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  • 1
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2021
    In:  Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. Vol. 75, No. 6 ( 2021-12-01), p. 411-416
    In: Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences., Walter de Gruyter GmbH, Vol. 75, No. 6 ( 2021-12-01), p. 411-416
    Abstract: In circumstances of COVID-19 epidemiological uncertainty, the causes and consequences of the disease remain important issues. The aim of this study was to investigate obesity as a potential predisposition and chronic fatigue syndrome (CFS) as a possible consequence of COVID-19. The study was conducted in two parts: a theoretical part, in which a literature review was performed, and an empirical part, in which COVID-19 patient survey data were analysed. To identify the main findings regarding the relationship between obesity and COVID-19, the literature review was focused on the investigation of systematic reviews and meta-analyses by three databases — Med-line (via PubMed), Cochrane COVID-19 Study Register, and PROSPERO (International prospective register of systematic reviews). The patient survey was performed to investigate the relationship between obesity and severity of the disease, as well as the presence of CFS symptoms in COVID-19 patients in Latvia. The main findings of the literature review showed that obesity increases the risk of hospitalisation, disease severity, clinical complications, poor outcomes, and mortality. The results of the patient survey showed that overweight and obesity were more critical factors for men (males) suffering with COVID-19 than for women (females) in Latvia. The patient group with obesity caused almost half of all hospitalisations. The research data assumed that CFS patients were not a high-risk group for COVID-19, but COVID-19 caused CFS-like symptoms in patients and potentially increased the number of undiagnosed patients. In the context of further epidemiological uncertainty and the possibility of severe post-viral consequences, preventive measures are becoming increasingly important.
    Type of Medium: Online Resource
    ISSN: 2255-890X
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2021
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  • 2
    In: Healthcare, MDPI AG, Vol. 8, No. 2 ( 2020-04-07), p. 88-
    Abstract: We have developed a Europe-wide approach to investigating the economic impact of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), facilitating acquisition of information on the economic burden of ME/CFS, and international comparisons of economic costs between countries. The economic burden of ME/CFS in Europe appears large, with productivity losses most significant, giving scope for substantial savings through effective prevention and treatment. However, economic studies of ME/CFS, including cost-of-illness analyses and economic evaluations of interventions, are problematic due to different, arbitrary case definitions, and unwillingness of doctors to diagnose it. We therefore lack accurate incidence and prevalence data, with no obvious way to estimate costs incurred by undiagnosed patients. Other problems include, as for other conditions, difficulties estimating direct and indirect costs incurred by healthcare systems, patients and families, and heterogeneous healthcare systems and patterns of economic development across countries. We have made recommendations, including use of the Fukuda (CDC-1994) case definition and Canadian Consensus Criteria (CCC), a pan-European common symptom checklist, and implementation of prevalence-based cost-of-illness studies in different countries using an agreed data list. We recommend using purchasing power parities (PPP) to facilitate international comparisons, and EuroQol-5D as a generic measure of health status and multi-attribute utility instrument to inform future economic evaluations in ME/CFS.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2721009-1
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  • 3
    Online Resource
    Online Resource
    University of Latvia ; 2018
    In:  Journal of Economics and Management Research Vol. 7 ( 2018), p. 26-48
    In: Journal of Economics and Management Research, University of Latvia, Vol. 7 ( 2018), p. 26-48
    Type of Medium: Online Resource
    ISSN: 2255-9000
    URL: Issue
    Language: Unknown
    Publisher: University of Latvia
    Publication Date: 2018
    detail.hit.zdb_id: 3031072-6
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  • 4
    In: Vaccines, MDPI AG, Vol. 10, No. 12 ( 2022-12-10), p. 2115-
    Abstract: (1) Background: The safety of medicines has been receiving increased attention to ensure that the risks of taking medicines do not outweigh the benefits. This is the reason why, over several decades, the pharmacovigilance system has been developed. The post-authorization pharmacovigilance system is based on reports from healthcare professionals and patients on observed adverse reactions. The reports are collected in databases and progressively evaluated. However, there are emerging concerns about the effectiveness of the established passive pharmacovigilance system in accelerating circumstances, such as the COVID-19 pandemic, when billions of doses of new vaccines were administered without a long history of use. Currently, health professionals receive fragmented new information on the safety of medicines from competent authorities after a lengthy evaluation process. Simultaneously, in the context of accelerated mass vaccination, health professionals need to have access to operational information—at least on organ systems at higher risk. Therefore, the aim of this