Health Care Crisis Research Articles

Cpx-signalling in Yersinia pseudotuberculosis modulates Lipid-A remodelling and resistance to last-resort antimicrobials

Antibiotic resistance is a global healthcare crisis. Bacteria are highly adaptable and can rapidly acquire mechanisms of resistance towards conventional antibiotics. The permeability barrier conferred by the Gram-negative bacteria cell envelope constitutes a first line of defence against the action of antibiotics. Exposure to extracytoplasmic stresses can negatively affect cell envelope homoeostasis and this causes localised protein misfolding, compromised envelope integrity and impairs barrier function. The CpxA-CpxR two-component regulatory system has evolved to sense extracytoplasmic stresses and to regulate processes that restore homoeostasis of the cell envelope. Hence, controlled Cpx-signalling assists bacteria in adapting, surviving and proliferating in harsh environments, including exposure to antibiotics. Herein, we determined that an intact Cpx-signalling is key to maintaining the Yersinia pseudotuberculosis resistance to colistin and polymyxin B. The susceptibility displayed by Cpx-signalling defective mutants, correlated with cell-envelope deformity and specific modifications of Lipid-A. In vivo transcriptional analysis and in vitro protein-DNA binding studies demonstrated that these modifications were dependent on the direct regulation of Lipid-A biogenesis and modifications of operons by the active phosphorylated CpxR~P isoform. Altogether, our work defines the regulatory mechanism that enables Cpx-signalling to actively control cell envelope remodelling and the permeability of antibiotics in the clinically relevant enteropathogen Y. pseudotuberculosis.

The impact of legal uncertainties on innovating HR practices in developing countries: a case study of remote work during the healthcare crisis in Kazakhstan’s technical gas industry

This study explores the influence of legal uncertainties on the process of innovating human resources (HR) practices in developing countries. Through a case study focused on introducing remote work within Kazakhstan’s Technical Gas Industry during a healthcare crisis, we examine the multifaceted challenges and opportunities that emerge when navigating a complex legal landscape. Our findings reveal that legal uncertainties, stemming from inadequacies in legislation and the tightness of norms, significantly impede the ability to adapt and modernize HR practices during crises. Furthermore, the criticality of the company’s position within the industry, combined with a low degree of legal enforcement, underscores the concept of ‘responsibilization’ among HR professionals. This phenomenon compels HR practitioners to assume greater responsibility and make strategic decisions that occasionally push the boundaries of existing laws and regulations. In this context, we propose a novel conceptualization of responsibilization, distinct from empowerment, as it involves embracing negative legal consequences associated with proactive decision-making during crises. This study contributes significantly to our understanding of how legal uncertainties influence the process of HR innovation in developing countries, highlighting the intricate interplay between regulatory frameworks, crisis management, and organizational transformation.

A "silent storm": uncovering the escalating crisis in mental healthcare for children and adolescents in Slovenia during and after the COVID-19 pandemic.

Our aim was to assess the burden of children and adolescents' mental health problems on the Slovenian outpatient healthcare system before, during and after the pandemic. In a retrospective analysis of healthcare indicators from 2008 to 2023, we analysed data from the National Institute of Public Health. Key domains included initial visits for mental and behavioural disorders (MBDs) to primary care for the population aged 0-19; the number of referrals to an initial assessment with a child and adolescent psychiatrist (CAP) at the secondary level for the population aged 0-17 along with the corresponding waiting times; and the number of urgent referrals for the population aged 0-17 to emergency mental health centres at the tertiary level. The calculations included rates per 1000 people. Descriptive statistics and diagrams were used to compare the data. Segmented linear regression analysis (SLR) was conducted on the primary healthcare data to identify the distinct temporal point indicating an increase. Comparing the average rates of the 2020-2022 period to those of the 2018-2019 period, there was a 20% increase in initial visits to primary care, a 23% increase in the referral rate to a CAP at the secondary level, and a 41% increase to the tertiary level of care. In secondary care, a four- to sevenfold increase in waiting times for the initial CAP assessment was observed between 2019 and 2023. The incidence of initial visits to primary healthcare services for MBD increased from 2008 to 2019 (average annual growth rate of 4.5%). The average annual growth rate for the 2020-2022 period tripled to 13.9%. The SLR showed that the trend of accelerating growth could have begun in 2017 for the 0-5 age group and possibly for the 15-19 age group as well. After the initial decline in 2020, all levels of the Slovenian healthcare system faced an increased burden of MBD in children and adolescents from 2021 to 2022 compared to pre-pandemic levels. Nevertheless, a portion of this increase aligns with longitudinal growing trends from 2008 onwards. Tackling the crisis requires urgent national action, significant improvement in organization, and investments in mental health.

