation of data: Zeng, Xiaolin, Junyu, Qiu, Yong, Song, Yiping. Drafting of the manuscript: Zeng, Xiaolin, Junyu, Qiu, Song, Yiping. Critical revision of the manuscript for important intellectual content: Zeng, Yong, Xu, Yiping. Statistical analysis: All authors. Obtained funding: Zeng, Xu, Yiping. Administrative, technical, or material support: Zeng, Junyu, Yong, Xu, Yiping. Supervision: Yong, Xu, Yiping. Conflict of Interest Disclosures: None reported. Additional Contributions: We thank the physicians who supported Suizhou Zengdu Hospital, Suizhou, China, in the fight against coronavirus disease 2019 for their contribution to patient management and data collection for this study. References 1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention.  JAMA. 2020. doi:10.1001/jama.2020.2648 ArticlePubMedGoogle Scholar 2. Pongpirul WA, Pongpirul K, Ratnarathon AC, Prasithsirikul W. Journey of a Thai taxi driver and novel coronavirus.  N Engl J Med. 2020;382(11):1067-1068. doi:10.1056/NEJMc2001621PubMedGoogle ScholarCrossref 3. Chen M, Wu A, Zhang L, et al. The increasing prevalence of myopia and high myopia among high school students in Fenghua City, eastern China: a 15-year population-based survey.  BMC Ophthalmol. 2018;18(1):159. doi:10.1186/s12886-018-0829-8PubMedGoogle ScholarCrossref 4. General Office of National Health Commission. Diagnosis and treatment protocols for novel coronavirus pneumonia (trial version 5, revised) [in Chinese]. Published February 4, 2020. Accessed March 15, 2020. http://www.gov.cn/zhengce/zhengceku/2020-02/09/content_5476407.htm 5. Chinese Student Physique and Health Research Group. Research on Chinese Students' Physique and Health [in Chinese]. People's Education Press; 1987. 6. van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1.  N Engl J Med. 2020;382(16):1564-1567. doi:10.1056/NEJMc2004973PubMedGoogle ScholarCrossref 7. Kwok YL, Gralton J, McLaws ML. Face touching: a frequent habit that has implications for hand hygiene.  Am J Infect Control. 2015;43(2):112-114. doi:10.1016/j.ajic.2014.10.015PubMedGoogle ScholarCrossref 8. Holappa M, Vapaatalo H, Vaajanen A. Many faces of renin-angiotensin system—focus on eye.  Open Ophthalmol J. 2017;11:122-142. doi:10.2174/1874364101711010122PubMedGoogle ScholarCrossref 9. Xiao X, Chakraborti S, Dimitrov AS, Gramatikoff K, Dimitrov DS. The SARS-CoV S glycoprotein: expression and functional characterization.  Biochem Biophys Res Commun. 2003;312(4):1159-1164. doi:10.1016/j.bbrc.2003.11.054PubMedGoogle ScholarCrossref 10. Guan WJ, Ni ZY, Hu Y, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China.  N Engl J Med. 2020;382(18):1708-1720. doi:10.1056/NEJMoa2002032PubMedGoogle ScholarCrossref 11. Wu P, Duan F, Luo C, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China.  JAMA Ophthalmol. 2020;138(5):575-578. doi:10.1001/jamaophthalmol.2020.1291 ArticlePubMedGoogle ScholarCrossref 12. Seah IYJ, Anderson DE, Kang AEZ, et al. Assessing viral shedding and infectivity of tears in coronavirus disease 2019 (COVID-19) patients.  Ophthalmology. 2020;127(7):977-979. doi:10.1016/j.ophtha.2020.03.026PubMedGoogle ScholarCrossref 13. Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored.  Lancet. 2020;395(10224):e39. doi:10.1016/S0140-6736(20)30313-5PubMedGoogle Scholar 14. World Health Organization. Coronavirus disease (COVID-19) advice for the public. Updated June 4, 2020. Accessed April 1, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public 15. Machida M, Nakamura I, Saito R, et al. Adoption of personal protective measures by ordinary citizens during the COVID-19 outbreak in Japan.  Int J Infect Dis. 2020;94:139-144. doi:10.1016/j.ijid.2020.04.014PubMedGoogle ScholarCrossref Comment Journal of the American Medical Association Ophthalmology September 19, 2020 Eye Protection as an Essential Part of PPE. Gary Ordog, MD, DABEM, DABMT | County of Los Angeles, Department of Health Services, (retired) Thank you for the informative study. First, in response to a previous question, the methodology is stated to include direct questioning about eyeglasses, also in my experience, the direct questioning of patients upon hospital admission includes the use of eyeglasses, dentures, prostheses, pacemakers, etc. which would make this information readily available on admission documents. So this set of data seems plausible. The validity of matching of the experimental with the control group is more questionable. Nevertheless, the results show a very strong association in the protective action of eyeglasses against SARS-CoV-2, and in conclusion would support the use of eye protection in PPE use. The preferred PPE should have eye protection that prevents "touching" and direct air flow to the eyes. Also, there may be other confounding variables that are causing this strong association, for example: 'further investigation could show that eyeglass users frequently clean the glasses with sterilizing wipe, thus presenting a chemical shield to the virus.' Again, thank you for your work, and as usual, further study is required. Stay safe with eye protection. CONFLICT OF INTEREST: None Reported
Thank you for your support. Stay safe, protect your eyes as well! Gary Ordog, MD September 17, 2020
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