DOES SIMULATION TRAINING IN ANSWERING A BLEEP IMPROVE CONFIDENCE AND PERFORMANCE IN ONCALL SITUATIONS FOR FIY1S DURING COVID-19 RESPONSE?

Background Several studies have shown that new medical graduates feel unprepared for their role as clinicians. In October 2019 Salisbury District Hospital (SDH) piloted a successful 'hold-the-bleep' simulation day for 5th year Southampton medical students. In March 2020, in response to COVID-19, medical students were given early registration. The majority of FiY1s had not received or missed out on formal bleep training due to graduating early. Methodology Over 2 days 8 FiY1s were issued with a bleep for a half-day period, continuing normal daily tasks whilst being bleeped for phone advice or to assess a simulated patient. 4 clinical stations and 4 phone calls were designed to simulate roles of FY1s with SIM-Man simulating the patients. Immediate feedback was recorded and generic themes discussed at a structured session, discussing what went well or was challenging. Each FiY1 completed a feedback for assessing confidence and wrote a reflective piece. Results Feedback was qualitatively and quantitatively positive. All found the SIM session useful and would recommend it. 7 of 8 candidates had a numerical increase in confidence in managing and prioritising calls. Conclusions and recommendations The stations addressed communication skills, prioritisation, clinical and practical skills, and drug prescribing. The improvement in FiY1s confidence and skills is likely to lead to improved patient outcome and satisfaction. Faculty who role played, reported an improvement in the trainees' performance. These results are similar to those from Liverpool and previous bleep SIM sessions we held at SDH.

Development of an Explicit Agent-Based Simulation Toolkit for Opening of Schools: An Implementation of COMOKIT for Universities in the Philippines

Since the start of the pandemic in early 2020, there have been numerous studies related to the design and use of disease models to aid in understanding the transmission dynamics of COVID-19. Output of these models provide pertinent input to policies regarding restricting or relaxing movements of a population. Perhaps the most widely used class of models for COVID-19 disease transmission is the compartmental model. It is a population model that assumes homogeneous mixing, which means that each individual has the same likelihood of contact with the rest of the population. Inspite of this limitation, the approach has been effective in forecasting the number of cases based on simulated scenarios. With the shift from nationwide lockdowns to granular lockdown as well as gradual opening of limited face to face classes, there is a need to consider other models that assume heterogeneity as reflected in individual behaviors and spatial containment strategies in smaller spaces such as buildings. In this study, we use the COVID-19 Modeling Kit (COMOKIT, 2020) as a basis for the inclusion of individual and spatial components in the analysis. Specifically, we derive a version of COMOKIT specific to university setting. The model is an agent-based, spatially explicit model with the inclusion of individual epidemiological and behavior parameters to show evidence of which behavioral and non-pharmaceutical interventions lead to reduced transmission over a given period of time. The simulation environment is set up to accommodate the a) minimum number of persons required in a closed environment including classrooms, offices, study spaces, laboratories, cafeteria, prayer room and bookstore, b) parameters on viral load per building or office, and c) percentage of undetected positive cases going on campus. The model incorporates the following interventions: a) compliance to health protocol, in particular compliance to wearing masks, b) vaccine coverage, that is, the percentage distribution of single dose, two doses and booster, c) distribution of individuals into batches for alternating schedules. For mask compliance, as expected, results showed that 100% compliance resulted to lowest number of cases after 120 days, followed by 75% compliance and highest number of cases for 50% compliance. For vaccine coverage, results showed that booster shots play a significant role in lowering the number of cases. Specifically, those who are fully vaccinated (2 doses) and 100% boosted produce the lowest number of cases, followed by the 50% of the population fully vaccinated and have had their booster shots. Intervals of no onsite work or class in between weeks that have onsite classes produce the lowest number of cases. The best scenario is combining the three interventions with 100% compliance to mask wearing, 100% fully vaccinated with booster, and having two batches or groups with interval of no onsite classes. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Mathematical analysis of a covid-19 compartmental model with interventions

