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Hung KKC, MacDermot MK, Hui TSI, Chan SY, Mashino S, Mok CPY, Leung PH, Kayano R, Abrahams J, Wong CS, Chan EYY, Graham CA. Mapping study for health emergency and disaster risk management competencies and curricula: literature review and cross-sectional survey. Global Health 2024; 20:15. [PMID: 38383465 PMCID: PMC10880341 DOI: 10.1186/s12992-023-01010-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/21/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND With the increasing threat of hazardous events at local, national, and global levels, an effective workforce for health emergency and disaster risk management (Health EDRM) in local, national, and international communities is urgently needed. However, there are no universally accepted competencies and curricula for Health EDRM. This study aimed to identify Health EDRM competencies and curricula worldwide using literature reviews and a cross-sectional survey. METHODS Literature reviews in English and Japanese languages were performed. We searched MEDLINE, EMBASE, CINAHL (English), and the ICHUSHI (Japanese) databases for journal articles published between 1990 and 2020. Subsequently, a cross-sectional survey was sent to WHO Health EDRM Research Network members and other recommended experts in October 2021 to identify competency models and curricula not specified in the literature search. RESULTS Nineteen studies from the searches were found to be relevant to Health EDRM competencies and curricula. Most of the competency models and curricula were from the US. The domains included knowledge and skills, emergency response systems (including incident management principles), communications, critical thinking, ethical and legal aspects, and managerial and leadership skills. The cross-sectional survey received 65 responses with an estimated response rate of 25%. Twenty-one competency models and 20 curricula for managers and frontline personnel were analyzed; managers' decision-making and leadership skills were considered essential. CONCLUSION An increased focus on decision-making and leadership skills should be included in Health EDRM competencies and curricula to strengthen the health workforce.
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Affiliation(s)
- Kevin K C Hung
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Makiko K MacDermot
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Theresa S I Hui
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Suet Yi Chan
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Sonoe Mashino
- Research Institute of Nursing Care for People and Community, University of Hyogo, Akashi, 673-8588, Japan
| | - Catherine P Y Mok
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Pak Ho Leung
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Ryoma Kayano
- World Health Organization Centre for Health Development, Kobe, 651-0073, Japan
| | - Jonathan Abrahams
- Monash University Disaster Resilience Initiative, Monash University, Clayton, Australia
| | - Chi Shing Wong
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y Y Chan
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Colin A Graham
- Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
- Collaborating Centre for Oxford University and Chinese University of Hong Kong for Disaster and Medical Humanitarian Response (CCOUC), JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Resende BDS, Dias RM, Ferrari G, Rezende LFM. Excess mortality in adults from Sao Paulo during the COVID-19 pandemic in 2020: analyses of all-cause and noncommunicable diseases mortality. Sci Rep 2023; 13:23006. [PMID: 38155297 PMCID: PMC10754941 DOI: 10.1038/s41598-023-50388-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
In this study, we estimated the excess mortality from all-causes of death and noncommunicable diseases (NCDs) in adults living in the state of São Paulo during the COVID-19 pandemic in 2020. Number of deaths were retrieved from the Mortality Information System before (2017-2019) and during (2020) the COVID-19 pandemic, considering the following underlying causes of death: Neoplasms; Diabetes Mellitus; Circulatory System Diseases, and Respiratory System Diseases. Standardized Mortality Ratio (SMR) were calculated by dividing the mortality rates in 2020 by average mortality rates in 2017-2019, according to sex, age group, geographic location (state, capital, and Regional Health Departments). In 2020, occurred 341,704 deaths in the state of São Paulo vs 290,679 deaths in 2017-2019, representing an 18% increase in all-cause mortality (SMR 1.18) or 51,025 excess deaths during the first year of COVID-19 pandemic. The excess mortality was higher in men (186,741 deaths in 2020 vs 156,371 deaths in 2017-2019; SMR 1.18; 30,370 excess deaths) compared to women (154,963 deaths in 2020 vs 134,308 deaths in 2017-2019; SMR 1.15; 20,655 excess deaths). Regarding NCDs mortality, we observed a reduction in cancer mortality (SMR 0.98; -1,354 deaths), diseases of the circulatory system (SMR 0.95; -4,277 deaths), and respiratory system (SMR 0.88; -1,945). We found a 26% increase in Diabetes Mellitus mortality (SMR 1.26; 2885 deaths) during the pandemic year. Our findings corroborate the need to create and strengthen policies aimed at the prevention and control of NCDs, in order to mitigate the impact of future infectious disease pandemics.
