ABSTRACT
Background: Pulmonary Rehabilitation is a high-impact intervention for IPF but access is limited in India, a problem exacerbated by the pandemic which has seen HBPR become a necessity. Aim(s): To explore the lived experiences of people living with IPF to inform HBPR in Delhi, India. Method(s): Ten semi-structured interviews with Adults with IPF. Data were analysed using thematic analysis. Result(s): Five key themes were developed (Figure): (1) Diagnosis Journey: Experiences before and during diagnosis, including misdiagnosis, and how family, friends and colleagues reacted to diagnosis. (2) Impact of IPF: The physical and psychological impacts on their life. (3) Non-IPF Impact: The impact of COVID-19 infection and restrictions and previous/existing comorbidities. (4) Management of IPF: Strategies to manage symptoms, including exercise and relaxed breathing. (5) HBPR: Perspectives of HBPR, including its advantages and challenges, their goals if they were to participate, and suggestions to the development of a paper HBPR manual. Conclusion(s): Patients living with IPF were positive about HBPR and the development of a paper-based manual to facilitate HBPR. The content of HBPR should be sensitive to the previous negative experiences of diagnosis, the additional impact of non-IPF health issues and challenges of reduced interactions with healthcare professionals.
ABSTRACT
Background/Purpose: To determine and compare the magnitude of humoral immune response after the first, second, and third and overall exposure to SARS-CoV- 2, either by natural infection or vaccination, between rheumatoid arthritis (RA) patients under various immunosuppressive treatments and healthy controls (HCs). Method(s): Blood samples from various time points before and after the COVID-19 pandemic and longitudinal data on exposure history were obtained from RA patients and HCs recruited for this study. Antibody levels were then determined using indirect ELISA and statistically analysed in relation to exposure history. Result(s): A significant rise in antibody levels after overall exposure to SARS-CoV- 2 in RA patients and HCs was found, with no significant difference between the two groups. Amongst RA patients, a progressive rise in antibodies following each exposure to SARS-CoV- 2 was found, with antibody levels rising above the cut-off for seropositivity following the second and third exposures. Incidentally, HCs, despite having high antibody levels following the first and second exposure, were found to have antibody levels below the cut-off for seropositivity upon their third exposure to SARS-CoV- 2. Conclusion(s): Contrary to popular belief, RA patients, despite under immunosuppressive treatments, are capable of eliciting a humoral response that is comparable to that of healthy individuals. The lower antibody levels found in HCs by third exposure could signify that more vaccine boosters may be required to increase the public's immunity against SARS-CoV- 2 for herd immunity and avoid creating a reservoir for the emergence of novel variants with persistent infections.
ABSTRACT
We discuss how youth "slowed down” an online STEAM makerspace during the COVID-19 pandemic, opening up new ways of being and doing together. The practices youth enacted in slowing down arose from their politicized care for one another. Adult mentors, through moments of slowing down, were given an opportunity to rethink how to listen to youth's desired ways of doing STEAM. To discuss the implications of slowing down, this article features two instances in which Black youth "slowed down” in sessions to demonstrate their desired ways of being together/doing together within the STEAM context. Highlighting youths' moves has implications for how educators think about co-designing programs with youth and how to enact politicized care in the face of rapid social, environmental, and political change. © ISLS.
ABSTRACT
Background: In March 2020, as part of the UK's COVID-19 prevention strategy, those identifed as 'clinically extremely vulnerable,' were advised to shield. This included a number of patients prescribed anti-rheumatic drugs, who were asked to continue their current treatment unless they developed symptoms of infection. Suboptimal treatment adherence (16.0%-81.0%) has been reported in patients with arthritic diseases, and is associated with psychological factors, including anxiety (1). Previous literature in non-UK cohorts has highlighted suboptimal adherence levels in immunosuppressed patients during the pandemic, although many were single centre studies (2,3). Objectives: The aim of this multi-centre study is to investigate the impact of the COVID-19 pandemic on adherence to anti-rheumatic medications in patients with established rheumatoid (RA) and psoriatic (PsA) arthritis in the UK who had recently commenced a biologic or targeted synthetic DMARD. Methods: Between September 2020 and May 2021, RA and PsA patients prescribed biologic or targeted synthetic anti-rheumatic drugs from two multi-centre observational studies (BRAGGSS and OUTPASS) were sent a questionnaire on medication usage, adherence, and perceptions to establish the impact of COVID-19 on these parameters. Patients were asked about compliance during the COVID-19 pandemic using a 5-point Likert scale (always, often, sometimes, rarely, and never) and the reason for non-adherence. Adherence was defned as never missing or delaying a dose, unless medically advised. Descriptive summary statistics were calculated, and logistic regression and Pearson's chi-squared tests were employed to investigate variables associated with self-reported non-adherence. Results: In total 159 questionnaires were returned (81.1% RA and 18.9% PsA). Methotrexate (53.5%) was the most frequently prescribed agent, followed by etan-ercept (25.2%), sulfasalazine (22.6%), hydroxychloroquine (21.4%) and adalimumab (19.5%). Furthermore, 68.6% of patients were prescribed ≥2 drugs. During the pandemic, 42.1% of patients reported missing or delaying a treatment dose for any reason. Adherence information was available for 97.5% of patients with 25.8% reporting non-adherence which was not medically advised. Methotrexate non-adherence was 27.1%, with similar levels reported for etanercept (20.0%), sulfasalazine (27.8%), hydroxychloroquine (35.3%) and adalimumab (29.0%). No drugs had signifcantly different adherence compared to methotrexate. Furthermore, there was no association between disease type or perception of disease control and adherence. Of non-adherent patients, 17.5% reported increased anxiety, fear, and increased risk due to the COVID-19 pandemic as an influencing factor. Meanwhile, 37.5% of non-adherent patients listed non-COVID-19 intentional reasons and 45.0% reported non-intentional reasons, with forgetting and running out of treatment listed most frequently. Conclusion: In a UK cohort self-reported non-adherence was reported in 25.8% of patients during the COVID-19 pandemic, despite medical advice, with reasons including increased anxiety due to COVID-19.
ABSTRACT
This study investigates how youth from two cities in the United States engage in critical data practices as they learn about and take action in their lives and communities in relation to COVID-19 and its intersections with justice-related concerns. Guided by theories of critical data literacies and data justice, a historicized and future-oriented participatory methodological approach is used to center the lived lives and communities of participants through dialogic interviews and experience sampling method. Data were co-analyzed with participants using critical grounded theory. Findings illustrate how youth not only aimed to reveal the dynamic and human aspects of and relationships with data as they engage with/in the world as people who matter but also offered alternative infrastructures for counter data production and aggregation toward justice in the here and now and desired possible futures. Implications for studies of learning with/through data practices in everyday life in relation to issues of justice are discussed.
ABSTRACT
The stance of different authorities on the relative harms of e-cigarettes and their role in smoking cessation is currently variable. This article examines the evidence for the benefits and risks associated with e-cigarettes in order to help healthcare professionals discuss these issues with patients.