Multidisciplinary Health Care Research Articles

Psychological PPE – Reflections on How to Implement Mindful Interventions to Protect the Healthcare Workforce

Interest in Mindfulness-based interventions (MBIs) with healthcare professionals has become increasingly popular. However, healthcare professionals’ busy schedules and low help-seeking behaviour requires the intervention to be easily accessible, convenient, and practical. This paper explores the reflections of multidisciplinary healthcare professionals regarding implementing a brief online MBI to draw on lessons learned that could guide future implementation and interventions in similar multicultural, resource-constrained settings. An online MBI was implemented with healthcare professionals (HCPs) working in urban and rural hospitals in South Africa during the first wave of Covid-19. Fifty-five healthcare professionals from various disciplines participated in a four-week online training programme via the Zoom platform. Participant reflections and feedback were collected via WhatsApp and Zoom room chats. The data collected were thematically analysed. Reflections from the implementation of the MBI were classified into questions of where, when, who, what, why, and how. The results reflect that a four-hour online mindfulness-based intervention could work more effectively if departments offered and supported the programme during work hours. The findings also reveal the greater potential for a brief online MBI to enhance resiliency in HCPs, especially during a pandemic emergency, as demonstrated in the study. The study proposes that mindfulness training could be offered to HCPs at many levels to help with psychological first aid and task shifting to reduce stress and prevent burnout.

Health-Promoting Behaviors among Older Adults with Noncommunicable Diseases in Rural and Urban Areas during the New Normal Post-COVID-19 Era: A Structural Equation Modeling Analysis.

This study aimed to develop and test a causal relationship among perceived self-efficacy (PSE), health literacy (HL), access to COVID-19 preventive material (ACPM), social networks (SN), and health-promoting behaviors (HPBs). Multistage stratified random sampling was used to recruit 250 older adults with noncommunicable diseases (NCDs) from Thai urban and rural communities. The data were collected with self-reported questionnaires. Data analyses used descriptive statistics and structural equation modeling. The results indicated that participants in urban communities had higher PSE, ACPM, HL, SN, and HPBs than rural participants. The fitness parameters of the modified model (χ2 = 71.936, df = 58, p-value = 0.103, χ2/df = 1.240; root mean square error of approximation (RMSEA) = 0.031; standardized root mean square residual (SRMR) = 0.042; goodness of fit index (GFI) = 0.964; normed-fit index (NFI) = 0.964; comparative fit index (CFI) = 0.993) indicated its suitability as the research model. HPBs were directly positively influenced by PSE (β = 0.40, p < 0.001), ACPM (β = 0.24, p < 0.001), HL (β = 0.19, p < 0.01), and SN (β = 0.01, p < 0.05). Therefore, taking all predicting variables together could explain 81.0% of the variance in HPBs. Multidisciplinary healthcare teams could use these findings to establish proper interventions or healthcare activities to increase HPBs among older adults, particularly in this era of the “new normal”.

Implementation of Molecular Autopsy for Sudden Cardiac Death in Japan - Focus Group Study of Stakeholders.

We assessed the awareness of multidisciplinary healthcare professionals of the challenges related to implementation of molecular autopsy (MA) for sudden cardiac death (SCD) among children and young adults.Methods and Results: We conducted 11 focus groups with 31 multidisciplinary healthcare professionals, and categorized them into 2 themes: values, and challenges of MA implementation. The participants recognized 2 different values of MA: discovering the unknown cause of SCD, and SCD prevention among family members of victims. The coexistence of these values makes the MA process and role of professionals more complex. Participants were concerned about the psychological burden for bereaved family members and mentioned challenges in each process of the MA delivery system: obtaining consent, cause of death investigation, disclosing results, and preventive intervention. MA is a valuable procedure both in terms of forensic and preventive medicine. However, the dual meanings and complex characteristics of genetic information is a potential source of concern and confusion among healthcare professionals as well as bereaved family members. Increasing awareness among healthcare professionals of the MA process is essential for connecting all related areas of expertise.

Differences in urban and suburban/rural settings regarding care provision and barriers of cancer care for older adults during COVID-19.

Care for older adults with cancer became more challenging during the COVID-19 pandemic, particularly in urban hotspots. This study examined the potential differences in healthcare providers' provision of as well as barriers to cancer care for older adults with cancer between urban and suburban/rural settings. Members of the Advocacy Committee of the Cancer and Aging Research Group, with the Association of Community Cancer Centers, surveyed multidisciplinary healthcare providers responsible for the direct care of patients with cancer. Respondents were recruited through organizational listservs, email blasts, and social media messages. Descriptive statistics and chi-square tests were used. Complete data was available from 271 respondents (urban (n = 144), suburban/rural (n = 127)). Most respondents were social workers (42, 44%) or medical doctors/advanced practice providers (34, 13%) in urban and suburban/rural settings, respectively. Twenty-four percent and 32.4% of urban-based providers reported "strongly considering" treatment delays among adults aged 76-85 and > 85, respectively, compared to 13% and 15.4% of suburban/rural providers (Ps = 0.048, 0.013). More urban-based providers reported they were inclined to prioritize treatment for younger adults over older adults than suburban/rural providers (10.4% vs. 3.1%, p = 0.04) during the pandemic. The top concerns reported were similar between the groups and related to patient safety, treatment delays, personal safety, and healthcare provider mental health. These findings demonstrate location-based differences in providers' attitudes regarding care provision for older adults with cancer during the COVID-19 pandemic.

A preliminary study to evaluate the impact of pharmaceutical care services on clinical outcome and medication adherence in type 2 diabetes mellitus patients from Ethiopian perspective.

The role of clinical pharmacist in hospital settings of Ethiopia is still new and infant. To evaluate the impact of pharmaceutical care on clinical outcome and medication adherence in type 2 diabetes mellitus (T2DM) patients. A single cantered, pre-post interventional study design was carried out by enrolling 100 uncontrolled T2DM patients from March 1-August 30, 2020. The intervention package included assessment of pharmacological and non-pharmacological needs, counselling patients in person at the clinic, and providing educational materials. Of the 100 patients initially enrolled, 87(87%) completed the follow-up and included in the final data analysis. The intervention showed a decrease in average FBG, systolic blood pressure (SBP), low density lipoprotein cholesterol (LDL-C) by 47.3 mg/dL, 22.6mmHg and 31.4mg/dL, while high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) exhibited significant increase by 13.4 mg/dL and 11.5 ml/min/1.73m2 respectively (p<0.0001). In addition, diastolic blood pressure, lipid values, kidney function parameters, and liver function parameters showed significant decrease in post intervention compared to pre-intervention (p<0.05). Medication adherence of the patients increased significantly at 6-month follow-up (p<0.001). These results also suggest the benefits of integrating clinical pharmacist services in multidisciplinary healthcare teams and diabetes management in Ethiopia.

Inclusion of Naturopaths in Northern Ontario Primary Care: A Proposed Solution for The Health Human Resources Shortage

The shortage of primary healthcare practitioners, such as physicians and nurses, in northern Ontario has persisted fordecades despite multiple strategies to address it. Poor health outcomes for people living in northern Ontario must be viewed through an equity lens that takes into account the multiple proximal, intermediate, and distal social determinants of health, including, but not limited to, the impact of colonization and continued colonialism on the health of Indigenous Peoples, challenges in housing, education and employment, as well as lack of food security. The increase in chronic health conditions in northern Ontario and the need for interprofessional healthcare teams that offer patient-centred care are key issues. Whole person care that takes into consideration the integration of body, mind, and spirit is central to Indigenous concepts of health and wellness, as well as being central to the foundations of naturopathic medical philosophy. Inclusion of naturopathic doctors in publicly funded multi-disciplinary primary healthcare settings is proposed as an achievable strategy to fill gaps in health human resources and advance the movement towards holistic care for Indigenous Peoples and others living in northern Ontario.

What are we aiming for? Exploring tensions in healthcare provider perspectives on and communications about eating disorder recovery

Eating disorder recovery is differently understood in multi-disciplinary healthcare contexts. In this study, we sought to better understand how healthcare providers (HCPs) describe recovery and communicating about recovery. We conducted an anonymous, online, qualitative survey with 41 eating disorder HCPs. In their responses, HCPs noted that communicating about recovery was core to their practice of establishing collaboration and communication with clients, as well as enabling “realistic hope” in clinical encounters. Recovery was described as related to the concept of attaining “normalcy” in life. We identified several tensions across HCP accounts, including what “normalcy” might look like, differences in the role of diagnostic and other contextual factors in determining recovery and different perspectives on how symptom remission figures in recovery. Our findings suggest that attending to differences in communication about recovery is an important direction for eating disorders research and treatment.

The role of pharmacist in guiding the pharmacy clients towards pharmaceutical preparations use

AbstractObjectivesPharmacist-client communication is one of the most significant relationships in the healthcare delivery system. Our study aims to assess the active role of the pharmacist in educating and guiding pharmacy clients who are receiving over-the-counter and/or pharmaceutical preparations properly and safely.MethodsThis study follows the descriptive and analytical approach by adapting the questionnaire instrument; the questionnaire was distributed through the Internet and the online survey using Google Forms was based on a quantitative measurement to estimate the independent and the dependent variables.Key findingsThe obtained data confirmed that there are statistically significant effects related to the pharmacist interaction skills (pharmacist’s trust, integrity, responsiveness and empathy) on guiding the consumers in taking medicines and pharmaceutical preparations effectively and safely.ConclusionsThe pharmacist’s role as a medications expert and member of multidisciplinary healthcare professional team must work in tandem with other healthcare professionals to guard the client’s safety and achieve good therapeutic outcomes.

Perfil do médico que atua em cuidados paliativos no Brasil

Abstract Palliative care is a multidisciplinary health care model that seeks to provide comfort to patients with life-threatening or severe and terminal illness. Palliative medicine has only recently been recognized in Brazil, and it is essential that physicians working in this area develop their knowledge. Thus, to improve training models in palliative care and in medical education in Brazil, we must understand the characteristics of this professional, identifying sociodemographic profile, professional training, and work activity. This is a cross-sectional, descriptive, and exploratory study, with a quantitative approach. Data were collected from a national survey conducted by means of questionnaires applied to palliative care physicians in Brazil.

Geriatrics communication skills training program for oncology healthcare providers to improve the management of care for older adults with cancer.

We evaluated the feasibility, acceptability, and preliminary efficacy of a novel intervention, the Geriatric Communication Skills Training Program (Geriatric Comskil Training) for multidisciplinary healthcare providers (HCPs). Three 2-h modules comprised the training: Geriatrics 101, Cognitive Syndromes, and Shared Decision-Making. Modules consisted of didactic knowledge, exemplary videos, and experiential learning role plays with standardized patients. We collected pre- and post-training data from 11 HCPs (module evaluations, self-efficacy, communication skills uptake in interaction with standardized patients, perceived ageism) and 44 patients (perceived HCP empathy, satisfaction with HCP communication). HCPs rated all modules high, with over 90% agreement on all course evaluation items assessing involvement, critical thinking, and reflectiveness, and significant improvements in self-efficacy. HCPs demonstrated an uptake in communication skills from pre- to post-training in agenda setting and overall skill use and reported promising trends towards lower ageism scores (d = 0.58). Promising trends in patient-reported HCP empathy (d = 0.39) and satisfaction with communication (d = 0.29) emerged from pre- to post-training. Continued efforts are needed to strengthen HCP education related to geriatric communication across the cancer continuum. The Geriatric Comskil Training demonstrated feasibility, acceptability, and increases in self-efficacy and communication skills uptake for HCPs.

IWII Wound Infection in Clinical Practice consensus document: 2022 update

Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clinical Practice consensus document. The updated document summarises current evidence and provides multidisciplinary healthcare providers with effective guidance and support on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII-WIC) and management plan. The aim of the 2022 IWII consensus document update was to provide an accessible and useful clinical resource in at least six languages, incorporating the latest evidence and current best practice for wound infection and prevention. Dissemination techniques for the consensus are discussed and highlighted.