Racism and Redlining in the History of Psychiatric Policy and Practice in Atlanta: Implications for Nursing.

Recently, the Georgia state House of Representatives passed House Bill 1013, also called The Mental Health Parity Act. The bill sought to address access to and insurance coverage for mental health services, first identified in a report in 2020. The budget for mental health services was reduced by $8 m in 2020, despite an all-time high demand due to the beginning of the Covid-19 pandemic. There is an increasing inability to secure mental health care in the state. Georgia is ranked 37th in the country for access to quality mental health care (Reinert, Fritze, and Nguyen, 2022) and half the counties in the state have no psychiatrist; the projected mental health workforce will be able to meet only 12% of consumer demand by 2025. Problems with mental health care in Georgia have a long history which intersects with the history of racism, geographical segregation, and policing. HB1013 does not consider any of this history in its recommendations, which barely include nursing. At the same time, policy and practice in Georgia continues to entangle nurses and other professionals with a carceral and punitive system which not only threatens the safety of patients, but also nurses themselves. Nurses need to understand this history if they hope to develop policy that will intervene in the mental health care crisis.

A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses

Introduction During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future. Aim The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors. Methods An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined. Results A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P < .01), poor teamwork (P = .02), more distress due to new circumstances (P < .01), more personal impact of how society responded to COVID-19 (P < .01), anticipation of negative future consequences (P < .01), and worse balance between family and work (P < .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%. Conclusion Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.

MASLD: What We Have Learned and Where We Need to Go-A Call to Action.

Since its introduction in 1980, fatty liver disease (now termed metabolic dysfunction-associated steatotic liver disease [MASLD]) has grown in prevalence significantly, paralleling the rise of obesity worldwide. While MASLD has been the subject of extensive research leading to significant progress in the understanding of its pathophysiology and progression factors, several gaps in knowledge remain. In this pictorial review, the authors present the latest insights into MASLD, covering its recent nomenclature change, spectrum of disease, epidemiology, morbidity, and mortality. The authors also discuss current qualitative and quantitative imaging methods for assessing and monitoring MASLD. Last, they propose six unsolved challenges in MASLD assessment, which they term the proliferation, reproducibility, reporting, needle-in-the-haystack, availability, and knowledge problems. These challenges offer opportunities for the radiology community to proactively contribute to their resolution. The authors conclude with a call to action for the entire radiology community to claim a seat at the table, collaborate with other societies, and commit to advancing the development, validation, dissemination, and accessibility of the imaging technologies required to combat the looming health care crisis of MASLD.

A Cohort Study of Lt. Col. Luke J. Weathers VA Medical Center Patients with Positive FIT and Incomplete GI Evaluation during the COVID-19 Pandemic.

