Advances in medical textiles

Medical textile is one of the technical textiles sectors, growing faster due to developments in polymer science and technology and innovation in forming new textile structures. In this review, current market trends for the growth of medical textiles for both pre and post covid pandemic periods were discussed. Focus is given to the classification of medical textiles and devices, specific requirements of fibers and widely used types of fibers, and advanced developments in this field, including nanofibers, bicomponent fibers, superabsorbent polymers, and conductive materials used in a wide range of advanced medical devices. Various fabric structures (woven/knitted/nonwoven/braided) have been in use in biomedical devices;however, recent 3D shaped structures such as spacer fabrics, and 3D-printed materials have profoundly marked their significance with its ability to adapt to specific needs of the medical community. Smart wearable sensor technologies for monitoring, diagnosis, and treatment are discussed and critically reviewed, enabling the readers to understand the complexity of the nature of interdisciplinary approaches required for developing such complex structures and systems. Antimicrobial agents (synthetic and natural/organic) used in the development of medical textiles mainly wound dressings, advances in antiadhesive textile coatings, and antimicrobial assessments of medical fabrics are critically reviewed. Finally, a case study on 3D printing of complex structures is presented to update modern developments using fine detail resolution (FDR), a selective laser sintering that uses carbon dioxide laser to produce delicate and complex 3D structures suitable for medical applications. It is anticipated that readers will benefit from this critical overview of trends in this sector and the multidisciplinary approaches needed to meet the demands of the ever-growing consumer base. © 2023 Elsevier Ltd. All rights reserved.

Falls Prevention: Community Exercise Programme, Reducing Risk of Falls, Deconditioning and Loneliness in Frail Elderly Patients

Introduction Covid has had a devastating effect on the Elderly, resulting in deconditioning, increased falls and loneliness. Tailored exercises can reduce falls in people aged over 65 by 54% and participation in physical activity reduces the risk of hip fractures by 50%, currently costing the NHS 1.7 billion per year in England. This 8-week intervention delivered by trained volunteers in patient's homes, aims to reduce deconditioning, loneliness and the risk, incidence and fear of falling (FOF) amongst frail patients post-discharge from hospital. Method A gap in service was identified in Frail patients discharged from hospital, at risk of falling and awaiting community physiotherapy. A steering group was set up including acute and community therapists, volunteers and carers to design a collaborative intervention to bridge the gap. At risk patients were identified and referred by ward therapists supported by the hospital volunteering team. Volunteers were trained to deliver an 8 weeks programme of progressive exercises in patients' homes with additional signposting to appropriate statutory and voluntary services. Qualitative and quantitative outcome measures were taken at week 1 and week 8 of the intervention Results 91.5% total health outcomes improved or maintained by average: - FOF reduced by 22.5% - 180 degree turn improved by 43% - 60 sec Sit to Stand improved by 14.75% - Timed Up And Go improved by 15.5% - Confidence to cope at home improved by 15% - Pain / discomfort (self-reported) improved by 18.75% - Overall health (self-reported) improved by 8.5% Conclusion(s) Targeted exercise at home with skilled volunteers can improve functional fitness and health outcomes in a frail elderly population at risk of falls when discharged home from hospital. The programme increases patients' connectivity to local voluntary and community sector services. Volunteers' mental health improves by engaging in meaningful service.

CHALLENGES AND SUPPORTS FOR VETERAN CAREGIVERS DURING THE COVID-19 PANDEMIC: A MIXED-METHODS STUDY

Informal caregivers face challenges in supporting older or medically-complex Veterans, which could be exacerbated by the COVID-19 pandemic. Our mixed methods observational study explored Veteran caregivers' supports, challenges, and self-identified impacts during the pandemic. Caregivers whose veterans needed help with at least one activity of daily living for the last year and received care at one of five Veterans Health Administration (VA) study sites were eligible. Survey participants (n=46) were 96% female, 32-83 years old (median 59);most (83%) cared for a spouse. A majority (67%, n=31) reported increased stress since the start of the pandemic. Top sources of increased stress included worry about COVID-19 infection, increased caregiving responsibility, delayed access to care, concerns about vaccine safety, and employment or financial concerns. Caregiver interviews (n=26) qualitatively analyzed using a rapid, templated approach identified the following themes: (1) the benefits and challenges of VA COVID precautions to Veteran care access (e.g. telehealth, getting care for new problems), (2) supports afforded by and limits of the expansion of the VA Caregiver Support Program, (3) declines in Veteran physical and cognitive functioning, (4) increased caregiver role in Veterans' support and care, (5) changes in work and living situations to address increased caregiving needs and/or reduce risk of exposure, and (6) loss of and then return to more usual routines and social outlets amid ongoing COVID-related uncertainties. Recommendations include targeted, personalized outreach to engage caregivers in existing supports, removing barriers and streamlining processes for obtaining services, and creating durable caregiver-to-caregiver, peer support opportunities.

