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PurposeThis study aims to investigate the perceptions of elderly learners in experiencing Zoom learning under the effects of COVID in the case of Hong Kong. Design/methodology/approachAn online survey and focus group interviews have been conducted with quantitative and qualitative approaches, respectively. The survey design was based on the input-process-output (IPO) model conceptual framework and used to assess students' perceptions regarding their Zoom learning experiences at the Elder Academy of Hong Kong Metropolitan University. Thereafter, selected students were invited to participate in focus group interviews to offer more in-depth comments for analysis purposes. Statistical Product and Service Solutions software and SmartPLS were used for data analysis of the survey, and content analysis was used to summarize opinions from the focus group interviews;thus, a comprehensive picture of elderly learners' learning experiences on Zoom is presented. FindingsAn overall positive perception was the result of elderly learners' Zoom learning journeys, particularly in the "input" and "process" stages of the IPO model. Yet, their perception of the "learning outcomes achieved" level in the "output" stage was lower among the rest, thus strongly affected by the factors of "interactions" and "teaching" experienced by elderly learners on Zoom. Although the perception of the youngest age group was more positive, none have agreed that Zoom learning was more favourable when compared with the traditional face-to-face mode. Originality/valueGiven Zoom as the short-term replacement option under the COVID pandemic, this study will provide recommendations for educators/institutions to improve their design of the whole learning process for elderly learners on the Zoom platform.
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Background: The evidence for management of severe COVID-19 with persistent respiratory failure (PRF) after acute treatment is scarce, despite some authors reported a good response to corticosteroid in histological proven secondary organising pneumonia (OP). Objective(s): This study aimed to study the disease course of COVID-19 patients with persistent respiratory failure, and its radiological pattern. Method(s): A single centre retrospective cohort study on severe COVID-19 patients was conducted from January 2021 to June 2021. All radiological imaging and data were retrieved from electronic database. Result(s): Severe COVID-19 pneumonia had a 78% (584/750) survival in our cohort. Among the survival, 48% (279/584) had PRF beyond 14 days of illness and 10% of them required oxygen therapy upon discharge. Eighty-six percent (240/279) of patients with PRF had a HRCT performed. Eighty percent (187/240) of them attended clinic follow up with 81% had a radiological pattern consistent with OP. The mean severity CT score was 10 (SD+/-3). [Jin C et al. Front Public Heal.2020;8] Seventy-eight percent of patients were perceived with WHO functional class of 1-2. Sixty-eight percent of patients (128/187) were given short course of prednisolone during admission with tapering doses. The mean prednisolone dose was 0.69mg/kg/day with a mean duration of 47 days (SD+/-18). Seventy-eight percent (146/187) had a follow up chest x-ray (CXR) at 12+/-8 weeks. Only 6.4% (12/187) of them had abnormal CXR findings whereby two patients were later confirmed to have pulmonary tuberculosis. Conclusion(s): Radiological pattern of OP is common in COVID-19 with PRF. HRCT is a non-invasive tool to assess this entity.
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Background: COVID-19 vaccines are important for patients with heart failure (HF) to prevent severe outcomes but the safety concerns could lead to vaccine hesitancy. This study aimed to investigate the safety of two COVID-19 vaccines, BNT162b2 and CoronaVac, in patients with HF. Methods: We conducted a self-controlled case series analysis using the data from the Hong Kong Hospital Authority and the Department of Health. The primary outcome was hospitalization for HF and the secondary outcomes were major adverse cardiovascular events (MACE) and all hospitalization. We identified patients with a history of HF before February 23, 2021 and developed the outcome event between February 23, 2021 and March 31, 2022 in Hong Kong. Incidence rate ratios (IRR) were estimated using conditional Poisson regression to evaluate the risks following the first three doses of BNT162b2 or CoronaVac. Findings: We identified 32,490 patients with HF, of which 3035 were vaccinated and had a hospitalization for HF during the observation period (BNT162b2 = 755;CoronaVac = 2280). There were no increased risks during the 0–13 days (IRR 0.64 [95% confidence interval 0.33–1.26];0.94 [0.50–1.78];0.82 [0.17–3.98]) and 14–27 days (0.73 [0.35–1.52];0.95 [0.49–1.84];0.60 [0.06–5.76]) after the first, second and third doses of BNT162b2. No increased risks were observed for CoronaVac during the 0–13 days (IRR 0.60 [0.41–0.88];0.71 [0.45–1.12];1.64 [0.40–6.77]) and 14–27 days (0.91 [0.63–1.32];0.79 [0.46–1.35];1.71 [0.44–6.62]) after the first, second and third doses. We also found no increased risk of MACE or all hospitalization after vaccination. Interpretation: Our results showed no increased risk of hospitalization for HF, MACE or all hospitalization after receiving BNT162b2 or CoronaVac vaccines in patients with HF. Funding: The project was funded by a Research Grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref. No. COVID19F01). F.T.T.L. (Francisco T.T. Lai) and I.C.K.W. (Ian C.K. Wong)'s posts were partly funded by the D24H;hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission. © 2022 The Authors
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Objective: The COVID-19 pandemic saw increased loneliness and social isolation among older adults as activities and visitor opportunities for residential communities closed down. Health professional students have limited access to geriatric education in coursework and clinical experiences. The Recreation and Education Network for Elder Wellness (RENEW) programme was created by medical students at Baylor College of Medicine in Houston, Texas, aiming to increase engagement and cross-generational communication with older adults, while also decreasing social isolation and loneliness. Method: The RENEW programme included Zoom sessions with two Houston retirement communities led by student facilitators enrolled in medical, dental, and undergraduate programmes on a variety of topics of interest for the residents. Pre- and post-surveys were sent to participants and requested non-identifying biographical data and included the Revised UCLA Loneliness Scale. Results: Facilitators and participants expressed high satisfaction with the programme. Survey results on the Revised UCLA Loneliness Scale showed that participants had an overall decreased loneliness score after participation in RENEW. Student facilitators reported increased exposure to care of older adults and self-reported confidence in communicating with this population. Conclusions: The RENEW model is a collaborative, bidirectional educational tool for older adults and students with possible applications following the COVID-19 pandemic. © 2022 Australian Psychological Society.
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The number of patients requiring intensive care has surged since the outbreak of the SARS-CoV-2 virus. This had rendered the intensive care unit (ICU) a huge challenge not only to provide care for the existing patients but also to support the COVID-19 patients. The ICU was restructured to ensure strict adherence to the infection control guidelines. The aspects of change in the ICU had been ranging from the clinical operation, medication equipment and facilities, medications supply, and staffing. Strategies required upon implementation of change include having contingency plans, being innovative, getting the collaboration from other ICUs, exchanging information, getting support from the health policymakers, and ensuring the safety of the healthcare workers. This article aimed to share the experience of challenges and strategies in managing an ICU for the COVID-19 pandemic in Malaysia. © 2022 UPM Press. All rights reserved.
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Background: Personal protective equipment used for protection of healthcare workers in the combat against Severe Acute Respiratory Syndrome Coronavirus 2 pandemic is in limited supply worldwide at present – 2020. Use of barrier enclosure during endotracheal intubation can potentially act as a cost-effective adjunct to minimize risks of transmitting the infection to healthcare workers. However, there is concern that the enclosure itself will act as a barrier to the intubation procedure in the emergency settings. Objective: To evaluate the negative effect of barrier enclosure (an aerosol box) on the performance of video-assisted intubation in a manikin Methods: A total of 41 Emergency Department doctors from a local hospital were recruited to perform intubation in a manikin simulating normal and more difficult airways (Cormack-Lehane grades I and IIb) with and without the box. The primary outcome was time of successful intubation. The secondary outcomes were first-attempt success rate, number of successful attempts, need of adjuncts, dental injury and ease of intubation as perceived by the participants. Results: The aerosol box had no significant negative effect on the time of successful intubation (p = 0.630 (Grade I airway) and p = 0.436 (Grade IIb airway)), first-attempt success rate, number of successful attempts, need of adjuncts or dental injury. Participants subjectively reported extra yet minor challenges during intubation in the presence of the box. Conclusion: Within limits of the pilot study, the aerosol box had no statistical significant difference but an increasing trend of prolonged endotracheal intubation interval in the Grade IIb airway and negative impact on first-pass success, and could potentially be used to protect healthcare workers during the aerosol-generating intubation procedure.