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The coronavirus pandemic stretched healthcare resources and infrastructure worldwide. The Emergency Department (ED) is a crucial component in the frontline response to the pandemic. In this chapter, we discuss the logistical and operational challenges faced, the innovative solutions employed, and the lessons learned in our ED as we strived to overcome this unprecedented challenge. Whilst we will share much of what we learned, what we did, and what we believe was responsible for our many successes, at the same time, we are left with a sadness that our healthcare systems (and ‘our' could be applied locally to our community, nationally to our country, and globally to our planet) were simply not designed nor prepared to properly confront a pandemic. The number of patient deaths we witnessed still feels somewhat incomprehensible and scarring. We do, however, hope that our learnings may help inform decisions at other EDs, help prepare us for future crises, and, if nothing else, confers confidence in the ED's ability to overcome this pandemic. © SBH Health System 2022.
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Introduction: The COVID-19 pandemic has interrupted participation in the labour force and may have affected mental health, both directly through the effects of illness and isolation and indirectly through negative effects on employment. Former military personnel may be at particular risk as a result of both additional exposure to risk factors for poor mental health and barriers to labour market participation raised by the transition from military to civilian working environments. This article examines furlough and unemployment as a result of the COVID-19 pandemic among UK working-age ex-service personnel and its associations with poor mental health. Methods: Participants from an existing cohort study of Iraq- and Afghanistan-era UK Armed Forces personnel were invited to provide information on employment before the COVID-19 pandemic and how it has changed since the pandemic. Mental health was measured using the General Health Questionnaire and compared with data collected pre-pandemic. Results: Although Veteran unemployment is not higher than civilian unemployment (4.7% and 4.8%, respectively, in September 2020), it rose during the pandemic from a lower level (1.3%). Part-time and self-employed Veterans were more likely than full-time employees to experience furlough or unemployment. A negative impact on employment was associated with the onset of new mental ill health. Discussion: Employment of ex-service personnel was more negatively affected by the COVID-19 pandemic, possibly because ex-service personnel are mostly men, and men were more affected in the UK general population. This employment instability has negative consequences for mental health that are not mitigated by furlough. LAY SUMMARYThis article examines how employment status changed for working-age UK ex-military personnel in the early period of the COVID-19 pandemic and how this relates to their mental health. Overall, the unemployment rate among ex-military personnel was not worse than that in the general population;however, because ex-military personnel generally have a lower unemployment rate than the general population, this suggests they were worse hit by the pandemic. Part-time and self-employed personnel were more likely to experience negative changes to their employment situation. Both becoming unemployed and being furloughed were correlated with negative changes in mental health. However, it should be noted that the mental health data used for this comparison predate the onset of the pandemic;hence, other factors related to both change in employment status and change in mental health could be the cause of this apparent relationship.
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The COVID-19 pandemic has resulted in a digital technology revolution which included widespread use in remote healthcare settings, remote working and use of technology to support friends and family to stay in touch. The armed forces have also increased its use of digital technology, but not at the same rate, and it is important that they do not fall behind in the revolution. One area where digital technology could be helpful is the treatment and management of mental health conditions. In a civilian setting, digital technology adoption has been found to be acceptable and feasible yet there is little use in the armed forces. In this personal view, we explore the potential use of personalised digital technology for mental health, the hype surrounding it and the dangers.This paper forms part of the special issue of BMJ Military Health dedicated to personalised digital technology for mental health in the armed forces.
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COVID-19 rendered the availability of exercise facilities sporadic and online exercise programs subsequently became more common. This research explored online exercise classes delivered to older adults during the pandemic from the perspective of service providers. Sixty-seven service providers completed the survey (88% female). The majority (54%) of respondents had worked in the fitness industry for greater than 10 years, and 66% were fitness class instructors, while fewer were managers (9%) and personal trainers (8%). Three participants had experience providing online exercise classes prior to the pandemic, while 43 more had experience providing online exercise classes since the pandemic began. Of these 46 service providers, 87% offered classes live through Zoom. The majority (64%) offered classes through an organization, and 61% charged a fee for participants to take part. The most common type of class was a general fitness class (63%), followed by yoga and flexibility classes (39%), and strength training (17%). Regarding equipment used, weights were most frequently required (69%), followed by resistance bands (49%) and mats (44%). Most classes lasted 40–60 minutes (59%) and were low intensity (74%). Of the 21 respondents who did not provide online exercise classes, 43% indicated this was because of a lack of interest, and 19% cited not knowing how to use technology to deliver classes online, though most (71%) indicated they would consider offering online classes in the future. This research reveals the adaptability of service providers and may serve to inform the continued development of online exercise programs for older adults.
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Engaging in physical activity can bring health benefits for older adults. However, during the pandemic the availability of in-person exercise classes has been sporadic. As such, online exercise programs have become more common. This research had the goal of exploring the uptake of online exercise programs by older adults in Manitoba, Canada in the first few months in the pandemic and then more than 1.5 years into the pandemic. Older adults (65 years and older) were recruited via emails from a variety of community organizations. Participants completed anonymous online surveys in summer 2020 (n=678) and fall 2021 (n=570). Less than 50% of respondents reported participating in online exercise classes during the pandemic in both surveys. For both surveys, pre-recorded classes were the most common, however, this decreased from 80% in the first survey, to 57% in the second survey. Conversely, live classes where the instructor could see the participants increased from 17% in the 2020 survey, to 47% in the 2021 survey. Additionally, platform use shifted from YouTube as the most popular in the first survey, to Zoom in the second survey. Most of the online classes originated from their local communities. Of those who participated in online exercise early and later in the pandemic, about two thirds reported that they would continue online exercise classes outside of the pandemic. A major reason for not participating was because they enjoy the social aspect of in-person classes. The perspectives of the study participants will be valuable for policymakers, programmers, and instructors.
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The COVID-19 pandemic drastically impacted nearly all aspects of life throughout the world during 2020. It had a particularly severe impact on air transportation with U.S. demand initially dropping by over 90%. In this paper, we investigate the impact on the performance of the U.S. domestic air transportation system. We analyze both the changes in the volume and characteristics of flight operations and also changes in system performance metrics. We also discuss various adjustments made by the Federal Aviation Administration (FAA) both to take advantage of reduced system congestions and also to cope with COVID-19 infections among controllers. © ATM 2021. All rights reserved.
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The COVID-19 pandemic has impacted the global economy massively, resulting in a magnitude of transitions and transformations in labor markets worldwide. Along with the need for more upskilling and reskilling, skills-based hiring has become another accelerating trend during the pandemic. Skill-based hiring challenges educators to take an innovative as well as viable approach to prepare students for this evolving workforce landscape. We propose a skills-focused approach emphasizing more on skills-based competencies rather than solely knowledge-based degree qualifications. This study demonstrates how we are reshaping our Information Technology (IT) undergraduate program with major shifts in thinking about how hiring is done today. We map the undergraduate IT curriculum against the skills identified from current job posting websites, aiming to align the course content to competencies and skills sought after by the employers. We are also creating various innovative channels to expand experiential learning opportunities for skills enhancement. © Proceedings of the 2021 AIS SIGED International Conference on Information Systems Education and Research.
