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Evusheld is a combination injection of tixagevimab/cilgavimab for pre-exposure COVID-19 prophylaxis and was made available to UK private clinics from October 2022. NICE review is ongoing. Whilst efficacy analysis of Evusheld has focused on the risk-reduction of contracting COVID-19, anecdotal reports suggest additional psychological benefits from Evusheld, although supportive objective data are lacking. In this study, we used 4 well-established psychological health questionnaires to assess different psychological parameters (EQ5D-3 L quality of life (QoL) score, DSM5 Agoraphobia score, Duke's Social Support Index (DSSI) and the hospital anxiety and depression score (HADS)) in blood cancer patients treated with Evusheld at the Genesis Care (GC) Clinic, Cambridge. Patient data (pre-and post-Evusheld) were compared with a control group of GC blood cancer patients who had not received Evusheld. The study was approved by GC and all patients had consented to email contact. Questionnaire replies were anonymised and free-text comments were invited. Questionnaires were completed by 29/40 Evusheld and 54/100 control patients. With EQ5D, Evusheld did not impact mobility, self-care and pain/discomfort scores and patient/ control groups scored at similar levels. EQ5D scores for 'usual activities' and 'anxiety/depression' improved post-Evusheld (patients reporting 'normal activities' increased from 52% to 76% (control = 78%);patients reporting 'no anxiety/ depression' increased from 45% to 66% (control = 65%)). The mean global EQ5D QoL score improved post-Evusheld [69.4% to 72.9% (control = 75.7%)]. With the DSM5 agoraphobia score, Evusheld treatment improved agoraphobia parameters, reducing the mean score from 15.7 to 5.1 (control = 3.7;max = 40) with certain striking changes;72% of pretreatment patients avoided crowded situations all of/most of the time, reducing to 14% post-Evusheld (control = 11%). The DSSI score assessed social/work interactions with external household contacts and post-Evusheld the mean number of interactions over 3 weeks increased from 1.48 to 3.37 (control = 3.77). Pre-Evusheld, 52% of patients had no interactions outside their household, dropping to 20% in the 3 weeks post-Evusheld (control = 17%). Using the HADS 14-point analysis of depression and anxiety revealed on average that each parameter was 25.3% 'significantly improved' and 25.4% 'a little improved' post-Evusheld. Accepting limitations of a small study and potential biases associated with a self-funding patient cohort, Evusheld treatment broadly improved all psychological scores assessed. Free-text comments clearly indicate that Evusheld had a major positive impact on QoL/social mobility for specific patients. The Evusheld patients had higher baseline scores for social isolation, anxiety, depression and agoraphobia compared with control patients, yet Evusheld treatment appeared to improve these parameters to a level similar to control patients.
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Background: The ongoing outbreak of Coronavirus disease 2019 (COVID-19) is a major challenge for mental health care systems and causes and exacerbates mental anxiety. Objective(s): This study sought to investigate the coping styles of stress in families and relatives of COVID-19 patients in the south of Iran, according to Lazarus and Folkman's Transactional theory of Stress coping model. Method(s): The present cross-sectional study was performed in the period from March 5 to July 5, 2020. Data collection was done electronically using a standard questionnaire on Lazarus and Folkman's coping methods. Finally, the output data of the electronic questionnaire were analyzed using descriptive and inferential statistics. Result(s): A total of 276 people participated in the present study. There was a statistically significant difference between age and all emotion-oriented coping style domains (P <0.05), except planful problem solving (P = 0.817) and positive reappraisal (P = 0.153). The results of the present study showed that from the emotion-oriented coping, the domain of self-controlling (%55.9) received an unfavorable score, but in the problem-oriented coping (60.02%), the two domains of social support (%71.27) and positive reappraisal (70%) obtained scores above 50%. Conclusion(s): Families and relatives need help to improve coping with stress in the area of self-controlling. The results of the present study showed that emotion-oriented coping (self-controlling) had less effect on family stress than problem-oriented coping (domains of social support and positive reappraisal). Also, with domains of social support and positive reappraisal, the stress in the families was reduced. Factors influencing coping styles were age, literacy, source of information, and underlying disease. Since the COVID-19 pandemic condition is a unique stressful situation, it is necessary to implement psychological and educational interventions to gain the ability to control stress, especially in relatives with COVID-19. Copyright © 2022 Faryabi et al.
