ABSTRACT
SESSION TITLE: Impact of Health Disparities and Differences SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Vulnerable patients, including minorities and underserved populations whose care relies on public hospitals, have limited access to advanced cardiac or respiratory care in shock centers or extracorporeal membrane oxygenation (ECMO)-capable hospitals, especially when socioeconomic or insurance barriers play a role in patient selection. Our aim is to describe the implementation of an ECMO program for cardiac and respiratory failure during the COVID-19 pandemic in the largest public health system in the country, as a strategy to mitigate healthcare disparities and improve access to care for minorities. METHODS: We collected clinical, demographic and socioeconomic data of all patients undergoing ECMO at Bellevue Hospital Center, the shock and ECMO center for New York City’s Health and Hospitals’ network. This public health system includes 11 Hospitals and provides care to 1 million New Yorkers. The decision to proceed with ECMO took place with a multidisciplinary team discussion, which was also in charge of providing longitudinal care during their hospitalization. RESULTS: A total of 49 patients were included [30 veno-venous (VV) ECMO, 19 venoarterial (VA) ECMO, including 9 extracorporeal cardiopulmonary resuscitation (ECPR)] from April 1st, 2020 to March 30th, 2022. The median age was 42.6 years, 57% were male, 38% were Hispanic, 35% African American, 14% white, 6% Asian and 8.2% had other ethnicities;33% were uninsured, 49% lived below the poverty level reported for New York City and 20% were undocumented. Level of education was 8th grade or less in 2.1%, high school in 24.5%, ≤ 2 years of college in 10.2%, >4 years of college in 12.2% and unknown in 51%. ECMO survival was 56% for VV ECMO, 44% for VA ECMO and 33% for ECPR. Survival to discharge was 56% for VV, 33% for VA and 33% for ECPR. One VV ECMO patient was bridged to lung transplant, there were no patients bridged to LVAD or heart transplant. Bleeding complications occurred in 3 patients (6%) and there were no procedural related complications. CONCLUSIONS: Our multidisciplinary ECMO program demonstrates feasibility to provide care to underserved and vulnerable populations with outcomes comparable to the national average, despite the challenges related to the potential limitations in bridging strategies for such patients. While socioeconomic and insurance status have a key role in bridging options for ECMO, they should not be a major determinant in denying patients advanced cardiopulmonary support if clinically indicated. CLINICAL IMPLICATIONS: Access to advance cardiorespiratory therapies including ECMO for vulnerable populations is a present need and is feasible with a multidisciplinary team DISCLOSURES: Speaker/Speaker's Bureau relationship with Zoll Please note: 3 years Added 04/04/2022 by Carlos Alviar, value=Honoraria No relevant relationships by Fariha Asef No relevant relationships by Sripal Bangalore No relevant relationships by Samuel Bernard No relevant relationships by Lauren Bianco No relevant relationships by Nishay Chitkara No relevant relationships by Jennifer Cruz No relevant relationships by Michael DiVita Research support relationship with Eurofins Viracor Please note: 12/1/2021 ongoing Added 12/23/2021 by Randal Goldberg, value=Grant/Research Support No relevant relationships by Kerry Hena No relevant relationships by William Howe No relevant relationships by Norma Keller no disclosure on file for Ma-Rosario Mertola;no disclosure on file for Thor Milland;No relevant relationships by vikramjit mukherjee No relevant relationships by Kayla Nunemacher No relevant relationships by Mansi Patel No relevant relationships by Radu Postelnicu No relevant relationships by Deepak Pradhan No relevant relationships by Vito Stasolla no disclosure on file for Amit Uppal;No relevant relationships by Susan Vlahakis No relevant relationships by Kah Loon Wan no disclosure on file for Victoria Yunaev;
ABSTRACT
This study examines the effect of strategies adopted by Chitkara International School for the continuous improvement of online learning of kindergarten students, during the transition of classes from offline mode to online mode. The objective of this study is to increase the interest of the students in online classes, to increase the engagement of the parents in the child's learning process and upskilling the teachers for handling online classes during COVID-19 time. The study was conducted on 373 kindergarten students, parents and 25 teachers of Chitkara International School. The study was conducted using Pre-test-post-test single group design. The sample was analysed based on the qualitative and quantitative data. The findings of the study reported that there was significant improvement in the attendance of the students of the kindergarten classes, the cooperation and involvement of the parents increased and there was a significant increase in the participation of the students in all the activities. This study was conducted with a purpose of providing Quality Education to students even during Covid times and all efforts were made in sync with the Sustainable Development Goal 4 which focusses on Quality Education. © The Electrochemical Society
ABSTRACT
Introduction: The global pandemic resulting from the coronavirus disease of 2019 (COVID-19) outbreak has caused significant limitations in the public’s access to routine dental and medical care. Objective: To audit the impact of the COVID-19 Pandemic on the utilization of dental services. Methods: The present retrospective study was conducted in the Department of Oral Medicine and Radiology in collaboration with the Public Health Dentistry Department, Christian Dental College and Hospital Ludhiana. The hospital records of the 972 patients who visited the hospital OPD during the lockdown were analyzed. Results: Men sought emergency treatment more frequently (54.8%) compared to women (45.2%). Approximately 63% of the patients reported had endodontic emergencies like pulpitis, symptomatic alveolar abscess, symptomatic apical periodontitis and failed root canal treatments. The oral surgery department received a patient turnout of around 20% with emergencies like pain is grossly decayed teeth, impacted teeth, road traffic accident cases, dental fracture, neuralgias, tumour and MPDS patients. Prosthetic visits were around about 8%. Conclusion: COVID-19 pandemic decreased the utilization of non-urgent dental services significantly. This subsequently can negatively impact the dental health of the general public. An immediate decrease in dental service utilization is also anticipated due to the financial downturn in the COVID-19 pandemic. © IJCRR.