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Affiliation(s)
- Bruna de Souza Resende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Rayara Mozer Dias
- Department of Epidemiology, Instituto de Medicina Social Hesio Cordeiro, Universidade Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de La Actividad Física, El Deporte y La Salud, Santiago, Chile
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile.
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Deslauriers F, Gosselin-Boucher V, Léger C, Vieira AM, Bacon SL, Lavoie KL. The impact of COVID-19 on the lives of Canadians with and without non-communicable chronic diseases: results from the iCARE Study. BMC Public Health 2023; 23:2106. [PMID: 37884921 PMCID: PMC10604733 DOI: 10.1186/s12889-023-15658-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/11/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and its prevention policies have taken a toll on Canadians, and certain subgroups may have been disproportionately affected, including those with non-communicable diseases (NCDs; e.g., heart and lung disease) due to their risk of COVID-19 complications and women due to excess domestic workload associated with traditional caregiver roles during the pandemic. AIMS/OBJECTIVES We investigated the impacts of COVID-19 on mental health, lifestyle habits, and access to healthcare among Canadians with NCDs compared to those without, and the extent to which women with NCDs were disproportionately affected. METHODS As part of the iCARE study ( www.icarestudy.com ), data from eight cross-sectional Canadian representative samples (total n = 24,028) was collected via online surveys between June 4, 2020 to February 2, 2022 and analyzed using general linear models. RESULTS A total of 45.6% (n = 10,570) of survey respondents indicated having at least one physician-diagnosed NCD, the most common of which were hypertension (24.3%), chronic lung disease (13.3%) and diabetes (12.0%). In fully adjusted models, those with NCDs were 1.18-1.24 times more likely to report feeling lonely, irritable/frustrated, and angry 'to a great extent' compared to those without (p's < 0.001). Similarly, those with NCDs were 1.22-1.24 times more likely to report worse eating and drinking habits and cancelling medical appointments/avoiding the emergency department compared to those without (p's < 0.001). Moreover, although there were no sex differences in access to medical care, women with NCDs were more likely to report feeling anxious and depressed, and report drinking less alcohol, compared to men with NCDs (p's < 0.01). CONCLUSION Results suggest that people with NCDs in general and women in general have been disproportionately more impacted by the pandemic, and that women with NCDs have suffered greater psychological distress (i.e., feeling anxious, depressed) compared to men, and men with NCDs reported having increased their alcohol consumption more since the start of COVID-19 compared to women. Findings point to potential intervention targets among people with NCDs (e.g., prioritizing access to medical care during a pandemic, increasing social support for this population and mental health support).
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Affiliation(s)
- Frédérique Deslauriers
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, CIUSSS du Nord- de- l'Ile- de- Montreal, Montreal, Québec, Canada
| | | | - Camille Léger
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Montreal Behavioural Medicine Centre, CIUSSS du Nord- de- l'Ile- de- Montreal, Montreal, Québec, Canada
| | - Ariany Marques Vieira
- Montreal Behavioural Medicine Centre, CIUSSS du Nord- de- l'Ile- de- Montreal, Montreal, Québec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, CIUSSS du Nord- de- l'Ile- de- Montreal, Montreal, Québec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Kim L Lavoie
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.
- Montreal Behavioural Medicine Centre, CIUSSS du Nord- de- l'Ile- de- Montreal, Montreal, Québec, Canada.
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Barzegari J, Raeissi P, Hashemi SM, Aryan Khesal A, Reisi N. Delivering Primary Health Care (PHC) Services for Controlling NCDs During the COVID-19 Pandemic: A Scoping Review. JOURNAL OF PREVENTION (2022) 2023; 44:579-601. [PMID: 37495870 DOI: 10.1007/s10935-023-00733-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 07/28/2023]
Abstract
Non-communicable diseases (NCDs) are the leading cause of death worldwide. NCDs also increase mortality from COVID-19 and primary health care (PHC) services are an important component in the prevention and control of long-term NCDs. The main goal of the present study was to review primary healthcare services for the NCDs patients via primary healthcare network during COVID-19 pandemic. In this scoping review, Search engines including PubMed, Scopus, and Science-direct up to 1st February 2022 were searched to identify studies regarding primary care services for NCDs patients via primary health care during COVID-19 pandemic. A total of 42 studies met the inclusion criteria and were included in our analysis. 24 studies were about the status and changes of primary health services for NCDs patients in PHC settings, while 18 studies focused on adaptive strategies used during COVID-19 in different countries including United States, Canada, United Kingdom, Portugal, Georgia, South Africa, Thailand, Mexico, India, Kenya, Guatemala and Saudi Arabia. These strategies included remote monitoring, follow up, consultation, empowerment and educational services as well as home visiting Disruption of NCDs services in PHC during the COVID-19 pandemic was observed in different countries, which highlights the urgency of attention of researchers and policy-makers to development of appropriate and adaptive policies to improve PHC service coverage and its quality during the pandemics.
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Affiliation(s)
- Javad Barzegari
- Department of Health Services Management, School of Health Services Management and Medical Information Science, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran
| | - Pouran Raeissi
- Department of Health Services Management, School of Health Services Management and Medical Information Science, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran.
| | - Seyed- Masoud Hashemi
- Department of Anesthesiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aidin Aryan Khesal
- Department of Health Services Management, School of Health Services Management and Medical Information Science, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran
| | - Nahid Reisi
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Child Growth and Development Research Center and Isfahan Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Kim JH, Kwok KO, Huang Z, Poon PKM, Hung KKC, Wong SYS, Chan EYY. A longitudinal study of COVID-19 preventive behavior fatigue in Hong Kong: a city with previous pandemic experience. BMC Public Health 2023; 23:618. [PMID: 37004041 PMCID: PMC10064631 DOI: 10.1186/s12889-023-15257-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/10/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND In addition to high vaccination levels, COVID-19 control requires uptake and continued adherence to personal hygiene and social distancing behaviors. It is unclear whether residents of a city with successive experience in worldwide pandemics such as SARS, would quickly adopt and maintain preventive behaviors. METHODS A population-based, longitudinal telephone survey was conducted between in first local wave of the COVID-19 pandemic (April 2020) and third local wave (December 2020) (n = 403). The study examined factors associated with personal hygiene and social distancing behavior fatigue, as measured by reduced adherence. RESULTS Over 9 months, face mask use increased (96.5-100%, p < 0.001). Although habitual hand hygiene remained unchanged (92.0%), blue collar workers and non-working individuals showed higher risk of hand hygiene fatigue. There was a decline (p < 0.05) in avoidance of social gatherings (81.1 to 70.7%), avoidance of public places (52.9-27.5%) and avoidance of international travel (81.9-77.4%) even with rising caseloads. Lowered perception of COVID-19 disease severity was associated with decreased avoidance of social gatherings and public places while lower education was associated with decline in avoidance of social gatherings. CONCLUSION Even in regions with past pandemic experience, maintaining social distancing behaviors during a protracted pandemic remains a major public health challenge.
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Affiliation(s)
- Jean H Kim
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Paul Kwok-Ming Poon
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Kevin Kei Ching Hung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China
- Accident & Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Ying Yang Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China.
- GX Foundation, Hong Kong, China.
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Gedik TE, Unal D, Suzan V, Bag Soytas R, Arman P, Bektan Kanat B, Ulugerger Avci G, Suna Erdincler D, Doventas A, Yavuzer H. The impact of COVID-19 pandemic on the geriatric inpatient unit. Curr Med Res Opin 2023; 39:259-265. [PMID: 36398760 DOI: 10.1080/03007995.2022.2148460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We aimed to determine the effects of the pandemic on the inpatients in the geriatric unit by comparing the demographic and clinical characteristics, reasons for hospitalization, morbidity, and mortality of the patients before and during the pandemic. METHODS The population of this retrospective, cross-sectional study consisted of inpatients in the geriatric unit for two years (11 March 2019-10 March 2021). The patients were separated into two groups according to the hospitalization time as pre-COVID-19 and COVID-19 period. Hospitalization types, reasons for hospitalization, length of stay, demographic data, chronic diseases, drugs, developed morbidities, discharge, and 1-year mortality status of the patients were recorded. RESULTS Three hundred and fifty patients were included in our study. The mean age was 80.4 ± 8.02. It was observed that the number of hospitalized patients decreased by ∼50% in the COVID-19 period. However, there was a significant decrease in hospitalization due to the control of chronic diseases during the COVID-19 period (p = .008). The number of inpatients from the emergency department was found to be higher during the COVID-19 period (p < .001). Regarding the presence of geriatric syndromes, polypharmacy (p = .011) and delirium (p = .035) were found to be significantly less in the pre-COVID-19 period. The percentage of malnutrition was also detected as lower, but it was not statistically significant. In terms of 1-year mortality, although not statistically significant, the all-cause mortality rate was higher during the COVID-19 period (p = .08). CONCLUSIONS Pandemic has greatly affected the geriatric unit. The prognosis of the patients has worsened and mortality rates have increased. Physiological and psychological deterioration caused by quarantine measures, worsening chronic diseases, and immunosenescence affected the prognosis of geriatric patients. This adds to the previous literature by proving the fact that older individuals are the most vulnerable group in the pandemic.
