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1.
International Journal of Health Sciences ; 6:10893-10901, 2022.
Article in English | Scopus | ID: covidwho-1989153

ABSTRACT

With the advancement of computer science and information technology, enormous generation of data and information in particular has been observed in every field of knowledge over the past decades. The ultimate purpose of information creation is to serve the need of information seekers. Due to complex nature of information, it needs to be organised and retrieved effectively so that it can be put to use. Information Retrieval can be defined as the process of representing, storing, organising and accessing of information, generally documents that are suitable to an information need at the user end. The present study attempts to make an analysis of information retrieving competence of the students of the University of Jammu during COVID-19. In order to meet the purpose of this study, survey method was adopted and a questionnaire was distributed online to the students. The outcomes of the study reveal if information retrieval was difficult during the period, various reasons for information seeking and the effect on information retrieving ability of the students. It also brings into light the capability of students to evaluate information for further use and the things they have learnt while retrieving information during the pandemic. © 2022.

2.
Investigative Ophthalmology and Visual Science ; 62(8), 2021.
Article in English | EMBASE | ID: covidwho-1378799

ABSTRACT

Purpose : The purpose of this study is to determine the effect of prolonged use of a surgical mask on tear meniscus parameters using anterior segment ocular coherence tomography (AS-OCT) and Ocular Surface Disease Index (OSDI) score amongst healthcare workers during the COVID-19 pandemic. Methods : Fifty healthcare workers from St. Joseph's Healthcare Hamilton in the Hamilton Regional Eye Institute Department, Hamilton, Ontario participated in the study. All participants completed OSDI Questionnaire and provided demographics data. Participants had an average of three AS-OCT imaging of the tear meniscus (TM) at baseline and 8hrs later, after their regular shift. During this 8hr period, participants were required to wear medical masks continuously throughout their shift. Data was analyzed using SPSS V27. Results : Participants' (n = 50) mean age was 38.9 ± 12.9 years;22.0% were male and 78.0% were female. Of these participants, 62.0% wear spectacles and 28.0% wear contact lens. 54.4% of participants (n = 100 eyes) had normal OSDI scores of <12, 34.0% had mild OSDI scores, 4.0% had moderate OSDI scores, 8.0% had severe OSDI scores. Baseline mean ASOCT TM height was 385.4±172.6 μm and mean TM area was 46,496.7±41,875.5 μm ;after 8 hours shift the parameters reduced to mean TM height of 296.6±99.9 μm and mean TM area of 28,187.8±18,761.3 μm . With the resultant mean TM height and area difference of 88.8±142.8 μm (p<0.001) and 18,308.9±35,901.9 μm (p<0.001), respectively. Participants had a mean reduction in tear meniscus parameters in left eye (TM height: 90.1±149.3 μm and TM area:18,290.9±39,538.78 μm ) and right eye (TM height: 87.5±137.5 μm and TM area: 18,326.9±32,262.7 μm ), regardless of OSDI scores and significance between the left and right eye (Area Difference p=0.996;TMH Difference p=0.927). Conclusions : This study shows that prolonged use of medical mask especially during COVID-19 may reduce tear meniscus parameters. There was a 23.0% reduction in tear meniscus height and 39.4% reduction in tear meniscus area compared to the initial parameters, regardless of the presence of OSDI scores.

3.
Thorax ; 76(SUPPL 1):A75, 2021.
Article in English | EMBASE | ID: covidwho-1194264

ABSTRACT

Introduction and Objectives Shared care allows for optimal local management of patients with support and guidance from the specialist secondary/tertiary care multidisciplinary teams. Implementing shared care for patients managed with immunomodulatory medicines by an interstitial lung disease (ILD) service was accelerated during the COVID-19 pandemic to minimise the risks associated with travelling to a specialist clinic for consultation, monitoring and supply of medication. Methods Patients were deemed eligible for shared care if they had been prescribed a stable dose of immunomodulatory medication included in the shared care guideline for 3 months. The specialist pharmacist(s) sought permission from the patient and requests were sent to general practitioners (GPS) with a primary care decision form to be returned within 2 weeks. Reminders were sent for shared care responses not received within this timeframe. All patients that had shared care accepted were transferred to GP for the monitoring and supply of immunomodulatory therapy. All other patients were monitored remotely and had medications supplied via specialist centre. Results Of 352 eligible patients, 350 agreed to requesting shared care with primary care providers for immunomodulatory medication(s). Acceptance of shared care was received for 226 patients (65%) and refusal for 17 patients (5%). The barriers to transferring care included no response from GP (104 patients, 30%), hospital only status of medicine under local Clinical Commissioning Group (CCG), patient deemed complex by GP and/or poor adherence. Conclusions This study demonstrates how different healthcare providers worked together effectively to deliver high standards of integrated care, tailored to the individual needs of patients with ILD, during the COVID-19 pandemic. Uptake of shared care could be improved by direct communication pathways with GPS, increased education in the management of immunomodulatory medicine(s) for primary care providers and review of CCG categorisation of medicines included in the shared care agreement. Shared care may improve accessibility to medicines and reduce environmental impact. We suggest further studies to assess monitoring in primary care, patient feedback, impact on specialist clinic capacity and financial implications.

