ABSTRACT
The Support and Aid to Families Electronically (SAFE) pilot program was developed through a community–university partnership to support parents of elementary students in Ontario, while providing stable practicums for social work students in the midst of COVID-19 restrictions. Purpose: The aim of the current study was to examine the feasibility of the SAFE pilot program as a mental health support to families by examining three feasibility objectives: demand, acceptably, and implementation. Method: Qualitative data from interviews, focus groups, and qualitative surveys involving service users, social work students, referring school board and university professionals (n = 37) were examined. Results: Demand for SAFE extended beyond the pandemic. A high-level of acceptance of SAFE was identified. Areas of success and considerations for implementation are outlined. Discussion: This study provides practice guidance on implementing this unique program, with potential to address gaps in service provision and the ongoing crisis in field education. © The Author(s) 2023.
ABSTRACT
Post-acute sequelae of SARS-CoV-2 infection (PASC) affects a wide range of organ systems among a large proportion of patients with SARS-CoV-2 infection. Although studies have identified a broad set of patient-level risk factors for PASC, little is known about the contextual and spatial risk factors for PASC. Using electronic health data of patients with COVID-19 from two large clinical research networks in New York City and Florida, we identified contextual and spatial risk factors from nearly 200 environmental characteristics for 23 PASC symptoms and conditions of eight organ systems. We conducted a two-phase environment-wide association study. In Phase 1, we ran a mixed effects logistic regression with 5-digit ZIP Code tabulation area (ZCTA5) random intercepts for each PASC outcome and each contextual and spatial factor, adjusting for a comprehensive set of patient-level confounders. In Phase 2, we ran a mixed effects logistic regression for each PASC outcome including all significant (false positive discovery adjusted p-value < 0.05) contextual and spatial characteristics identified from Phase I and adjusting for confounders. We identified air toxicants (e.g., methyl methacrylate), criteria air pollutants (e.g., sulfur dioxide), particulate matter (PM2.5) compositions (e.g., ammonium), neighborhood deprivation, and built environment (e.g., food access) that were associated with increased risk of PASC conditions related to nervous, respiratory, blood, circulatory, endocrine, and other organ systems. Specific contextual and spatial risk factors for each PASC condition and symptom were different across New York City area and Florida. Future research is warranted to extend the analyses to other regions and examine more granular contextual and spatial characteristics to inform public health efforts to help patients recover from SARS-CoV-2 infection.
Subject(s)
COVID-19 , Sleep Deprivation , Food HypersensitivityABSTRACT
Rationale: During March to July 2020, in the COVID-19 pandemic, Aneurin Bevan University Health board reported 2,761 patients diagnosed with COVID-19 1. Many of those with severe COVID-19 showed persisting fatigue, shortness of breath, muscle mass loss and deconditioning. This resulted in decreased exercise tolerance, in addition to ongoing complex psychological and health concerns. There is significant evidence to support PR as a means of improving mental and physical health in many respiratory conditions. 2 A bespoke face to face COVID-19 pulmonary rehabilitation (PR) programme was therefore setup to maximise patient recovery.Aim: 1. To assess the impact of PR on the Modified Fatigue Impact Scale (MFIS) of patients diagnosed with severe COVID-19. 2. To assess the impact of PR on six minute walk test, sit to stand test and Borg dyspnoea score 3. To identify patients most likely to benefit from PR in the future.Method: Patients were identified as 'severe COVID-19' and referred for PR following a consultant case review of patients requiring non-invasive and invasive ventilation in either the respiratory high care unit (RHCU) or intensive care unit (ICU). Patients were then assessed by a multidisciplinary team to ensure consent and appropriateness for the PR programme.Patients completed MFIS and were assessed on a variety of other physical and psychological measures, including: six minute walk test, sit to stand test and Borg dyspnoea score. During weekly PR sessions the patients engaged with a tailored programme of cardio and strengthening exercises as well as Pilates to improve movement and flexibility. Patients repeated the assessments after six weeks.Results: A total of 31 patients attended the programme. 97% of patients attended 80-100% of sessions. The median change in total MFIS was -16%. There were also improvements seen in the six minute walk test with a median increase of 23% and sit to stand with a median increase of 36%. Median change in BORG score -0.5(-50%).Graph 1: Conclusion: Face to face pulmonary rehab is an effective treatment for patients who have been diagnosed with severe COVID-19 following resolution of their acute illness. PR has resulted in improved physical abilities and psychological wellbeing. Improvements were seen in MFIS in all three MFIS severity categories and PR should be offered to all patients recovering from severe COVID-19.