Service user satisfaction with telemedicine in an occupational healthcare setting.

BACKGROUND: Telemedicine has existed pre-pandemic and has been used in some healthcare settings with high patient satisfaction. The COVID-19 pandemic increased the use of telemedicine to help minimize transmission while maintaining service provision. AIMS: To assess service user satisfaction with telephone assessment and to assess distance/time saved by telephone assessment as services users did not have to travel to their appointment. METHODS: Prospective review of service users attending one occupational health clinic over a 1-month period. Service users were asked two questions regarding method of travel, and satisfaction with telephone review. All data captured were anonymous, and distances and times for travel were calculated for driving using Google Maps. RESULTS: Seventy-three service users were recruited to the review. Ninety per cent were reviewed by telephone and 10% reviewed in person. Eighty-eight per cent of service users were satisfied with telephone review. Seventy-eight per cent of service users planned to drive to Dr Steevens' Hospital. In total, 4058.4 km (77 h 6 min) of commuting was saved with phone reviews, and 2753.2 km (54 h 16 min) driving was saved. CONCLUSIONS: Service user satisfaction with telephone review was found to be high, and telephone review resulted in saving of both commuting time for the healthcare worker, reduced time away from the workplace, as well as having a positive environmental impact.

Improving Functional Communication Outcomes in Post-Stroke Aphasia via Telepractice: An Alternative Service Delivery Model for Underserved Populations

Many persons with aphasia (PWA) have limited access to speech-language treatment (SLT) due to limited funding, speech-language pathologist shortages, geographical barriers, physical disabilities, transportation barriers, and the COVID-19 pandemic. The purpose of this study was to determine if telepractice is an effective and feasible service delivery model for PWA. Ten PWA completed 8 hours of remote treatment over 4 weeks. Synchronous telepractice sessions employed Oral Reading for Language in Aphasia (ORLA) and Conversational Script Training (CST). Pre- and post-assessment outcome measures included the Communication Activities of Daily Living-3 (CADL-3) and the Communication Confidence Rating Scale for Aphasia (CCRSA). Participants completed a telepractice satisfaction survey following post-assessment. All participants demonstrated improvements in CCRSA scores, total words produced correctly on trained CST stimuli, and total words produced correctly on trained ORLA stimuli. No differences were noted in CADL-3 scores. All participants were highly satisfied with telepractice as a service delivery model.

Vascular Access Device Selection, Insertion, and Maintenance in Patients with Covid-19 in Icu: A Scoping Review

Introduction: Two fundamental supportive invasive interventions in the intensive care unit (ICU) are ventilation and intravenous therapy. Ventilation research has dominated the literature since the pandemic began, with little research on vascular access devices (VADs), despite these interventions existing almost co-dependently. This scoping review aimed to identify the types of evidence available, knowledge gaps and key concepts on vascular access (VA) approaches in patients with Covid-19 in ICU. The main objective was to conduct a systematic search to examine the types of research conducted on VADs during the pandemic. Method(s): Design: scoping review. The Joanna Briggs Institute (JBI) three-step approach was followed to undertake a systematic search using databases and search engines EMBASE, Medline, CINAHL, PubMed and clinical trials registries. Study designs were searched from 2019 to March 2022 limited to the English language. Our data extraction instrument was developed using a template from JBI (Table 1). The PRISMA-ScR checklist was used to report findings. Result(s): A total of 5107 results were identified (Figure 1). From this number data was extracted from 67 papers. Among the study designs were: retrospective studies (20), editorials and commentaries (17), case reports (14), prospective cohort studies;observational studies;cross sectional studies (8), conference s (2), quality improvement initiative (2), one survey (1), study protocol (1). Two clinical guidelines from expert groups were identified. No randomised controlled trials were identified. No clinical trials, registered or ongoing, were identified. Discussion(s): This review identified that Covid-19 patients are requiring more VADs, over longer periods with an increased risk of mortality. These patients are proned for up to 18 hours a day, reducing access for regular VAD assessment. Well-designed VA research is lacking in COVID 19 cohorts. Conclusion(s): The foundation of evidence-based practice depends on the integration of valid research alongside clinical expertise. Despite VA recommendations being in existence, no randomised controlled trials, systematic reviews or meta-analysis exist to support these recommendations. Future research needs to focus on high quality randomised controlled trials. A systematic review and meta-analysis is, at present, unnecessary.

The Impact of COVID-19 on the Welsh Music Industries: A Strategic Partnership with Welsh Government

This article reflects upon an extensive report written by Paul Carr for the Culture, Welsh Language and Communications Committee (CWLCC), a body that recommends policy to Welsh Government and holds it to account. After initially providing a brief historical account of the ways in which the UK and more specifically the Welsh Government responded to the pandemic in terms of generic and targeted support, in addition to how private sector bodies “filled the gaps”, the article discusses how the report’s recommendations resonated with both the CWLCC Turn Up the Volume report and the official Welsh Government response, providing an account of how three distinct narratives (the reports from Carr, the CWLCC and Welsh Government) have been able to improve the prospects of live music stakeholders in Wales. © Equinox Publishing Ltd 2022, Office 415, The Workstation, 15 Paternoster Row, Sheffield S1 2BX