The reasons for and incidence of delay in screening colonoscopies during the coronavirus disease 2019 (COVID-19) pandemic are of major public health interest. The risks and reasons for delay likely vary between public and private institutions. This research sought to analyze data regarding the completion of screening colonoscopies after a positive fecal immunochemical test (FIT) before and during the COVID-19 pandemic and the reasons for a delay in obtaining these results at the Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center. The goals were to evaluate the institutional resilience and analyze the problems associated with this major healthcare crisis. This closed cohort study included all positive FITs from our local Veterans Affairs (VA) medical center from October 2019 to January 2020 and July 2020 to May 2021. A total of 115 VA patients with a positive FIT prepandemic and 157 VA patients with a positive FIT during the pandemic were included. Completion rates within 180 days were measured, and charts were reviewed to identify the reasons for lack of completion. Both community and local VA procedures for veterans were included. Univariate and multivariable analyses were applied to calculate odds ratios (ORs). The Pearson χ2 test was applied to calculate P values. VA patients' percentage of timely completion was lower pre-COVID-19 than it was during the pandemic, and the percentage of delayed completion was higher pre-COVID-19 than it was during the pandemic. Comparing patients who completed a colonoscopy with those who did not, increasing age had an OR of 0.947 (95% CI 0.920-0.975), and White race had an OR of 0.504 (95% CI 0.291-0.873). Evaluating delays in colonoscopy completion, VA colonoscopies versus referral to the community had an OR of 4.472 (95% CI 1.602-12.483), and pre-COVID-19 completion versus during COVID-19 had an OR of 4.663 (95% CI 1.727-12.594) with multivariable logistic regression. There was a statistically significant increase in timely colonoscopy completion during the study period when compared with the pre-COVID-19 period. The completion rate was higher at the Lt. Col. Luke Weathers, Jr. VA Medical Center than a large population average in 2020, possibly related to community colonoscopies and an aggressive case management system. In addition, increasing age and White race were associated with decreased colonoscopy completion. Predictors of an increased delay in colonoscopy completion included a pre-COVID-19 positive FIT and colonoscopies performed within the VA rather than being referred to providers in the community. A common reason for delay in all of the groups was patients declining intervention and delay/lack of referral.

The Growing Cybersecurity Crisis in Healthcare: A Call to Action

Electronic healthcare technology is pervasive throughout the globe, and it affords vast opportunities to enhance clinical outcomes, as well as for the transformation of models of care. Concerns are, however, growing, related to healthcare data and device security. Increased connectivity to legacy computer networks brought cybersecurity vulnerabilities for medical devices. Healthcare represents an attractive target for cybercrime because healthcare data is precious. This sector in present times is full of unique cybersecurity challenges, especially for susceptible kinds of patient information at stake. Second, many legacy systems will be prevalent—not adding more to that—with the changing face of cyber threats. Cybersecurity breaches have comprised stealing health information and focused ransomware attacks on hospitals; this could mean as vivid an attack as on implanted medical devices. This only points to the fact that ransomware attacks and other kinds of cyber-attacks against hospitals and other medical facilities are gaining ground; there is every reason to get alarmed and put in place stricter cybersecurity measures. An excellent healthcare cybersecurity strategy, therefore, has to consider access control, intrusion detection systems, encryption techniques, and periodic security testing. Data breaches and cyber-attacks are forcing any healthcare provider to invest in new state-of-the-art technologies related to keeping pace with trends regarding cybersecurity. The dangers that can be caused by cyber-attack include a considerable diminution in patient trust, potential health system collapse, human life threats, etc. On the whole, cybersecurity is strenuously linked with the question of patient safety.