The COVID-19 pandemic through the lens of four tech workers Walk a Mile in Their Shoes

ON MARCH 11, 2020, the World Health Organization officially declared COVID-19 a global pandemic. What followed was one of the most tumultuous times in recent history, filled with uncertainties about almost every aspect of daily life-including the workplace. Specifically, major tech companies shifted their operations from an office-based model to work from home (WFH) within a matter of weeks. Twitter mandated work from home on March 3, Microsoft and Facebook made similar announcements on March 4 and 6, respectively, and much of the world followed soon after. At the time, most people expected about a two-week outbreak. A few weeks turned into months, and at the time of this writing, 20 months after the initial WFH directive hit tech workers, we are still writing this article from our basements. Tech workers were at an advantage working from home since much of their job happens on computers, and collaboration can often be done over the Internet. That said, this was still a major change for software development companies, and it took time

PATIENT-REPORTED EXPERIENCES WITH SARS-COV-2: A SURVEY STUDY EXAMINING ACUTE- AND LONG-TERM SYMPTOMS AND HOW THEY RELATE TO AREA OF HOSPITALIZATION AND LONG-TERM DISEASE

SESSION TITLE: Post-COVID-19 Outcomes SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has caused an influx of hospitalized patients with acute disease, as well as an influx of outpatient visits for long-term symptoms. There is still much to learn about symptom patterns in different patient groups based on age, race, sex, and illness severity. Patients with post-acute COVID-19 syndrome (PACS), colloquially called long-haulers, are another group who may have unique symptom profiles. We conducted this study to characterize patients’ experiences with COVID-19 symptoms in both the acute and long-term phase. METHODS: Participants were recruited using existing research panel through Qualtrics, a national consumer insights platform. Eligible participants included those who reported a positive COVID-19 test sometime in 2021 and sought some type of medical care. In an online survey, participants were asked about the three most bothersome physical symptoms they experienced out of body aches or joint pain, “brain fog”, chest pain, cough, fatigue or feeling tired/weak, fever/chills/sweating, GI issues such as vomiting/diarrhea, headache, loss of taste or smell, shortness of breath, and insomnia. This list of physical symptoms was sourced by qualitative, in-depth interviews with 55 hospitalized and recovered COVID-19 patients. In addition, participants reported basic demographics, hospitalizations, and whether they considered themselves long-haulers. RESULTS: Of these patients, 29.8% considered themselves long-haulers. There were 2570 survey respondents who participated, of which 61% were female, 48% were male, and 1% were nonbinary. The patients were all age 18 years or older with 14% Hispanic/Latino/a/x/or Spanish origin, and 25% were non-white. Of those who sought medical treatment through a hospital, 59% reported that they sought treatment for COVID-19 in the emergency room, 32% were hospitalized, and 9% were hospitalized in the Intensive Care Unit (ICU). The most bothersome symptoms reported overall were cough, fatigue/feeling weak, and body aches. We compared bothersome symptoms by hospitalization location and long-haul status descriptively. For 18% of participants hospitalized in the ICU, the most bothersome symptom was shortness of breath compared to 11% of those hospitalized on the general floor, and 11% of those seen in the emergency room. Among participants who reported that they consider themselves long-haulers, the most common symptom reported most bothersome was cough. CONCLUSIONS: Data indicate that symptom patterns may differ by illness severity, age, and race. Patients who consider themselves long-haulers also have a different symptom pattern from those who do not report long-term symptoms. CLINICAL IMPLICATIONS: Our findings contribute to the understanding of patient experience with COVID-19 symptoms both in the acute and long-term phase. DISCLOSURES: No relevant relationships by Samuel Brown No relevant relationships by Jorie Butler no disclosure on file for Hirshberg Elliotte;No relevant relationships by Danielle Groat No relevant relationships by Kathryn Hendrickson No relevant relationships by Stephanie Stokes

Climate change and Pacific food systems: decision-making for transformational change - proof-of-concept - final report

Many studies have been conducted on Pacific food crops and fisheries, their vulnerability to climate change, and resilience-building strategies. However, there is a lack of decision-making tools that integrate this information and enable stakeholders to anticipate rapid climate change and uncertainty, and to adapt and transform food systems accordingly. To meet this challenge, in 2019-2020 the Australian Centre for International Agriculture Research (ACIAR) and New Zealand's (NZ) Ministry for Primary Industries (MPI) funded a proof-of-concept Small Research Activity (SRA). The SRA sought to develop innovative participatory decision-making tools that can map transformational options at a regional level to allow exploration and planning for future food systems. These aimed to integrate up-to-date climate projections with scientific and local knowledge of food systems, as well as determine how existing adaptation pathways planning methods could be modified for application in a food systems context, which has not been done to date. The SRA established a Steering Committee to guide the process, and a Science Committee of Australian and NZ food system researchers to design and test a conceptual approach. A case study was selected in Malaita Province, the Solomon Islands, following discussions with the Ministry of Agriculture and Livestock, and the Australian and NZ High Commissions in Honiara. Central and West Kwara'ae Constituencies and Langalanga Ward, which surround the provincial capital of Auki, formed the case study area. While the primary purpose of the SRA was to develop pathways planning methods suitable for a food systems context, the use of a case study helped to ground this in a practical context and test the attractiveness of these approaches with key decision-makers and stakeholders in one or more Pacific Island Countries. In September 2019 - March 2020 the science team collated available downscaled climate projections, sea level rise, cyclone risk and population projection data for the case study, plus an inventory of food and commodities produced in the area. The impact of a 'business as usual' scenario of climate change and population growth was modelled using the Assets Drivers Wellbeing Interaction Matrix (ADWIM), looking forward to both 2030 and 2050. A conceptual approach to planning with these drivers and their impacts in mind was designed based on the 'adaptation pathways' method, which plans for an uncertain future by identifying impacts and assessing and sequencing response options and actions over time. A two day adaptation pathways workshop to provide key decision-makers with an initial introduction to the approach was to be held in Auki in March 2020. With the onset of the COVID-19 pandemic, there were multiple delays and a fully re-designed workshop was finally conducted in November 2020 with remote participation by the science team, and facilitation by local experts. The workshop process was co-designed with the facilitators, and participants were invited from local farmer groups, the Auki Market Vendors Association, women and youth groups, NGOs and provincial and national government departments. The climate and population projection information, pest and disease, alternative production methods and ADWIM modelling results were presented as part of a decision-into-practice learning cycle. Participants described the current food system, assessed drivers of change, their impacts in 2030 and 2050, agreed an aspirational vision for the food system in 2050, and then began to formulate adaptation pathways to reach the vision by re-designing the food system. Instead of focusing on production alone, the pathways approach addressed many aspects of the food system, including resource conservation, marketing, consumption, waste management, education, land disputes and governance.

A Tale of Two Cities: Software Developers Working from Home during the COVID-19 Pandemic

The COVID-19 pandemic has shaken the world to its core and has provoked an overnight exodus of developers who normally worked in an office setting to working from home. The magnitude of this shift and the factors that have accompanied this new unplanned work setting go beyond what the software engineering community has previously understood to be remote work. To find out how developers and their productivity were affected, we distributed two surveys (with a combined total of 3,634 responses that answered all required questions) weeks apart to understand the presence and prevalence of the benefits, challenges, and opportunities to improve this special circumstance of remote work. From our thematic qualitative analysis and statistical quantitative analysis, we find that there is a dichotomy of developer experiences influenced by many different factors (that for some are a benefit, while for others a challenge). For example, a benefit for some was being close to family members but for others having family members share their working space and interrupting their focus, was a challenge. Our surveys led to powerful narratives from respondents and revealed the scale at which these experiences exist to provide insights as to how the future of (pandemic) remote work can evolve.

COVID - Another Blow to LTSS Nursing Workforce Challenges

Background: Long-term services and supports (LTSS) settings have long experienced licensed nurse (LN) and certified nursing assistant (CNA) staffing challenges: shortages, turnover, lack of qualified applicants, and low wages. The COVID-19 pandemic exacerbated these challenges, resulting in further staffing shortages. A goal of our Geriatric Workforce Enhancement Program is to provide LTSS settings in our state with staff training and support. The purpose of this project was to better understand current and anticipated LN and CNA staffing concerns. Methods: In partnership with state LTSS organizations, we developed an anonymous online 34-item questionnaire to assess COVID-related LTSS staffing challenges as perceived by administrators from: Assisted Living (ALF), Intermediate Care (ICF), and Skilled Nursing (SNF) facilities;Home Health (HH), Hospice (H), and Personal Care (PCA) agencies. Non-parametric statistical analyses were performed in R. Results: 106 questionnaires (55% AL, 13% HH, 10% H, 3% ICF, 12% SNF, 6% PCA) were completed. Significantly more open full- and part-time positions were reported for CNAs (mean=3.5 AL, 10.4 ICF, 5.9 SNF, 10.0 PCA) than LNs (mean=0.3 AL, 1.6 ICF, 2.6 SNF, 0.0 PCA) in most settings (p≤0.05 Mann-Whitney U), but not HH (mean=2.1 CNA, 1.3 LN) or H (mean=2.7 CNA, 2.3 LN). Respondents predicted significantly more open positions post-vaccine mandate for CNAs (mean=4.1 AL, 9.9 SNF, 17.0 PCA) than LNs (mean=0.2 AL, 3.7 SNF, 0.0 PCA) in most settings (p≤0.05 Mann-Whitney U), but not HH (mean=3.3 CNA, 2.7 LN) or H (mean=2.4 CNA, 1.9 LN). Top barriers to reaching ideal staffing ratios included wages, candidate pool, competition, and turnover. There were no differences in predicted CNA resignations post-vaccine mandate (mean=11.7 HH, 30.0 H, 36.7 ICF, 24.4 SNF, 16.3 PCA) compared to LNs (mean=16.0 HH, 27.0 H, 33.3 ICF, 22.9 SNF, 60.0 PCA) in all settings except AL (mean=33.4 CNA, 11.5 LN) (p=0.00 Mann-Whitney U). Conclusions: LTSS settings are facing severe nursing staffing shortages that our results predict will increase post COVID-19 vaccine mandate, particularly for LNs. Multi-faceted, multi-level approaches are needed to integrate COVID policies and processes into training and provide emotional and financial support to retain and build the workforce in LTSS settings.

Developing and Implementing an Immersive Virtual Study Abroad Course on the History and Science of Information

The covid pandemic took a tremendous toll on study abroad programs, which are a common hallmark experience in higher education. This adds another challenge for computer science (CS) and physics students for whom there were already few discipline-specific study abroad opportunities. In order to address this issue, we created a virtual, CS/physics-based, short-term study abroad course focused on the history and science of information in England. This work demonstrates that it is possible to offer engaging and immersive virtual travel courses and provides insight into their design and development. © 2022 Owner/Author.

Prescriber Perceptions on Utilization of the Antibiotic Self-Stewardship Time Out Program (SSTOP) at Veterans Affairs Medical Centers (VAMC): A Strategy for Improved Antibiotic Use

Background. Evidence is lacking on how to implement effective and sustainable antibiotic stewardship strategies. The Antibiotic Self-Stewardship Time Out Program (SSTOP) evaluated the implementation at VAMCs of an "Antibiotic Timeout" 3 days after the initiation of antibiotics to encourage providers to review continued use of broad-spectrum antibiotics. Methods. Sites launched the SSTOP note templates in a rolling fashion from June 2019-March 2020. Clinical pharmacists largely drove the implementation. The vancomycin note template was implemented at 6 of 8 sites and the antipseudomonal note template across 4 of 8 sites. Two sites were unable to launch the note templates due to lack of resources, however they utilized SSTOP principles/guided tools. From Sept 2019-Nov 2020 we conducted post-launch qualitative interviews with Antibiotic Stewardship Program (ASP) champions involved in implementation across the 8 VAMCs. Interviews were transcribed and analyzed for thematic content. Results. Feedback from ASP providers suggests prescribers had mixed reviews on the note template, but overall liked the process and deemed it to be straightforward. Many valued the algorithm, indicating it was helpful in both thinking about antibiotics prior to initiation, and identification of appropriate antibiotics. Barriers included staffing (e.g., rotating residents/turnover), surgery service, information technology (IT) support, COVID-19, and the need to remind providers to use the template. Facilitators consisted of strong stewardship, local champions (e.g., ID Fellow), medicine service, and SSTOP data feedback reports. Recommendations largely centered on improvements to the note template usability and to SSTOP feedback reports (e.g., inclusion of patient/provider-level data). Conclusion. Overall, the SSTOP note templates were considered acceptable and straightforward. By guiding providers to prescribe more appropriate antibiotics, they act as influencers for practice change, and may strengthen provider/ASP relations. Plans for continued utilization of the note templates after the project concludes suggest SSTOP may serve as a way to achieve sustainable promotion of antibiotic use improvements.

DISSEMINATED BLASTOMYCOSIS IN A 38-YEAR-OLD MAN WITH BACK PAIN

TYPE: Case Report TOPIC: Chest Infections INTRODUCTION: Blastomycosis is endemic to the midwest, south-central and southeast regions of North America. It should thus be suspected in the differential of patients presenting with atypical symptoms, as extrapulmonary manifestations can be seen. We present a case of disseminated blastomycosis to the spine prior to development of significant pulmonary symptoms. CASE PRESENTATION: 38 year old male presents to a tertiary center in Southern Indiana with back pain of 8 months, fever and dyspnea. Magnetic resonance imaging was significant for L1 osteitis and chest x-ray showed diffuse interstitial markings. Lab work showed leukocytosis with erythrocyte sedimentation rate of 91, and C-reactive protein of 45. He was initiated on broad spectrum antibiotics without any improvement. Due to worsening respiratory failure requiring supplemental oxygen, infectious disease and pulmonology specialists ruled out Legionella, Aspergillosis, COVID-19, HIV, Histoplasmosis, Mycoplasma, Hantavirus and Tuberculosis. Blood cultures and respiratory panel were negative. Urinary blastomycosis antigen was positive. Patient completed 14 days of amphotericin B and was discharged on itraconazole for at least 1 year. DISCUSSION: Blastomycosis can have a broad spectrum of manifestations with pulmonary infection in more than 79% of patients. Extrapulmonary dissemination is less common though can occur in approximately 25-40% of symptomatic patients. Osseous blastomycosis is the second most common dissemination site following the skin and is seen in approximately 5-25% of patients. CONCLUSIONS: We recommend early consideration of blastomycosis in patients with atypical infectious symptoms who reside in Blastomyces endemic regions. Early diagnosis is key in initiating appropriate treatment and preventing severe complications of disseminated disease. DISCLOSURE: Nothing to declare. KEYWORD: blastomycosis

IoT-Based Sanitizer Station Network: A Facilities Management Case Study on Monitoring Hand Sanitizer Dispenser Usage

Maintaining hand hygiene has been an essential preventive measure for reducing disease transmission in public facilities, particularly during the COVID-19 pandemic. The large number of sanitizer stations deployed within public facilities, such as on university campuses, brings challenges for effective facility management. This paper proposes an IoT sensor network for tracking sanitizer usage in public facilities and supporting facility management using a data-driven approach. Specifically, the system integrates low-cost wireless sensors, LoRaWAN, and cloud-based computing techniques to realize data capture, communication, and analysis. The proposed approach was validated through field experiments in a large building on a university campus to assess the network signal coverage and effectiveness of sensor operation for facility monitoring. The results show that a LoRaWAN created from a single gateway can successfully connect to sensors distributed throughout the entire building, with the sensor nodes recording and transmitting events across the network for further analysis. Overall, this paper demonstrates the potential of leveraging the IoT-based Sanitizer Station Network to track public health mitigation methods in a large facility, which ultimately contributes to reducing the burden of maintaining public health during and post-pandemic.

Challenges and Gratitude: A Diary Study of Software Engineers Working From Home During Covid-19 Pandemic

Covid-19 dramatically changed how organizations worked. Microsoft was one of the first to ask employees to work from home (WFH). We des eloped an anonymous nightly diary study with 335 participants anti learned about their experiences user the first 10 weeks of the WFH directive. We found the largest challenges were basing too many meetings, feeling overworked, and physical and mental health. However, engineers reported gratitude for family, increased flexibility, being employed, and team support. People who reported no gratitude were 22% (p-value=.000007) less likely to report being satisfied that day. Many people also reported that the simple act of reflecting nightly during the studs was helpful to them. Our management used the anonymized, aggregate data to create new programs (such as No Meeting Friday) to address these challenges. We then saw immediate feedback on these programs in the diaries and used that to inform future decisions.

A multidisciplinary team initiative toend pj paralysis was successful inachieving cultural change on an acutegeriatric ward

Introduction Prolonged bedrest amongst the elderly causes deconditioningleading to;increased hospital length of stay, additional socialcosts and decreased quality of life. An audit on an acute geriatricward in November 2018, found that over a third of patientsmedically fit (PMF) to sit out remained in bed all day. Therefore, aservice development initiative was undertaken, addressing themisconception that keeping elderly patients in bed is safe, when infact, unintentional harm results. Method In a root cause analysis, four main reasons for bedrest wereidentified: risk aversion, unknown function, widespread “bed issafe” culture and lack of equipment. The project tasked gettingPMF out of bed each day and was audited daily from November2018 to present, involving all members of the multi-disciplinaryteam (MDT) and using a “plan, do, study, act” approach. Results Initially, the project showed an increase in percentage of PMFsitting out each day, but this subsequently decreased with winterpressures. However, for a whole year (February 2019-February2020) a sustained and significant improvement was achieved(64.3%-89.7%). The pre-COVID19 period (February-March2020) saw fluctuations in PMF sitting out. Data collection haltedduring the COVID19 peak, although observationally most patients remained in bed. Auditing resumed from June 2020 (COVID19recovery phase) which showed a steady increase in PMF out of bed,with recent figures surpassing pre-COVID19 levels (97.8%). Conclusion Cultural change takes time to embed and needs persistentreviewing by a dedicated and engaged MDT. Improvements weremade through more accessible doctor's advice, better MDTeducation and communication, daily feedback of data and sourcing additional equipment. Disruption to working patternsover the COVID19 period made this unachievable and the projectlost impetus. In the COVID19 recovery phase, the specialized MDTreformed and worked successfully to restore the cultural change asevidenced by audited data.

The efficacy of remote virtual care in comparison to traditional clinical visits for elective orthopaedic patients: A meta-analysis of prospective randomised controlled trials.

INTRODUCTION: The Orthopaedic Trauma Association has recommended limitation of in-person encounters to absolute necessity. One method of ensuring standard patient care within these guidelines is through the implementation of telemedicine. AIMS: To evaluate the efficacy of telemedicine for elective orthopaedic patients in the recovery and/or rehabilitation period. METHODS: A systematic review and meta-analysis of articles in Medline/PubMed and The Cochrane Library databases was performed according to the PRISMA guidelines for prospective randomised controlled trials to compare clinical and symptomatic measures for elective patients managed routinely with remote care compared to those managed with standard in-clinic management. To be included for meta-analysis, parameters must be evaluated in ≥3 studies. RESULTS: Eleven studies were included in the meta-analyses. Both telemedicine and control cohorts were comparable for patient satisfaction (RR, 0.98; 95% CI, 0.90-1.07; I2 = 0%; p = 0.52) and patient retention analysis (RR, 1.25; 95% CI, 0.51-3.06; p = 0.54; I2 = 0%). Similarly, there was no statistical difference appreciated between cohorts for overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (p = 0.30), Timed Up and Go Test (p = 0.40), and Stair Test (p = 0.18). Significant difference did exist for visual analogue scale (VAS) scores (p = 0.02) in favour of in-clinic management. CONCLUSION: Telemedicine will serve an integral aspect of healthcare delivery throughout the current COVID-19 pandemic and beyond in an effort to deliver safe, efficient and time-sensitive care to the orthopaedic patient population. The results of our meta-analyses indicate that virtual consultations are as effective as traditional in-person consultations for the care of elective orthopaedic patients in the recovery and rehabilitation period. However, further studies are needed to evaluate for initial consultations and certain sub-specialties of orthopaedics.

Quantifying Worsened Glycemic Control During the COVID-19 Pandemic.

AIMS: We hypothesized that glycemic control in outpatients, measured by HbA1c, was worse during the early months of the COVID-19 pandemic than in 2019. We sought to quantify how much worse and to determine if social determinants of health were associated with these differences. MATERIALS AND METHODS: Data were extracted from the electronic medical records of 2 cohorts of patients seen in the family medicine clinic of a southeastern academic health center. Three hundred patients with baseline HbA1c results as well as HbA1c results in May 2019 or May 2020 were evaluated. RESULTS: The groups had similar mean baseline HbA1c (7.65, SD = 1.50 for 2019; 7.61, SD = 1.71 for 2020; P = .85). Mean May HbA1c decreased from baseline in 2019 (7.19, SD = 1.45) but rose in 2020 (7.63, SD = 1.73), a statistically significant difference (P < .01). Controlling for age, gender, race, and insurance status, HbA1c in May 2020 (meanadj = 7.73) was significantly higher than in May 2019 (meanadj = 7.16). CONCLUSIONS: During the early months of the COVID-19 pandemic, glycemic control in our patient population was significantly worse than during the same period in 2019 (mean HbA1c difference = 0.57). Contrary to our expectations, we did not find associations between patient demographic variables and glycemic control, including race.