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Affiliation(s)
- Tugce Emiroglu Gedik
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Damla Unal
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Veysel Suzan
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Rabia Bag Soytas
- Department of Geriatrics, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Pınar Arman
- Deparment of Geriatrics, Kutahya Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Bahar Bektan Kanat
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gulru Ulugerger Avci
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Deniz Suna Erdincler
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Health Emergency and Disaster Risk Management Workforce Development Strategies: Delphi Consensus Study. Prehosp Disaster Med 2022; 37:735-748. [PMID: 36326090 PMCID: PMC9726469 DOI: 10.1017/s1049023x22001467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Health workforce development is essential for achieving the goals of an effective health system, as well as establishing national Health Emergency and Disaster Risk Management (Health EDRM). STUDY OBJECTIVE The objective of this Delphi consensus study was to identify strategic recommendations for strengthening the workforce for Health EDRM in low- and middle-income countries (LMIC) and high-income countries (HIC). METHODS A total of 31 international experts were asked to rate the level of importance (one being strongly unimportant to seven being strongly important) for 46 statements that contain recommendations for strengthening the workforce for Health EDRM. The experts were divided into a LMIC group and an HIC group. There were three rounds of rating, and statements that did not reach consensus (SD ≥ 1.0) proceeded to the next round for further ranking. RESULTS In total, 44 statements from the LMIC group and 34 statements from the HIC group attained consensus and achieved high mean scores for importance (higher than five out of seven). The components of the World Health Organization (WHO) Health EDRM Framework with the highest number of recommendations were "Human Resources" (n = 15), "Planning and Coordination" (n = 7), and "Community Capacities for Health EDRM" (n = 6) in the LMIC group. "Policies, Strategies, and Legislation" (n = 7) and "Human Resources" (n = 7) were the components with the most recommendations for the HIC group. CONCLUSION The expert panel provided a comprehensive list of important and actionable strategic recommendations on workforce development for Health EDRM.
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STACHTEAS P, STACHTEAS C, SYMVOULAKIS EK, SMYRNAKIS E. The Role of Telemedicine in the Management of Patients with Chronic Diseases in Primary Care During the COVID-19 Pandemic. MAEDICA 2022; 17:931-938. [PMID: 36818259 PMCID: PMC9923072 DOI: 10.26574/maedica.2022.17.4.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Introduction:The COVID-19 pandemic has rapidly spread to many countries and has led various primary healthcare services of chronic diseases to be neglected and only partially be replaced by telemedicine services. This study aims to investigate the role of telemedicine in the management of patients with noncommunicable diseases in primary health care during the COVID-19 pandemic. Method: A narrative review of the literature was carried out through searching the PubMed and Google Scholar databases. Results: From the initial stages of the pandemic, several scientific medical societies issued guidelines which urged citizens and health personnel to adopt digital means in the provision of regular chronic care as much as possible. The significant benefits of the telemedicine sessions partially only filled the gap of the deferred chronic care. On the other hand, many barriers need to be addressed in order to achieve an equitable and high-quality implementation of telemedicine services. Conclusion:The widespread application of telemedicine and self-monitoring was brought about by the COVID-19 pandemic and currently, they have become common ways of managing non-communicable diseases in primary health care. Innovations introduced need to be maintained and integrated into conventional traditional practices, so that health systems are more resilient to future public health emergencies.
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Affiliation(s)
- Panagiotis STACHTEAS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Charalampos STACHTEAS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Emmanouil K. SYMVOULAKIS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Emmanouil SMYRNAKIS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
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Zhu Y, Liu Y, Jiang H. Geriatric Health Care During the COVID-19 Pandemic: Managing the Health Crisis. Clin Interv Aging 2022; 17:1365-1378. [PMID: 36158515 PMCID: PMC9491878 DOI: 10.2147/cia.s376519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/20/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 pandemic significantly threatens the health and well-being of older adults. Aging-related changes, including multimorbidity, weakened immunity and frailty, may make older people more susceptible to severe infection and place them at higher risk of morbidity and mortality from COVID-19. Various quarantine measures have been implemented to control the spread of COVID-19. Nevertheless, such social distancing has disrupted routine health care practices, such as accessibility of medical services and long-term continuous care services. The medical management of older adults with multimorbidity is significantly afflicted by COVID-19. Older persons with frailty or multiple chronic disease may poorly adapt to the altered health care system, having detrimental consequences on their physical and mental health. COVID-19 pandemic has posed great challenges to the health of older adults. We highlighted the difficulties and obstacles of older adults during this unprecedented time. Also, we provided potential strategies and recommendations for actions to mitigate the COVID-19 pandemic threats. Certain strategies like community primary health care, medication delivery and home care support are adopted by many health facilities and caregivers, whereas other services such as internet hospital and virtual medical care are promoted to be accessible in many regions. However, guidelines and policies based on high-quality data are still needed for better health promotion of older groups with increasing resilience during the COVID-19 pandemic.