Mathematical models of the COVID-19 pandemic have been utilized in a variety of settings as a core component of national public health responses. Often based on systems of ordinary differential equations, compartmental models are commonly used to understand and forecast outbreak trajectories. In view of the primarily applied nature of COVID-19 models, theoretical analysis can provide a global and long-term perspective of key model properties, and relevant insights about the infection dynamics they represent. This work formulates and undertakes such an investigation for a compartmental model of COVID-19, which includes the effect of interventions. More specifically, this paper analyzes the characteristics of the solutions of a compartmental model by establishing the existence and stability of the equilibrium points based on the value of the basic reproductive number R0. Our results provide insights on the possible policies that can be implemented to address the health crisis. © 2021 American Institute of Physics Inc.. All rights reserved.

Telerreabilitation in Multiple Sclerosis in the Pandemic Period: Brazilian Casuistics

Background: The reception and rehabilitation services for Multiple Sclerosis (MS) have been partially interrupted in most countries since the beginning of the COVID-19 pandemic. Objectives: To present the health care in neurorehabilitation promoted by the Brazilian Association of Multiple Sclerosis (ABEM) during a pandemic period by COVID-19. Methods: A Social Therapeutic Action Plan was developed to identify the needs of people with MS. Social Service call centers were made available via landline, cell phone, WhatsApp and e-mail at the beginning of the pandemic. Results: 2,975 telephone calls were made between March 23 to September 30, 2020, referrals were made and distributed as follows: art therapy = 29 (1%), physiotherapy = 2,185 (73.4%), neurology = 29 (1%), psychology = 638 (21.4%), psychiatry = 8 (0.3%), shiatsu = 86 (2.9%). Conclusions: In addition to raising awareness and encouraging people with MS not to abandon physical and mental health monitoring during the pandemic, it is extremely important to offer and provide essential services such as social and health care. The findings of this study showed the importance of the organization aimed at people with MS in the optimization and continuity of health care and access to effective interventions to promote quality of life. Diagnostic Criteria and Differential Diagnosis.

Physician and patient satisfaction with the switch to remote outpatient encounters in epilepsy clinics during the Covid-19 pandemic.

PURPOSE: Analyzing parents' and physicians' opinions regarding phone-based encounters in emergency shifts of a French pediatric epilepsy center compared to traditional face-to-face encounters during the first lockdown of the COVID-19 pandemic METHODS: Prospective monocentric study on remote encounters at Necker rare epilepsy reference center from March 20th, 2020 to April 23rd, 2020 due to lockdown measures. This study was conducted with a survey based on 5-point Likert scales (LS-2/2) designed for both parents and physicians. We compared first versus follow-up encounters as well as physicians' and parents' opinions. RESULTS: We had a total of 224 responses, among which 204 were completed by physicians (91%) and 173 (84,4%) by parents. Twenty five were first encounters (14,2%). Physicians pointed out the need for clinical examination (42.6%), mainly for first encounters (p=0.0004). Physicians rated the quality of communication lower (p=0.003) as their capacity to answer parents' questions (p=0.004). They were significantly less satisfied with remote encounters compared to parents (p<10-4). We identified six urgent (2.9%) and 50 semi-urgent (24%) situations requiring programming face-to-face encounter during or shortly after the lockdown. CONCLUSION: Remote encounters could be a helpful practice for pediatric patients with epilepsy in emergency situations such as pandemics. It allowed the identification and prioritization of emergency situations. Physicians were less positive than parents. We raised the possible use of remote encounters in association to face-to-face encounters for routine follow-up of pediatric patients with epilepsy.

Science and Public Service during a Pandemic: Reflections from the Scientists of the Philippine Government's Covid-19 Surveillance Platform

During the Covid-19 pandemic, science plays an important role in understanding and intervening in local outbreaks. Conducting scientific operations for pandemic response also takes on unique human and social dimensions. Reflexivity is often a key to understanding the perspectives that scientists take in applying theory to practice. In this essay we share that reflexivity by detailing personal reflections as scientists of FASSSTER, an integrated platform providing scientific intelligence to the Philippine government for monitoring and responding to the Covid-19 outbreak in the country.