Hemato-oncology services and COVID-19 Pandemic: The experience of Kazakhstan

Abstract Objectives The COVID-19 pandemic in Kazakhstan disrupted numerous healthcare services, including those critical for hemato-oncology patients, due to the strained healthcare system. This study examines how the COVID-19 pandemic has affected access to hemato-oncology healthcare services in Almaty, Kazakhstan. Methods We retrospectively analyzed patient data from two tertiary centers, City Clinical Hospital 7 (H7) and Kazakh Institute of Oncology and Radiology (KazIOR), from March 1, 2019, to February 28, 2022. Variables included age, gender, residence, hospitalization rate, treatment outcomes (discharged/deceased/transferred), diagnoses (acute leukemia, lymphoproliferative diseases, myeloproliferative diseases), and referral sources. The Statistical Yearbook of Kazakhstan provided comparative data. Results From 2019-2022, 6,763 hemato-oncology hospitalizations were registered: 3,583 in H7 and 3,180 in KazIOR. The mean age was 55.04 (SD = 16.07) for females and 51.2 (SD = 16.7) for males. Urban and rural patient proportions were 6,191 (92%) and 571 (8.4%), respectively (Chi-square 13.8, P = 0.001). Fewer patients were discharged in 2020-2021 (n = 2,047) compared to 2019-2020 (n = 2,387) and 2021-2022 (n = 2,081) (Chi-square 20.09, P = 0.003). The death rate was higher in 2020-2021 (3.5%) than in 2019-2020 (3.2%) and 2021-2022 (2.6%) (Chi-square 20.09, P = 0.003). Emergency admissions were 403 (19%) in 2020-2021, 368 (14.8%) in 2019-2020, and 394 (18.3%) in 2021-2022 (Chi-square 2,231, P < 0.001). Transfers from other hospitals increased by 12.4% in 2020-2021. Conclusions The COVID-19 pandemic negatively impacted access to hemato-oncology services, increasing mortality. Further studies are needed to understand the factors affecting hospitalization and mortality trends during healthcare crises. Funding: Grant No. AP09260497. Key messages • Access to healthcare services during COVID-19 pandemic for hemato-oncology patients. • Impact of the pandemic on access to healthcare.

The primary healthcare workforce crisis: a comparative assessment of the European region

Abstract Background The healthcare workforce crisis strongly affects the primary healthcare sector, worsening the work conditions of healthcare workers and hampering service delivery and health system resilience. This study introduces a health system and governance approach to identify transformative capacities in health system contexts. Methods A qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England. Results Our findings reveal both convergence and pronounced diversity across the healthcare systems, with none fully aligning with the ideal attributes of primary healthcare suggested by WHO. However, across all categories, Denmark and the Netherlands, and to a lesser extent also Kazakhstan, depict closer alignment to this model than the other countries. Workforce composition and skill-mix vary strongly, while disparities persist in education and data availability, particularly within Social Health Insurance systems. Policy responses and interventions span governance, organisational, and professional realms, although with weaknesses in the implementation of policies and a systematic lack of data and evaluation. The WHO primary healthcare model only marginally informs policy decisions, but it may receive some more attention in Kazakhstan. Conclusions We conclude that aligning primary healthcare and workforce considerations within the broader health system context may help move the debate forward and build governance capacities to improve resilience in both areas. Speakers/Panelists Tiago Correia NOVA IHMT, Lisbon, Portugal Viola Burau Aarhus University, Aarhus C, Denmark Marius-Ionuț Ungureanu Babeș-Bolyai University, Cluj-Napoca, Romania Anna Sagan WHO European Centre for Primary Health Care, Almaty, Kazakhstan

A Woman’s Right to Know: State Abortion Law and the Due Process Fair Notice Requirement

When the Supreme Court overturned Roe v. Wade in 2022, the loss of reproductive freedom was not the only health care crisis created by the Court. Across the country, people with chronic conditions, including autoimmune disease, were unable to access their prescription medication after abortion bans imposed restrictions on abortion-inducing drugs. Texas’s state medication abortion law, the Woman’s Right to Know Act, may prevent those with disabilities from accessing lifesaving medication with abortifacient properties. This unintended consequence puts health care professionals such as doctors and pharmacists at risk of legal liability for simply prescribing the best course of treatment. This Note argues that the Woman’s Right to Know Act has left health care professionals unable to understand what conduct is prohibited and provides too much discretion to law enforcement, rendering the law unconstitutionally vague. Clarifying the law and prohibiting provider liability is in the best interests of both patients and providers and will allow health care professionals to continue their work to protect patient health.

A Privacy Perspective in Adopting Smart Contract Applications for Healthcare

ABSTRACT Smart contract applications are currently implemented in healthcare, but further research is needed to investigate their adoption by embracing a privacy perspective. This study fills this research gap by exploring smart contracts’ adoption in healthcare through a privacy calculus model integrated with technical, legal, and social factors. The authors explore two specific applications: smart contracts implementing immune certificates (SC-ICs) to fight a healthcare crisis and smart contracts encoding and storing electronic health records (SC-EHRs) in the absence of such a crisis. Data are collected through a survey, and partial least square modeling is used to test the research hypotheses. The results provide significant contributions for academics and practitioners by showing how the influence of technical, legal, and social factors on privacy evaluations and privacy calculus evaluations themselves differ in the case of different applications of the same technology, i.e. SC-ICs and SC-EHRs because of the peculiar healthcare scenario.