study was to perform a primary data analysis of publicly available data on suspected COVID-19 vaccine-related adverse reactions in Europe, in order to identify the predominant groups of reported medical conditions after vaccination and their association with vaccine groups, as well as to evaluate the data accessibility on specific syndromes. (2) Methods: To achieve the objectives, the data publicly available in the EudraVigilance European Database for Suspected Adverse Drug Reaction Reports were analyzed. The following tasks were defined to: (1) Identify the predominant groups of medical conditions mentioned in adverse reaction reports; (2) determine the relative frequency of reports within vaccine groups; (3) assess the feasibility of obtaining information on a possibly associated syndrome—myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). (3) Results: The data obtained demonstrate that the predominant medical conditions induced after vaccination are relevant to the following categories: (1) “General disorders and administration site conditions”, (2) “nervous system disorders”, and (3) “musculoskeletal and connective tissue disorders”. There are more reports for mRNA vaccines, but the relative frequency of reports per dose administered, is lower for this group of vaccines. Information on ME/CFS was not available, but reports of “chronic fatigue syndrome” are included in the database and accessible for primary analysis. (4) Conclusions: The information obtained on the predominantly reported medical conditions and the relevant vaccine groups may be useful for health professionals, patients, researchers, and medicine manufacturers. Policymakers could benefit from reflecting on the design of an active pharmacovigilance model, making full use of modern information technologies, including big data analysis of social media and networks for the detection of primary signals and building an early warning system.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2703319-3
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  • 5
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 14 ( 2021-07-06), p. 3017-
    Abstract: Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a poorly understood, complex, multisystem disorder, with severe fatigue not alleviated by rest, and other symptoms, which lead to substantial reductions in functional activity and quality of life. Due to the unclear aetiology, treatment of patients is complicated, but one of the initial problems is the insufficient diagnostic process. The increase in the number of undiagnosed ME/CFS patients became specifically relevant in the light of the COVID-19 pandemic. The aim of this research was to investigate the issues of undiagnosed potential ME/CFS patients, with a hypothetical forecast of the expansion of post-viral CFS as a consequence of COVID-19 and its burden on society. Methods: The theoretical research was founded on the estimation of classic factors presumably affecting the diagnostic scope of ME/CFS and their ascription to Latvian circumstances, as well as a literature review to assess the potential interaction between ME/CFS and COVID-19 as a new contributing agent. The empirical study design consisted of two parts: The first part was dedicated to a comparison of the self-reported data of ME/CFS patients with those of persons experiencing symptoms similar to ME/CFS, but without a diagnosis. This part envisaged the creation of an assumption of the ME/CFS shadow burden “status quo”, not addressing the impact of COVID-19. The second part aimed to investigate data from former COVID-19 patients’ surveys on the presence of ME/CFS symptoms, 6 months after being affected by COVID-19. Descriptive and analytical statistical methods were used to analyse the obtained data. Results: The received data assumed that the previously obtained data on the ME/CFS prevalence of 0.8% in the Latvian population are appropriate, and the literature review reports a prevalence of 0.2–1.0% in developed countries. Regarding the reciprocity of ME/CFS and COVID-19, the literature review showed a lack of research in this field. The empirical results show quite similar self-esteem among ME/CFS patients and undiagnosed patients with longstanding disease experience, while former COVID-19 patients show a significantly lower severity of these problems. Notably, “psychological distress (anxiety)” and “episodic fatigue” are significantly predominant symptoms reported by former COVID-19 patients in comparison with ME/CFS patients and undiagnosed patients prior to the COVID-19 pandemic. The results of our analysis predict that the total amount of direct medical costs for undiagnosed patients (out-of-pocket payments) is more than EUR 15 million p.a. (in Latvia), and this may increase by at least 15% due to the consequences of COVID-19. Conclusions: ME/CFS creates a significant shadow burden on society, even considering only the direct medical costs of undiagnosed patients—the number of whom in Latvia is probably at least five times higher than the number of discerned patients. Simultaneously, COVID-19 can induce long-lasting complications and chronic conditions, such as post-viral CFS, and increase this burden. The Latvian research data assume that ME/CFS patients are not a high-risk group for COVID-19; however, COVID-19 causes ME/CFS-relevant symptoms in patients. This increases the need for monitoring of patients for even longer after recovering from COVID-19′s symptoms, in order to prevent complications and the progression of chronic diseases. In the context of further epidemiological uncertainty, and the possibility of severe post-viral consequences, preventive measures are becoming significantly more important; an integrated diagnostic approach and appropriate treatment could reduce this burden in the future.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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  • 6
