Shortage Of Medical Equipment Research Articles

An Assessment of Healthcare Services in Jordanian Public Hospitals from the Perspective of COVID-19 Patients in the Aftermath of COVID-19

Hospitals faced many challenges during the COVID-19 pandemic when it came to providing healthcare to patients. These obstacles included limited bed availability, shortages of medical equipment and staff, insufficient drug supply, inadequate physical facilities, and a lack of healthy environments. As the pandemic continues into its third year, it has become clear that viruses could remain a permanent part of our lives, leading to a rise in the demand for healthcare services. With this in mind, a study was conducted to investigate the impact of different healthcare service dimensions provided by public hospitals in Jordan on patient satisfaction. The research revealed that reliability, assurance, and responsiveness are the most critical dimensions for patient satisfaction, followed by tangibility and empathy. In addition, the study discovered healthcare service characteristics positively affected patient satisfaction according to the patient's age, gender, and place of treatment. In addition, the study discovered healthcare service dimensions positively affected patient satisfaction according to the patient's age, gender, and place of treatment. In order to improve and manage the healthcare services offered to patients, the study advises public hospital administrators to identify the significance of healthcare service dimensions. Administrators should pay close attention to the dimensions of tangibility and empathy, which are strong yet good, and take into account patient demographic disparities.

Uncertain Cures: The Medical Marketplace in Pahlavi Iran

AbstractHistorians of Pahlavi Iran have demonstrated that physicians, pharmacists, dentists, and nurses were encouraged by early nation-builders to civilize patients and shepherd the masses into modernity. Medicine, however, was not only a top-down affair. Medical professionals maintained a dialogue with their patients, cognizant of the cultural mores of local communities and the threat of medical malpractice lawsuits. In fact, medicine, far from a universal science, was highly localized, inflected by traditional curatives (like herbs and spices), shortages of medical equipment and drugs, and local policing to safeguard patient rights. Through social history, scholars may examine the dialectic between patient and provider, which proved fundamental to the practice of modern medicine in Pahlavi Iran.

A sustainable scheduling system for medical equipment: Towards net zero goals for green healthcare.

Shortages of medical equipment, growth in medical waste and carbon emissions have increased healthcare pressures and has a huge impact on the environment. An efficient scheduling of medical equipment will effectively reduce the pressure on healthcare and improve the healthcare system's ability to respond to unexpected disasters. A medical equipment scheduling system was established to improve the sustainable utilization of medical equipment within the healthcare network and to reduce the carbon emissions of the healthcare process. First, this paper combines medical equipment information to establish a medical equipment scheduling decision model that considers pollution to filter qualified medical equipment for scheduling. Then, this paper constructs and solves a multi-objective robust optimization model by collecting the patient's travel information and the medical pressure information of each region. In addition, to meet dynamic healthcare needs, a dynamic medical equipment configuration framework was constructed to enhance the flexibility of equipment scheduling and the resilience of the healthcare network. Combined with case studies, the results show that the medical equipment scheduling system can help decision makers make quick scheduling decisions and achieve sustainable use of medical equipment, with a corresponding increase in medical equipment utilization of 12.25% and a reduction in carbon emissions of 26.50%. The study will help enhance healthcare resource utilization and contribute to the net-zero goal of green healthcare.

Nurses' experiences of discrimination in health care: A qualitative study in Iran.

Justice in health is one of the main concerns of health organizations, and discrimination in health care is one of the negative outcomes to achieving this goal. Hence, a full understanding of the phenomenon of discrimination in health care and adopting strategies to eliminate it is necessary. The present study was conducted to explore and describe the experiences of nurses of discrimination in health care. The present qualitative content analysis study was conducted between 2019 and 2020. Data were collected through semi-structured interviews with 18 participants (two physicians, three nursing supervisors, two head nurses, four clinical nurses, two nursing assistants, and three hospitalized patients) in one public and one private hospital in the city of Tehran. The participants were selected by purposive sampling, which continued until saturation of data. Data obtained were analyzed using the Graneheim and Lundman method. Four main categories and 14 subcategories were extracted from data analysis: 1) habitual discrimination (everyday discrimination in health centers, ignoring patient rights, low levels of trust in medical staff); 2) interpersonal relationships (expectations of associates, respect for colleagues and friends, the possibility of the occurrence of similar situations, reciprocating people's favors); 3) shortage of health-care resources (shortage of medical equipment, heavy workload, infrastructure of medical centers, lack of access to physicians); and 4) favoritism (ethnicity, favoritism as a common method, and favoritism as the ultimate solution to treatment problems). The present study revealed certain dimensions of discrimination in health care that remain hidden in many quantitative studies. It appears that health system managers will be able to move toward eliminating discrimination in health care. Thus, designing effective models to reduce discrimination in health care based on the underlying concepts of this study is recommended.

Hybrid combinatorial remanufacturing strategy for medical equipment in the pandemic

The COVID-19 pandemic hit the medical supply chain, creating a serious shortage of medical equipment. To meet the urgent demand, one realistic way is to collect abandoned medical equipment and then remanufacture, where the disassembled modules are shared with all stock-keeping units (SKUs) to improve utilization. However, in an emergency, the equipment should be processed sequentially and immediately, which means the decision is short-sighted with limited information. We propose a hybrid combinatorial remanufacturing (HCR) strategy and develop two reinforcement learning frameworks based on Q-learning and double deep Q network to find the optimal recovery option. In the frameworks, we transform HCR problem into a maze exploration game and propose a rule of descending epsilon-greedy selection on reweighted valid actions (DeSoRVA) and Espertate knowledge dictionary to combine the cost-minimizing objective with human judgment and the global state of the problem. A real-time environment is further implemented where the quality status of the in-transit equipment is unknown. Numerical studies show that our algorithms can learn to save cost, and the larger scale of the problem is, the more cost-down can be achieved. Moreover, the sophisticated knowledge refined by Espertate is effective and robust, which can handle remanufacturing problems at different scales corresponding to the volatility of the pandemic.

Evaluation of Quality Assurance at Sub Primary Health Care Center in Basra City

Background: In the health context, the word “quality” often denotes a spectrum of desirable characteristics of health systems and, in particular, health care. Quality assurance programs are designed to investigate the effectiveness, efficiency, safety, and standards of health services and strategies and to identify measures for achievable improvements. A characteristic feature of quality assurance in health is that, with dynamic developments in medical practice required to stay in line with modern trends, the quality assurance system needs to be continually updated. Aims of The Study: To evaluate the quality assurance of sub-primary health care centers in Basra city, relative to their structure, process, and outcome. Methodology: A Descriptive study design was employed to evaluate the quality of primary healthcare with respect to structure, process, and consumer satisfaction, involving (60) clients and (10) sub-primary health Basra city for the period of October 15th 2021 through May 1st 2022. Non-probability “convenient” sample of (10) primary health care centers. Conclusion: The Ministry of Health and Environment with the collaboration of the Basra health directorate periodically monitors the primary healthcare centers in Basra City and guarantees that all of them, regardless of their classification as sub-primary healthcare centers. The Directorate of Public Health in Basra, which is responsible for the primary health care sectors in Basra, must distribute the medical staff according to health standards and indicators to ensure quality because there is a shortage of medical staff and in addition to a shortage of medical equipment because the primary care sub-centers cross the important part, especially in rural areas. Keywords: Evaluation, Quality assurance, Primary healthcare, Primary Health Care Centers.

Resource support of certified quality management systems of dental care

Abstract. Standards for quality management systems require support for the system resources: human, infrastructure, process environment, knowledge, competence, awareness, communication, documented information. Objective. To conduct a systematic analysis of resource management in certified quality management systems of dental institutions; suggest ways to improve it. Materials and Methods. Forms №№ 17, 20 of the state statistical reporting, internal documents of municipal non-profit enterprises: "Zhytomyr Regional Dental Medical Association"; Kharkiv Regional Council "Regional Dental Clinic"; "Chernihiv Regional Dental Clinic of the Chernihiv Regional Council" were used (a total of 37 units). Methods: medical and statistical; system approach; content and comparative analysis; graphic. Results. It has been established that the institutions are provided with highly qualified competent medical staff, but there are no dental hygienists among the positions and individuals of specialists, which overloads dentists with simpler preventive procedures. At the same time, preventive measures are important to prevent the development of caries, periodontitis and diseases of the oral mucosa. There is no widespread involvement of employees in freelance organizational structures, monitoring and internal audit of processes and quality management systems. Heads of institutions did not organize the development and implementation of local clinical protocols based on evidence data. Dental care technologies are regulated by industry standards developed in 2004 on the basis of professional consensus. Clinical pathway of the patient, as organizational regulations of dental care, are descriptive textual in nature, the direction of the patient's movement is not traced, as well as the sequence of interaction of structural units - participants in the treatment and diagnostic process. Clinical quality indicators are not implemented in institutions and are not subject to calculations and monitoring. This creates risks for the effectiveness of patient-centered dental care. External and internal interactions of institutions and their structural units are unclear; there is a shortage of medical equipment; modern digital technologies are used to a limited extent for internal and external communications. Conclusion. Opportunities for the implementation of quality management, laid down in the standard, in each dental institution in the real conditions of its operation are not fully used, which requires the attention of heads of institutions in problematic areas.

BREXIT in 2021

The UK's withdrawal from the European Union in 2020, as well as the 2016 referendum, had a significant impact on the functioning of many economic mechanisms and even on the lives of people in the European Union and the United Kingdom. The tightened scope of work after the 2020 pandemic has only worsened the state of many enterprises. Consumers faced heavy taxes on imported goods and services, as well as restrictions on movement between countries. The article presents a detailed analysis of the consequences of Brexit for different parties of the negotiations, as well as illuminates the situation in 2021. As you know, everything has become even more complicated with the pandemic. In recent years, it has become increasingly difficult to reach a reasonable compromise on how to get out of this crisis: the UK economy is shaken by shortages of medical equipment, hospitals, and resources to save enterprises from COVID-19, while the introduction of new taxes on trade with the European Union is becoming more complicated due to Brexit.

Risk stratification for COVID-19 hospitalization: a multivariable model based on gradient-boosting decision trees.

Background:The COVID-19 pandemic has led to an increased demand for health care resources and, in some cases, shortage of medical equipment and staff. Our objective was to develop and validate a multivariable model to predict risk of hospitalization for patients infected with SARS-CoV-2.Methods:We used routinely collected health records in a patient cohort to develop and validate our prediction model. This cohort included adult patients (age ≥ 18 yr) from Ontario, Canada, who tested positive for SARS-CoV-2 ribonucleic acid by polymerase chain reaction between Feb. 2 and Oct. 5, 2020, and were followed up through Nov. 5, 2020. Patients living in long-term care facilities were excluded, as they were all assumed to be at high risk of hospitalization for COVID-19. Risk of hospitalization within 30 days of diagnosis of SARS-CoV-2 infection was estimated via gradient-boosting decision trees, and variable importance examined via Shapley values. We built a gradient-boosting model using the Extreme Gradient Boosting (XGBoost) algorithm and compared its performance against 4 empirical rules commonly used for risk stratifications based on age and number of comorbidities.Results:The cohort included 36 323 patients with 2583 hospitalizations (7.1%). Hospitalized patients had a higher median age (64 yr v. 43 yr), were more likely to be male (56.3% v. 47.3%) and had a higher median number of comorbidities (3, interquartile range [IQR] 2–6 v. 1, IQR 0–3) than nonhospitalized patients. Patients were split into development (n = 29 058, 80.0%) and held-out validation (n = 7265, 20.0%) cohorts. The gradient-boosting model achieved high discrimination (development cohort: area under the receiver operating characteristic curve across the 5 folds of 0.852; validation cohort: 0.8475) and strong calibration (slope = 1.01, intercept = −0.01). The patients who scored at the top 10% captured 47.4% of hospitalizations, and those who scored at the top 30% captured 80.6%.Interpretation:We developed and validated an accurate risk stratification model using routinely collected health administrative data. We envision that modelling such risk stratification based on routinely collected health data could support management of COVID-19 on a population health level.

Violence among Female Health Care Workers

Introduction: Healthcare workers (HCWs) are at risk for workplace violence(WPV). It is a serious problem in both developed and developing countries andhas a great negative impact on the well-being of HCWs and on the quality of thehealth system. Aim of Work: To determine the prevalence, pattern, associatedfactors and impacts of WPV among female HCWs at Al-Zahraa UniversityHospital and to detect the causes and seek out suggestions to prevent suchincident. Materials and Methods: A cross-sectional study was conducted over4 months from September to December 2019 at Al-Zahraa University Hospitalusing a standardized questionnaire. The sample size was 312 physicians andnurses. Results: The prevalence of violence was 66.3% among the studiedHCWs with statistically significant higher prevalence among nurses (72.5%)than physicians (61.9%). Verbal violence was the most recurrent type (62.3%)followed by the physical type (19.8%). Patient relatives and friends were themost frequent perpetrators (63.3%). Emergency room was the most commonplace for violence (42.5%). Violent incidents result in physical, psychologicalimpacts and job dissatisfaction. There was significant association of violencewith the marital status and the work shift (p value 0.05). Low socioeconomic status of patients, shortage of medicalequipment and medicine and inadequate security were the most frequentlysuggested causes of violence. Conclusion and Recommendations: WPVis highly prevalent among the studied HCWs particularly the verbal one andresulted in physical, psychological and work related effects; that highlightsthe need to develop management strategy to overcome WPV against HCWs.Provision of medical equipment, medicine, security measures, legislationand to restrict public access to examination rooms were the most frequentlysuggested preventive measures.

Analysis and Management of COVID-19 Using Computational Intelligence Technologies

After the outbreak of COVID-19, the world economy and people’s health have been greatly challenged. What is the law of the spread of COVID-19, when will it reach its peak, and when will it be effectively controlled? These have all become major issues of common concern throughout China and the world. Based on this background, this article introduces a variety of classic computational intelligence technologies to predict the spread of COVID-19. Computational intelligence technology mainly includes support vector machine regression (SVR), Takagi-Sugeuo-Kang fuzzy system (TSK-FS), and extreme learning machine (ELM). Compare the predictions of the infection rate, mortality rate, and recovery rate of the COVID-19 epidemic in China by each intelligent model in 5 and 10 days, the effectiveness of the computational intelligence algorithm used in epidemic prediction is verified. Based on the prediction results, the patients are classified and managed. According to the time of illness, physical fitness and other factors, patients are divided into three categories: Severe, moderate, and mild. In the case of serious shortage of medical equipment and medical staff, auxiliary medical institutions take corresponding treatment measures for different patients.

Sleep deficit in COVID-19 health-care workers may increase the infection risk.

The COVID-19 pandemic has had negative effects on health-care workers. The rapid growth of the disease has led to overwhelmed health-care systems, overcrowded hospitals, an insufficient number of health-care professionals and shortages of medical equipment. The potential exposure of front-line health-care workers during the COVID-19 outbreak has led to self-isolation and the appearance of adverse feelings such as stress, anxiety and fear. All these factors, combined with an increased workload and extra and changed shifts, are determinants of a sleep-loss process that may result in insomnia. The exacerbated pro-inflammatory milieu caused by insomnia and sleep deprivation present in health professionals may therefore make them more prone to developing severe COVID-19 if infected and/or aggravate the symptoms of the disease. Keeping these professionals healthy and doing everything possible to prevent them from being infected with COVID-19 should be a top priority. As part of this effort, we must be aware of the important effects of insomnia on the immune systems of these professionals and take all possible measures to counter these effects.

Cancer in Africa: The Untold Story.