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Affiliation(s)
- Yingqian Zhu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| | - Yue Liu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| | - Hua Jiang
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
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Stachteas P, Symvoulakis M, Tsapas A, Smyrnakis E. The impact of the COVID-19 pandemic on the management of patients with chronic diseases in Primary Health Care. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sakur FJ, Ward K, Khatri NN, Lau AYS. Self-care Behaviours and Technology utilised during COVID-19: Systematic Review. JMIR Hum Factors 2022; 9:e35173. [PMID: 35442904 PMCID: PMC9217152 DOI: 10.2196/35173] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/18/2022] [Accepted: 04/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Self-care behaviors are essential for people living with chronic conditions; however, the outbreak of the COVID-19 pandemic has imposed additional complications on their daily routines. Few studies have analyzed how self-care behaviors have changed during COVID-19 and the role of digital technology, especially among people with chronic conditions. Objective This study aims to review how self-care behaviors have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period. Methods A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, and Google Scholar, including articles from December 2019 onward. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (ie, self-care maintenance, monitoring, and management). The methodological quality of the included articles was assessed with the McMaster Critical Review Forms for Quantitative or Qualitative Studies. Results In total, 36 primary research articles were included. Changes to self-care behaviors during COVID-19 among people with chronic conditions were organized according to the middle-range theory of self-care of chronic illness focusing on self-care maintenance (ie, medication adherence, physical activity, and diet control), self-care monitoring (ie, monitoring signs and symptoms), and self-care management (ie, consultations with health care providers). Positive self-care behaviors observed include the following: individuals trying to maintain good glycemic control during COVID-19 increased their medication adherence in 27% (10/36) of studies; and diet control improved in 50% (18/36) of studies. Negative self-care behaviors observed include the following: decline in physical activities and increased sedentariness were observed in 65% (23/36) of studies; poor diet control was observed in 57% (21/36) of studies; and self-monitoring of health status dropped in 43% (15/36) of studies. The use of technology to support self-care of chronic conditions during COVID-19 was reported in 72% (26/36) of studies. The actual use of telehealth in place of physical consultations during COVID-19 was observed in 50% (18/36) of studies, and other digital technologies (eg, social media apps, smartphone apps, web-based platforms, and web browsing) were used in 50% (18/36) of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77% (28/36) of studies. Conclusions This review highlighted the necessity to rethink how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) among a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions.
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Affiliation(s)
- Fareeya Jan Sakur
- Australian Institute of Health Innovation, Macquarie University,, 75 Talavera Rd,, North Ryde, AU
| | - Kanesha Ward
- Australian Institute of Health Innovation, Macquarie University, North Ryde, AU
| | - Neha Nafees Khatri
- Australian Institute of Health Innovation, Macquarie University, North Ryde, AU
| | - Annie Y S Lau
- Australian Institute of Health Innovation, Macquarie University, North Ryde, AU
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12
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Hung KKC, Lam RPK, Tsui MSH. Emergency medicine during COVID-19: Global challenges and Asian solutions. HONG KONG J EMERG ME 2022. [DOI: 10.1177/10249079221086708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Ghimire S, Shrestha A, Yadav UN, Mistry SK, Chapadia B, Yadav OP, Ali AM, Rawal LB, Yadav P, Mehata S, Harris M. Older adults with pre-existing noncommunicable conditions and their healthcare access amid COVID-19 pandemic: a cross-sectional study in eastern Nepal. BMJ Open 2022; 12:e056342. [PMID: 35115356 PMCID: PMC8814747 DOI: 10.1136/bmjopen-2021-056342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND COVID-19 has greatly impacted older adults with pre-existing noncommunicable conditions (hereafter called pre-existing conditions) in terms of their access to essential healthcare services. Based on the theory of vertical health equity, this study investigated access to healthcare by Nepali older adults with pre-existing conditions during the COVID-19 pandemic. METHODS A cross-sectional study surveyed 847 randomly selected older adults (≥60 years) in three districts of eastern Nepal. Survey questionnaires, administered by trained community health workers, collected information on participants reported difficulty obtaining routine care and medications during the pandemic, in addition to questions on demographics, socioeconomic factors and pre-existing conditions. Cumulative scores for pre-existing conditions were recoded as no pre-existing condition, single condition and multimorbidity for the analyses. χ2 tests and binary logistic regressions determined inferences. RESULTS Nearly two-thirds of the participants had a pre-existing condition (43.8% single condition and 22.8% multimorbid) and reported experiencing difficulty obtaining routine care (52.8%) and medications (13.5%). Participants with single (OR 3.06, 95% CI 2.17 to 4.32) and multimorbid (OR 5.62, 95% CI 3.63 to 8.71) conditions had threefold and fivefold increased odds of experiencing difficulty accessing routine care. Findings were similar for difficulty obtaining medication (OR single: 3.12, 95% CI 1.71 to 5.69; OR multimorbid: 3.98, 95% CI 2.01 to 7.87) where odds were greater than threefolds. CONCLUSIONS Older adults with pre-existing conditions in Nepal, who require routine medical care and medication, faced significant difficulties obtaining them during the pandemic, which may lead to deterioration in their pre-existing conditions. Public health emergency preparedness should incorporate plans for both managing the emergency and providing continuing care.
