A changing supply chain for a changing health care system: Barriers and facilitators of implementing enterprise resource planning

BACKGROUND: No studies have examined how health care mergers and acquisitions affected the hospital supply chain and its employees since the passing of the Patient Protection and Affordable Care Act. OBJECTIVE: To describe the barriers and facilitators of digital transformation in a hospital supply chain from the employee perspective. METHODS: We conducted two rounds of interviews, one year apart, with supply chain employees at an urban academic health system preparing to adopt an enterprise resource planning (ERP) software (N = 11 in Round I and N = 8 in Round II). Two researchers coded transcripts for themes using NVivo 11. RESULTS: We identified the following barriers to technology integration: silos between supply chain groups (e.g. Purchasing, Information Management, Strategic Sourcing), between employees and management, and resulting from prior mergers; focus on short-term problems and fear of change; and lack of transparent communication about upcoming changes. Facilitators of technology integration included motivation to work in supply chain; long-term vision that allowed tolerance of change and positive outlook; and transparent communication. CONCLUSION: Desire for shared leadership among employees emerged as a major theme, indicating the need for active involvement of employees during transition to new integrative technology.

Determinants of SARS-CoV-2 vaccine willingness among people incarcerated in 3 Canadian federal prisons: a cross-sectional study

BACKGROUND

Maximizing uptake of SARS-CoV-2 vaccines among people in prison is essential in mitigating future outbreaks. We aimed to determine factors associated with willingness to receive SARS-CoV-2 vaccination before vaccine availability.

METHODS

We chose 3 Canadian federal prisons based on their low uptake of influenza vaccines in 2019-2020. Participants completed a self-administered questionnaire on knowledge, attitude and beliefs toward vaccines. The primary outcome was participant willingness to receive a SARS-CoV-2 vaccine, measured using a 5-point Likert scale to the question, "If a safe and effective COVID-19 vaccine becomes available in prison, how likely are you to get vaccinated?" We calculated the association of independent variables (age, ethnicity, chronic health conditions, 2019-2020 influenza vaccine uptake and prison security level), identified a priori, with vaccine willingness using logistic regression and crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS

We recruited 240 participants from Mar. 31 to Apr. 19, 2021 (median age 46 years; 19.2% female, 25.8% Indigenous). Of these, 178 (74.2%) were very willing to receive a SARS-CoV-2 vaccine. Participants who received the 2019-2020 influenza vaccine (adjusted OR 5.20, 95% CI 2.43-12.00) had higher odds of vaccine willingness than those who did not; those who self-identified as Indigenous (adjusted OR 0.27, 95% CI 0.11-0.60) and in medium- or maximum-security prisons (adjusted OR 0.36, 95% CI 0.12-0.92) had lower odds of vaccine willingness than those who identified as white or those in minimum-security prisons, respectively.

INTERPRETATION

Most participants were very willing to receive vaccination against SARS-CoV-2 before vaccine roll-out. Vaccine promotion campaigns should target groups with low vaccine willingness (i.e., those who have declined influenza vaccine, identify as Indigenous or reside in high-security prisons).

[Not Available]

The aim of this study was to examine association between IFNL4 gene ss469415590 and treatment efficiency in group of Ukrainian PEG-interferon/ribavirin-treated chronic hepatitis C patients. Study group consisted of 92 unrelated hepatitis C virus genotype 1 mono-infected patients: case group - 29 patients with late or absent virological response; control group - 63 patients with sustained virological response. Study material was genomic DNA. Genotyping was performed using amplification-refractory mutation system PCR. Statistical analysis was performed using GenePop and OpenEpi statistical packages. Obtained results show that ss469415590 ΔG/ΔG genotype is associated with poor virological response (OR = 3.62; CI 95%: 1.12-11.67) in PEG-interferon/ribavirin-treated chronic hepatitis C patients from Ukraine.

Ophthalmic complications associated with orthognathic surgery

Ophthalmic complications are rare following maxillary osteotomies. Potential complications include a decrease in visual acuity, extraocular muscle dysfunction, neuroparalytic keratitis, and nasolacrimal problems involving both an increase or a decrease in tearing. Ophthalmic injuries appear to be primarily mediated through indirect injuries to neurovascular structures occurring from traction, compression, or contrecoup injuries from forces transmitted during the pterygomaxillary dysjunction using an osteotome or from fractures extending to the base of the skull or orbit associated with the pterygomaxillary dysjunction or the maxillary downfracture. A review of the literature of previous ophthalmic complications as well as eight new cases are reported. The possible etiologic basis for these injuries is discussed in detail as well as treatment possibilities when appropriate.