A Cost-Effectiveness Analysis of Prehabilitation for High-Risk Surgical Patients in Canada: Results from a Nonrandomized Clinical Trial

<h3>Research Objectives</h3> To evaluate the cost-effectiveness of a pragmatic model of prehabilitation for high-risk surgical candidates from a hospital perspective. <h3>Design</h3> A cost-effectiveness analysis (CEA) from a hospital perspective was performed using data from a nonrandomized clinical trial of a pragmatic model of prehabilitation compared to usual care (UC) for high-risk surgical patients. <h3>Setting</h3> A large academic hospital in Toronto, Ontario, Canada. <h3>Participants</h3> High-risk surgical candidates referred by their physician at the time of surgical planning. <h3>Interventions</h3> The prehabilitation group underwent baseline assessments from a multidisciplinary healthcare team followed by shared-decision making concerning allocation to facility-based, home-based, or virtual prehabilitation. Prehabilitation modalities included individualized exercise, nutrition, psychological support, and smoking cessation over the preoperative period. The control group received UC. <h3>Main Outcome Measures</h3> The primary endpoint was an incremental cost-effectiveness ratio (ICER) with surgical complications as the effect measure. Nonparametric bootstrapping methods were employed to investigate the joint distribution of incremental costs and incremental effects, estimate ICER uncertainty, and generate cost-effectiveness acceptability curves (CEACs). Results were presented for overall prehabilitation and stratified by each prehabilitation delivery strategy. <h3>Results</h3> Sixty-seven patients were included (prehabilitation n=49; UC n=18). Prehabilitation was associated with averting more surgical complications but came at greater costs compared to UC. Results indicate the potential cost-effectiveness of prehabilitation for reducing surgical complications, although data limitations and point-estimate uncertainty preclude conclusive recommendations. When stratified by prehabilitation delivery strategy, estimated cost-effectiveness varied considerably, and beckon future research to clarify economically optimal prehabilitation protocols within an implementation context. <h3>Conclusions</h3> This was the first CEA of a pragmatic model of prehabilitation for high-risk surgical patients, contributing an increasingly relevant economic perspective regarding the potential role of prehabilitation implementation from a hospital perspective. Future economic evaluations of prehabilitation are necessary to clarify optimal prehabilitation protocols and definitively inform implementation decisions. <h3>Author(s) Disclosures</h3> No disclosures.

A Comparison Between the Rates of Radiation Oncologist and Urologist Consultations in Men Diagnosed With Prostate Cancer in Northern Ontario, Canada

PurposeRecommendations from Cancer Care Ontario stress the importance of multidisciplinary care from radiologists and urologists for prostate cancer treatment. The present study sought to examine what percentage of patients had a consultation with a radiation oncologist before undergoing a radical prostatectomy in Ontario, Canada, between 2010 and 2019. Methods and MaterialsAdministrative health care databases were used to analyze the number of consultations billed to the Ontario Health Insurance Plan from radiologists and urologists who treated men with a first prostate cancer diagnosis (n = 22,169). ResultsIn Ontario, 94.70% of Ontario Health Insurance Plan billings for patients with prostate cancer who had a prostatectomy within 1 year of a prostate cancer diagnosis were from urology, and 37.66% and 1.77% of billings were received from radiation oncology and medical oncology specialties, respectively. When sociodemographic variables were examined, having a lower neighborhood income (adjusted odds ratio [aOR], 0.69; confidence interval [CI], 0.62-0.76) and a rural residence (aOR, 0.72; CI, 0.65-0.79) were associated with lower odds of receiving a consultation from a radiation oncologist. When billings for consultations were examined geographically by region, Northeast Ontario (Local Health Integrated Network 13) had the lowest odds of receiving a radiation consultation compared with the rest of Ontario (aOR, 0.50; CI, 0.42-0.59). ConclusionsThe results of this study show that differences in equitable access to multidisciplinary health care exist for men with a first prostate cancer diagnosis who reside in more northern and rural regions within Ontario, relative to the rest of the province. The reasons for these findings are likely multifactorial and may include factors such as patient treatment preference and distance/travel to receive treatment. However, as diagnosis year increased, so did the chances of receiving a radiation oncologist consultation, and this upward trend may reflect the implementation of Cancer Care Ontario guidelines.

Relationships between job satisfaction, organizational commitment, burnout and job performance of healthcare professionals in a district-level health care system of Shenzhen, China.