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Affiliation(s)
- Saruna Ghimire
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Aman Shrestha
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Uday Narayan Yadav
- National Centre for Epidemiology & Population Health, The Australian National University, Canberra, ACT, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- Centre for Reserach Policy and Implementation, Biratnagar, Nepal
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- ARCED Foundation, Dhaka, Bangladesh
- BRAC James P Grant School of Public Health, Dhaka, Bangaladesh
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Bunsi Chapadia
- Department of Microbiology, Miami University, Oxford, Ohio, USA
| | - Om Prakash Yadav
- Government of Nepal Ministry of Health and Population, Kathmandu, Nepal
| | | | - Lal B Rawal
- School of Health Medical and Applied Sciences, Central Queensland University, Sydney, New South Wales, Australia
| | - Priyanka Yadav
- Centre for Reserach Policy and Implementation, Biratnagar, Nepal
| | - Suresh Mehata
- Government of Nepal Ministry of Health and Population, Kathmandu, Nepal
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
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Disaster preparedness of emergency departments in Hong Kong. HONG KONG J EMERG ME 2022. [DOI: 10.1177/10249079211063270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Zhang X, Sun F, Wang Q. Health services for non-communicable diseases have been severely disrupted by COVID-19 based on an analysis of MicroBlog rescue data in Wuhan, China. Int J Health Plann Manage 2022; 37:1832-1837. [PMID: 35034379 PMCID: PMC9015239 DOI: 10.1002/hpm.3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/06/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
Diagnostic and treatment services for non‐communicable diseases (NCDs) face significant challenges in the context of the COVID‐19 pandemic. We used the Python programing language to extract and classify messages for help posted on the social networking platform microblog by NCD patients in the early stage of the COVID‐19 epidemic in Wuhan, China. We found of all NCD patients, the most frequently recorded conditions were basic chronic diseases (42.50%), acute critical diseases (35.53%), malignant tumours (15.10%), and patients requiring haemodialysis (6.79%). Regarding COVID‐19, 54.70% of patients reported suspected symptoms of infection, 32.01% were diagnosed with comorbidities, and 13.29% were non‐COVID‐19 patients. According to the analysis of the needs of the patients, 82.46% of the patients reported “No beds were available in the hospital”, 25.31% of patients needed nucleic acid tests. Our results confirmed it is difficult to meet the regular needs in the diagnosis and treatment of patients with NCDs. Effective prevention and management of NCDs in public health emergencies has become an urgent issue to be addressed. During the COVID‐19 epidemic, it is necessary to pay particular attention to the prevention and control of NCD patients, especially those with chronic disease. Governments and medical and health institutions at all levels should improve treatment mechanisms during major epidemics and ensure the uninterrupted treatment of patients with NCDs.
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Affiliation(s)
- Xiaoyan Zhang
- School of Public Administration, Hubei University, Wuhan, China
| | - Fenghua Sun
- School of Public Administration, Hubei University, Wuhan, China
| | - Qianyan Wang
- LiYuan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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16
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Dietert RR. Microbiome First Approaches to Rescue Public Health and Reduce Human Suffering. Biomedicines 2021; 9:biomedicines9111581. [PMID: 34829809 PMCID: PMC8615664 DOI: 10.3390/biomedicines9111581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/27/2021] [Indexed: 01/03/2023] Open
Abstract
The is a sequential article to an initial review suggesting that Microbiome First medical approaches to human health and wellness could both aid the fight against noncommunicable diseases and conditions (NCDs) and help to usher in sustainable healthcare. This current review article specifically focuses on public health programs and initiatives and what has been termed by medical journals as a catastrophic record of recent failures. Included in the review is a discussion of the four priority behavioral modifications (food choices, cessation of two drugs of abuse, and exercise) advocated by the World Health Organization as the way to stop the ongoing NCD epidemic. The lack of public health focus on the majority of cells and genes in the human superorganism, the microbiome, is highlighted as is the "regulatory gap" failure to protect humans, particularly the young, from a series of mass population toxic exposures (e.g., asbestos, trichloroethylene, dioxin, polychlorinated biphenyls, triclosan, bisphenol A and other plasticizers, polyfluorinated compounds, herbicides, food emulsifiers, high fructose corn syrup, certain nanoparticles, endocrine disruptors, and obesogens). The combination of early life toxicity for the microbiome and connected human physiological systems (e.g., immune, neurological), plus a lack of attention to the importance of microbial rebiosis has facilitated rather than suppressed, the NCD epidemic. This review article concludes with a call to place the microbiome first and foremost in public health initiatives as a way to both rescue public health effectiveness and reduce the human suffering connected to comorbid NCDs.
