ABSTRACT
Introduction: The 'ICU Liberation Bundle' is recommended by Society of Critical Care Medicine guidelines as standard supportive care. Significant deviations were made to providing bundled care during the COVID-19 pandemic. Implications on patient outcomes are unknown. Research Question or Hypothesis: What influence did COVID-19 have on bundle adherence and clinical outcomes? Study Design: A single-center retrospective cohort study of adult medical ICU patients requiring mechanical ventilation (MV) >= 48 hours and ICU stay >= 7 days. Patients with comfort measures within 48 hours, long-term care residents, and hospital transfers were excluded. Patients were separated into three cohorts based on ICU admission time and COVID-19 status: (Pre-pandemic [pre-group] April 2019-March 2020;Pandemic COVID-19 negative [COV-neg] and Pandemic COVID-19 positive [COV-pos]: April 2020-March 2021). Method(s): Assessment of daily bundle eligibility and adherence was performed over the first 7 days after intubation. Primary outcomes were average daily adherence and days of complete adherence. Secondary outcomes included days alive and free of MV and delirium, readmission, and mortality. Categorical data were compared using Fisher's exact test and continuous data using Kruskal-Wallis/Mann Whitney U tests. Result(s): A total of 410 patients were eligible. A random sample of 170 patients found 137 meeting inclusion of which 31 were excluded. An additional random sample was performed including 67 patients in the final analysis (pre-group n=21;COV-neg n=21;COV-pos n=25). Baseline demographics were similar. Median daily adherence and days of complete adherence were statistically different across cohorts (pregroup 68.6% [65-72.8] vs COV-neg 51.4% [45-60.7] vs COV-pos 32.6% [22.6-47.6];p <0.001) and (pre-group 1 [0-1] vs COV-neg 0 [0-0] vs COV-pos 0 [0-0];p <0.001), respectively. Days alive and free of MV was significantly higher pre-pandemic (pre-group 23 [21-24] vs COV-neg 20[15-22] vs COV-pos 18 [7-21];p=0.0149). No other outcomes were different. Conclusion(s): ICU bundle adherence was significantly reduced during the COVID-19 pandemic with possible implications on patient outcomes..
ABSTRACT
During COVID-19, there has been an unprecedented rise of videoconferencing use, primarily through Zoom. This increasingly popularity of Zoom has led to growing debates about its negative health impacts. In particular, ‘Zoom fatigue’ is a rapidly popularizing phenomena that describes the mental exhaustion or burnout arising from Zoom use. However, the specific mechanisms through which Zoom leads to Zoom fatigue are not well understood. To fill this gap, this study tested a mediated model linking Zoom use with the camera on (‘ZUC’) to Zoom fatigue, through the mediator of social interaction anxiety on Zoom, with a survey sample from the United Kingdom. It was also posited that self-monitoring positively moderated the effects of ZUC on social interaction anxiety on Zoom. The results demonstrated that the direct effects of ZUC on Zoom fatigue was significant and positive. The paper also showed that social interaction anxiety on Zoom increased Zoom fatigue. However, ZUC failed to indirectly increase Zoom fatigue due to the insignificant effects of ZUC on social interaction anxiety on Zoom. Self-monitoring also did not moderate the insignificant relationship between ZUC and social interaction anxiety on Zoom. These insights can guide conceptual frameworks for future research exploring the social psychological impacts of digital media on health. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
ABSTRACT
Oxford COVID-19 Database (OxCOVID19 Database) is a comprehensive source of information related to the COVID-19 pandemic. This relational database contains time-series data on epidemiology, government responses, mobility, weather and more across time and space for all countries at the national level, and for more than 50 countries at the regional level. It is curated from a variety of (wherever available) official sources. Its purpose is to facilitate the analysis of the spread of SARS-CoV-2 virus and to assess the effects of non-pharmaceutical interventions to reduce the impact of the pandemic. Our database is a freely available, daily updated tool that provides unified and granular information across geographical regions. Design type Data integration objective Measurement(s) Coronavirus infectious disease, viral epidemiology Technology type(s) Digital curation Factor types(s) Sample characteristic(s) Homo sapiens.