Introduction: Covid Recovery and Early Covid Music Literature

While commencing the introduction of this special edition in the early months of 2021, the live music industries across the world were just beginning to tentatively emerge from what one commentator described as their “biggest collective threat in living memory”—COVID-19 (Mullova 2020). In England for example, as part of the “post-Covid” recovery process, a government-sanctioned trial event took place in Liverpool’s Sefton Park on 2 May 2021, where 5,000 people attended with no masks or social distancing, in what Youngs (2021) described as “the largest number of people to have legally crammed into a small space in the UK since the start of the pandemic”. Despite this being an iconic occasion for both artists and audience, the event gave scientists the opportunity to study factors such as the impacts of audience movement and catering and alcohol consumption, with it being compulsory for all attendees to take supervised lateral flow tests. This concert, promoted by Festival Republic, was part of the UK Government’s broader “Events Research Programme”, which included activities such as the FA Cup final and the World Snooker Championships. This series of events, overseen by an industry-led steering group and taking place between 18 April and 15 May 2021, were used to inform UK Government policy on social distancing, ventilation and test and trace protocols (UK Government 2021). © Equinox Publishing Ltd 2022

Acceptance of COVID-19 vaccination among cancer patients in an Irish cancer centre

Background: Hospitalised cancer patients have a three times higher risk of death (14%) from COVID-19 than the general public. Vaccination provides an unprecedented opportunity to decrease morbidity & mortality, however, there is a limited data regarding cancer patients’ attitudes towards COVID-19 vaccination. Methods: An anonymised questionnaire was completed by volunteering cancer patients attending the ambulatory care unit of a large tertiary cancer centre (Feb to April 2021), prior to vaccination rollout in this cohort. It assessed patients’ acceptance of, and attitudes toward, COVID-19 vaccination. Statistical significance was assessed with Chi-square test (χ2). Results: There was an 80% response rate (143/179). This included 79 females (55%) with a median age range of 51–60 yrs. (n = 35/24%). Most (78%) had a good performance status (PS = 0-1) & lung was the most frequent (28%) cancer type. Eight (6%) had previous COVID-19 infection. Among respondents, 128 (90%) intended on getting vaccinated, 12 (8%) were unsure & three (2%) would refuse. Those intent on vaccination were less concerned with side effects, viewed the pandemic as serious & perceived cancer as a cause for more severe infection compared to the rest (Table). All 101 (71%) patients who received the influenza vaccine were intent on COVID vaccination. Almost 20% (n=28) reported that they were more likely to receive the flu vaccine due to the pandemic. Twelve (8%) identified attending their GP as a barrier, with 97% (n=135) willing to attend hospital for vaccination. While this service is free, 69% (n=99) were willing to pay, with nearly 40% (n=57) up to €50. [Formula presented] Conclusions: Our study demonstrates a very high acceptance rate of COVID-19 vaccination among Irish cancer patients such that many would be willing to pay & attend hospital to receive it. The barriers to uptake provide an opportunity to improve education. An unexpected consequence, may be a beneficial increased uptake of the influenza vaccine. Legal entity responsible for the study: S. Cuffe. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Telephone consultation in the covid-19 era: An occupational health perspective

With the advent of the Covid-19 pandemic and resulting exponentially increased workload for occupational and other health departments worldwide;telemedicine has been brought to the fore at rapid pace. Healthcare and the management of services have seen a drive to innovate and reinvent the way we conduct our communication with colleagues and patients alike. It is imperative that healthcare professionals (occupational health physicians included), continue to uphold standards and maintain the utmost in professional levels of communication to preserve the doctor patient relationship in these challenging times. Occupational health in particular is responsible for the health and wellbeing of so many staff, most notably the hard working,-and most at risk-health care staff.

Will access to COVID-19 vaccine in Aotearoa be equitable for priority populations?

AIM: This research examines the equity implications of the geographic distribution of COVID-19 vaccine delivery locations in Aotearoa New Zealand under five potential scenarios: (1) stadium mega-clinics;(2) Community Based Assessment Centres;(3) GP clinics;(4) community pharmacies;and (5) schools. METHOD: We mapped the distribution of Aotearoa New Zealand's population and the location of potential vaccine delivery facilities under each scenario. Geostatistical techniques identified population clusters for Maori, Pacific peoples and people aged 65 years and over. We calculated travel times between all potential facilities and each Statistical Area 1 in the country. Descriptive statistics indicate the size and proportion of populations that could face significant travel barriers when accessing COVID-19 vaccinations. RESULTS: Several areas with significant travel times to potential vaccine delivery sites were also communities identified as having an elevated risk of COVID-19 disease and severity. All potential scenarios for vaccine delivery, with the exception of schools, resulted in travel barriers for a substantial proportion of the population. Overall, these travel time barriers disproportionately burden Maori, older communities and people living in areas of high socioeconomic deprivation. CONCLUSION: The equitable delivery of COVID-19 vaccines is key to an elimination strategy. However, if current health services and facilities are used without well-designed and supported outreach services, then access to vaccination is likely to be inequitable.