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Affiliation(s)
- Rodney R Dietert
- Department of Microbiology and Immunology, Cornell University, Ithaca, NY 14853, USA
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17
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Chan EYY, Kim JH, Kwok KO, Huang Z, Hung KKC, Wong ELY, Lee EKP, Wong SYS. Population Adherence to Infection Control Behaviors during Hong Kong's First and Third COVID-19 Waves: A Serial Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111176. [PMID: 34769694 PMCID: PMC8583559 DOI: 10.3390/ijerph182111176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 12/24/2022]
Abstract
Background: Although COVID-19 has affected over 220 countries by October 2021, there is limited research examining the patterns and determinants of adherence to infection control measures over time. Aims: Our study examines the sociodemographic factors associated with changes in the frequency of adherence to personal hygiene and social distancing behaviors in Hong Kong. Methods: A serial cross-sectional telephone survey in the general population was conducted during the first (March 2020) (n = 765) and third wave (December 2020) (n = 651) of the local outbreak of the COVID-19 pandemic. Respondents were asked about their level of compliance with various personal hygiene and social distancing recommendations. Results: By the third wave, mask use increased to 100%, and throughout the study periods, >90% practiced frequent hand hygiene. However, adherence to social distancing measures significantly waned over time: avoidance of social gatherings (80.5% to 72.0%), avoidance of public places/public transport (53.3% to 26.0%), avoidance of international travel (85.8% to 76.6%) (p < 0.05). The practice of ordering food takeout/home delivery, however, increased, particularly among high-income respondents. Higher education, female gender and employment status were the most consistently associated factors with adherence to COVID-19 preventive practices in the multivariable models. Conclusions: In urban areas of this region, interventions to improve personal hygiene in a prolonged pandemic should target males and those with low education. In addition to these groups, the working population needs to be targeted in order to improve adherence to social distancing guidelines.
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Affiliation(s)
- Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China; (Z.H.); (K.K.C.H.)
- GX Foundation, Hong Kong, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
- Correspondence:
| | - Jean H. Kim
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
| | - Kin-on Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China; (Z.H.); (K.K.C.H.)
| | - Kevin Kei Ching Hung
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong, China; (Z.H.); (K.K.C.H.)
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
- Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Eliza Lai Yi Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
| | - Eric Kam Pui Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (J.H.K.); (K.-o.K.); (E.L.Y.W.); (E.K.P.L.); (S.Y.S.W.)
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18
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Sornsenee P, Vichitkunakorn P, Choomalee K, Romyasamit C. Effect of the COVID-19 Pandemic and Other Predictors of True Therapeutic Inertia on Patients with Hypertension in a Primary Care Clinic in Thailand. Risk Manag Healthc Policy 2021; 14:3807-3816. [PMID: 34548829 PMCID: PMC8448536 DOI: 10.2147/rmhp.s327644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/29/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Hypertension (HT) has a significant impact on health care worldwide. Therapeutic inertia (TI) is defined as the failure to intensify therapy in the absence of an optimal goal and is widely used as a quality of care parameter. The coronavirus disease 2019 (COVID-19) pandemic has affected many health-care systems, including HT care. Therefore, the present study assessed the impact of the COVID-19 pandemic on TI and its predictors in patients with HT. Methods The electronic medical records of patients with HT who attended a primary care clinic at a tertiary hospital during pre-COVID-19 (February 2019 to February 2020) and COVID-19 (March to August 2020) periods were reviewed. Results Our study included 6089 visits during the 12-month pre-COVID-19 period and 2852 visits during the 6-month COVID-19 period. Most of the baseline characteristics of the HT patients were not significantly different between the two time periods. During the COVID-19 period, the percentage of uncontrolled HT visits decreased from 43% to 31%. Similarly, the prevalence of TI decreased from 81% to 77%. False TI was predominantly due to physicians' concerns regarding the in-clinic blood pressure measurement being inaccurate during both the periods. Conclusion After readjustment for the physicians 'reasons, the true TI was 64% and 60% in the pre-COVID-19 and COVID-19 period. For adjusted physician and patient-related factors, multilevel modeling was used. Senior medical staff visits, elderly patients, prior diabetes mellitus diagnosis, patients who used more than one type of anti-HT medication, and patients with systolic blood pressure >150 mmHg were all predictors of TI. The COVID-19 period, on the other hand had no effect on TI with an adjusted odds ratio of 0.82 (95% confidence interval, 0.67-1.01).