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Background:: Maintaining physical distancing is one of the most important steps to enforce in educational institutions to reduce the risk of transmission of COVID-19. However, close proximity and physical contact between students are often considered ‘normal' during physical education (PE) classes, making it challenging for PE teachers to ensure physical distancing. Objectives:: The aim of this study was to assess the effect of the implementation of the Good Behaviour Game (GBG) in maintaining physical distancing in PE settings in times of the COVID-19 pandemic. Method:: In a quasi-experimental design, two groups were separately designated as an experimental group (20 classes involving 220 students) and a control group (20 classes involving 231 students). They were all enrolled in the eighth grade of the Tunisian education system. In the experimental group, the PE teacher managed physical distancing by administering the GBG. Physical distancing was evaluated by direct observation of videos of filmed PE sessions using a code grid. It was measured twice for the two groups using Kinovea software. Results:: Quantitative data analyses showed that the level of maintaining physical distancing increased after the GBG intervention in the experimental group (p < .001). Furthermore, greater percent changes between pre- and post-intervention were identified in the experimental group compared to the control group (120% vs 1%, respectively). Conclusion:: The GBG was effective in ensuring students' physical distancing when implemented in PE settings.
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Numerous studies links movement activity (e.g., physical activity, sedentary behavior [SB], and sleep) with mental health or illness indicators during the COVID-19 pandemic;however, research has typically examined time-use behaviors independently, rather than considering daily activity as a 24-hour time-use composition. This cross-sectional study aimed to use compositional isotemporal analysis to estimate the association between reallocation of time-use behaviors and depression symptoms in young adults in China. Participants (n = 1475;68.0% of female;20.7 [1.60] years) reported their time spent in moderate to vigorous physical activity (MVPA), light physical activity (LPA), SB, and sleep. Replacing SB with sleep, LPA, and MVPA at 5, 10, or 15 min was significantly associated with lower estimated depression symptoms scores. For example, adding MVPA from SB at 15 min was associated with lower depression symptoms scores (estimated difference: -0.13 [-0.17, -0.09]). The associations between reallocation of time use behaviors with depression symptoms scores were slightly differentiated. Our results emphasize the importance of increased MVPA and decreased SB as well as their mutual replacements for lowering the risks of depression symptoms in young adults during the COVID-19 pandemic. Our results can inform policy to develop effective plans and strategies for mental health promotion.
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Introduction and ObjectivesActivity monitors (i.e. apps and wearables) are becoming increasingly utilised by the general population and people with Chronic Obstructive Pulmonary Disease (COPD). Adapting to COVID-19 involved the remote delivery of COPD treatments, including pulmonary rehabilitation. However, research prior to COVID-19 has reported that few healthcare practitioners used activity monitors within treatment and rarely discussed or reviewed patients’ activity data. Barriers to utilising patient activity data have included;time, expertise, and scepticism about the benefits of reviewing data. Understanding how healthcare practitioners can incorporate technology and utilise activity data collected at home could enable more effective remote delivery of interventions, healthcare, and treatment. This qualitative research aimed to explore healthcare practitioners’ views and experiences of supporting people with COPD who have used activity monitors.MethodsSeventeen semi-structured telephone or online interviews were conducted with healthcare practitioners between September 2020 and May 2021. Healthcare practitioner occupations included nurse, occupational therapist, physician, and physiotherapist. Participants all had experience of supporting people with COPD who had used activity monitors. Interviews were analysed using inductive thematic analysis.ResultsFive preliminary themes were developed underlining healthcare practitioners’ experiences of supporting patients with COPD using activity monitors;1) Using skills and experience to increase accessibility, digital literacy and engagement, 2) The importance of discussion and dialogue to support patients with using activity monitors, 3) Using objectively monitored activity levels to encourage physical activity and support exercise prescription, 4) Implementation of research into usual care and applications to real life, and 5) Benefits of using activity monitors and their future potential.ConclusionsThis study highlighted that HCPs recognise the potential for activity monitors to positively impact patients’ ability to self-manage their COPD. However, there is also a need for training, best practice guidelines and/or recommendations to support HCPs to engage with activity monitors. If physical activity data collected at home is utilised and integrated effectively and efficiently into healthcare practices to support COPD treatment, there is potential for activity monitors to positively impact patients‘ health and self-management behaviours.