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Introduction: The outbreak of the Wuhan Covid-19 virus has had a significant impact across all industries. How we practice, medicine has seen substantial change. Consequently, medical education has diminished as it has not been deemed essential given the current climate. Here in Australia and other parts of the globe, experienced education restrictions across all the Health Science Universities and university hospitals. Given the substantial research output in Urology and the necessity of local, national, and global conferences, education within the specialty has suffered. Therefore, there has been significant demand for medical education to be delivered through alternative mediums. In contrast to the Spanish flu of 1918- 1920, we have the luxury of modern technology and a plethora of platforms to deliver education in the field of Urology. One such platform is podcasts. Aim: We aim to investigate whether the Urology industry has invested in podcasts since the outbreak of COVID-19 to combat this educational dilemma. Methods: On October 12th, 2021, we searched the term Urology on Spotify. We excluded all non-English podcasts that were not Urology-focused, podcasts that didn't make Urology the focus, and channels that didn't show continued and consistent output, i.e., < 5 episodes. We included all podcasts that focused on Urology education, non-English podcats that were clearly Urology focused (i.e., Anotomia Urologica), and included podcats on sexual health that had a Urology focus (i.e. 'The Full release'). Results: We obtained 97 podcasts on the Spotify search engine using the above criteria. After excluding podcats based on our above methodology, we had 63 results. Of the 63 results, 33 were in English. Out of the 33 in English, one was on andrology, four on urological products, one on sexual health, two on Urology anecdotes, two on prostate health, 14 on general Urology education for trainees, two on urology pediatrics, 3 were patientfocused, three were for guideline updates and one on the news in Urology. Of the 63 podcasts, 53 were created post the outbreak of the COVID-19 outbreak. Conclusion: In conclusion, 84% of educational Urology podcasts today have been created post the outbreak of the COVID-10 outbreak, confirming our hypothesis.
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Introduction & Objectives: The COVID pandemic has rapidly catapulted scientific conferences into a virtual or hybrid format. The format of traditional scientific communication has abruptly changed from physical presentations at conferences, to virtual pre-recorded contributions and participations. We assessed the quality of presentation skills at a major urology conference, the European Association of Urology Annual Meeting (#EAU21), to identify areas for improvement. Methods: Using the EAU Urosource Resource Centre, we reviewed ondemand sessions posted from the #EAU21 virtual meeting, focusing on Plenary, Industry, Poster, Semi-live and Specialty sessions. Using a predefined matrix based on industry experts, a panel of reviewers rated presentations using quality criteria including camera angle, audio quality, virtual content optimised for virtual viewers which was assessed on both laptop and iphone to replicate typical viewer experiences. Levels of quality were defined from Level I (minimum standard), to Level 3 (excellent). Results: We reviewed 138 on-demand sessions (7 plenary, 44 poster, 11 industry, 9 semi-live, 67 specialty) posted from #EAU21. Of 2068 virtual appearances assessed, 1710 (82.7%) failed to meet the minimum defined quality standard of Level 1, with camera violations being the most common offence (91.7% of time). Of those who attained level 1 standards, 39/358 (10.8%) reached Level 2, out of which only 4 (10.3%) presentations met level 3 standards. Deficiencies in audio and content presentation domains were equally common (55.9% and 55.1%, respectively) in those with level 1 standards who did not reach level 2, while video elements were less common (51.5%). There was high inter-observer agreement in the scoring (87-91.3%). Even after excluding professional studio recordings provided by EAU, there was a consistent trend of chairpersons and moderators outperforming presenters in terms of level 1 standards (31.6% vs 13.7%, p<0.001). The only exception was seen in the industry sessions where more presenters met level 1 standards (48.1% vs 30.8%, p = 0.29). Qualitative analyses revealed a wide range of styles used including the interesting use of automated voiceover narrations seen only in poster sessions (1.2%) which could overcome language barriers. In the presentations that met level 3 standards, the use of professional video and audio editing tools was evident and helped optimised the delivery of the scientific content for viewers. Conclusions: A high proportion of virtual presentations did not achieve a reasonable minimum standard for scientific communication during the virtual #EAU21 meeting. Simple technical measures can significantly improve the quality of virtual presentations and ensure a better viewer experience. Further training will help the scientific community communicate more effectively in the virtual and hybrid meeting era.