Existing research indicates that job satisfaction has effects on job performance, but little evidence exists about the mechanism through which the satisfaction-performance association operates. This study aims to examine the effect of job satisfaction on job performance in a district-level health care system of China and to explore the effect mechanism mediated by organizational commitment and burnout. Cluster sampling was used in this study. All healthcare professionals in the Nanshan Medical Group, who were at work in the last 3 months and able to complete online questionnaire independently were invited to participate the anonymous online survey. Job satisfaction, organizational commitment, burnout and job performance were measured by tools, which have been validated in China. Descriptive statistics were used for the socio-demographic variables and the four job psychological variables. Pearson correlation coefficients was used to determine associations among each of the psychological variables. Linear regression was used to examine association between job performance and other three psychological variables. PROCESS macro was used to examine the mediation effects of organizational commitment and burnout on the association between job satisfaction and performance. In total, 1,200 healthcare professionals completed the anonymous online survey. Job satisfaction, organizational commitment, and job performance were positively correlated with one another, with burnout negatively correlated with them. Linear regression revealed that demographic characteristics, job satisfaction, organizational commitment, and burnout explained 5, 6, 2, and 9% of the variance in job performance. Path analysis showed that the coefficient of the direct effect of job satisfaction on job performance was 0.18, the coefficients of the indirect effects of job satisfaction on job performance through organizational commitment and burnout were 0.17 and 0.37, respectively. The coefficients of the indirect effects of organizational commitment on job performance through burnout was -0.04, but it was not significant. It is promising to improve job performance of providers in Chinese healthcare systems by improving job satisfaction and reducing burnout. Tailored support policies for female healthcare professionals, appropriate incentive mechanisms and improving multidisciplinary healthcare delivery are potential to improve job performance of healthcare professionals in integrated healthcare systems.

Application of Interprofessional Education Model to University Pre-Licensure Health Students in the Management of Chronic Care Conditions in Zambia

Background: There is evidence that multidisciplinary healthcare teams can provide better quality of care and treatment outcomes compared to that delivered by individuals from a single health discipline. The project on which this article is based applied the interprofessional education model to university pre-licensure health students in the management of chronic care conditions in Zambia.&#x0D; Methods: Four distinct but interrelated approaches, namely desk review; module development workshops; review and validation of modules by experts; piloting and review of the training modules were employed.&#x0D; Results: Several models of interprofessional education currently in existence and used successfully by higher education institutions in other settings were identified. While several models of Interprofessional Education were identified, our project adapted the “didactic program, community-based experience, and interprofessional-simulation experience” models. To apply the models, modules of seven chronic care conditions were developed and piloted. The extent to which the module activities promoted interprofessional education were rated between 74 - 87% (agree or strongly agree) by the students.&#x0D; Conclusion: Three models of Interprofessional Education were identified and adapted in the project, and seven modules were developed and administered to the students. The process was effective for putting forth an interprofessional training program at the undergraduate level, with the potential to improve quality of care for patients.

Application of Interprofessional Education Model to University Pre-Licensure Health Students in the Management of Chronic Care Conditions in Zambia.

There is evidence that multidisciplinary healthcare teams can provide better quality of care and treatment outcomes compared to that delivered by individuals from a single health discipline. The project on which this article is based applied the interprofessional education model to university pre-licensure health students in the management of chronic care conditions in Zambia. Four distinct but interrelated approaches, namely desk review; module development workshops; review and validation of modules by experts; piloting and review of the training modules were employed. Several models of interprofessional education currently in existence and used successfully by higher education institutions in other settings were identified. While several models of Interprofessional Education were identified, our project adapted the "didactic program, community-based experience, and interprofessional-simulation experience" models. To apply the models, modules of seven chronic care conditions were developed and piloted. The extent to which the module activities promoted interprofessional education were rated between 74 - 87% (agree or strongly agree) by the students. Three models of Interprofessional Education were identified and adapted in the project, and seven modules were developed and administered to the students. The process was effective for putting forth an interprofessional training program at the undergraduate level, with the potential to improve quality of care for patients.

Multidisciplinary team healthcare professionals' perceptions of current and optimal acute rehabilitation, a hip fracture example A UK qualitative interview study informed by the Theoretical Domains Framework.