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Affiliation(s)
- Phoomjai Sornsenee
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Polathep Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kittisakdi Choomalee
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chonticha Romyasamit
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
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Cuschieri S, Grech S. Insight into the Occurrence of Common Non-communicable Diseases at a Population Level and the Potential Impact During the Coronavirus Pandemic - a Need for a Syndemic Healthcare Approach? SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:2393-2400. [PMID: 34568765 PMCID: PMC8455231 DOI: 10.1007/s42399-021-01064-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
People suffering from non-communicable diseases (NCDs) are at an increased risk for severe Covid-19. The aim was to determine the burden of common NCDs at a population level, assess Covid-19 impact while exploring whether a syndemic approach is merited to deal with NCDs and Covid-19. Baseline data from a Malta national representative survey. Individuals with type 2 diabetes (T2DM), hypertension, cardiovascular disease, dyslipidaemia and overweight-obese status were considered. Prevalence for single disease and multimorbidity were used to estimate population burden. Covid-19 impact at a population level was estimated through local Covid-19 infectivity rates. Years of life lost (YLL) and mortality rate were calculated using Covid-19 data and compared to corresponding NCDs data reported by global burden of disease (GBD) study. Half the study population (n = 3947) had a single NCD while a third had multimorbidity. Of these, 6.55% were estimated to be at risk of Covid-19 and require admission. Covid-19 YLL over 12 months was 5228.54 years, which is higher than the estimated YLL for hypertension and T2DM by GBD study for Malta. Health systems and policies should be re-focused to accommodate both Covid-19 and NCDs simultaneously through a targeted syndemic approach with primary healthcare playing a central role. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42399-021-01064-2.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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20
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Chung GKK, Chan SM, Chan YH, Yip TCF, Ma HM, Wong GLH, Chung RYN, Wong H, Wong SYS, Yeoh EK, Marmot M, Woo J. Differential Impacts of Multimorbidity on COVID-19 Severity across the Socioeconomic Ladder in Hong Kong: A Syndemic Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8168. [PMID: 34360461 PMCID: PMC8346110 DOI: 10.3390/ijerph18158168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/23/2022]
Abstract
The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72-3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32-2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system.
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Affiliation(s)
- Gary Ka-Ki Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
| | - Siu-Ming Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Yat-Hang Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
| | - Terry Cheuk-Fung Yip
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hon-Ming Ma
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roger Yat-Nork Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hung Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng Kiong Yeoh
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael Marmot
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- UCL Institute of Health Equity, UCL Research Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Jean Woo
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
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Mistry SK, Ali ARMM, Yadav UN, Ghimire S, Hossain MB, Das Shuvo S, Saha M, Sarwar S, Nirob MMH, Sekaran VC, Harris MF. Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study. PLoS One 2021; 16:e0255534. [PMID: 34324556 PMCID: PMC8320993 DOI: 10.1371/journal.pone.0255534] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. MATERIALS AND METHODS The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. RESULTS Most of the participants aged 60-69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33-2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17-7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11-4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03-9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. CONCLUSIONS Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - A. R. M. Mehrab Ali
- ARCED Foundation, Dhaka, Bangladesh
- Innovations for Poverty Action, New Haven, Connecticut, United States of America
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Center for Research Policy and Implementation, Biratnagar, Nepal
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, United States of America
| | - Md. Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Manika Saha
- Action Lab, Department of Human-Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia
| | - Sneha Sarwar
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Md. Mohibur Hossain Nirob
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College (Manipal Campus) MAHE, Manipal, Karnataka, India
| | - Mark F. Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
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22
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Chan EYY, Lam HCY. Research in Health-Emergency and Disaster Risk Management and Its Potential Implications in the Post COVID-19 World. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052520. [PMID: 33806262 PMCID: PMC7967319 DOI: 10.3390/ijerph18052520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022]
Abstract
Health-Emergency Disaster Risk Management (Health-EDRM) is one of the latest academic and global policy paradigms that capture knowledge, research and policy shift from response to preparedness and health risk management in non-emergency times [...].
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Affiliation(s)
- Emily Ying Yang Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
- Correspondence:
| | - Holly Ching Yu Lam
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK;
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