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INTRODUCTION AND OBJECTIVE: The COVID pandemic has rapidly catapulted scientific conferences into a virtual or hybrid format. The format of traditional scientific communication has abruptly changed from physical presentations at conferences, to virtual pre-recorded contributions and participation. We assessed the quality of presentation skills at a major urology conference, the European Association of Urology Annual Meeting (#EAU21), to identify areas for improvement. METHODS: Using the EAU Urosource Resource Centre, we reviewed on-demand sessions posted from the #EAU21 virtual meeting, focusing on Plenary, Industry, Poster, Semi-live and Specialty sessions. Using a pre-defined matrix based on industry experts, a panel of reviewers rated presentations using quality criteria including camera angle, audio quality, virtual content optimised for virtual viewers which was assessed on both laptop and iphone to replicate typical viewer experiences. Levels of quality were defined from Level I (minimum standard), to Level 3 (excellent). RESULTS: We reviewed 138 on-demand sessions (7 plenary, 44 poster, 11 industry, 9 semi-live, 67 specialty) posted from #EAU21. Of 2068 virtual appearances assessed, 1710 (82.7%) failed to meet the minimum defined quality standard of Level 1, with poor camera angle being the most common offence (91.7% of cases). Of those who attained level 1 standards, 39/358 (10.8%) reached Level 2, out of which only 4 (10.3%) presentations met level 3 standards. Deficiencies in audio and content presentation domains were equally common (55.9% and 55.1%, respectively) in those with level 1 standards who did not reach level 2, while video elements were less common (51.5%). There was high inter-observer agreement in the scoring (87-91.3%). Even after excluding professional studio recordings provided by EAU, there was a consistent trend of chairpersons and moderators outperforming presenters in terms of level 1 standards (31.6% vs 13.7%, p <0.001). The only exception was seen in the industry sessions where more presenters met level 1 standards (48.1% vs 30.8%, p=0.29). Qualitative analyses revealed a wide range of styles used including the interesting use of automated voice-over narrations seen only in poster sessions (1.2%) which could overcome language barriers. In the presentations that met level 3 standards, the use of professional video and audio editing tools was evident and helped optimised the delivery of the scientific content for viewers. CONCLUSIONS: A high proportion of virtual presentations did not achieve a reasonable minimum standard for scientific communication during the virtual #EAU21 meeting. Simple technical measures can significantly improve the quality of virtual presentations and ensure a better viewer experience. Further training will help the scientific community communicate more effectively in the virtual and hybrid meeting era.
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Successful use of biomedical forms of HIV risk-reduction may have predisposed many gay and bisexual men (GBM) to vaccination against COVID-19, which may, in turn, affect their sexual behavior. A total of 622 Australian GBM provided weekly data on COVID-19 vaccination history and sexual behaviour between 17 January 2021 and 22 June 2021. We identify factors associated with COVID-19 vaccination, and compare sexual behavior before and since vaccination. Mean age was 47.3 years (SD 14.0). At least one-dose vaccination coverage had reached 57.2%, and 61.3% reported that the majority of their friends intended to be vaccinated. Vaccinated men reported a mean of 1.11 (SD 2.10) weekly non-relationship sex partners before vaccination and 1.62 (SD 3.42) partners following vaccination. GBM demonstrated high confidence in COVID-19 vaccines. Their sexual activity increased following vaccination suggesting that greater sexual freedom may be a specific motivation for vaccine uptake among some men.
Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Australia/epidemiology , Bisexuality , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Middle Aged , Sexual Behavior , Sexual PartnersABSTRACT
AIMS: The national PrEP programme launched in Ireland in November 2019 with tenofovir/emtricitabine free to those meeting eligibility criteria. We assessed the impact of the first year of the PrEP programme on new HIV diagnoses in the largest sexual health and HIV service in Ireland. METHODS: A free PrEP service was established in November 2019. We reviewed the number of new diagnoses of HIV between November 2018-2019, before the introduction of the national PrEP programme and compared this with the number of new HIV diagnosis between November 2019-2020. RESULTS: There were 95 new HIV diagnoses (63.3% MSM) between November 2018 and 2019 and 73 new HIV diagnoses (65.7% MSM) between November 2019 and 2020. There was a statistically significant decline in new HIV diagnoses between the 2 years (P = 0.0003). 546 patients were prescribed PrEP as of December 2020.106 patients (19.4%) changed their PrEP dosing regimen due to lockdown. 178 individuals (32.6%) had a rectal infection diagnosed. CONCLUSION: There has been a reduction in new HIV diagnoses in our cohort (although this has occurred during a global pandemic). It is too early to say if PrEP reduces late presentations of HIV based on our findings. A significant number of rectal infections were identified in the PrEP clinic suggesting ongoing risk despite pandemic restrictions. Further research into sexual practices during COVID-19 is needed to assess if this had an impact on the lower rates of HIV acquisition.