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INTRODUCTION: A key aspect of the public health response to COVID-19 in Scotland was enhanced community surveillance, including testing in dental settings. Across Scotland, dental settings offered patients over 5-years-old the opportunity to participate in community surveillance of COVID-19. METHODS: A Health Inequalities Impact Assessment (HIIA) was conducted to understand the differential impacts the programme would have on the population and to improve the accessibility of the programme. HIIA is a tool to allow the assessment, understanding, and mitigation of impacts on people of a proposed policy or practice. It fulfils an organisational duty to meet the requirements of the Equality Act and Fairer Scotland Duty. The HIIA was conducted rapidly in parallel with the programme development. An action research approach included an online workshop, consultation, review of population data and a literature search. RESULTS: Adjustments were required to improve the programme's accessibility. Stakeholders, including dental teams from across Scotland were involved in the consultation and brought their front-line experience in different settings. Common issues identified included digital literacy and access, language and cultural barriers to participation, and issues relating to the implications of a positive COVID-19 result. Literature indicated limited evidence on the acceptability, accessibility, and equity of asymptomatic COVID-19 surveillance. CONCLUSION: This HIIA was conducted during the COVID-19 pandemic. As an example of good practice in tackling inequalities in access to programmes it should represent the benchmark for other similar initiatives.
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COVID-19 , Humans , Child, Preschool , COVID-19/epidemiology , Health Status Disparities , Pandemics , Health Impact Assessment , Program Development , Scotland/epidemiologyABSTRACT
Introduction: Accurate diagnosis of the COVID-19 disease is important. Currently, chest computed tomography (CT) and reverse polymerase chain reaction (RT-PCR) are being used for the diagnosis of the COVID-19 disease. This study was performed to evaluate the Chest computed tomography (CT) diagnostic value in comparison with the RT-PCR method among COVID-19 patients. Methods: This cross-sectional study was performed on suspected cases of COVID-19 in Imam Khomeini Hospital, Jiroft, Iran. Studied patients were evaluated via both a chest CT scan and nasopharyngeal swab for SARS-CoV-2 detection. Data was collected using a self-administered checklist, including demographic information, medical history, and symptoms of COVID-19, chest CT scan, and RT-PCR findings. Data were analyzed using SPSS-V21. Results: One thousand and ninety (1090) cases participated in the study;the mean age of the cases of COVID-19 was 48.20± 7.31 years old. The results of the RT-PCR test were 410 (37.6%) positive and 680 (62.4%) negative cases. According to the results of RT-PCR, which is the gold standard method, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of chest CT were 98.5%. (99.4-96.8 CI: 95%), 55.7% (59.5 – 51.9 CI: 95%), 71.5% (74.4-69.0 CI: 95%), 57.3% (60.9 – 53.5 CI: 95%), and 98.4% (99.4%-99.6 CI: 95%), respectively. Discussion: The results of the present study showed that a chest CT scan is highly sensitive for the diagnosis of the COVID-19 disease. Therefore, it can be used as a suitable method for screening and early detection, which requires knowledge of its common radiologic patterns. However, the results showed that the use of this method has low specificity, so it cannot be used for definitive diagnosis and should be used as a complementary method concomitant to the RT-PCR test. © 2022 Razzaghi et al.
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Resit exams permit students who have failed a subject to sit a supplementary exam to demonstrate achievement of the academic standards required for program progression. This study analyses student perceptions of the strengths and limitations of resit exams during a pandemic and discusses their potential role in Australian Higher Education. The data were obtained from student performance metrics, questionnaires, and focus groups. Students acknowledged the pedagogical and psychological benefits of resit exams within the context of the challenges posed by exam thresholds, high-stakes summative exams, and the COVID-19 pandemic. Students questioned whether the imposition of exam thresholds and high-stakes summative exams adequately supported their learning and accurately measured their performance. © 2022 Elsevier Ltd. All rights reserved.
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A prominent issue for patients with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is obesity. Some reports claim that obese patients with acute respiratory distress syndrome have better outcomes. This inverse relationship has been termed the obesity paradox and is not yet understood in patients with coronavirus disease 2019 (COVID-19) hospitalized in the intensive care unit (ICU). The aim of this study was to investigate the obesity paradox in patients with COVID-19 admitted to the ICU. In this retrospective observational study, 5230 patients with COVID-19, admitted to the ICU between June 1, 2020, and January 10, 2021, were analyzed. Body mass index (BMI) was calculated according to the World Health Organization classification, and patients were categorized as underweight, normal, overweight, or obese for statistical analysis. A Kaplan-Meier survival analysis, Cox regression model, and dose-response relationship between BMI level and ICU length of stay (LOS) and connection to the ventilator survival were conducted. Of the 5230 patients studied, 3233 (62%) had nonobese BMIs, and 2997 (38%) were obese. We found no significant difference in mortality between obese and nonobese patients with COVID-19, where 1699 patients (31%) survived. However, there were significant differences in BMI level for ICU LOS and ventilation duration (P < 0.05, P < 0.03). In multivariable Cox regression, significant differences were observed in ICU LOS and ventilation duration of patients between obese and nonobese patients (P < 0.001, P < 0.005). There was no association between BMI and survival among patients with LOS in the ICU LOS or connection to a ventilator. However, obese patients with COVID-19 require more care than nonobese patients because of additional comorbidities, higher inflammation, and a weaker immune system.
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Purpose or Objective Following completion of an evaluation program of SABR for primary lung cancer and metachronous extracranial oligometastatic disease, NHS England & NHS Improvement funded a SABR expansion program to increase SABR provision to 50 radiotherapy centres. With reduced access to surgery due to the impact of the COVID-19 pandemic, efforts were focussed on implementing SABR for lung primary and oligometastatic disease in the first instance. Materials and Methods The program consisted of 3 elements, delivered by multi-disciplinary SABR experts from the SABR Consortium and the National Radiotherapy Trials Quality Assurance (RTTQA) Group: Education;Mentorship of RT centres new to SABR by those with extensive experience;QA to ensure the safe and consistent implementation of the technique. A contouring workshop for radiation oncologists was developed by the SABR Consortium Steering Committee. In addition, educational sessions were provided within the SABR Consortium Online Conference, offered free of charge to enable wide access to education and professional development. The Committee produced a Guide for SABR Mentorship, setting out a consistent framework under which mentorship would proceed (Table 1). Mentoring and local protocols followed implementation guidance from the UK SABR Consortium Guidelines. In parallel, RTTQA developed a comprehensive RT QA program (Table 2). Two radiation oncologists and one treatment platform were assessed per hospital. Credentialed clinicians then provided cascade training and education within their departments, formally documenting peer reviews through standard templates provided by RTTQA. (Table Presented) (Table Presented) Results 54 radiation oncologists participated in the contouring workshop. The conference had 1335 registrants, 65% of whom were UK multi-professionals. 15 experienced centres were invited to mentor 24 new SABR sites. Mentors were assigned by equipment for planning and delivery. The mentoring framework was adjusted to accommodate visiting restrictions due to the pandemic and performed remotely through email and video-conferencing instead. The RT QA program commenced in June 2020 with circulation of the facility questionnaire, collecting data on equipment, technique, intention to treat and expected level of mentoring. Responses were used to tailor mentoring and inform what components of the QA program were required for each centre. Contouring submissions were received from 46 radiation oncologists and planning benchmarks were completed by all 24 centres, 22 of which underwent the dosimetry audit. All assessments were reported through standard templates to ensure consistent feedback. Conclusion The implementation of lung SABR was completed in June 2021. Collaboration amongst all stakeholders ensured centres were trained and supported to safely deliver high-quality SABR for lung primary and oligometastatic disease. The education, mentoring and QA program proved effective and has now been rolled out to other oligometastatic sites.
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BACKGROUND AND AIMS: The first documented case of SARS-CoV-2 infection was diagnosed in South Africa on the 5 March 2020 and a pandemic declared on the 25 March 2020. Patients on dialysis are at increased risk for COVID-19 infection due to their high burden of comorbidities, impaired immune response, need to attend dialysis and the higher incidence of severe disease. In this study, we evaluated the prevalence, clinical management and outcome of dialysis patients and dialysis healthcare workers who tested positive for COVID-19. Further, the study aimed to provide insight into strategies to minimize COVID-19 spread in outpatient dialysis facilities. METHOD: A retrospective cohort study was conducted on 1382 chronic dialysis patients and 292 healthcare workers from 69 chronic haemodialysis centres and 17 home therapy divisions who have tested COVID-19 positive from the 5 March 2020 until the 26 July 2021. RESULTS: From the 1382 chronic dialysis patients who tested positive during the study, the mean age was 57.5 ± 12.7 years of age;61.3% of patients were male and 38.7% female. COVID-19 re-infection was prevalent in 3.5% (n = 48) of the chronic dialysis patient population within the study duration. The overall 28-day mortality rate for patients testing COVID-19 positive was 13.1% (n = 181). The mean age of patients succumbing to COVID-19 was 63.6 ± 11.1 years of age. A further, 292 healthcare workers tested positive during the study duration, 63.4% (n = 185) were frontline healthcare staff (nurses or clinical technologists) and 22.9% (n = 67) were support services and 13.7% (n = 40), were administrative staff. Only one staff member succumbed to COVID-19 (0.3%). At the end of the study duration 69% of healthcare workers and 27.6% of patients had been vaccinated. CONCLUSION: The COVID-19 pandemic has had a significant impact on chronic dialysis patients. Dialysis patients are associated with more adverse clinical outcomes and increased mortality. In South Africa, better vaccination rates and more dosing and appropriate preventative strategies remain our strongest defense to mitigate excess cases and death.
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In recent months, we have watched COVID-19 spread across the planet like an out-of-control tsunami. As the deaths mount, evidence suggests that minority communities have been hit harder by the virus in every respect. However, influenza type viruses are not new in the United States or other parts of the world. In fact, the Centers for Disease Control and Prevention estimated that influenza caused 34, 000 deaths in the U. S. during the 2018-2019 season. While much of the literature examines the incidence of death from influenza from a medical perspective, this research takes a social science perspective with the goal of influencing public policy. The analysis addresses two important questions. Are certain states and regions of the U. S. more prone to deaths from influenza? Are nonwhites more likely to die from influenza than whites? Our analysis demonstrates that certain U. S. states, regions, and racial groups are more likely to die from influenza than other groups. © 2021 by Nova Science Publishers, Inc.
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In The Great Reset, Richard Florida defines Great Resets as “broad and fundamental transformations of the economic and social order that involve much more than economic or financial events.” In this chapter, we expand Florida’s model to give a much greater emphasis to politics and power and then argue that, while the Trump administration can be viewed as a response to America’s ongoing Great Reset in the 21st century, its efficacy appears to be highly problematic, in large part because it represents a “Back to the Future” vision of where America should go. In particular, the Great Reset that has transformed the political economy of the United States after World War II is composed of a complex set of interacting economic, political, and social phenomena. Economic resets include: 1) the transformation of the economy from an industrial to an information-age one;2) the communications and transportation revolutions that spurred globalization;3) the laissez-faire international order after World War II;4) the transformation of the impact of globalization from positive to negative on many aspects of the economy;5) deindustrialization;6) the changing nature of employment;7) changing business philosophy;8) the marginalization of labor;9) slower economic growth;and 10) the Covid-19 crisis. Political and social resets include: 1) the replacement of Keynesianism by neoliberalism as the nation’s public philosophy;2) the rise of cultural issues in domestic politics;3) the abjuring of large-scale government interventions in the economy, such as the GI Bill and Great Society Programs;4) the “Great Risk Shift” in social insurance;5) decline of educational system;6) financialization of economy;7) limited reduction in barriers facing marginalized members of society;8) the escalating polarization of domestic politics;9) escalating inequality;and 10) the creation and then decline of broad middle class. The Trump administration has had a mixed response to the threats and opportunities that these resets create for continuing and expanding the “American Dream.” It has clearly tried to reverse: 1) globalization’s changing impact on the American economy;2) the changing nature of employment;3) deindustrialization;4) slower growth;5) the changing fortunes of the middle class;6) macroeconomic neoliberalism;7) the role of public education;and 8) the negative impact of the Covid-19 crisis on the economy. In addition, it has accelerated: 1) the rise of cultural issues;2) the polarization of American politics;3) the barriers facing marginalized members of society;4) the financialization of the U.S. economy;and 5) the marginalization of labor. In contrast, it has generally ignored: 1) the transformation from an industrial to an information-age economy;2) the postwar communications and transportations revolutions;3) the change in business philosophy;4) direct government interventions, like the Great Society and G.I. Bill;5) the Great Risk Shift;and 6) rapidly rising inequality. © 2021 by Nova Science Publishers, Inc.
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The rapid advances in information and communication technologies and the widespread adoption of disruptive technologies such as AI and automated systems are changing the work landscape dramatically and are affecting especially older workers and workers with disabilities. Since 2020, the COVID-19 pandemic has accelerated some of these changes, widening the unemployment gap for people with disabilities. To facilitate reskilling and upskilling of older workers and people with disabilities we need to create inclusive work environments that consider their evolving needs and capabilities. The Global Public Inclusive Infrastructure (GPII) provides workers, employers and organizations with tools and methods to include accessibility into their practices and policies. The SmartWork project provides a great opportunity to test how Morphic, the auto-personalization from preference solution provided by the GPII, can help building a more inclusive workplace.
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Research into problematic smartphone use is growing as people are increasingly dependent on technological connections – a situation highlighted during the COVID-19 pandemic. However, current research has been limited by measurement validity issues and a lack of construct clarity. In response, this study developed and validated the Smartphone Connectivity Stress Scale (SCSS) for adolescents and adults. An online survey included an item pool, based on previous research and existing scales, as well as several psychosocial measures (N = 814;aged 14–80 years;59% female). Iterative exploratory factor analyses, classical test theory and item response theory (IRT) analyses produced a unidimensional six-item scale of smartphone connectivity stress – from a perceived obligation to be constantly connected with others. Two-week test-retest reliability was assessed through a follow up survey (n = 190). SCSS factor structure and reliability were strong for adolescents (aged 14–18) and adults (aged 19–80). The SCSS demonstrated good internal consistency (α = 0.87, ωt = 0.91);test-retest reliability, r = 0.82;and all items captured significant information across the latent trait. The SCSS demonstrated no differential item functioning by sex, age, ethnicity or urban/rural residence. The SCSS was positively correlated (ps < .001) with anxious attachment style and psychopathology symptoms (stress, anxiety, depression, suicidality). This is the first measure of smartphone connectivity stress and included valuable IRT analyses. The brief public domain SCSS provides reliable measurement, with reduced error, of a validated construct, and is suitable for use with adolescents and adults. © 2021