ABSTRACT
Since the unfolding of the COVID-19 virus as a global health crisis that threatens public health, government and health officials in Canada and in many other countries used Twitter as an instrument for health communication. It has been a relevant mean for informing and raising public awareness about precautionary measures to better mitigate the pandemic. In Canada, governments and public health institutions at federal, provincial and territorial levels have been using Twitter to spread COVID-19 related public health information to their citizens during the first, second and third waves of the pandemic. In this study, we aimed to investigate the use of Twitter by governments and health institutions at the Federal government of Canada, and Canadian provinces and territories. Specifically, our main purpose is to explore insights from Twitter online public discourse harnessed by the government and the public health institutions in Canada through their official accounts. These insights will be studied from three analysis: Activity, engagement, and trends. To do so, we collected 32,198 tweets published from a total of 62 government (i.e. 29 Twitter accounts) and health accounts (i.e. 33 Twitter accounts) including institutions (e.g ministries) and officials (e.g Prime Ministers accounts) Twitter accounts between 01 September 2020 and 31 August 2021. Our results show that the health and government institutions have been more active during the third wave of the pandemic than the second wave. The results also show that among all the Twitter accounts, the federal representatives and the representatives of the provinces of Ontario, Alberta, and British Columbia respectively have been more active. Finally, the results demonstrate that the Twitter users in Canada have been more engaged with the government accounts at the federal level than at the provinces and territories level. © 2022 ACM.
ABSTRACT
Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in -hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada, from 1 March 2020 to 30 June 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n = 106;6.2%). The most common atypical symptoms were anorexia (n = 598;33.5%), weakness (n = 519;2 3.9%), and delirium (n = 449;25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05;95% confidence interval [CI] 1.62-2.62), tachycardia (aOR 1.87;95% CI 1.14-3.04), and delirium (aOR 1.52;95% CI 1.18-1.96) were inde-pendently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presenta-tions in older adults.
ABSTRACT
TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: The need for swift international collaboration alongside rapidly deployable remote medical knowledge transition and implementation programs has been highlighted during the ongoing COVID-19 pandemic. Virtual programs have emerged as cost-effective alternatives to in-person education to spread best practices to resource-limited locations and garner purposeful learner engagement. Understanding local practice needs is paramount to the development of an effective quality improvement initiative. This study aimed to gain insight into the interests, clinical challenges, and attitudes of a group of interprofessional critical care providers from Bosnia and Herzegovina in preparation for a longitudinal remote education and quality improvement program. METHODS: A novel learning needs assessment tool was implemented in a cohort of critical care professionals from four hospitals in Bosnia and Herzegovina. A sequential explanatory design was employed, and a mixed-method assessment was conducted in three phases. 1) Utilizing the Delphi method, twenty statements containing common critical care entrustable professional activities (EPAs) were developed by a board of intensivists and medical education specialists. 2) Local learners used Q Sort methodology to rank-order EPAs based on self-perceived learning priorities, with subsequent by-person factor analysis. 3) Learners were invited for focus-group interviews to gather details of the rationale behind their rankings. RESULTS: Forty nine out of 105 participants completed the rank-order survey (response rate 47%). Factor analysis categorized the participants into two main groups based on the typology of their opinions, 22 participants into factor 1 and 9 participants into factor 2. The highest-ranked EPAs amongst the two factors were “evaluation and management of the patients with shock, stabilization, and resuscitation of critically ill patients” and “evaluation and management of ARDS,” respectively. Statements regarding common ICU complications and procedures were regarded as neutral. The lowest rank amongst factor 1 was “patient-centered care, communication skills, and interprofessional collaboration.” Participants in factor 2 ranked “preoperative evaluation and management” and “common hematologic and oncologic complications” the lowest. The rationale behind rank orders focused on the current patient population and perceived EPA importance to critical care practice. Participants in factor 1 displayed pessimistic attitudes toward patient-centered care and interprofessional collaboration due to cultural and healthcare system constraints. Interviewees in both factors described local challenges and expressed a need for change. CONCLUSIONS: We conducted a remote needs assessment in an international, interprofessional group of critical care providers. In addition to building trust with learners, the acquired knowledge of cultural differences, needs, and barriers to implementation will guide an ongoing remote education and quality improvement initiative. CLINICAL IMPLICATIONS: This investigation will shape a critical care best practices quality improvement initiative and remote education program in a country with limited resources. DISCLOSURES: No relevant relationships by Marija Bogojevic, source=Web Response No relevant relationships by Yue Dong, source=Web Response Patent/IP rights for a licensed product relationship with Ambient Clinical Analytics Please note: From 2016 Added 05/23/2021 by Ognjen Gajic, source=Web Response, value=Royalty no disclosure on file for Pedja Kovacevic;No relevant relationships by Heyi Li, source=Web Response No relevant relationships by Aida Mujakovic, source=Web Response No relevant relationships by Alexander Niven, source=Web Response No relevant relationships by Manja Spahalic, source=Web Response no disclosure on file for Slavenka Straus;No relevant relationships by Simon Zec, source=Web Response