ABSTRACT
Objective: The rapid rise of telemedicine, necessitated by the COVID-19 pandemic, has changed how care is administered and created additional burdens for healthcare professionals. This study investigated how Diabetes Care and Education Specialists (DCES) have implemented telemedicine in their practices to identify possible areas for improvement. Method: 350 DCES from an opted-in US research panel were surveyed. Respondents were asked about their expected and present use of telemedicine, satisfaction with telemedicine versus in-person appointments, and perceived changes in the frequency of treatment decisions made over telemedicine compared to in-person. Result: On average, respondents reported that 57% of appointments were conducted using telemedicine this year and estimated a decrease in telemedicine use during 2021 (41%). While 67% of respondents were satisfied with in-person visits (selecting a 9 or 10 on a 10-point scale), just 25% were satisfied with telemedicine visits. Analysis of verbatim comments revealed dissatisfaction with telemedicine stems from difficulty with teaching patients virtually (20%), technology use (18%), establishing personal connections with patients (16%), and obtaining patient device data (11%). DCES indicated that larger treatment decisions like starting new therapies/devices occur less often over telemedicine whereas adjusting patient's settings occurs more often. For example, relative to in-person visits, 64% report starting patients on new insulin pumps less often while 62% report adjusting pump settings just as often. Conclusion: Telemedicine has become a regular part of DCES's practices despite notable gaps in satisfaction and ability to make certain treatment decisions when compared with in-person visits. Although telemedicine may be a useful tool for adjusting doses and device settings, these findings emphasize the need for improvements surrounding virtual diabetes care to alleviate the challenges experienced by providers.
ABSTRACT
Background Maintaining high levels of immunisation uptake is vital to protect children from vaccine-preventable disease. The COVID-19 pandemic and measures taken to control it, including national lockdowns, threatened to disrupt routine immunisation programmes. Initial reports from the early weeks of lockdowns in the UK and worldwide suggested that preschool immunisation uptake was falling. In Scotland enhanced surveillance databases were set up to monitor and rapidly assess the impact on childhood immunisation uptake rates. Objectives This aim of this study was to evaluate the impact on timely childhood immunisation uptake (defined as within 4 weeks of becoming eligible for the immunisation according to the national immunisation schedule) before, during and after a national lockdown using data from the entire Scottish population. Methods This was an observational study using routinely collected data in the year prior to the pandemic (2019), immediately before (January -22 March 2020), during (22 March-31 July 2020) and after (August-September 2020) the first period of the UK 'lockdown'. Data were obtained for Scotland from the Public Health Scotland 'COVID19 wider impacts on the health care system' dashboard (https://scotland.shinyapps.io/ phs-covid-wider-impact/). Uptake of the three doses of DTaP/ IPV/Hib/HepB vaccine in early infancy and two doses of MMR at age 12 months and 3 years 4 months was evaluated at the four time points. Timely uptake rates were compared using binary logistical regression analysis. Data were also analysed separately by geographical region and indices of deprivation. Results Vaccination rates in Scotland for all the childhood immunisations rose during lockdown compared to the previous year (table 1). Significant increases in uptake were seen across all deprivation level, though there was evidence of greater improvement for the least deprived for the MMR immunisations. Conclusions This study demonstrates that the national lockdown in Scotland has had a positive effect on timely preschool immunisation uptake. This provides an excellent opportunity to explore the reasons behind this increase, whether this has been achieved through the removal of barriers, increased motivation or awareness campaigns including those co-ordinated by the Scottish Immunisation programme and sharing of best practice. Promoting immunisation uptake and addressing potential vaccine hesitancy is particularly important in the context of ongoing and repeated lockdownstyle control measures and with future of a paediatric COVID-19 vaccination campaigns.
ABSTRACT
In an era of social media, and amid the coronavirus pandemic, teachers’ curation of instructional resources stands as an opportunity to observe teachers’ planning and conceptualization of their practice in real time. This work explores the resources teachers curate, their rigor, and the effects on students’ learning across years. Merging big data from Pinterest, a prominent social media platform, and administrative data from the Indiana Department of Education on 10,383 fourth-through sixth-grade students across 2010–2017, this study employed three-level hierarchical linear models to identify relationships between the inherent cognitive rigor in teachers’ curated instructional tasks and students’ achievement. Results indicate teachers curating resources focused on basic memorization and remembering negatively affected students’ learning, whereas higher-level tasks focused on understanding and applying had a positive impact on achievement. Identified effects were comparable to those related to student and teacher attributes, signaling the importance of teachers’ curation. © 2021 by The University of Chicago. All rights reserved.