ABSTRACT
BACKGROUND: A dementia diagnosis presents a myriad of non-medical needs that are burdensome to caregivers and critical for disease management. Most medical professionals lack the time and training to meet these needs for support, education, and resources. The Alzheimer's Association MA/NH Chapter has developed the Dementia Care Coordination program that partners health care providers and payors with dementia care consultants to improve outcomes for caregivers. Dementia Care Coordination is a telehealth-based program that has provided invaluable support and tools for caregivers to manage the increased challenges and isolation of the COVID-19 pandemic. This caregiver support and efficacy are vital to the health and well-being of a person living with dementia.
ABSTRACT
COVID-19 causes high rates of mortality and morbidity in older adults, especially those with pre-existing conditions. Since epilepsy is associated with premature mortality, we aimed to evaluate in-hospital outcomes, including mortality, in older compared (>65) to younger adults (<65) with COVID-19 and epilepsy. We hypothesized that adults >65 years with epilepsy would have higher mortality despite adjustment for comorbidity. This retrospective study in a large multicenter New York health system included consecutive patients with epilepsy admitted with COVID-19 between 3/15/2020-5/17/2021. Epilepsy was identified using a validated ICD-CM based case definition. Outcomes were level of respiratory support, ICU admission, and mortality. Chi-square tests, Fisher's exact tests, Student's t-tests and Mann-Whitney U or Kolmogorov Smirnov tests were conducted as appropriate. Multivariable logistic regression models were generated to examine factors associated with mortality. We identified 173 older and 161 younger adults with epilepsy and COVID-19. Median age of older (>65) compared to younger (<65) adults was 74 vs. 52 (p<.001). A larger proportion of older adults died in hospital (35.8% vs. 23%, p=.01). Older adults were less likely to be discharged to home (21.4% vs. 38.5%, p<.001) and more likely to go to a chronic care facility (19.7% vs. 10.0%, p<.001). Ventilation status (35.8% vs. 39.8%, p=.45) or ICU admission rate (34.7% vs. 44.1%, p=.08) were not significantly different between the age groups. Older adults had higher odds of mortality after adjusting for sex, race, language and Charlson Comorbidity Index (CCI) (OR, 2.04;95% CI, 1.22-3.40, p=0.01). Within the over 65 group, increasing years of age (OR 1.07;95% CI 1.02-1.12, p=0.01), and increasing CCI score (OR 1.16, 95% CI 1.01-1.32, p=0.03) were associated with in-hospital mortality while sex, race, and language were not. Our study found higher in-hospital mortality in older compared to younger adults with epilepsy diagnosed with COVID-19. Consistent with prior work, increasing age and increasing number of comorbid diseases was associated with increased odds of mortality, reinforcing the need to communicate risks of multimorbidity and COVID-19 in older adults with epilepsy.
ABSTRACT
The pandemic in 2020 and measures to control the COVID-19 virus led to many teenagers and Young People(YP) isolated from their friends, through shielding and extended home schooling. It has affected their mental health and wellbeing, with an increasing demand upon mental health services (BMJ 2021, Miller et al 2020, Jeffery et al 2021). In the Thames Valley we look after approx 200 YP with haemoglobinopathy disorders, a third between the ages of 13 & 18 years. A low prevalence area, a very wide geographical spread, making access to specialist services challenging. Access to technology and virtual connections, and a newly appointed psychologist led us to look at provision of an online wellbeing support group for teenagers. Aims: To invite teenagers between 13-18 years to a weekly 'drop in' group, where they would be able to access strategies and resources to support with varying aspects of well-being, as well as the opportunity to ask questions, in a safe supportive environment. Method: The group initially ran on a weekly basis for one hour at the end of the school day, led by 2 specialist nurses and a clinical psychologist. We covered subjects such as: stress, anxiety, low mood, fatigue, as well as more media related content like vaccinations and navigating social media. We used the Zoom platform, but then moved to Microsoft Teams, as this was the Trust's preferred platform. Our YP and their parents were contacted and asked if they would like to join and then they would be sent an invite via email. A reminder was also sent the day before the next meeting. Parents would be included in any email communication and resources;however, they were not encouraged to join the meeting. Meeting etiquette and ground rules were explained at the beginning of the meeting and with each new attendee, in order to establish trust and inclusion. Following the meeting, a summary and any material used was circulated to the whole group. Results: 13 meetings January- November 2021 (Initially weekly, however we changed to monthly over the summer as demand dropped off). Subjects covered include: COVID-19 & dealing with anxiety, stress, Low mood/dealing with sadness, Vaccine safety, fatigue, returning to school, Paintalking to people about your diagnosis.Attendance was variable - with the maximum being 6 young people. A short survey was circulated to try and identify what was working, what needed to change and to have input from the YP on content. As a result of this feedback, we moved to a different day of the week and a later session time. Summary: small numbers YP would regularly attend, parents commented they looked forward to this group, which we took to be a sign of success. Other attendees, joined sporadically on 1 or more occasions. We found the YP to be engaged. Most were happy to say hello and introduce themselves on camera but would then prefer the camera off. We didn't have anyone comment on difficulties with access, many used their smartphone devices. Session preapration was time consuming, but as we progressed, we became more efficient at re-using material and needing less 'team brief' time as we understood how the sessions ran. It is an expensive service, professional time wise. However, we haven't compared to using a clinic environment or education room on site, which would take more organising and possibly less availability. There are no transport cost or travel time, so equitable for all Conclusion: This has been a valuable service for a small cohort.
ABSTRACT
The objective of this study is to present a preventive measures pertaining to COVID-19 in swimming pools and hot springs in Europe, Canada, United States, and Colombia. After the start of pandemic, all swimming pools, beaches, and hot springs in Colombia were closed. Currently, official management plans have yet to be presented for the opening of hot springs and swimming pools. However, the European Association of Water Parks presents a two-stage reopening plan for public recreation centres, while countries such as United States, Australia, Canada, China, and Austria follow similar measures. Among the most representative management measures mandated to prevent the spread of the virus, medical authorities from a variety of governments have collectively recommended the following: i) maintaining rigorous social distancing, ii) cleaning or disinfection of surfaces and common areas routinly, iii) maintaining healthy environments and most importantly, iv) personal care (ie. if not feeling well, stay home and do not put others at risk). © 2021 IEEE.
ABSTRACT
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in an unprecedented shutdown in social and economic activity, with the cultural sector particularly severely affected. Restrictions on musical performances have arisen from a perception that there is a significantly higher risk of aerosol production from singing than speaking, based upon high-profile examples of clusters of COVID-19 following choral rehearsals. However, comparing aerosol generation from different types of vocalization, including singing, across a range of volumes is a rapidly evolving area of research. Here, we measured aerosols from singing, speaking and breathing from a large cohort of 25 professional singers in a range of musical genres in a zero-background environment, allowing unequivocal attribution of aerosol production to specific vocalizations. We do not assess the relative volumes at which people speak and sing. However, both showed steep increases in mass concentration with increase in loudness (spanning a factor of 20–30 across the dynamic range measured, p < 0.001). At the quietest volume (50 to 60 dBA), neither singing (p = 0.19) nor speaking (p = 0.20) were significantly different to breathing. At the loudest volume (90 to 100 dBA), a statistically significant difference (p < 0.001) was observed between singing and speaking, but with singing only generating a factor of between 1.5 and 3.4 more aerosol mass. Guidelines for musical performances should be based on the loudness and duration of the vocalization, the number of participants and the environment in which the activity occurs, rather than the type of vocalization. Mitigations such as the use of amplification and increased attention to ventilation should be employed where practicable. Copyright © 2021 American Association for Aerosol Research. © 2021 American Association for Aerosol Research.