Comparison of the level of physical activity after the COVID-19 pandemic in Poland, Slovakia and the Czech Republic

BACKGROUND

The COVID-19 pandemic was associated with limited physical activity (PA) of most of the world's population. This cross-sectional prospective study aimed to assess the levels of PA of university students in Poland, Czech Republic and Slovakia after COVID-19 using the International Physical Activity Questionnaire Short Form (IPAQ-SF).

METHODS

A total of 2635 students completed questionnaires regarding their PA levels using the IPAQ-SF between September and December 2022.

RESULTS

PA measured by metabolic equivalent of task (MET) scores, varied between the three countries: Slovakia median MET-minutes/week score 4459.9; Czech Republic 3838.8 Poland 3567.1. The results of the post hoc analysis revealed there were significant differences in MET-minutes/week values between the Czech Republic and Poland (p < 0.035) as well as between the Czech Republic and Slovakia (p < 0.037). The analysis of energetic expenditure during walking revealed that students from the Czech Republic and Slovakia had higher median MET-min/weeks values (Czech 2284.1; Slovak 2467.1) compared to their Polish (1536.1) peers (p < 0.001). Polish cohort presented with significantly higher body mass index (BMI) (p < 0.001) than Czech and Slovak groups (BMI Czech: 22.3; Slovak 22.8; Polish 23.8).

CONCLUSIONS

Significant differences in PA levels between the Czech Republic, Poland, and Slovakia university students were identified. Slovakia showed the highest median PA measured as a MET score, and Poland showed the lowest. Compared to available pre-COVID studies it seems the total level of PA in the observed cohorts has not returned to the pre-COVID levels and students remain less active.

[Medication reconciliation on admission: One year of practice in health care institutions during the COVID-19 pandemic]

OBJECTIVES

Medication reconciliation is a key point of the v2020 certification. The main objective of this study was to evaluate this activity over one year, including the first epidemic wave at COVID-19. The secondary objectives were to identify the obstacles and levers and to evaluate doctor satisfaction.

METHODS

This was a retrospective study of drug reconciliations performed on admission during 12 months of the emergence of COVID-19. Patients aged 65 years and older from orthopedic and visceral surgery, acute hospitalization and conventional medicine units were included. Unintentional discrepancies were analyzed. The obstacles and levers were identified by means of a focus group. Doctors' satisfaction was collected using online quiz.

RESULTS

A total of 760 patients were conciliated, of which 27% (n=208) by hospital pharmacy technicians. A decrease in activity was observed during the first epidemic wave. An unintentional discrepancy was found in 77% of patients, and only 48% were corrected by the prescriber. These results were impacted by the pandemic. The pharmaceutical team was mobilized in the logistical management of the crisis, but it was able to adapt in order to perpetuate the activity. Doctors are satisfied with the process.

CONCLUSIONS

Medication reconciliation on admission is essential for the prevention of iatrogeny, particularly with the impact of the COVID-19 pandemic in healthcare institutions.

Data driven flexible supplier network of selfcare essentials during disruptions in supply chain

During disruptive events, supply chains struggle to meet the demand due to limitations posed by logistics, transportation and supply side failures. In the present study, a flexible supplier network of personal protective equipment (PPEs), such as face masks, hand sanitizers, gloves, and face shields, has been modelled using an extensive risk enabled data driven decision making for addressing disruptions in the supply chain. This paper studies various risks which exists in PPE supply chain and evaluates the total supplier risk based on them. Furthermore, the paper proposes a Multi-objective Mixed Integer Linear Program (MOMILP) to optimally select suppliers and the sustainable allocation of orders under various risks, namely disruption, delay, receivables, inventory, and capacity. The proposed MOMILP model is also extended to promptly revise the orders to other suppliers under a disruption scenario enabling an effective response resulting in minimization of stockouts. The criteria-risk matrix is developed with the help of supply chain experts from industry and academia. Conclusively, the numerical case study and its computational analysis is conducted on the PPE data received from distributors to demonstrate the applicability of the proposed model. The findings suggest that the proposed flexible MOMILP can optimally revise allocations during disruptions to drastically reduce the stockouts and minimize overall cost of procurement in the PPE supply network.

PytuTester: RaspberryPi open-source ventilator tester

PytuTester is an open-source ventilator tester developed to help bio-engineers in the design and verification of new ventilator prototypes. A ventilator tester allows measuring the flow, pressure, volume, and oxygen concentration provided to the patient. During the global pandemic COVID-19, several open-source ventilators prototypes were developed; however, due to high cost and demand testers, they were not available. In this context, a low-cost tester was developed using a Raspberry Pi and medical-grade sensors for the test ventilators prototypes. This paper presents the design files, software interface, and validations tests. Our results indicate that the tester has good accuracy to evaluate the efficacy and performance of new prototypes. When tested on two ventilator designs developed in Paraguay, PytuTester reported flow profiles that were concordant with the industry-standard VT650 Gas Flow Analyzer. PytuTester was then field deployed to test several DIY ventilator designs in low-resource areas.

