The strain on healthcare systems including emergency departments increased substantially during the Covid-19 pandemic,negatively affecting healthcare workers and their well-being. The emotional distress experienced by healthcare staff during the pandemic was worsened by confusion and conspiracy theories that circulated in the news and online media. Reports on the pandemic and general consumption of media intensified as the public's demand for information increased. There is limited research on how doctors perceived media coverage, and how they were affected in their work. This study aimed to explore how medical doctors in emergency departments perceived the media coverage during the Covid-19 pandemic. Twelve doctors at two different emergency departments in Stockholm, Sweden, participated. Interview questions on media were asked as part of a more extensive questionnaire. Informants' responses were analysed qualitatively. The results indicate that doctors to some extent used media as a source of information, due to limited access to knowledge about the virus. Results further suggest that media coverage triggered fear of infection, caused worry and job strain. The doctors percieved that the media coverage on Covid-19 affected patient-seeking behaviour as well as the doctor-patient relationship. The findings can be relevant in preparation for future pandemics and considered in development of policy for media and emergency departments.
Since its outbreak in December 2019 in China, COVID-19 has spread like wild fire to affect many communities of the world. The high infectivity and case fatality rates of the disease among the general population and the severely ill patients respectively drew the attention of the global community. Our review showed that socio-demographic and lifestyle-related risk factors and underlying comorbid diseases were directly and indirectly associated with increased susceptibility and severity of COVID-19. These factors included older age (⩾60 years), male gender, and ethnic minority groups (especially blacks), smoking, low serum level of vitamin D, unhealthy diet, physical inactivity (with poor exposure to sunlight), overweight/obesity, high blood pressure/hypertension, high blood cholesterol, cardiovascular diseases (like stroke and coronary heart disease), diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, and some cancers (like leukemia, lymphoma, or myeloma). The literature further revealed that the clinical progression of the majority of these associated risk factors can be modified through effective and comprehensive risk reduction through healthy living and lifestyle modification. COVID-19 preventive and treatment guidelines that give adequate attention to risk reduction and healthy lifestyle among people-either in the pre-, peri-, or post-COVID-19 stage, should be developed by public health policymakers and clinicians. This will play a significant role in the global effort to combat the pandemic, and reduce its negative impact on the life expectancy and socio-economic development of the world particularly in low- and middle-income countries (LMICs).
Trauma-informed practice (TIP) is expanding as a means of improving patient safety and engagement. Accordingly, professionals and other stakeholders increasingly come together in meetings and workshops to learn about, plan and evaluate TIP in health and social care settings. However, these kinds of trauma-informed work are sometimes carried out in a way that is not itself trauma-informed - missing an opportunity to 'model the model' and risking re-traumatisation and disengagement from further trauma-informed work for some attendees. Inaccurate use of language, the desire to destigmatise, and conflation of trauma-informed and trauma-enhanced practice may all be contributing factors. Careful attention to remit and content, accuracy of language and adequate provisions around the discussion of traumatising adversities can do much to reduce the risk of psychological harm and enable our trauma-informed work to be fully enriched by those who bring lived experience that is undisclosed as well as experiences that may be extant in their roles. Issues of relationality and context are not only central to traumatisation but offer a means to avoid it, both in our work as practitioners, managers, commissioners and researchers and in the ways that we come together to plan and reflect on that TIP.
Introduction: Globally, the COVID-19 pandemic has brought many disruptions in health service delivery. Evidence show that the pandemic has negatively affected routine healthcare utilization such as maternal and child health services, but the literature on the effect on non-communicable diseases (NCDs) is scant in South Africa. These disruptions can have long-term health and economic implications for patients.
Objective: To estimate the impact of COVID-19 lockdown on service utilization among chronic disease patients in South Africa using administrative data.
Methods: Using monthly data from the Centralized Chronic Medication Dispensing and Distribution (CCMDD) program database covering November 2018 to October 2021, we examined the effects of COVID-19 lockdown on utilization among patients receiving antiretroviral therapy (ART) medication only (ART-only), patients receiving both ART and NCD medication (ART + NCD), and patients receiving NCD medications only (NCD-only). We employed segmented interrupted time series approach to examine the changes. We stratified the analysis by socioeconomic status.
Results: We found that, overall, the lockdown was associated with increased utilization of CCMDD services by 10.8% (95% CI: 3.3%-19%) for ART-only and 10.3% (95% CI: 3.3%-17.7%) for NCD-only patients. The increase in utilization was not different across socioeconomic groups. For patients receiving ART + NCD medications, utilization declined by 56.6% (95% CI: 47.6%-64.1%), and higher reductions occurred in low SES districts.
Conclusion: Patients should be educated about the need to continue with utilization of disease programs during a pandemic and beyond. More efforts are needed to improve service use among patients with multi-morbidities.
This study estimates the years of potential life lost (YPLL), years of potential productive life lost (YPPLL), and cost of productivity loss (CPL) owing to injury-related mortalities in Mongolia. By implementing a retrospective cohort study, the study used secondary mortality data for Mongolia from 2016 to 2020 from the Health Development Center. Our study incorporates information on 13 551 fatalities from injuries and external factors, with the aim of estimating YPLL, YPPLL, and CPL associated with the leading causes injury-induced deaths. These include exposure to toxic substances, road accidents, homicides, suicides, and falls. Our findings reveal majority of the losses occur because of exposure to poisonous chemicals, road accidents, suicides, falls, and homicides. Furthermore, 444 550 years of potential life are lost owing to injury-related mortalities, in which YPPLL accounts for 338 482 years. The CPL caused by these premature deaths during the study period accounts for $1.368 billion. Notably, YPLL, YPPLL, and CPL rates are significantly higher in males than in females. The YPLL from exposure to poisonous chemicals is higher than those caused by other factors. This study is the first to calculate the CPL owing to YPLL from injury in Mongolia.
Background: There has been a concerted effort to reduce malaria burden and bring malaria related mortality to zero. The objectives of this survey were to assess the level of adherence to the current revised malaria control guidelines in the public health facilities in Cross River State of Nigeria and to identify the challenges as well as suggest ways for improvement in treatment outcomes.
Methods: This was a mixed observational and qualitative survey conducted in 32 public health facilities from 21st to 25th June 2022. Treatment records on malaria were assessed for adherence to the National guidelines. In-depth interviews were conducted with 36 key informants and 4 purposefully selected stakeholders to identify the successes and challenges. Quantitative data were summarized and presented in simple proportions and percentages while qualitative information was recorded, the transcripts thematically coded, analyzed and presented using NVivo 11 software.
Results: The survey revealed that vector control program was poorly implemented across the state. For case management, presumptive treatment was frequently practiced especially at secondary health facilities for uncomplicated malaria. More than 60% of uncomplicated malaria were being treated with parenteral artemether instead of oral artemisinin combination therapy (ACTs) as recommended. Severe malaria were not treated with Intravenous (IV) Artesunate as first line drug in about 40% of the secondary health facilities. Key successes were noted in malaria management in pregnancy. Major challenges identified include: stock out of commodities, shortage of clinical man power, and low trust in parasitological diagnosis.
Conclusion: The survey showed that adherence to the key recommendations in various categories of malaria control among health care providers in the public health facilities was below expectation. Malaria preventive treatment in pregnancy with SP fared better perhaps because of its inclusion in ANC packages.