Subject(s)
Anti-HIV Agents , COVID-19 , HIV Infections , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Anti-HIV Agents/therapeutic use , Communicable Disease Control , HIV , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Pandemics , SARS-CoV-2ABSTRACT
Aims Assessment of a supported discharge service for a cohort of patients admitted to Cork University Hospital with COVID-19 that were identified as being appropriate for remote patient monitoring. Methods Patients uploaded SpO2, subjective breathlessness scores, and temperature readings onto the PatientMpower application, and received a daily phone call from the physiotherapist. Readmission was triggered where appropriate. Patient satisfaction questionnaires were completed following service discharge. Results Over 12 weeks, 15 patients had a supported discharge. Readmission was triggered for 3 patients (20%). Compared to non-readmitted patient, readmitted patients had more abnormal SpO2 readings (9 (5.5-22.5) vs 1 (0-1), p= 0.022) and all 6 temperature spikes that occurred, but lower subjective breathlessness scores (3 (1-6) vs 4.25 (2-8), p = 0.003). Differences in mean abnormal SpO2% readings were not statistically significant. Conclusion A supported discharge service including remote monitoring and regular contact with healthcare professionals can facilitate safe, and timely discharges of select patient groups.
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Low-Dose Radiation Therapy (LD-RT) is an emerging treatment option for patients with COVID-19 related pneumonia. Infectivity of the SARS-CoV-2 virus complicates incorporation of LD-RT into existing radiation oncology clinics. The first phase I/II trial of LD-RT for COVID-19-related pneumonia implemented novel operational protocols to address risk of infection and respiratory events. Patients were transported from hospital rooms to linear accelerators and treated with 0.5 Gy or 1.5 Gy using pre-planned, two-dimensional treatments prepared using diagnostic x-rays and caliper measurements. Workflows were revised over time to balance infection risks with implementation burden. Between April 24 and December 7, 2020, fifty-two patients were enrolled and forty were treated. The end-to-end process comprised 16 distinct teams and > 120 cooperating staff members (> 50 core radiation oncology staff). The trial was operationalized at two hospitals at the onset of the COVID-19 pandemic, prior to vaccine availability. Teams included trial leadership/screening (n > 4), inpatient floor staff (n > 10), clinical trials staff and coordinators (n = 8), transport (n = 2), radiation therapists (n > 20), respiratory therapists (n = 5), radiation nursing (n > 7), ICU nursing (n = 4), rapid response teams (n = 4), medical physics (n > 4), dosimetry (n > 3), infection prevention (n > 3), environmental services (n > 6), security (n = 7), lab personnel (n = 1), and physicians from radiation oncology (n = 7), infectious diseases (n = 2), pulmonary/critical care medicine (n = 2), anesthesia (n = 2), and internal medicine (n > 20) [total > 120]. All non-intubated patients were transported by a multi-disciplinary team, consisting of a physician, nurse, transporter, infection prevention specialist, and (when needed) a respiratory therapist. Treatments occurred after normal clinic hours, were initiated by team huddles, check lists, and included personal protective equipment supervision at multiple time points. Transport routes were 880 to 1760 feet (0.33 miles) one-way, with 1 to 3 elevator banks and required 20-35 minutes for round-trip transport and treatment. Oxygen supplementation in non-intubated patients ranged from 2 to 15 L/min. One intubated patient was transported with a portable ventilator and accompanying ICU staff. There were no code-level events during transport. No patient-facing staff contracted COVID-19 from trial activities. Workflow burden was successfully reduced and protocols relaxed over time with increased staff experience. Whole-lung low-dose radiation therapy (LD-RT) for COVID-19-related pneumonia was successfully incorporated into existing workflows at a major academic university. Forty patients were treated with no code-level events, and no staff contracted the virus during eight months of trial accrual. Instructional materials and implementation check lists are provided. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)