Stress coping strategies used by nurses during the COVID-19 pandemic

Introduction

The risk of getting SARS-CoV-2 infection, worries about exposing loved ones, anxiety and frustration, emotional and physical exhaustion, burn out, a feeling of being overwhelmed, and struggles and challenges with parenting are a few among many factors that affect nurses' personal lives and professional functioning. The aim of the research is to assess nurses' level of stress during the COVID-19 pandemic and their sense of self-efficacy, and to learn what coping strategies they use.

Methodology/Methods

The study was carried out online and based on the diagnostic poll method, using an original survey questionnaire, the General Self-Efficacy Scale (GSES 10-40), the Mini-COPE questionnaire (0-3), and the Perceived Stress Scale PSS-10 (0-40). The respondent group was made up of nurses (n = 220) who provide health services in inpatient and outpatient health care institutions in the northeastern region of Poland. The statistical analysis was performed using the STATISTICA 13.0 package (StatSoft). The distribution of variables was checked with Shapiro-Wilk tests. The Mann-Whitney U test was used to compare two independent samples, while the Kruskal-Wallis test was used to compare more samples. The adopted statistical significance level was p < 0.05. Multivariate regression analysis was applied to determine which factors were related to the level of stress.

Results

The mean age of the participants was 43.3 years. The vast majority were women (96.4). The mean work experience of the nurses was over 20 years (58.2%). A total of 62.3% worked directly with patients in hospitals, including 11.8% respondents working at COVID-19 units and 37.7% working at primary care institutions. The analyses show that the respondents represented a high level of stress (PSS-10 - 20.9), related to their work experience as a nurse (β -0.250, p = 0.014), the number of hours worked a month (β 0.156, p = 0.015), and self-assessed health status (β -0.145, p = 0.037). They declared an average sense of self-efficacy (GSES - 29.1), which significantly depended on the nurses' places of employment (p = 0.044). Out of stress coping strategies (Mini-COPE), the younger nurses mentioned venting (p = 0.010), instrumental support (p = 0.011), sense of humour (p = 0.013) and self-blame (0.031). Practice nurses also chose the strategy of behavioral disengagement (p = 0.032), and nurse managers chose the strategy of planning (p = 0.018).

Conclusions

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect nurses' mental health and to take extensive prevention measures in critical situations. Special attention should be given to nurses who are younger and have shorter work experience. It is also important to monitor nurses' working time and health status, and those who work at outpatient health care institutions should be given more support and information.

Selection of healthcare waste disposal firms using a multi-method approach

The aim of this study is to propose a hybrid multi criteria decision making model with a linear programming (LP) model to tackle the issue of safe disposal of hazardous and infectious healthcare waste. For this, ten criteria in this study have been identified from literature and field surveys which are modelled using Decision making trial and evaluation (DEMATEL) and Analytic network process (ANP) methods to select the best disposal firm i.e. single sourcing for a hospital. We found that Experience of the firm, Technology for disposal, and Waste collection infrastructure acts as the most vital criteria in selecting a healthcare waste disposal firm for single sourcing. Furthermore, to optimize the total value of disposal and mitigating the risk involved in disposing waste through single sourcing; the LP model considering constraints such as waste lose constraint and waste processing constraint etc. Is solved for multiple sourcing using Lingo 18.0. The solution to LP results into allocation of 500, 500, and 1000 (kg/day) disposables to healthcare waste disposal firms D1, D2 and D3, respectively. The multi-method approach proposed in this study helps the hospital management in selecting economically, socially, and environmentally sustainable healthcare waste disposal firm.

[Working conditions among Mental Healthcare workers at the beginning of COVID-19 pandemic in Argentina]

INTRODUCTION

The current COVID-19 pandemic highlights the different difficulties that healthcare workers have to face in this context. In order to quantify some aspects of the current working situation, the Asociación de Psiquiatras Argentinos (APSA) designed a survey for Mental Healthcare workers. The goal was to: measure and know what are the working conditions of those working in Mental Health in Argentina, in this pandemic context.

METHODS

Cross sectional descriptive study. Convenience sample. The survey was designed and sent in a digital format, thru APSA means of communication. The survey had 27 questions and one comments option. Questions explored sociodemographic variables, worked related aspects and discrimination suffered by participants.