4.
Thorax ; 76(SUPPL 1):A144-A145, 2021.
Article in English | EMBASE | ID: covidwho-1146446

ABSTRACT

Introduction: Mepolizumab is a biologic agent targeting interleukin (IL)-5 which is currently licensed as add-on therapy for severe eosinophilic asthmatic (SEA). It is usually administered in a hospital setting but with the option of homecare being introduced in 2019, the 4-weekly subcutaneous injections can be self-administered at home. We investigated whether there was a change in asthma control following the transition to home administration and whether a differential response to treatment exists following transition to homecare before and after the onset of the COVID-19 pandemic. Methods: Patients receiving mepolizumab via home care were stratified according to those who had a planned transition to homecare prior to 1st Feb 2020 versus those who had an unplanned transition after this date necessitated by the COVID-19 pandemic. The last Asthma Control Questionnaire-6 (ACQ6) measured in clinic ('baseline') was compared with that collected by telephone consultation 6-8 weeks after transition ('homecare'). Patients were excluded if both values were not available. Results: Of 87 mepolizumab patients included in the analysis, 46 were planned transitions. There was no significant (Figure presented) difference in the pre-biologic ACQ6 (p=0.07) between groups. Immediately prior to transition to homecare (baseline), the planned group had a lower mean ACQ6 than those in the unplanned group (1.19 vs 1.90, P=0.004). The ACQ6 on homecare decreased significantly in both groups (-0.47 in the planned group vs -0.56 in the unplanned group, both P<0.001). The ACQ6 for the planned cohort during homecare was significantly lower than that for the unplanned group (0.72 vs 1.34, P=0.012) (figure 1). (Table presented) Conclusions: We found a significant improvement in ACQ6 for all SEA patients established on Mepolizumab who transitioned to home mepolizumab administration. This improvement occurred irrespective of whether the transition was 'planned' or 'unplanned'. Further research is required to understand the potential influence of shielding during lockdown and the method of ACQ assessment (telephone vs face-to-face ACQ reporting in clinic) on this improvement.

5.
Thorax ; 76(SUPPL 1):A144, 2021.
Article in English | EMBASE | ID: covidwho-1146445

ABSTRACT

Introduction: The COVID-19 pandemic necessitated the rapid transition of large numbers of patients onto homecare to facilitate on-going therapy in a cohort of patients who were 'shielding'. Alongside this, patients continued to need to be initiated on biologic therapy in spite of the pandemic. The impact of administering biologic therapy at home is largely unknown, yet crucial to optimise patient outcome and minimise steroid burden. We investigated whether there was a differential response following transition to homecare of established patients versus those newly started. Methods: Patients with severe eosinophilic asthma receiving home benralizumab were stratified according to those who had received ≥3 doses prior to COVID-19 lockdown on the 15th March 2020 ('established' patients) versus those who were initiated after this date ('new' patients). We compared the last Asthma Control Questionnaire-6 (ACQ6) measured in clinic with that collected by telephone consultation 8-12 weeks after transition to homecare. Patients were excluded if both values were not available. Results: 246 benralizumab patients were included in the analysis, of whom 49 (20%) were new. There was no significant difference in pre-biologic ACQ6, pre-homecare (baseline) (Figure presented) ACQ6 or post-homecare ACQ6 between the new and established patient groups. Both cohorts exhibited a similar magnitude of improvement in their ACQ6 following the transition to homecare (-0.73 in the established group vs -0.73 in the new group, both P<0.0001) (figure 1). Conclusions: We have demonstrated that early transition to homecare in patients treated with benralizumab is not associated with worse clinical outcomes as assessed by ACQ6. The improvements in ACQ6 were seen irrespective of whether they were 'established' on therapy at time of transition or 'new'. Further research is required to understand the potential influence of lockdown and/or telephone vs face-to-face ACQ reporting.

6.
Journal of the National Medical Association ; 112(5):S16, 2020.
Article in English | EMBASE | ID: covidwho-988446

ABSTRACT

Introduction: Despite significant improvements in early detection and treatment, the disparities seen among cancer patients have persisted. Sepsis and Deep Vein Thrombosis (DVT) / Pulmonary Embolus (PE) remain leading causes of death among cancer patients. Emergency departments (ED) serve as critical entry points into the inpatient acute care setting. The novel SARS-COV2 virus has intensified the risk facing these patients. The purpose of this study is to characterize the mortality and morbidity rates in cancer patients admitted through the ED of an urban academic hospital. Methods: Retrospective cohort analysis of cancer patients seen in the ED in 2019. Billing data was used to identify the cohort of cancer patients using the terms “Neoplasm”, “Malignant”, “Malignancy” or “Cancer”. Excluded were terms like benign, family history or screening. The final cohort included patients with both active cancer as well as those with a history of cancer. Results: Of the 27,327 unique patients seen in the ED, 1,597 (5.8%) were cancer patients, accounting for 3,135 (6.9%) visits. Of the total of 133 deaths seen in patients admitted through the ED, 29 (21.8%) were in cancer patients. This represents a mortality rate of 9.3 per 1000 visits (18.2 per 1000 patients). This is in contrast to an overall mortality rate of 2.9 per 1000 visits (4.9 per 1000 patients). Among the cancer cohort, the mortality rate increased to 20% (7/35) with a sepsis diagnosis and 4.8% (2/41) with a diagnosis of DVT/PE. Conclusion: Understanding the significant risk associated with cancer patients requiring inpatient admission highlights the needs for screening protocols for early detection of life-threatening conditions such as sepsis and DVT/PE upon entry into the inpatient setting, especially among populations at risk for poor outcomes.

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