Examining Psychological Well-Being and Predictors of Burnout in Registered Nurses (RNs) Employed in Rural Acute Care Settings

This mixed-methods study examined the psychological well-being of registered nurses (RNs) working in a rural, acute care setting. The study used four instruments that measured anxiety, depression, stress, and burnout to determine psychological well-being. Data collection also included a demographic questionnaire and two open-ended questions. The quantitative findings of this mixed-methods study will be shared. The results found that participants experienced burnout, anxiety, depression, and stress. Using a post-pandemic lens this manuscript will discuss necessary traits that can be used by nurse leaders to initiate change, make improvements, and effectively prepare for the next healthcare crisis.

Adapting Efficiency Analysis in Health Systems: A Scoping Review of Data Envelopment Analysis Applications During the COVID-19 Pandemic.

Objective: To synthesize the current evidence base concerning the application of Data Envelopment Analysis (DEA) in healthcare efficiency during the COVID-19 pandemic using a scoping review of 13 primary studies. Methods: We consulted databases including Web of Science (WoS) and Scopus, as well as manual search entries up to September 2022. Included studies were primary applications of DEA for assessing healthcare efficiency during the COVID-19 pandemic. Key findings derived from thematic analysis of repeating pattern observations were extracted and tabulated for further synthesis, taking into consideration the variations in DMU definitions, the inclusion of undesirable outputs, the influence of external factors, and the infusion of advanced technologies in DEA. Results: The review observed a diverse application of DMUs, ranging from healthcare supply chains to entire national health systems. There was an evident shift towards incorporating undesirable outputs, such as mortality rates, in the DEA models amidst the pandemic. The influence of external and non-discretionary factors became more pronounced in DEA applications, highlighting the interconnected nature of global health challenges. Notably, several studies integrated advanced computational methods, including machine learning, into traditional DEA, paving the way for enhanced analytical capabilities. Conclusions: DEA, as an efficiency analysis tool, has exhibited adaptability and evolution in its application in the context of the COVID-19 healthcare crisis. By recognizing the multifaceted challenges posed by the pandemic, DEA applications have grown more comprehensive, integrating broader societal and health outcomes. This review provides pivotal insights that can inform policy and healthcare strategies, underscoring the importance of dynamic and comprehensive efficiency analysis methodologies during global health emergencies.

A randomized clinical trial of emotional freedom techniques for chronic pain: Live versus self-paced delivery with 6-month follow-up.

Chronic pain represents a major global healthcare crisis, and current treatments are limited in effectiveness and safety. Emotional freedom techniques (EFTs) show promise as a potential psychological treatment. The current study investigated the effect of a randomized clinical trial of EFT for chronic pain in a sample of 147 adult chronic pain sufferers (89.9% female; mean 54.63 years). Participants engaged in a 6-week EFT programme (either online self-paced or in-person). The per-protocol analysis indicated pain severity and interference scores were significantly lower at the end of treatment for the EFT group compared to waitlist, and these were sustained at follow-up. There were no differences between the in-person or self-paced programmes at follow-up for pain severity and interference. Somatic symptoms were significantly lower after EFT, although no further differences at follow-up. Quality of life scores were significantly higher after EFT, which were sustained at follow-up, and no differences between two styles of programme. No significant effects were found for anxiety, depression, happiness or satisfaction with life across the 6-week programmes for either style of delivery or at follow-up. These are discussed in terms of clinical score meanings. Intent-to-treat analysis was consistent with the per-protocol analyses. Limitations of the study are identified and future directions are discussed. Findings offer early promise for EFT as a potentially effective pain management strategy, as well as support for online intervention without compromising treatment outcomes. An emerging body-based intervention for chronic pain may be a possible solution for remote clients who cannot attend in-person sessions. In this clinical trial Emotional Freedom Techniques (EFT) significantly reduced chronic pain severity and interference, and there were no differences between and online self-paced program toan online in-person EFT intervention. Both were equally effective, also enhancing quality of life without compromising outcomes. The results were significant at 6-month follow-up/. These findings highlight a body-based approach as a promising, accessible pain management strategy, and highlights that online programs may be part of the solution for chronic pain patients.

Incidence of Medication Errors and Most Common Drugs Involved during Management of Isolated Patients with COVID 19 in an Egyptian General Hospital

Abstract Background The second wave of the COVID-19 pandemic presented significant challenges to healthcare systems worldwide. This retrospective cohort study aimed to investigate incidence and type of medication errors among patients isolated in an Egyptian general hospital during the early months of 2021. Methods A total of 468 patient records were reviewed for medication errors. Data collection included patient demographics, comorbidities, admission details, and clinical pharmacist data. Medication errors were categorized based on ordering, administration, and monitoring processes. Statistical analysis included descriptive statistics, and visual representations of key variables. Results A total of 934 medication errors were found with a prevalence of 42 per 100 patient days and almost 2 errors per patient. All participants experienced drug therapy problems, with the most prevalent issues related to dosing regimen (31%), needs drugs (27%), and monitoring (18%). The main drugs involved in medication errors were anticoagulants (17.6%), antibiotics (12.3%), corticosteroids (10%) and antiviral drugs (9%). Conclusion This study highlights the very high incidence of medication errors among COVID-19 patients during the second wave of the pandemic. The main issues were related to “dosing regimen”, “needs a drug” and “needs monitoring”. Also, the main drug groups involved in theses errors were anticoagulants and antibiotics, followed by corticosteroids and antiviral drugs. Recommendations Addressing medication errors, especially in critical care settings, is crucial for improving patient safety and outcomes. Future interventions should focus on enhancing healthcare professionals' knowledge and communication, particularly in high-stress environments like ICUs. These findings can guide healthcare practice improvements and enhance patient care during pandemics and other healthcare crises.

The burden of neurological diseases in conflict settings: Narrative review Gaza situation

Neurological disorders present formidable challenges, particularly in conflict zones, where access to healthcare is severely restricted. This review examines the profound impact of neurological diseases, including traumatic brain injury (TBI), Alzheimer’s disease, epilepsy, Parkinson’s disease, and post-traumatic stress disorder, on individuals in conflict zones, with a focus on the situation in Gaza. Amidst the ongoing conflict, Gaza faces significant health crises exacerbated by limited access to medication, rehabilitation, and healthcare services due to infrastructure destruction and resource constraints. Traumatic head injuries, a hallmark of conflict, impose immense strain on the healthcare system, and blast-related TBIs are prevalent. This review underscores the critical need for immediate action to address the healthcare crisis in Gaza, including prioritizing ceasefires, strengthening healthcare facilities, providing specialized training for healthcare professionals, and ensuring continued international aid and support. Failure to act promptly exacerbates suffering and increases the likelihood of permanent disabilities and psychological damage, emphasizing the urgency of the situation.

Building Relationships, Forming Collaborations: Lessons Learned From an Unconference Seeking to Cultivate Solutions in Healthcare.

Calls for a 'major rethinking' of the delivery of healthcare services are echoed across Canada as the healthcare crisis continues. Proposed strategies to address the challenges of this crisis include: a transdisciplinary approach that is patient-focused and community-based; a representative team composed of patients, caregivers, healthcare providers, decision makers and policymakers; and authentic collaboration among stakeholder groups throughout the research cycle. This study aimed to enable community members to take on a leading role in building capacity and to provide a space for discourse among diverse groups while respecting community wisdom, values and priorities. The Collaborative Health Research Institute of Southern Alberta (CHRISA) organized a participant-oriented Unconference event to address the factors contributing to the healthcare crisis in Alberta, Canada. An Unconference is a participant-oriented meeting where the attendees nominate the topics, agree on the agenda and lead the sessions. This article describes the Unconference programme and presents the findings from a thematic analysis of the discussion notes from breakout sessions, feedback from participants (i.e., lessons learned) and pragmatic recommendations for future Unconference events. Findings from sessions included the following: (1) identifying the 'wicked' problems, (2) the factors/causes contributing to each problem (i.e., contributors) and (3) potential multifaceted solutions or ideas to remedy the problem. Lessons learned from the postevent evaluation resulted in six recommendations for organizing future Unconferences. The CHRISA Unconference achieved its goals by providing a venue for attendees to connect, engage and network on topics of interest, explore new ways of addressing challenges in healthcare and serve as a foundation for future initiatives and collaborations in healthcare research and practice. The Unconference was attended by community members who identify as patients, frontline workers, programme administrators and representatives of public organizations and agencies. Participants contributed to breakout session discussions, provided feedback on the Unconference and offered recommendations for future events. The co-authors are service users, people with lived experience or those work in the healthcare setting; they have been involved in data collection, analysis and interpretation, and contributed to this report.

Professional quality of life among Israeli social workers in hospitals and a health maintenance organization (HMO) during the COVID-19 pandemic.

We examined differences between social workers in hospitals versus social workers in community health services regarding levels of professional quality of life (ProQoL), proximity to COVID-19, resilience, perceived social support, and preparedness for the next pandemic during waves 3-5 of the COVID-19 pandemic in Israel (December 2020-December 2021, the main COVID-19 variants were Alpha and Delta). We also examined the moderating role of resilience, social support, preparedness for the next pandemic, and health care service type in the association between proximity to COVID-19 and ProQoL. Participants were 163 social workers from four hospitals and 98 social workers from a major health maintenance organization in the community. Social workers in both settings revealed moderate-high levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. The study's model indicated that after controlling for the effects of the covariates, higher levels of self-reported-resilience and greater perceived organizational support were associated with higher compassion satisfaction and lower burnout and secondary traumatic stress. Furthermore, a stronger sense of preparedness for the next pandemic was related to lower levels of burnout. The model indicated that the effects of organizational support, informal social support, and preparedness on compassion satisfaction were dependent on the study group (i.e., working in hospital or community settings). Findings indicate that intervention programs should be implemented to help increase compassion satisfaction and prevent/reduce burnout and secondary traumatic stress among social workers in health care settings during health care crises. Enhancing resilience and preparedness should focus not only on the social workers as individuals but also on the institutions for which they work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In silico investigation of HCV and RNA synthesis inhibitor antibiotic drugs as potential inhibitors of SARS‑CoV‑2 main protease (Mpro)

BackgroundSince December 2019, a global crisis has unfolded with the emergence of a new strain of coronavirus known as SARS-CoV-2. This pandemic has afflicted hundreds of millions of people worldwide, resulting in millions of fatalities. In response to this urgent healthcare crisis, extensive efforts have been made to discover inhibitors of the COVID-19 virus. Given the structural similarities between SARS-CoV-2 and HCV, drugs approved by the FDA for treating HCV were selected and subjected to in silico testing against the SARS-CoV-2 virus, with Remdesivir used as the standard for validation. Drug repurposing and phytochemical testing have also been conducted to identify potential candidates capable of inhibiting or suppressing the infection caused by the coronavirus. The time constraints imposed by the pandemic necessitated the in silico analysis of existing drug molecules against the coronavirus. Eleven HCV drugs approved by the FDA, along with one RNA synthesis inhibitor antibiotic drug, were tested using the in silico method due to their structural similarities with HCV and the SARS-CoV-2 virus.ResultsMolecular docking and MD simulation studies were performed for all selected compounds. Binding energies, root-mean-square deviation, root-mean-square fluctuation, solvent-accessible surface area, radius of gyration, and molecular mechanics generalized born surface area were calculated. Based on docking and MD simulation studies all the selected compounds have shown good binding energy values with Mpro (PDB ID: 6LU7). No toxicity measurements are required for these drugs since they were previously tested prior to their approval by the FDA.ConclusionsThis study shows that FDA-approved HCV drugs can be used as for SARS-COVID-19 inhibitors.