ABSTRACT
Aim: To determine the impact of the COVID-19 pandemic on Resuscitation Council UK Advanced Life Support (ALS) and Immediate Life Support (ILS) course numbers and outcomes. Methods: We conducted a before-after study using course data from the Resuscitation Council UK Learning Management System between January 2018 and December 2021, using 23 March 2020 as the cut-off between pre- and post-pandemic periods. Demographics and outcomes were analysed using chi-squared tests and regression models. Results: There were 90,265 ALS participants (51,464 pre-; 38,801 post-) and 368,140 ILS participants (225,628 pre-; 142,512 post-). There was a sharp decline in participants on ALS/ILS courses due to COVID-19. ALS participant numbers rebounded to exceed pre-pandemic levels, whereas ILS numbers recovered to a lesser degree with increased uptake of e-learning versions. Mean ALS course participants reduced from 20.0 to 14.8 post-pandemic (P < 0.001).Post-pandemic there were small but statistically significant decreases in ALS Cardiac Arrest Simulation Test pass rates (from 82.1 % to 80.1 % (OR = 0.90, 95 % CI = 0.86-0.94, P < 0.001)), ALS MCQ score (from 86.6 % to 86.0 % (mean difference = -0.35, 95 % CI -0.44 to -0.26, P < 0.001)), and overall ALS course results (from 95.2 %to 94.7 %, OR = 0.92, CI = 0.85-0.99, P = 0.023). ILS course outcomes were similar post-pandemic (from 99.4 % to 99.4 %, P = 0.037). Conclusion: COVID-19 caused a sharp decline in the number of participants on ALS/ILS courses and an accelerated uptake of e-learning versions, with the average ALS course size reducing significantly. The small reduction in performance on ALS courses requires further research to clarify the contributing factors.
ABSTRACT
Introduction: Depression is a debilitating disorder affecting individuals' level of bio-psychosocial functioning across different age groups around the globe. The recent development of a new NIBS called Transcranial Pulse Stimulation (TPS), also known as low-intensity extracorporeal shock wave therapy (Li-ESWT), has been proven effective for only a 2-week treatment of 35 patients with Alzheimer's disease (AD). Patients' cognition and memory have shown significant improvement which lasted up to 3 months. However, there is a lack of scientific evidence on the efficacy of this TPS intervention on other psychiatric population such as Major Depressive Disorder (MDD), which is increasingly prevalent in Hong Kong and nationwide especially during the COVID-19 pandemic. Nonetheless, there is no trial evaluating the efficacy of TPS on other neuropsychiatric disorders. This gave us the impetus to evaluate the efficacy of TPS on young adults with Major Depressive Disorder (MDD) in Hong Kong. Method(s): In this single-blinded, randomized controlled trial, participants had a confirmed clinical diagnosis of MDD, recruited from the community, NGOs and private enterprise. The intervention was a 2-week TPS treatment comprised six 30-min TPS sessions, delivered by trained mental health professionals. A total of 30 participants were recruited and randomized into either the TPS group or the Waitlist Control (WC) group. Randomization was stratified by gender and age by an independent statistician on a 1:1 ratio. Our primary outcome was determined by whether participants' depressive symptom severity demonstrated significant reduction, compared with the WC group, using the Hamilton Depression Rating Scale-17 (HDRS17). This trial is registered with Clin.Trials.gov, number NCT05006365. Result(s): We recruited 30 participants from 1 August to 31 Oct 2021. They were between 18-54 years old and were predominantly female (73%), ethnically Chinese. There was a significant group x time interaction (F(1, 28) = 818.8, p <.001). Compared with the WC group, there was a significant reduction in the depressive symptom severity in the TPS group (mean difference = -6.60, p = 0.02, Cohen's d = -0.93). Results showed a significant intervention effect and the effect was large. Conclusion(s): TPS is safe and effective to reduce depressive symptoms among young individuals with MDD in this trial. Therefore, TPS may be considered as a top treatment option for neuropsychiatric disorders in clinical psychiatry. Funding(s): This trial is funded by the Departmental General Research Fund, the Hong Kong Polytechnic University, Hong Kong SAR, China. Copyright © 2022