Tele-Neuro-Ophthalmology: An Update One YearInto The COVID-19 Pandemic

Objective: This study evaluates the usage of tele-neuro-ophthalmology one year into the pandemic. Background: Tele-neuro-ophthalmology emerged as a resource early in the COVID-19 pandemic. Since then, telehealth utilization has evolved. Design/Methods: Telehealth utilization pre-COVID-19, early pandemic (March, 2020), and 1 year later (March, 2021) was surveyed among practicing neuro-ophthalmologists in and outside the United States using an online platform. Demographics, utilization, perceived benefits, barriers, and data utility opinions were collected over a two-week period in May 2021, prior to the emergence of the Delta and Omicron variants. Results: 135 practicing neuro-ophthalmologists (81.5% United States, 47.4% females) participated in the survey. One year into the pandemic, the proportion of respondents utilizing video telemedicine (50%) decreased from early-pandemic rates (65%) (p<0.0005, McNemar), but was sustained above pre-pandemic percentages (6%, p<0.0005, McNemar). 82% of current video users plan to continue video visits. Proportion of respondents using remote testing (42.2% vs 46.2%, p=0.45), virtual second opinions (14.5% vs 11.9%, p=0.38), eConsults (13.5% vs 16.2%, p=0.25), online portal communications, and remote interpretation of patient-submitted testing remained similar between March 2020 and 2021. The majority selected increased access to care, better continuity of care, and enhanced patient appointment efficiency as benefits, while reimbursement, liability, disruption of in-person clinic flow, limitations of video exams, and patient technology use were barriers. Many neuro-ophthalmic exam elements were deemed more suitable collected in a separate in-person visit rather than during a live video session, although respondents felt some exam components could be evaluated adequately via a virtual platform. Conclusions: One year into the COVID-19 pandemic yet prior to the emergence of the Delta and Omicron variants, neuro-ophthalmologists have maintained telemedicine utilization at rates higher than pre-pandemic levels. Tele-neuro-ophthalmology remains a valuable tool in augmenting patient care.

Group singing for health and wellbeing in the Republic of Ireland: the first national map.

AIMS: (1) To catalogue and map all singing for health and wellbeing groups in the Republic of Ireland (ROI); (2) determine how they prioritise health outcomes; (3) understand what they consider success; and (4) identify gaps in provision. METHODS: A novel mixed-methods survey was distributed electronically through SING Ireland (the Choir Association of Ireland), artsandhealth.ie, and to 2736 potential stakeholders with links to singing for health and wellbeing and singing on social prescription (SSP) from October 2020 to April 2021. Thematic analysis was used to analyse four open-ended survey questions. RESULTS: A total of 185 singing for health and wellbeing groups were identified, with varied representation in each of the ROI's 26 counties. 35 groups were noted to have links to SSP. Gaps in provision for clinical and individual populations and for SSP were identified. Six themes related to the success of group singing for health and wellbeing programmes were determined: fostering and funding social and community connections; the people and the approach; enjoyment and atmosphere; musical and personal growth, programmatic structure and musical content; and the impact of Covid. CONCLUSION: The first-ever national mapping of group singing for health and wellbeing in the ROI, and one of few internationally, this study may serve as a roadmap for gathering information about existing singing for health and wellbeing provision and identifying geographical and clinical gaps internationally. Recommendations are included for future research to address gaps in provision, explore the feasibility of integrating SSP more widely and for further public health investment.

Gynecologic cancer appointment attendance during the COVID-19 pandemic

Objectives The COVID-19 pandemic has significantly disrupted medical care. The purpose of this analysis was to determine the impact of the pandemic on gynecologic cancer appointment adherence. Methods All appointments scheduled at an academic gynecologic oncology center from March 2019 to January 2021 were included. Appointments were stratified into two groups - pre-pandemic (March '19 to January '20) and pandemic (March '20 to January '21). Appointments were determined 'missed' if the patient did not show or cancelled. A multivariable logistic regression was performed to determine the odds ratio (OR) of appointment adherence during the pandemic. Results 31,803 appointments were scheduled during the study period (15,834 (49.8%) pre-pandemic and 15,969 (50.2%) during the pandemic). There were significantly more appointments missed during the pandemic than prepandemic - 7266 (45.5%) vs. 6131 (38.7%);p<.0001. The adjusted odds of missing an appointment were significantly higher during the pandemic (OR 1.43 [95% CI 1.36 to 1.51];p<0.0001). There were more return visits missed during the pandemic than before - 6696 (47.0%) vs 5341 (39.5%);p<0.0001. New-patient visit adherence was unchanged. Race, ethnicity, and income were not associated with missed appointments. Conclusions There were increased odds of missing an appointment during the pandemic than during the year prior. This association was mostly explained by return visits as new patient visit adherence was not impacted by the pandemic. Initiatives should be undertaken to determine the effects of pandemic- induced appointment nonadherence.