ABSTRACT
Introduction: Long-COVID is associated with restrictions in neuropsychological health e.g., depression, anxiety, or cognitive impairments leading to deficits in work ability. Rehabilitation could improve these symptoms but less is known about the benefits of rehabilitation in patients acquiring COVID-19 in the workplace, e.g., healthcare professionals. Aims and objectives: The current study investigates the outcomes of a disease-specific rehabilitation on neuropsychological health in patients after acute COVID-19 acquiring in the workplace. We assumed that neuropsychological health will be improved after rehabilitation. Method(s): Until now, 49 patients (female n=38, age: M=50.86 years) acquiring COVID-19 in the workplace were recruited within a longitudinal study. At the beginning (T1) and the end (T2) of an inpatient rehabilitation (duration: at least 3 weeks) in the German BG Hospital Bad Reichenhall the following measurements were implemented: Hospital Anxiety and Depression Scale (for depression and anxiety), and Digit Symbol Substitution Test (for processing speed). Paired T-tests were used for analysis. Result(s): At T2 patients showed significant improvements in depression (T1: M=7.98, T2: M=7.02;T(1,45)=2.277, p=0.028, d=0.336), anxiety (T1: M=7.00, T2: M=6.02;T(1,45)=2.268, p=0.028, d=0.330), and processing speed (T1: M=47.14, T2: M=52.57;T(1,44)=2.852, p=0.007, d=-0.430). Conclusion(s): The results indicated that rehabilitation in patients acquiring COVID-19 in the workplace has positive effects on neuropsychological health. For long-term results, measurements will be repeated 6 and 12 months after T1.
ABSTRACT
Background. Nontuberculous mycobacteria (NTM) are environmental organisms that can form biofilms in municipal water systems and as such are difficult to eliminate. Mycobacterium abscessus is a rapid-growing NTMthat can cause skin and soft tissue, disseminated, and pulmonary infections. M. abscessus is difficult to treat, often requiring prolonged therapy with several antibiotics due to its intrinsic drug resistance. In 2021, our institution identified a significant increase in pulmonary infections caused by M. abscessus in the cardiothoracic transplant population. Methods. All M. abscessus cases among inpatients at our institution were extracted from the electronic medical record (EMR) between January 2019 and September 2021. Clinical characteristics were determined through EMR review and included demographics, transplant status, specimen type, COVID-19 history, and patient care practices involving water. A multidisciplinary team conducted an investigation to identify possible variations in practice related to the source of water used for clinical care activities in this identified population. Results. Between January 2021 and September 2021, there were 12 cases of M. abscessus among inpatients at our institution compared to 6 cases in 2019 and 5 in 2020 (Figure 1). Between 2019 and 2020, post-heart and pre-/post-lung transplant patients comprised 9% of cases, 55% of cases were pulmonary infections, and none had a history of COVID-19 infection. In 2021, post-heart and pre-/post-lung transplant patients comprised 58% of cases, 83% of cases were pulmonary infections, and 33% of cases had a history of COVID-19 infection. There were varying sources of water utilized for the clinical care activities in this identified population (Table 1). Conclusion. To investigate the potential outbreak, we are actively collecting water samples and swabs from water fixtures in both patient and nourishment rooms for water culturing. To mitigate a potential water-borne source, we will use sterile water for all clinical care practices involving water and for all patient water drinking needs in the post-heart and pre-/post-lung transplant population impacted by the outbreak. The only use of tap water is hand hygiene and patient bathing.
ABSTRACT
Background: In 2020, due to the COVID-19 pandemic, most group therapists moved their practice to online platforms. Surveys of psychotherapists indicate that many intend to maintain at least part of their practices online after the pandemic. This survey-based study is an attempt to identify therapist experiences with doing group therapy online, and to examine factors that are associated with therapist-rated outcomes. Method: We surveyed 307 group therapists about their ratings of the ease or difficulty in conducting group therapy online versus in-person, and indicators of patient outcomes in online groups. A confirmatory factor analysis resulted in a good fitting three latent factor solution: group therapeutic process factor (therapist ratings of ease to foster therapeutic alliance, group cohesion, and patient self-disclosure), group therapist factor (therapist presence, empathy, and focus in online therapy), and group therapeutic challenges factors in online work (related to the difficulty of working through conflict, managing avoidance, observing nonverbal communication, and discomfort during the online session). An online group therapy outcome factor was the dependent variable modeled as a latent factor of therapists' perception of patient outcomes and their own satisfaction with online groups. In a structural equation model, higher levels of the group therapeutic processes and group therapist factors, and lower group challenges were associated with higher online group therapy outcomes. Discussion: The present study suggests that online groups operate based on many of the same factors that have been supported in in-person group treatment. These factors were associated with the therapist's perceptions of online group effectiveness. However, difficulties in managing relationships in the online session may represent a barrier to enacting group therapeutic factors. Postpandemic research on conducting online group therapy and managing online therapeutic relationships may lessen perceived drawbacks to its use.
ABSTRACT
In order to cope with the exponentially increasing number of patients infected with SARS-CoV-2, European countries made enormous efforts to reorganize medical assistance and several diseases, including stroke, were particularly impacted. We report the experience of stroke neurologists from three European countries (Italy, France and Germany) that faced the pandemic at diverse time points and with different approaches, depending on their resources and healthcare system organization. Pre-hospital and in-hospital acute stroke pathways were reorganized to prioritize COVID-19 management and, in severely affected regions of Italy and France, stroke care was centralized to a limited number of centers, whereas the remaining stroke units were dedicated to patients with COVID-19. Access to acute stroke diagnostics and time-dependent therapies was limited or delayed because of reduced capacities of emergency services due to the burden of patients with COVID-19. A marked reduction in the number of patients presenting with transient ischaemic attack and stroke was noted in the emergency departments of all three countries. Although we only have preliminary data, these conditions may have affected stroke outcome. These indirect effects of the COVID-19 pandemic could negate the efforts of stroke neurologists over the last few years to improve outcome and reduce mortality of stroke patients. Although the SARS-CoV-2 infection rate is slowing down in Europe, the effects of ending lockdown in the next months are unpredictable. It is important for the European and world stroke community to share what has been learned so far to be plan strategies to ensure stroke care in the future and upcoming challenging times.