    In: Medicina, MDPI AG, Vol. 57, No. 4 ( 2021-04-16), p. 388-
    Abstract: This report addresses the extent to which there may be scope for preventive programmes for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and, if so, what economic benefits may accrue from the implementation of such programmes. We consider the economic case for prevention programmes, whether there is scope for preventive programmes for ME/CFS, and what are the health and economic benefits to be derived from the implementation of such programmes. We conclude that there is little scope for primary prevention programmes, given that ME/CFS is attributable to a combination of host and environmental risk factors, with host factors appearing to be most prominent, and that there are few identified modifiable risk factors that could be the focus of such programmes. The exception is in the use of agricultural chemicals, particularly organophosphates, where there is scope for intervention, and where Europe-wide programmes of health education to encourage safe use would be beneficial. There is a need for more research on risk factors for ME/CFS to establish a basis for the development of primary prevention programmes, particularly in respect of occupational risk factors. Secondary prevention offers the greatest scope for intervention, to minimise diagnostic delays associated with prolonged illness, increased severity, and increased costs.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2088820-X
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  • 7
    In: Frontiers in Neuroscience, Frontiers Media SA, Vol. 17 ( 2023-7-21)
    Abstract: Theoretical and empirical studies discover that an integrative approach is particularly important in chronic disorders and multiple long-term conditions, such as chronic fatigue. Chronic fatigue syndrome (CFS) is a classic example of a potentially severe, multisystemic illness with a wide diversity of symptoms and the corresponding diagnostic complexity. The prevalence of CFS-like syndromes expanded in the context of the COVID-19 pandemic, increasing the disorder and treatment burden. Thus, this article aimed to draw attention to the possibilities to strengthen the integrative approach to diagnosing and treating chronic disorders and multiple long-term conditions. The main critical success factors identified for integrative approaches were: a holistic approach, that provides a more comprehensive diagnostic and personalized treatment strategy, a multidisciplinary team, and patient engagement. The strengths and weaknesses of these factors were explored and coaching was identified as a potential unifying and reinforcing element. Coaching has a wide spectrum of manifestations clearly representing a holistic approach, that has been successfully used in multidisciplinary team building. Moreover, coaching exposes support addressing the patient engagement issues identified by the Patient Needs-Resources Model (PN-R Model) such as low levels of self-efficacy, optimism, and subjective well-being. Coaching may assist patients to identify and prioritize their goals, becoming aware of their personal resources, developing strategies for managing symptoms, and building skills to increase their self-efficacy and active engagement in the treatment process. Therefore, the authors emphasize coaching as a perspective element of optimization of patient care, that requires additional theoretical and long-term empirical research.
    Type of Medium: Online Resource
    ISSN: 1662-453X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2411902-7
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  • 8
    Online Resource
    Online Resource
    Fundacja Pro Medicina ; 2013
    In:  Journal of Health Policy & Outcomes Research ( 2013-07-25), p. 58-63
    In: Journal of Health Policy & Outcomes Research, Fundacja Pro Medicina, ( 2013-07-25), p. 58-63
    Abstract: In Latvia, the drug reimbursement system for outpatient treatment develops under limited resources. The reimbursement is performed against the degree of severity of certain diseases. The largest part of the health care budget recourses for the reimbursement system is allocated for groups of diagnoses ‘Diseases of the circulatory system’ (21.48% of total expenditures in 2012), ‘Endocrine, nutritional und metabolic diseases’ (20.44% of total expenditures in 2012) and ‘Neoplasms’ (14.60% of total expenditures in 2012). Taking into account the rapid growth of the reimbursement expenditures in 2011 as well as the patients’ co-payment for non-reference medicinal products certain measures have been implemented such as refund, depending on the exceeded market share, which was implemented for the period of 2011-2012 and amounted to LVL 3.7million in 2011 and LVL 2million in 2012. The two-level tender system has been implemented since September 2011 for interchangeable medicinal products and for newly diagnosed patients only reference medicine is reimbursed by the NHS at the time of the first treatment. As the result of these activities with the increased number of patients an average price per prescription was reduced from LVL 15.30 in 2011 to LVL 14.43 in 2012 the expenditures per patient were reduced from LVL 157.38 in 2011 to LVL 145.63 in 2012. With the strictly limited state budget, a necessity to use additional possibilities to optimise the resource allocation for the health care program and prevention activities remain topical.