BackgroundDespite rising incidence and mortality rates in Africa, cancer has been given low priority in the research field and in healthcare services. Indeed, 57% of all new cancer cases around the world occur in low income countries exacerbated by lack of awareness, lack of preventive strategies, and increased life expectancies. Despite recent efforts devoted to cancer epidemiology, statistics on cancer rates in Africa are often dispersed across different registries. In this study our goal included identifying the most promising prevention and treatment approaches available in Africa. To do this, we collated and analyzed the incidence and fatality rates for the 10 most common and fatal cancers in 56 African countries grouped into 5 different regions (North, West, East, Central and South) over 16-years (2002–2018). We examined temporal and regional trends by investigating the most important risk factors associated to each cancer type. Data were analyzed by cancer type, African region, gender, measures of socioeconomic status and the availability of medical devices.ResultsWe observed that Northern and Southern Africa were most similar in their cancer incidences and fatality rates compared to other African regions. The most prevalent cancers are breast, bladder and liver cancers in Northern Africa; prostate, lung and colorectal cancers in Southern Africa; and esophageal and cervical cancer in East Africa. In Southern Africa, fatality rates from prostate cancer and cervical cancer have increased. In addition, these three cancers are less fatal in Northern and Southern Africa compared to other regions, which correlates with the Human Development Index and the availability of medical devices. With the exception of thyroid cancer, all other cancers have higher incidences in males than females.ConclusionOur results show that the African continent suffers from a shortage of medical equipment, research resources and epidemiological expertise. While recognizing that risk factors are interconnected, we focused on risk factors more or less specific to each cancer type. This helps identify specific preventive and therapeutic options in Africa. We see a need for implementing more accurate preventive strategies to tackle this disease as many cases are likely preventable. Opportunities exist for vaccination programs for cervical and liver cancer, genetic testing and use of new targeted therapies for breast and prostate cancer, and positive changes in lifestyle for lung, colorectal and bladder cancers. Such recommendations should be tailored for the different African regions depending on their disease profiles and specific needs.

Unintended consequences of COVID-19: Opportunities for respiratory therapists’ involvement in developing respiratory-related technologies

More than ever, the role of the registered respiratory therapist (RRT) is critical to Canadians’ health. Nationally, RRTs are mobilizing their efforts to battle a novel viral enemy. Members of the Canadian RRT community, from clinicians to educators to students, are meeting the challenge of the COVID-19 pandemic crisis. RRTs have consistently demonstrated innovation, professionalism, and a commitment to providing evidence-based care for patients through the profession’s 50-year history; this remains unchanged and arguably more apparent considering the COVID-19 pandemic. RRTs’ clinical experience, expertise, and academic training render RRTs indispensable in some unintended consequences of the COVID-19 pandemic. One of these unintended consequences of the COVID-19 pandemic is the rapid development of innovative respiratory-related technologies. The need to develop new respiratory technology A significant consequence of the COVID-19 pandemic is the shortage of medical equipment (e.g., personal protection equipment [1]). On 20 March 2020, the Government of Canada asked Canadian businesses and industrialists to help develop and manufacture supplementary health care supplies for health professionals [2]. Since the call, almost 3,000 companies have volunteered their engineering and manufacturing expertise, including their facilities, to produce medical equipment. Some include clothing brands repurposing stock to provide medical gowns and sports manufacturers providing face shields [3, 4]. Comparisons of this type of industry collaboration have been made to automobile companies’ wartime efforts—including Ford and GM—to produce tanks and airplanes using their factories during World War II [5]. RRTs working directly with patients with COVID-19 have the first-hand experience and knowledge to be invaluable counsel for these companies on medical equipment requirements. Another significant consequence of the pandemic includes a potential shortage of available critical care mechanical ventilators [6]. The Canadian government acknowledged the potential shortage and focused its efforts to secure and manufacture Canadian-made mechanical ventilators. Additionally, the Canadian-made mechanical ventilators would be distributed to other countries if not required in Canada [7]. The call for Canadian-made mechanical ventilators mobilized many medical experts and entrepreneurs to design and produce easy-to-use mechanical ventilators rapidly. Collaboration across the world has already resulted in many ventilator prototypes and adjunct therapy devices. Some were designed by large established medical companies [8], while some made by small, independent teams [9]. These devices need to be built quickly and inexpensively with readily available hardware and infrastructure. The devices must be user-friendly so that all health care professionals are easily able to learn to use them while still ensuring minimal safety standards.

Perceived Barriers Toward Provider-Initiated HIV Testing and Counseling (PITC) in Pediatric Clinics: A Qualitative Study Involving Two Regional Hospitals in Dar-Es-Salaam, Tanzania.

BackgroundAccording to Provider-Initiated HIV Testing and Counseling (PITC), healthcare providers recommend HIV testing and counseling to persons attending health care facilities as a standard component of medical care. In order to reduce the morbidity and mortality of late Human Immunodeficiency Virus (HIV) diagnosis, timely diagnosis and initiation of ARVs is necessary. This aims to accelerate universal access to HIV prevention, treatment, care, and support services for people living with HIV/AIDS. The present study aimed to explore perceived barriers toward PITC provision in pediatric clinics.MethodsThe study had a cross-sectional exploratory study design. In-depth interviews were used to collect data from the informants in Mwananyamala and Temeke hospitals in Dar-es-Salaam. Nineteen informants were recruited purposely for in-depth interviews. All the interviews were audio recorded, transcribed verbatim, and translated from Swahili to English. Lastly, data were analyzed using a thematic analysis approach.ResultsThe study findings showed six barriers including inadequate training on PITC among healthcare providers, little practice of PITC provision, inability to properly counsel patients due to little knowledge, poor attitude of healthcare providers in providing PITC, shortage of healthcare providers, and little motivation and incentives among healthcare providers. Patient barriers included little understanding of PITC among parents/guardians of children and its importance in terms of their children’s health, absence of parents, overcrowding at clinics, HIV/AIDS stigma, lack of privacy at clinics, and harsh language of some of the healthcare providers. Health facility barriers included inadequate space to provide PITC and shortage of medical equipment and medical supplies for HIV testing. Policy-related barriers included the absence of PITC guidelines in each consultation room.ConclusionPerceived barriers toward PITC must be understood for effective implementation of PITC to reach 90-90-90 goal. The study identified several barriers which need to be addressed in order to improve PITC provision.

Accessing medical equipment in developing countries through remanufacturing

While many developing countries may not afford state-of-the-art medical equipment, they may take advantage of the significant price reduction and other benefits of remanufacturing to solve their perennial healthcare problems that are aggravated by the shortage of medical equipment. As a first step towards implementing medical equipment remanufacturing in developing countries, the regulatory perspectives which plays a crucial role in the industry should be understood. However, since regulation of medical equipment is weak or inexistent in most developing countries, the regulatory perspectives with respect to remanufacturing or related activities in both the European Union (EU) and the United States of America (US) are first examined to determine their impacts. Unfortunately, there appears to be a lack of precise definition of remanufacturing for medical devices. An unambiguous definition is necessary to promote effective research, improve understanding, ensure uniformity of standards, drive quacks out of the remanufacturing market and thus, enhance customer confidence in remanufactured products. This paper proposes a definition for medical equipment remanufacture. The principal advantage of this definition is that it could be adopted in future research toward increasing access to functional medical equipment to developing countries through remanufacturing.

Equipment for essential surgical care in 9 countries across Africa: availability, barriers and need for novel design

Shortages of medical equipment in low-and-middle income countries (LMICs) have been found by several previous studies that assessed surgical capacity. To increase surgical capacity, there is a need to identify the availability of specific types of surgical equipment on a local, regional and national level. A survey was conducted among surgeons attending the annual meeting of the College Of Surgeons of East, Central and Southern Africa (COSECSA) in December 2016. General information of the facilities, availability of surgical equipment, reasons for limited availability, daily usage of equipment and equipment that could benefit from redesign were assessed. Forty-two respondents participated in this study, representing 33 individual healthcare facilities (14 public referrals, 9 public district and 10 private (for-profit and non-profit)). The respondents worked in 9 countries in East, Central, Western and Southern Africa. A deficiency in availability of basic surgical equipment was found, especially in public district hospitals. Electrosurgical units, endoscopes, defibrillators, infusions pumps and electrocardiogram monitors were of limited availability. Reasons indicated for this limited availability were: no need, too costly, no training, no disposables and no repair. Lack of maintenance and old/overused equipment were identified as major reasons for failure of equipment. Equipment that could benefit from redesign were for example: electrosurgical units, laparoscopic equipment and theatre lights. Availability of surgical equipment should be increased, especially in public district hospitals. Novel context appropriate redesign that is adapted to fit the context in LMICs could decrease the barriers to availability and to failure of surgical equipment.