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In the published article, there was an error in affiliation 1. Instead of "Department of Global Health, Washington, DC, United States,” it should be "Save the Children USA, Department of Global Health, Washington, DC, United States.” The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.In the published article, there was an error in affiliation 2. Instead of "Save the ChildrenInternational, Democratic Republic of Congo Country Office, Goma, Democratic Republic ofCongo,” it should be "Save the Children International, Rwanda-Burundi Country Office, Kigali,Rwanda.” The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. © 2022 Meyer, Abimpaye, Harerimana, Williams and Gallagher.
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Two thirds of family caregivers to persons living with dementia provide complex care tasks, including medical/nursing tasks, and nearly half worry about making a mistake. Learning Skills Together (LST) was designed to prepare caregivers to provide complex care through hands-on instruction (e.g., practice using a gait belt). Consistent with self-efficacy theory, the in-person intervention integrated behavioral modeling, strengths-based feedback, and knowledge-building. COVID-19 prompted a transition to digital delivery of LST over Zoom. Intervention content was modified to accommodate a digital approach while continuing to adhere to self-efficacy theory. Results from a pre- and post-test pilot study (N=35) indicate improvement in self-efficacy on (mean difference (MD)=1.0, SD= 1.6, p-value=0.004). Caregiver comments during qualitative interviews affirm intervention objectives were met. For example, caregivers described the importance of peer learning (modeling) during discussion. Results indicate that complex care intervention can be digitally delivered to family caregivers to improve self-efficacy surrounding complex care.
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Persons living with dementia (PLWD) and family caregivers are particularly vulnerable to the effects of the COVID-19 pandemic. A multi-methods study was conducted to describe the impact of the pandemic on dementia care from the perspectives of stakeholders, including PLWD, family caregivers, and health and social care professionals (HCPs).The study was conducted using a community engaged approach. Cross-sectional surveys were conducted with PLWD (n=27), family caregivers (n=161), and HCPs (n=77), followed by focus groups and interviews with a sub-sample of survey participants (n=55). Participants reported declines in health and quality of life for PLWD and family caregivers. Participants experienced delayed or cancelled dementia care attributed to the pandemic. Most reported telehealth and tele-support were effective alternative models to care. The pandemic impacted the quality and accessibility of dementia care. Results highlight opportunities to improve quality of care through addressing inequities and identifying approaches to address isolation and virtual care.
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Purpose: Increasing mismatch between kidneys available for transplant and the number of patients on the transplant wait list has led to research into novel sources of organs. One such source is kidneys from hepatitis C NAT positive deceased donors. This was previously deemed unforbidden territory due to the risk of disease transmission;however, with the development of direct-acting antiviral agents for effective treatment of Hepatitis C, this organ pool is now usable. Method(s): A retrospective analysis of outcomes of Hepatitis C NAT positive kidney transplants into Hepatitis C seronegative recipients was conducted at newly opened Appalachian transplant center. Due to insurance constraints, the criteria to initiate hepatitis C therapy was seroconversion to positive Hepatitis C PCR. Outcomes examined include median creatinine, glomerular filtration rate (GFR), liver function tests, recipient Hepatitis C seroconversion, concomitant Ebstein Barr virus (EBV), Cytomegalovirus (CMV) or polyoma hominis (BK) activation, morbidities and mortality. Result(s): Six transplants (of 15 total kidney transplants) from Hepatitis C NAT positive donors were performed in the first year of establishment. Male to female ratio was 2:1 and median patient age was 55.7 years (Range 42-73 years). Median follow-up was 10 months (Range 2-12 months). Diabetes and hypertensive nephrosclerosis were the most common causes of end stage renal disease at 40%. The average time on dialysis was 2.9 years (Range 1-6 years), the most common type being hemodialysis (67%) followed by peritoneal dialysis (33%). Average time on transplant waitlist was 5.57 months (Range 1.2-13.2 months). All patients seroconverted but with treatment, by 24 weeks all patients maintained undetectable viral loads. Patient survival rate was 83% with a death censored graft survival rate of 100%. One patient died due to respiratory failure from COVID-19 infection. Median creatinine and GFr were 1.96 mg/dL (Range 1.8 - 2.6 mg/dL) and 41.3 (Range 35.3 - 50) respectively. One case each of acute antibody and T cell mediated rejection was seen (6.7%), which were treated successfully. CMV, BK and EBV virus reactivation were seen in one patient each (6.7%). The most common complication was COVID-19 infection (50%) followed by neutropenia (33%). Conclusion(s): With the development of direct-acting antiviral agents offering complete cure of Hepatitis C, kidneys from Hepatitis C positive donors can be used for transplantation with excellent outcomes.