RESULTS

The survey, in its digital format, was answered by 710 participants. 32% of those in the public sector pointed out that people needed to bring their own personal protective equipment, compared to 56% in the private sector. For protocols in place, nearly 82% of public sector responses said there is a protocol for COVID-19 compatible symptoms in patients, compared to 58% in the private sector. And for new patients in an inpatient facility, responses showed that more than 50% had a protocol in the public sector, vs less than half in the private setting.

CONCLUSIONS

This survey and the results allows to know and have evidence on which were the working conditions at the beginning of the pandemic. Having a plan considering what is known and what is available, allows a more appropriate approach, for both the workers and those who depend on them for care.

Affective Concept-Based Encoding of Patient Narratives via Sentic Computing and Neural Networks

The automatic generation of features without human intervention is the most critical task for biomedical sentiment analysis. Regarding the high dynamicity of shared patient narrative data, the lack of formal medical language sentiment dictionaries prevents retrieval of the appropriate sentiment, which is unapproachable and can be prone to annotator bias. We propose a novel affective biomedical concept-based encoding via sentic computing and neural networks. The main contributions include four aspects. First, a biomedical embedding, in which a medical entity is defined, normalized, and synthesized from a text, is built using online patient narratives after being combined with label propagation from a widely used comprehensive biomedical vocabulary. Second, considering the dependence on biomedical definitions, drug reaction sample selection based on general matching is suggested. These feature settings are then used to build and recognize affective semantics and sentics based on an extreme learning machine. Finally, a semisupervised LSTM-BiLSTM model for biomedical sentiment analysis is constructed. There was a massive influx of patient self-reports related to the COVID-19 pandemic. A study was conducted in this direction, and we tested the validity, medical language familiarity, and transferability of our approach by analyzing millions of COVID-19 tweets. Comparisons to affective lexicons also indicate that integrating extreme learning machine cognitive capabilities has advantages over biomedical sentiment analysis. By considering sentics vectors on top of the formed embeddings, our semisupervised LSTM-BiLSTM achieved an accuracy of 87.5%. The evaluations of unsupervised learning approximated the results of the previous model when dealing with a serious loss of biomedical data. In this paper, we demonstrate the effectiveness of integrating deep-learning-based cognitive capabilities for both enhancing distributed biomedical definitions and inferring sentiment compositions from many patient self-reports on social networks. The relevant encoding of affective information conveyed regarding medication subjects clearly reveals defined roles and expectations that can have a positive impact on public health.

How did we take care of our older cancer patients during the first COVID-19 wave? The French experience

BACKGROUND

The management of older cancer patients has been highly challenging for clinicians in a health-care system operating at maximum capacity during the COVID-19 pandemic.

PATIENTS AND METHODS

We analyzed data from 9 different institutions. The primary endpoint was to assess the prevalence of adapted patient care during the pandemic for elderly cancer patients. The secondary endpoint was to assess the incidence of hospitalization and mortality due to COVID-19. All patients were older than 65years of age.

RESULTS

We analyzed data from 332 outpatients' case files between 9th of March and 30th of April 2020. The median age was 75years (range: 65-101) and 53% were male. Because of the COVID-19 pandemic, more than half of the outpatients received modified patient care, defined as postponement or cancellation of surgery, irradiation scheme adapted, systemic treatment or the use of telemedicine. Among patients with localized cancer, 60% had a change in management strategy due to the pandemic. Changes in management strategy were made for 53% of patients at the metastatic stage. GCSF was used , in 83% of patients, increasing considerably in the context of the pandemic. Sixty-nine percent of physicians used telemedicine. In the final analysis, only one patient was hospitalized for COVID-19 infection. No deaths due to COVID-19 were reported in elderly cancer patients during this time period.

CONCLUSION

Our study is the first to assess modification of patient care in elderly cancer outpatients during an epidemic. With this unprecedented crisis, our objective is to protect our patients from infection via protective barrier measures and social distancing, but also to guarantee the continuity of cancer care without overexposing this fragile population. Physicians were able to adapt their practice and used new forms of management, like telemedicine.

Dynamic model of infected population due to spreading of pandemic COVID-19 considering both intra and inter zone mobilization factors with rate of detection

Most of the widely populated countries across the globe have been observing vicious spread and detrimental effects of pandemic COVID-19 since its inception on December 19. Therefore to restrict the spreading of pandemic COVID-19, various researches are going on in both medical and administrative sectors. The focus has been given in this research keeping an administrative point of view in mind. In this paper a dynamic model of infected population due to spreading of pandemic COVID-19 considering both intra and inter zone mobilization factors with rate of detection has been proposed. Few factors related to intra zone mobilization; inter zone mobilization and rate of detection are the key points in the proposed model. Various remedial steps are taken into consideration in the form of operating procedures. Further such operating procedures are applied over the model in standalone or hybridized mode and responses are reported in this paper in a case-studies manner. Further zone-wise increase in infected population due to the spreading of pandemic COVID-19 has been studied and reported in this paper. Also the proposed model has been applied over the real world data considering three states of India and the predicted responses are compared with real data and reported with bar chart representation in this paper.