To understand multidisciplinary team healthcare professionals' perceptions of current and optimal provision of acute rehabilitation, perceived facilitators and barriers to implementation, and their implications for patient recovery, using hip fracture as an example. A qualitative design was adopted using semi-structured telephone interviews with 20 members of the acute multidisciplinary healthcare team (occupational therapists, physiotherapists, physicians, nurses) working on orthopaedic wards at 15 different hospitals across the UK. Interviews were audio-recorded, transcribed verbatim, anonymised, and then thematically analysed drawing on the Theoretical Domains Framework to enhance our understanding of the findings. We identified four themes: conceptualising a model of rehabilitative practice, which reflected the perceived variability of rehabilitation models, along with facilitators and common patient and organisational barriers for optimal rehabilitation; competing professional and organisational goals, which highlighted the reported incompatibility between organisational goals and person-centred care shaping rehabilitation practices, particularly for more vulnerable patients; engaging teams in collaborative practice, which related to the expressed need to work well with all members of the multidisciplinary team to achieve the same person-centred goals and share rehabilitation practices; and engaging patients and their carers, highlighting the importance of their involvement to achieve a holistic and collaborative approach to rehabilitation in the acute setting. Barriers and facilitators within themes were underpinned by the lack or presence of adequate ways of communicating with patients, carers, and multidisciplinary team members; resources (e.g. equipment, staffing, group classes), and support from people in leadership positions such as management and senior staff. Cornerstones of optimal acute rehabilitation are effective communication and collaborative practices between the multidisciplinary team, patients and carers. Supportive management and leadership are central to optimise these processes. Organisational constraints are the most commonly perceived barrier to delivering effective rehabilitation in hospital settings, which exacerbate silo working and limited patient engagement.

Physicians' Perceptions of and Barriers to Cardiopulmonary Rehabilitation for Heart Failure Patients in Saudi Arabia: A Cross-Sectional Study.

Cardiopulmonary rehabilitation (CR) serves as a core component of the management strategy for patients with heart failure (HF). CR is administered by multidisciplinary healthcare providers, but their perceptions toward delivering CR to HF patients, and the factors and barriers that might influence referral, have not been studied. This study aims to assess physicians' perceptions toward delivering CR programs to HF patients and identify factors and barriers that might influence their referral decisions. Between 15 February and 5 June 2022, a cross-sectional online survey with ten multiple-choice items was distributed to all general and cardiac physicians in Saudi Arabia. The characteristics of the respondents were described using descriptive statistics. Percentages and frequencies were used to report categorical variables. The statistical significance of the difference between categorical variables was determined using the chi-square (2) test. Logistic regression was used to identify referral factors. Overall, 513 physicians (general physicians (78%) and cardiac doctors (22%)) completed the online survey, of which 65.0% (n = 332) were male. Of the general physicians, 236 (59%) had referred patients with HF to CR. Sixty-six (58%) of the cardiac doctors had referred patients with HF to CR. A hospital-supervised program was the preferred mode of delivering CR programs among 315 (79%) general physicians, while 84 (74%) cardiac doctors preferred to deliver CR programs at home. Apart from the exercise component, information about HF disease was perceived by 321 (80%) general physicians as the essential component of a CR program, while symptom management was perceived by 108 (95%) cardiac doctors as the essential component of a CR program. The most common patient-related factor that strongly influenced referral decisions was "fatigue related to disease" (63.40%). The availability of CR centers (48%) was the most common barrier preventing the referral of patients to CR. CR is an effective management strategy for HF patients, but the lack of CR centers is a major barrier to the referral of patients. A hospital-supervised program is the preferred method of delivering CR from the general physicians' perspective, while cardiac doctors prefer home-based CR programs. Apart from the exercise component, information about HF disease and symptom management is essential components of CR programs from general physicians' and cardiac doctors' perspectives, respectively.

"Without social there is no health": Social work perspectives in multidisciplinary healthcare.