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Purpose: Kidney transplantation has become the optimal treatment for end stage renal disease (ESRD), allowing dialysis free survival. Despite widespread availability of transplant programs;rural patients have limited access to transplantation due to several barriers including increased travel time and financial burden. We report outcomes after establishment of a kidney transplant program serving rural West Virginia. Method(s): A retrospective review of the first 15 kidney transplants performed at a newly established Appalachian transplant program was conducted. Primary outcomes measured were graft survival and function. Other outcomes included graft rejection, patient survival and complications. Data related to patient demographics, etiology of ESRD, type of renal replacement therapy, time on transplant waitlist and average travel to transplant center were also collected. Result(s): The first 15 kidneys transplanted had an overall death censored graft survival rate of 100%. Median patient age was 53 (Range 31- 73 years) and a median follow-up of 6 months (Range 1-13 months). The average time on dialysis for this cohort was 4 years (n=13, Range 1-6 years) and average time on waitlist was 4.06 months (Range 0.4-13.2 months). The most common type of dialysis was hemodialysis (77%) followed by peritoneal dialysis (15%). Two patients were predialysis. Diabetes with hypertension (20%), IgA nephropathy (13%) and diabetes without hypertension (13%) were the most common causes of ESRD. Median graft creatinine was 1.51 mg/dL (Range 1.26 - 1.83 mg/dL) with a glomerular filtration rate (GFR) at 51.38 (Range 41.86-70) at one year. One patient developed acute antibody mediated rejection and one developed borderline T cell mediated rejection (13.3%), which were successfully treated with steroids, plasmapheresis and immune globulin therapy. Two patients died (13.3 %);one from acute respiratory failure following coronavirus (COVID-19) infection and one from cardiac arrest secondary to myocarditis (possible COVID-19). Patients experienced COVID-19 infection at a rate of 13.3 %. The average distance patients had to travel was 94 miles (Range 12 - 164 miles) with a travel time of 1 hour and 52 minutes on average (Range 20 minutes - 2.5 hours) to reach the transplant center. Conclusion(s): We report comparable outcomes from our new rural transplant program despite several barriers to delivery of quality care to our population.
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T1 Figure 1ConclusionsOverall, this largest paediatric single cell COVID-19 study to date showed significant differences in response to SARS-CoV-2 between children and adults, reflecting the changes of the immune landscape over developmental time, which in children are dominated by naïve and innate responses.
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Entrepreneurs play a focal role in a society's economic recovery from major disruptions such as the COVID-19 pandemic. We argue that entrepreneurs' ability to identify and act on entrepreneurial opportunities during the crisis reflects their resilience, and their innovations facilitate new patterns of work, learning, and leisure activities in post-COVID-19 societies. However, how, how quickly they act, and how influential their actions are depends on their context in terms of institutions, resource access, and market volatility. In China, some entrepreneurs have shown great resilience by utilizing network relationships and digital technology, not only to overcome short-term disruptions in 2020 but to shape the evolving 'new normal' where behaviors and capabilities have changed as a consequence of the experience of the pandemic. We discuss drivers of such resilient entrepreneurship during the COVID-19 pandemic in China and call for further research on the interplay between external disruptions, different types of entrepreneurship, and the consequences for resilience in emerging economies. © The Author(s), 2021. Published by Cambridge University Press on behalf of The International Association for Chinese Management Research.
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By some counts, up to 98% of environmental news stories are negative in nature. Implicit in this number is the conventional wisdom among many communicators that increasing people's understanding, awareness, concern or even fear of climate change are necessary precursors for action and behavior change. In this article we review scientific theories of mind and brain that explain why this conventional view is flawed. In real life, the relationship between beliefs and behavior often goes in the opposite direction: our actions change our beliefs, awareness and concerns through a process of self-justification and self-persuasion. As one action leads to another, this process of self-persuasion can go hand in hand with a deepening engagement and the development of agency - knowing how to act. One important source of agency is learning from the actions of others. We therefore propose an approach to climate communication and storytelling that builds people's agency for climate action by providing a wide variety of stories of people taking positive action on climate change. Applied at scale, this will shift the conceptualization of climate change from 'issue-based' to 'action-based'. It will also expand the current dominant meanings of 'climate action' (i.e. 'consumer action' and 'activism') to incorporate all relevant practices people engage in as members of a community, as professionals and as citizens. We close by proposing a systematic approach to get more reference material for action-based stories from science, technology and society to the communities of storytellers - learning from health communication and technologies developed for COVID-19. © 2020 The Author(s). Published by IOP Publishing Ltd.