Strategies for qualified triage stations and fever clinics during the outbreak of COVID-2019 in the county hospitals of Western Chongqing.
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ABSTRACT:
SUBMITTER: Wu X
PROVIDER: S-EPMC7118631 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-EPMC7159020 | biostudies-literature
Project description:BackgroundCurrently, the need to prevent and control the spread of the 2019 novel coronavirus disease (COVID-19) outside of Hubei province in China and internationally has become increasingly critical. We developed and validated a diagnostic model that does not rely on computed tomography (CT) images to aid in the early identification of suspected COVID-19 pneumonia (S-COVID-19-P) patients admitted to adult fever clinics and made the validated model available via an online triage calculator.MethodsPatients admitted from January 14 to February 26, 2020 with an epidemiological history of exposure to COVID-19 were included in the study [model development group (n=132) and validation group (n=32)]. Candidate features included clinical symptoms, routine laboratory tests, and other clinical information on admission. The features selection and model development were based on the least absolute shrinkage and selection operator (LASSO) regression. The primary outcome was the development and validation of a diagnostic aid model for the early identification of S-COVID-19-P on admission.ResultsThe development cohort contained 26 cases of S-COVID-19-P and seven cases of confirmed COVID-19 pneumonia (C-COVID-19-P). The final selected features included one demographic variable, four vital signs, five routine blood values, seven clinical signs and symptoms, and one infection-related biomarker. The model's performance in the testing set and the validation group resulted in area under the receiver operating characteristic (ROC) curves (AUCs) of 0.841 and 0.938, F1 scores of 0.571 and 0.667, recall of 1.000 and 1.000, specificity of 0.727 and 0.778, and precision of 0.400 and 0.500, respectively. The top five most important features were age, interleukin-6 (IL-6), systolic blood pressure (SYS_BP), monocyte ratio (MONO%), and fever classification (FC). Based on this model, an optimized strategy for the early identification of S-COVID-19-P in fever clinics has also been designed.ConclusionsA machine-learning model based solely on clinical information and not on CT images was able to perform the early identification of S-COVID-19-P on admission in fever clinics with a 100% recall score. This high-performing and validated model has been deployed as an online triage tool, which is available at https://intensivecare.shinyapps.io/COVID19/.
| S-EPMC7940949 | biostudies-literature
Project description:Background:Positive patient experiences with care have been linked to improved health outcomes. Patient experience surveys can provide feedback about the level of patient-centered care provided by clinical pharmacists and information about how to improve services. Objectives:Study objectives are: 1) To describe patient experience with clinical pharmacist services in a federally qualified health center (FQHC). 2) To determine if demographic or health-related factors were associated with patient experience. Methods:This cross-sectional survey included adult patients who were English or Spanish speaking, and completed a clinical pharmacist visit in March or April 2018. Patient experience was evaluated, on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), with 10 items using four domains: pharmacist-patient interaction information provision, support for self-care, and involvement in decision making. In addition, one item was used to rate the overall experience. Demographic and health-related variables were also collected. Eligible patients completed the survey after their clinical pharmacist visit. Descriptive and inferential statistics, as well as Cronbach's alpha for scale reliability, were employed. Results:Respondents (N=99) were 55.4 (SD=12.1) years and 53.1% were women. Overall, patients rated their experiences very high with the 10-item scale score of 4.8 (SD=0.4) out of 5 points and the overall experience rating of 4.9 (SD=0.4) out of 5 points. With the exception of race, there were no differences between patient experience and demographic and health-related variables. African Americans had significantly (p=0.0466) higher patient experience scores compared to Hispanics. Conclusions:Patients receiving care in a FQHC highly rated their experience with clinical pharmacists. This indicates that clinical pharmacists provided a high level of patient-centered care to a diverse group.
| S-EPMC7194041 | biostudies-literature
Project description:ObjectivesThe objectives of this study were to evaluate existing nomenclature used for outpatient referrals triage and propose a system, which meets the needs of McMaster Children's Hospital and can be modified for use in other hospitals.MethodsWe reviewed triage practices in the Department of Pediatrics, McMaster Children Hospital, Hamilton, Ontario and conducted a literature search to assess terminology used for outpatient referrals triage at other institutions.ResultsThere is lack of unified terminology for triaging outpatient referrals. Existing systems are not widely accepted, lack uniformity, and often miss recording the true acuity of the referral. We developed a system that covers most outpatient triage scenarios, allocates either flexible or precise visit timelines to referrals and plans for logistics of the patient's visit. Triage categories are iMMediate (MM), Acute (A) (1 to 14 days), Semi-Acute (S) (1 to 3 months), Timetabled (T) (next available appointment slot), Evaluated (E) (used for either forwarding to another provider or requesting additional information), and Rejected (R) categories-McMASTER triage system. Several numbered subcategories are used in each category to define precise timelines, if needed. Visit logistics categories are the following: Hub (H) (place to see the patient), How to notify patient and referring provider (HP) and (HD), need to Start with tests prior to appointment (S), and need to Complete (C) other relevant local processes-HHSC logistics system. Both these systems may be adapted for local use in other institutions.ConclusionThis is the first publication that proposes terminology standardization in triaging outpatient referrals for specialist paediatric services.
| S-EPMC9394629 | biostudies-literature
Project description:investigate the paratyphoid fever outbreak caused by Salmonella enterica serovar Paratyphi A with genome resequencing
| PRJEB6350 | ENA
Project description:In 2012, chikungunya virus (CHIKV) was reported for the first time in Bhutan. IgM ELISA results were positive for 36/210 patient samples; PCR was positive for 32/81. Phylogenetic analyses confirmed that Bhutan CHIKV belongs to the East/Central/South African genotype. Appropriate responses to future outbreaks require a system of surveillance and improved laboratory capacity.
| S-EPMC3810753 | biostudies-literature
Project description:A cluster of sporotrichosis cases occurred in the Busselton-Margaret River region of Western Australia from 2000 to 2003. Epidemiologic investigation and mycologic culture for Sporothrix schenckii implicated hay initially distributed through a commercial hay supplier as the source of the out-break. Declining infection rates have occurred after various community measures were instigated.
| S-EPMC2828077 | biostudies-literature
Project description:ObjectiveTo understand the work experiences of pharmacists in fever clinics and isolation wards of designated hospitals for the novel coronavirus pneumonia in China and provide the basis for work management strategies and psychological interventions in pharmacy for prevention and control of future epidemics.MethodsUsing qualitative research methods, 13 pharmacists who met the inclusion criteria and worked in fever clinics and isolation wards of designated hospitals for novel coronavirus pneumonia attended focus group interviews and semistructured interviews. The Colaizzi analysis method was used for data analysis, summary and induction.ResultsThree themes were identified: (1) the roles of pharmacists in fever clinics and isolation wards in epidemic prevention and control, including ensuring the supply of medicines, providing medication guidance for patients, providing medication information for physicians and nurses, and participating in infection control; (2) the difficulties at work, including the lack of office equipment, information equipment and other infrastructure, the difficulty of management of pharmacists in isolation wards, challenging environments, and insufficient attention of hospitals, medical staff, and society to pharmacists; (3) the loopholes in drug management, including the management of special-class drugs and national free AIDS antiviral drugs, and the retrieval of drugs.ConclusionPharmacists have played an essential role in the fight against the epidemic of novel coronavirus pneumonia in China. The themes and experiences identified in this study can offer guidance to the pharmacy society in implementing strategies to prepare for future public health events.
| S-EPMC8587528 | biostudies-literature
Project description:African swine fever (ASF) is a contagious viral transboundary animal disease affecting domestic pigs caused by ASF virus (ASFV). This study was conducted in order to determine the genetic characteristics, risk factors and socioeconomic impact of an ASF outbreak in 2019 in Ngara, western Tanzania. Tissue samples from dead domestic pigs with clinical picture suggestive of ASF infection were collected for ASF confirmation and genetic characterization of ASFV. Data on the risk factors and socioeconomic impact associated with the ASF outbreak were collected from consenting farmers using a semi-structured questionnaire. Disease confirmation was done by detection of genomic ASFV DNA using polymerase chain reaction. Partial amplification of the ASFV genome, dideoxynucleotide sequencing of the PCR products followed by bioinformatics analyses was conducted to determine the ASFV genotypes. Phylogenetic reconstruction of the variable 3'-end of the B646L gene clustered the ASFV isolate into genotype X. Analysis of the intergenic fragment sequences between 173R and 1329L genes showed that the viral strains TAN/19/Ngara and Kenya 1950 similarly lacked a 36 bp fragment that is present in strain Ken05/Tk1. Feeding pigs of uncooked swill was shown to be significantly associated with ASF spread (OR = 3.08, C.I.95% = 1.06-8.99, P = 0.0009). Occurrence of ASF outbreak resulted in loss of income and investment as most farmers kept pigs for the purpose of income generation. Food security was disturbed due to high pig mortality following occurrence of ASF outbreak. A total of 93,630,000 Tanzanian shillings (approximately 41,065 USD) was estimated to be lost as a result of pigs' mortality in 219 households. The findings of the present study associate ASFV genotype X with the 2019 ASF outbreak in Ngara and feeding pigs with uncooked swill with spread of the disease.
| S-EPMC8455476 | biostudies-literature
Project description: Not available
| S-EPMC3471616 | biostudies-literature