ABSTRACT
Introduction: The AbC-19™ lateral flow immunoassay (LFIA) performance was evaluated on plasma samples from a SARS-CoV-2 vaccination cohort, WHO international standards for anti-SARS-CoV-2 IgG (human), individuals ≥2 weeks from infection of RT-PCR confirmed SARS-CoV-2 genetic variants, as well as microorganism serology. Methods: Pre-vaccination to three weeks post-booster samples were collected from a cohort of 111 patients (including clinically extremely vulnerable patients) from Northern Ireland. All patients received Oxford-AstraZeneca COVID-19 vaccination for the first and second dose, and Pfizer-BioNTech for the third (first booster). WHO international standards, 15 samples from 2 variants of concern (Delta and Omicron) and cross-reactivity with plasma samples from other microorganism infections were also assessed on AbC-19™. Results: All 80 (100%) participants sampled post-booster had high positive IgG responses, compared to 38/95 (40%) participants at 6 months post-first vaccination. WHO standard results correlated with information from corresponding biological data sheets, and antibodies to all genetic variants were detected by LFIA. No cross-reactivity was found with exception of one (of five) Dengue virus samples. Conclusion: These findings suggest BNT162b2 booster vaccination enhanced humoral immunity to SARS-CoV-2 from pre-booster levels, and that this antibody response was detectable by the LFIA. In combination with cross-reactivity, standards and genetic variant results would suggest LFIA may be a cost-effective measure to assess SARS-CoV-2 antibody status.
ABSTRACT
History The University of Chicago Comprehensive Cancer Center's HealthyU program started as a health education initiative to reach University of Chicago Medicine employees from across a variety of sections and departments. HealthyU consisted of weekly workshops, called Workshop Wednesdays and pledge cards for cancer screenings. HealthyU programming was only done during awareness months for the “screenable” cancers: breast, cervix, colon, and lung. Attendance at our workshops was sporadic and completed pledge cards usually did not meet programmatic goals. Making the Switch to Virtual Programming Beginning in October 2020, in the wake of the COVID-19 pandemic, we took the HealthyU program online for Breast Cancer Awareness Month. Our breast cancer programming consisted of four educational webinars to encourage breast cancer screening, a digital screening pledge card, and a mammogram toolkit with printable resources to promote mammography. We had 50% more webinar participants and 23% more pledge cards signed virtually than we did in October of 2019 during our in-person programming. The success of our virtual Breast Cancer Awareness Month programming prompted us to expand HealthyU dramatically. Cutting out the logistics of on-campus programming has allowed us to broaden the scope of the HealthyU program in the following ways: 1. The target audience has grown beyond UChicago Medicine employees to include a variety of community partners across greater geographic areas both within and outside of our catchment area. 2. We host webinars on a weekly basis and for a wide range of cancer-related topics. 3. Our physical pledge cards are virtual and have grown to include pledge cards for other cancer screenings and risk-associated behaviors. 4. We created online toolkits to share with our community and UCM partners with information and shareable resources that can be used online or printed and distributed. 5. We have incorporated virtual contests to encourage cancer screening advocacy and awareness. 6. We designed self-guided cancer education modules and an online video library to supplement our programming. 7. We leveraged our social media presence to engage in real-time cancer-focused conversations online. 8. We developed other online webinar series, including documentary short screenings, survivorship storytelling, researcher/survivor summits, and singular webinars on public health topics. Outcomes & Future Directions Through the HealthyU program, we've connected over 100 UCM employees and community partners with 64 different University of Chicago faculty experts and 26 community experts. We plan to use the techniques and outreach strategies learned to expand our reach in other areas, including an online training course for cancer investigators and community members on the principles of community-based participatory research, and a community-scientist virtual summit on Cancer and the Microbiome. We have leveraged the success of this program to secure device donations to expand our outreach to communities with inadequate technology access.
ABSTRACT
Objective This study specifically aimed to explore the experiences of pregnancy, childbirth, antenatal and postnatal care in women belonging to ethnic minorities in NHS Lothian, and to identify any specific challenges that these women faced during the SARS-CoV-2 pandemic. Design An exploratory descriptive qualitative research design was used as it facilitated the gathering and interpretation of rich data. Method Purposive sampling was implemented to recruit women who self-identified as ethnic minority and had booked their pregnancies within NHS Lothian. Each community midwifery hub and two obstetric units were provided with a study recruitment pack containing a participant information sheet, consent form and pre-paid envelope. Patient details were securely passed onto researcher, JJ, who telephoned each patient 48 h after they received a recruitment pack. JJ started interviews by reconfirming participants' consent, including permission to audiotape and transcribe the conversations. Data collection occurred between December 2020 and January 2021. Interviews were audio-recorded and transcribed verbatim by First Class Secretarial Services. Data collected was kept confidential by allocating a distinct code to each woman in order to protect her anonymity. Data was collected until no new themes were identified and inductive thematic saturation was perceived. This study adopted a data analysis methodology based on the principles of thematic analysis. Results 16 women from diverse backgrounds participated in telephone interviews from across all community midwifery hubs within NHS Lothian. 7 identified as Black-African, 3 as Asian- Indian, 2 as Arab, 1 as Asian-Bangladeshi, 1 as Asian-Chinese, 1 as Asian-Pakistani and 1 as Black- Caribbean. Only 1 participant required an interpreter (Arabic). The 4 main themes influencing quality of maternity care that were derived from each interview were communication;health care professional interaction, racism and the pandemic effect, with subthemes within each. Conclusions Respectful communication, accent bias, language barriers and cultural dissonance played key roles in the perception of communication as being effective or ineffective. Interactions with health care professionals were graded by classification into continuity of care, empathy, informed decision making and dissonance with other health care systems. Racism was felt to be institutional, interpersonal or internalised. These 3 themes were key factors in the lived experience of pregnancy for ethnic minority women however the added challenges due to isolation, psychological impact, and barriers to access of care under the major theme of the pandemic effect significantly exacerbated existing challenges contained within the first 3 themes.
ABSTRACT
Strategic and tactical capacity planning are critical decisions faced by hospitals. While these problems have received significant attention, current queueing-based approaches do not address realistic healthcare constraints such as blocking, transient arrivals, transient capacity assignments, and surge capacities. A queueing methodology is developed to extend the analysis of these constructs. The methodology developed is generic for hospitals responding to demand surges during epidemics and pandemics such as the recent COVID-19, and in other application areas in manufacturing, supply chain management, and logistics. The medical staff and patient chairs in the emergency room, beds in the operating theater, ICU, and medical/surgical care units are used in patient treatment at a hospital. They can be considered as servers in a system, where capacity and operational policies affect performance measures such as patient throughput. The methodology develops the probabilities from which system performance measures can be estimated for a serial queueing network with blocking. Transient analysis is employed, due to the time varying nature of the patient arrival patterns. The methodology has the capability to analyze different interventions such as increasing and decreasing capacities, and ambulance diversion. In order to handle typical hospital sized problems that result in thousands of ordinary differential equations defining the system probabilities, a transient version of Kanban queueing network decomposition is developed along with procedures for dealing with the discontinuities that arise at capacity changes. Verification/validation is presented along with several scenarios that illustrate the potential application of this methodology in emergency hospital management.