Evaluation of medical practices in oncology in the context of the COVID-19 pandemic in France: Physicians' point of view: the PRATICOVID study

The cancer population seems to be more susceptible to COVID‐19 infection and have worse outcomes. We had to adapt our medical practice to protect our patients without compromising their cancer prognosis. The national PRATICOVID study aims to describe the adaptation of cancer patient care for this population. We analyzed data from nine different institutions. The primary endpoint was to assess the prevalence of adapted patient care during the pandemic. The secondary endpoints were to describe the point of view of clinicians and patients during and after the pandemic. We analyzed 435 medical procedures between 9^th of March and 30^th of April. Because of the COVID‐19 pandemic, 47.6% of the outpatients received modified patient care. Twenty‐four percent of scheduled surgeries were postponed, or were performed without perioperative chemotherapy, 18.4% followed a hypofractioned schedule, and 57% had an adaptive systemic protocol (stopped, oral protocol, and spacing between treatments). Seventy percent of physicians used telemedicine. During this period, 67% of the physicians did not feel distressed taking care of their patients. However, 70% of physicians are worried about the aftermath of the lockdown, as regards future patient care. The PRATICOVID study is the first to assess modification of patient care in cancer outpatients during an epidemic. With this unprecedented crisis, physicians were able to adapt their practice in order to protect their patients against the virus while ensuring continuity of patient care. But physicians are worried about the aftereffects of the lockdown specifically in regard to care pathway issues.

Hospital Radiopharmacy in Argentina during the COVID-19 pandemic. Criteria and rationale for the organization of work

This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis.

Thoracic computerised tomography scans in one hundred eighteen orthopaedic patients during the COVID-19 pandemic: identification of chest lesions; added values; help in managing patients; burden on the computerised tomography scan department

Purpose

Based on the recent literature, chest computed tomography (CT) examination could aid for management of patients during COVID-19 pandemic. However, the role of chest CT in management of COVID-19 patients is not exactly the same for medical or surgical specialties. In orthopaedic or trauma emergency, abdomen, pelvis, cervical, dorsal, and lumbar spine CT are performed to investigate patients; the result is a thoracic CT scan incorporating usually the thorax; however, information about lung parenchyma can be obtained on this thorax CT, and manifestations of COVID-19 can be diagnosed. The objective of our study was to evaluate this role in orthopedic patients to familiarize orthopaedists with the value and limits of thoracic CT in orthopaedic surgery.

Materials and methods

Among the 1397 chest CT scans performed during the pandemic period from 1 March 2020 to 10 May 2020, in two centres with orthopaedic surgery, we selected all the 118 thoracic or chest CT performed for patients who presented to the Emergency Department of the hospital with a diagnosis of trauma for orthopaedic surgical treatment. Thirty-nine of these 118 patients were tested with PCR for the diagnosis of COVID-19 infection. Depending on clinical status (symptomatic or non-symptomatic), the information useful for the orthopaedist surgeon and obtained from the Chest CT scan according to the result of the PCR (gold standard) was graded from 0 (no or low value) to 3 (high value). The potential risks of chest CT as exposure to radiation, and specific pathway were analyzed and discussed. A group of patients treated during a previous similar period (1 March 2018 to 15 April 2018) was used as control for evaluation of the increase of CT scanning during the COVID-19 pandemic.

Results

Among the 118 patients with chest CT, there were 16 patients with positive COVID-19 chest CT findings, and 102 patients with negative chest CT scan. With PCR results as reference, the sensitivity, specificity, positive predictive value of chest CT in indicating COVID-19 infection were 81%, 93%, and 86%, respectively (p = 0.001). A useful information for the orthopaedic surgeon (graded as 1 for 71 cases, as 2 for 5 cases, and as 3 for 11 cases) was obtained from 118 chest CT scans for 87 (74%) patients, while the CT was no value in 30 (25%) cases, and negative value in one (1%) case. Roughly 20% of the total number of CT scanner performed over the pandemic period was dedicated to COVID-19, but only 2% were for orthopaedic or trauma patients. However, this was ten times higher than during the previous control period of comparison.

Conclusion

Although extremely valuable for surgery management, these results should not be overstated. The CT findings studied are not specific for COVID-19, and the positive predictive value of CT will be low unless disease prevalence is high, which was the case during this period.