The pandemic has not just affected the health sphere: strong social effects of the emergency have added to the health risk, stressing on social relations and the deterioration of people's living conditions, and making those who are already fragile more fragile. Notwithstanding, during the emergency following the COVID-19 pandemic the attention was focused, indeed understandably, on the health aspects, widening the already existing misalignment between the health interventions and the social ones. Emergency oriented efforts and resources more toward a clinical care approach (cure) than toward support for the social and the inclusion aspects (care). Reflecting on the specific area of health care that interacts with social care (and vice versa), shows how the medicalization in managing the emergency have undermined or, at least, weakened the global approach to the person and to vulnerability profiles that should inspire the socio-healthcare integration. The aim of this review is describing the relationship between the health and social systems and the effects of the COVID-19 pandemic on it: a review of studies on the role played by social work in the health sector before and during COVID-19 pandemic emergency shows how much potential there is still to be developed for social work in the health sector that acts together with the personal health services; a care that looks at the person within his or her relationships, community resources and environmental aspects requires an investment toward integration between hospital care, social services and local communities.

Enabling the Implementation of Next-Generation Sequencing into Clinical Diagnosis: Nemhesys Project

Training for the use and analysis of Next-Generation Sequencing (NGS) is uncommon, as shown by the lack of specialized health professionals in this area. This delays NGS implementation into the healthcare system, with the result that NGS solutions hardly ever translated into real and precise experiences. . NEMHESYS (NGS-Establishment in Multidisciplinary HEalthcare SYStem) is an Erasmus Plus Knowledge Alliance programme with the aim of improving the translation of NGS into clinical practice for hematological diagnosis and prognosis by providing clinical and biomedical staff with suitable training in NGS NEMHESYS was initiated in March 2020 with partners from five Academic Institutions (University of Salamanca, Queen's University Belfast, University of Helsinki, Central European Institute of Technology (CEITEC) at Masaryk University and Charité University Medicine Berlin) and three small/medium enterprises (SME) (Artelnics, Mnemotix and IDimás). The project developed an online Masterclass for participants to complete over a 12-16-week period. The course, via the Moodle Platform hosted at the University of Helsinki, included a pre-module and five modules of which, in order to successfully pass the course, modules A & B were mandatory and at least one of the optional modules C, D or E. Regarding the contents, Module A was an introduction to all clinical and laboratory essentials for NGS in the clinic, whilst Module B was focused on all aspects of the analysis of NGS data. Module C looked at the barriers and risks around the implementation of NGS in health systems, Module D explored the role of artificial intelligence, linked data and knowledge graph, and Module E examined innovative programs and intra-entrepreneurship for NGS in the clinic. Three cohorts of the NGS Masterclass were run (March 2021, October 2021, and February 2022). Registration was high for each of the cohorts (161, 253, and 172 participants, respectively). Around 75% of the participants were from Europe but a significant number were from USA, Brazil, Argentina, Egypt, Australia as well as from Africa and Middle Eastern countries. The background of the participants was reported to be medics, biomedical and clinical scientists, graduate students, and a small proportion of bioinformaticians. As expected, there was a large number who didn't participate further than registration, but overall, at least 180 participants across the three cohorts successfully completed the Masterclass program. Additionally, participants who belonged to one of the five partner academic institutions, and had passed the online NGS training course, were entitled to apply for a learning mobility opportunity. Pre-covid this had been planned to for periods of 2 -12 weeks, but this was modified to enable more participants to be involved when considering covid related travel and other restrictions. Therefore, five Mobility Workshops were planned of one week duration at each of the academic centres, taking place from April to October (2022), and covering fundamental and of interest aspects of the application of NGS methodologies in the clinical practice and research. At the end, twenty-eight (28) participants were involved in the Mobility. The Brno hands-on workshop "Basic Skills in NGS: from PB sample to the Report" covered the clinical and laboratory essentials of NGS. The Salamanca workshop further explored novel technologies and trends in Real World NGS, whilst a focus on Precision Medicine and blood cancer diagnosis was covered by the Belfast workshop. Then, with more innovative methodologies, Charité covered the 4th generation Nanopore Technology, and the Helsinki workshop focused on Single Cell Sequencing Analytics. Overall, the NEMHESYS Masterclass and mobility program achieved the aim of giving online and practical training to a significant number of clinical and biomedical participants around the globe in the use of NGS for hematological disorders. This will enable the delivery of higher quality clinical services. PROJECT REF.: 612639-EPP-1-2019-1-ES-EPPKA2-KA. Disclaimer: The European Commission support for the production of this publication does not constitute an endorsement of the contents that reflects the views only of the authors, and the Commission cannot be held responsible for any use that may be made of the information contained therein. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal