Awareness, Perceptions and Beliefs About Physiotherapy Profession Among Orthopedists and Neurosurgeons Working in the Main Hospitals of the Ministry of Health in Gaza Strip

Background: - Healthcare professions have rapidly developed due to advancements in technology along with innovations over years, and Physiotherapists are considered as a key-member of collaborative inter-professional teams due to their broad scope of practice. - Increasing disabilities in Palestine due to occupation and other reasons, life expectancy and the special circumstances made it one of the most imperative socioeconomic medical issues in Gaza Strip. This emphasizes the need for the development and recognition of physiotherapy in multidisciplinary healthcare structures. - In order to deliver effective care, communication, cooperation and agreement between physicians and physiotherapist is essential. - If a physician were well informed about physiotherapy abilities in helping the treatments, prevent complications and decrease hospital stays, that would decrease the burden on the healthcare system. - Lack of knowledge about physiotherapy among medical professionals affects several aspects, including patients, the role of physiotherapy as a part of the healthcare teams, and the outcomes. Objectives: - The aim of the study was to identify awareness, perception and believes about physiotherapy among orthopedists and neurosurgeons. Methods: - A cross-sectional study was conducted between January – June 2019 at the three main hospitals of the Ministry of Health in Gaza Strip. The study population included Orthopedists and Neurosurgeons who work according to the settings. - The total collected samples were 67, and participants of the study were recruited through a Non-Probability convenience sample. - Data was collected through a questionnaire, that was designed in English, with four main parts, a total of 30 items, then data analysis using the (SPSS-V.22) and several statistical operations were done including Cross tabulation using chi-squarer with significance value was defined as p≤0.05. Results: - Results of this study showed that the awareness of orthopedists and neurosurgeons about physiotherapy was 95.5%. The study showed that 54.7% of these physicians received their knowledge through their studying. The study showed that 78.1% of physicians believe that the intervention of physiotherapy is in therapeutic exercises, while 57.8% believe that the biggest intervention is the use of electrical modalities, and 60.9% believe that it is manual therapy. The study found that 96.9% of physicians believe that physiotherapy plays an important role in the treatment plan for the patient. And 71.9% of the physicians believe that the physiotherapist has the right to return the patient to the physician due to misdiagnosis. The study indicated that 90.6% of physicians believe it is important to discuss the patient's discharge with a physiotherapist, and shocking result was that 95.3% of physicians say that they write on the referral what should a physiotherapist do to a patient, and that is a huge violation of the physiotherapists right of making their own decision. Conclusions: - There is a close association between orthopedists and neurosurgeons about physiotherapy. The study has shown that they have a clear awareness, perception and beliefs about physiotherapy. - This relationship should be supported and developed to provide the best possible treatment to patients

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality