ABSTRACT
There is a well-established body of evidence that intergenerational bonding programs (IGPs) can improve the overall well-being of older adults and strengthen relationships and understanding between generations. There is limited literature on the experience of IGPs in an Asian context, despite many of these countries facing faster rates of population ageing than other Western countries. In Singapore, intergenerational bonding is a priority in national efforts to encourage successful ageing. This paper presents a case study of the development and implementation of a co-located (shared site) model IGP in Singapore. Drawing on interviews with key stakeholders, the aim of this case study is to present the realities of the evolution of an IGP from conceptualisation through to implementation, and used the nursing home's COVID-19 experience to illustrate issues of sustainability affecting IGPs with vulnerable populations. The findings will inform the development and implementation of similar future programs.
ABSTRACT
BACKGROUND: An epidemic of COVID-19 broke out in Wuhan, China, since December 2019. The ordinary medical services were hindered. However, the emergency cases, including aneurysmal subarachnoid hemorrhage (aSAH), still required timely intervention. Thus, it provoked challenges to the routine management protocol. In this study, we summarized our experience in the emergency management of aSAH (Beijing Tiantan Protocol, BTP) in Beijing, China. METHODS: Demographic, clinical, and imaging data of consecutive emergency aSAH patients who underwent craniotomy clipping during the COVID-19 epidemic season were reviewed and compared with the retrospective period last year. Subgroup analysis was further performed to assess the outcomes of different screening results and several detailed protocols. Neurological outcomes were evaluated by the modified Rankin Scale (mRS). RESULTS: A total of 127 aSAH were referred to our emergency department, and 42 (33.1%) underwent craniotomy clipping between January 20, 2020, and March 25, 2020. The incidence of preoperative hospitalized adverse events and the perioperative outcomes were similar (- 0.1, 95% CI - 1.0 to 0.8, P = 0.779) to the retrospective period last year (January 2019-March 2019). After the propensity score matching (PSM), there were still no statistical differences in prognostic parameters between the two groups. Eight (19.0%) of the 42 individuals were initially screened as preliminary undetermined COVID-19 cases, in which 2 of them underwent craniotomy clipping in the negative pressure operating room (OR). The prognosis of patients with varied COVID-19 screening results was similar (F(2, 39) = 0.393, P = 0.678). Since February 28, 12 cases (28.6%) received COVID-19 nucleic acid testing (NAT) upon admission, and all showed negative. The false-negative rate was 0.0%. The preoperative hospitalized adverse events and postoperative prognosis were still similar between patients with and without COVID-19 NAT (- 0.3, 95% CI - 1.4 to 0.9, P = 0.653). CONCLUSIONS: Our emergency surgery management protocol (BTP) is reliable for scheduling emergency aneurysm craniotomy clipping in non-major epidemic areas.
ABSTRACT
RATIONALE: The cystic features of the novel coronavirus disease 2019 (COVID-19) found on computed tomography (CT) have not yet been reported in the published literature. We report the cystic chest CT findings of 2 patients confirmed to have COVID-19-related pneumonia. PATIENT CONCERNS: A 38-year-old man and a 35-year-old man diagnosed with severe COVID-19 pneumonia were admitted to the intensive care unit. DIAGNOSES: Chest CT findings showed multiple cysts in ground-glass opacities (bilaterally) with/without pneumothorax. The cysts had a smooth inner wall. INTERVENTIONS: The patients continued to be given oxygen by mask and received antitussive, phlegm-dispelling treatment. OUTCOMES: At follow up, there was a reduction in the number of multiple cystic lesions on CT. To date, 1 patient was discharged from hospital, while the other had been transferred to the rehabilitation department. LESSONS: COVID-19 may independently result in pulmonary cyst formation and pneumothorax; the application of a ventilator may be another causative factor.