    Type of Medium: Online Resource
    ISSN: 2299-1247
    Language: English
    Publisher: Fundacja Pro Medicina
    Publication Date: 2013
    detail.hit.zdb_id: 2940169-0
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  • 9
    Online Resource
    Online Resource
    RISEBA University ; 2022
    In:  Journal of Business Management Vol. 20 ( 2022), p. 23-35
    In: Journal of Business Management, RISEBA University, Vol. 20 ( 2022), p. 23-35
    Abstract: Purpose. The term “healthcare system resilience” is becoming topical in policy planning documents around the world, increasingly in the context of the COVID-19 pandemic. This research aimed to explore the role of the contextual framework in the research on resilience and prevailing aspects of the healthcare system’s resilience. Design / methodology / approach. The research hypothesised on the increasing relevance of the concept of resilience in the healthcare system as demonstrated by scientific literature; on determining elements that characterise the interrelationship between the domains of the healthcare system and the concept of resilience; and on the role of the contextual framework in creating an awareness of the concept of resilience in the healthcare system. The hypotheses were verified by the literature review on the PubMed, Web of Science, and Scopus databases. Findings. The concept of resilience was introduced to the healthcare system literature from the ecological sciences through an increased understanding of the healthcare system as a complex adaptive system (CAS). The perception of the nature of the healthcare system in the context of a CAS, viewing it as a complex, dynamic part of the socio-economic system, operating in circumstances of high uncertainty, provides additional opportunities for understanding the healthcare system’s functioning, governance and decision-making. Originality / value. This study identified a research gap in the practical implementation of the CAS approach in the healthcare system on the highest level of governance. A CAS contains a multitude of characteristics and elements that could assist in attaining a more nuanced understanding of healthcare system resilience. Significantly, the inherent characteristics of a CAS, such as flexibility and an adaptive nature, which seem to undermine the stability of the system, actually create the core of this system’s resilience, and these aspects merit increased attention. Further research could be devoted to the investigation of healthcare system resilience in the context of healthcare system reforms. Keywords: healthcare system, contextual framework, organization, governance, ecological approach, networks
    Type of Medium: Online Resource
    ISSN: 1691-5348
    Language: English
    Publisher: RISEBA University
    Publication Date: 2022
    detail.hit.zdb_id: 2500769-5
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  • 10
    Online Resource
    Online Resource
    EDP Sciences ; 2018
    In:  SHS Web of Conferences Vol. 51 ( 2018), p. 02001-
    In: SHS Web of Conferences, EDP Sciences, Vol. 51 ( 2018), p. 02001-
    Abstract: The United Nations Sustainable Development Goals appoint that all Member States have agreed to try to achieve Universal Health Coverage by 2030. This includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines for all. The World Health Organisation has defined the Universal Health Coverage as a priority, which means that all people can use the preventive, curative, rehabilitative and palliative health care services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. The classic approach of the unmet medical needs is defined as the total self-reported unmet needs for medical care for the following three reasons: financial barriers, waiting times, too far to travel. According to the Eurostat data, overall range of unmet medical needs in Latvia is the highest of the European Union countries, however, the accessibility of health services depends on a multitude of factors that relate to the health system and also to the patients themselves. Therefore the Multi-criteria decision analysis approach could be acceptable for assessment of the unmet medical needs. The data on unmet medical needs for Latvia should be additionally evaluated, taking into account the “therapeutic need”, which refers to the need for a better treatment than the treatment currently reimbursed, from the perspective of the patient. Apart from therapeutic need, the concept of societal need should be investigated, which refers to the need for a better treatment than the currently available treatment for societal reasons.
    Type of Medium: Online Resource
    ISSN: 2261-2424
    Language: English
    Publisher: EDP Sciences
    Publication Date: 2018
    detail.hit.zdb_id: 2755676-1
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