ABSTRACT
Objectives: Suicide is a global epidemic that claims up to 800,000 lives each year and is the second leading cause of death in young people aged 15-29 years. With the COVID-19 pandemic came increased rates of stress, helplessness, and suicide among adolescents. The increasing popularity of telemedicine opens new doors for identifying patients in distress, decreasing suicide rates, and increasing access to mental health services. Youth and adolescents grew up with electronics and will likely be open to the use of telemedicine in the future. However, it is unknown how prepared learners are for the unique challenges of these new modes of patient interaction. Method(s): We designed a telemedicine simulation for medical and physician assistant students to identify, assess, and appropriately escalate care for a standardized patient (SP) with suicidal ideation. We incorporated didactics on telepsychiatry, a motivational interviewing exercise, and a simulated telemedicine objective structured clinical exam (OSCE). Students completed a participant survey and were evaluated by SPs on their medical knowledge, interpersonal/communication skills, and 8 key telemedicine competencies. Result(s): Forty-four students completed the workshop, and 30 students completed the participant survey. Students were strongest in interpersonal/communication skills and weakest in telemedicine competencies. SPs evaluated telemedicine performance by deeming students "not yet entrustable," "approaching entrustment," or "entrustable" based on their ability to perform a described behavior or task unsupervised. Only 20% of students were entrustable to describe when patient safety was at risk, including when and how to escalate care. Fifty percent correctly interpreted the Patient Health Questionnaire, 59% completed the Columbia Suicide Risk Assessment, and 41% completed a suicide safety plan. Ninety-seven percent of students said that they expect to use telemedicine in their future practice. Conclusion(s): The telepsychiatry OSCE revealed gaps in students' telepsychiatry knowledge, particularly in telemedicine-specific competencies. Future studies are needed to assess the generalizability of our findings, including incorporating adolescent SPs to prepare students for the mental health needs of all ages given increasing rates of suicide in adolescent populations. TVM, S, AC Copyright © 2022
ABSTRACT
High-quality sustainable development is the common goal pursued by all countries in the world. China's high-quality development (HQD) includes five concepts of "innovation, coordination, green, opening-up, and sharing ". In this context, we established an evaluation system that included these five fundamental characteristics, used the comprehensive entropy method and BP neural network to evaluate and predict the high-quality development of Hubei Province in China, and conducted a spatiotemporal deductive analysis. The study found that: 1) Economic growth still has an important impact on HQD, for all the five main indicators, "opening-up " and "innovation " have the highest impact weights, which are 0.379 and 0.278, respectively, while the proportions of coordination and sharing are both less than 0.1. 2) There are huge differences in the level of high-quality development between regions in Hubei Province. From 2010 to 2020, the average comprehensive index of Wuhan City was greater than 0.5, which is 7 times that of the second Xiangyang City, and 46 times that of the last Shennongjia district. 3) In the past few years, the overall high-quality development of Hubei Province has shown a fluctuating upward trend. However, due to the impact of COVID-19, during the following years, its comprehensive development index will decline by an average of 5% annually, but starting from 2022, it will gradually increase. As a result, tailored and coordinated sustainable environmental policies of integrating institutional and open-market measures should be provided.
ABSTRACT
From January 24, 2020 to May 18, 2020, Chaoshan took measures to limit the spread of COVID-19, such as restricting public gatherings, wearing masks, and suspending classes. We explored the effects of these measures on the pathogen spectrum of pediatric respiratory tract infections in Chaoshan. Pharyngeal swab samples were collected from 4075 children hospitalized for respiratory tract infection before (May-December 2019) and after (January-August 2020) the COVID-19 outbreak. We used liquid chip technology to analyze 14 respiratory pathogens. The data were used to explore between-group differences, age-related differences, and seasonal variations in respiratory pathogens. The number of cases in the outbreak group (1222) was 42.8% of that in the pre-outbreak group (2853). Virus-detection rates were similar in the outbreak (48.3%, 590/1222) and pre-outbreak groups (51.5%, 1468/2853;Χ2= 3.446, P = 0.065), while the bacteria-detection rate was significantly lower in the outbreak group (26.2%, 320/1222) than in the pre-outbreak group (44.1%, 1258/2853;Χ2= 115.621, P < 0.05). With increasing age, the proportions of respiratory syncytial virus (RSV) and cytomegalovirus (CMV) infections decreased, while those of Mycoplasma pneumoniae (MP), and adenovirus (ADV) infections increased. Streptococcus pneumoniae (SP), CMV, and rhinovirus infections peaked in autumn and winter, while RSV infections peaked in summer and winter. We found that the proportion of virus-only detection decreased with age, while the proportion of bacteria-only detection increased with age (Table 2). Anti-COVID-19 measures significantly reduced the number of pediatric hospitalizations for respiratory tract infections, significantly altered the pathogen spectrum of such infections, and decreased the overall detection rates of 14 common respiratory pathogens. The proportion of bacterial, but not viral, infections decreased.