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2.
Open Forum Infectious Diseases ; 8(SUPPL 1):S312, 2021.
Article in English | EMBASE | ID: covidwho-1746571

ABSTRACT

Background. Early assessments of COVID19 preparedness reported resource shortages, use of crisis capacity strategies, variations in testing, personal protective equipment (PPE), and policies in US hospitals. One year later, we performed a follow-up survey to assess changes in infection prevention practice and policies in our diverse network of community and academic hospitals. Methods. This was a cross-sectional electronic survey of infection preventionists in 58 hospitals within the Duke Infection Control Outreach Network (community) and Duke/UNC Health systems (academic) in April-May 2021 to follow-up our initial survey from April 2020. The follow-up survey included 26 questions related to resource availability, crisis capacity strategies, procedures, changes to PPE and testing, and staffing challenges. Results. We received 54 responses (response rate, 93%). Facilities reported significantly fewer PPE and resource shortages in the follow-up survey compared to our initial survey (Figure 1, P< 0.05). Only 32% of respondents were still reprocessing N95 respirators (compared to 73% in initial survey, P< 0.05). All hospitals performed universal masking, universal symptom screening on entry, and 30% required eye protection. In 2020, most hospitals suspended elective surgical procedures in March-April, and restarted in May-June. Approximately 92% reported in-house testing for SARS-COV-2 by April 2020, at least a third of which had a weekly capacity of >100 tests. Almost 80% performed universal pre-operative testing, while 61% performed universal preadmission testing for SARS-COV-2. Almost all hospitals switched from test-based to time-based strategy for discontinuing isolation precautions, majority in August-September 2020. Twenty-five percent hospitals reported infection prevention furloughs, staffing cuts, and or reassignments, while 81% reported increased use of agency nursing during the pandemic. Conclusion. Our follow-up survey reveals improvement in resource availability, evolution of PPE guidance, increase in testing capacity, and burdensome staffing changes. Our serial surveys suggest increasing uniformity in infection prevention policies, but also highlight the increase in staff turnover and infection prevention staffing shortages.

3.
British Journal of Clinical Pharmacology ; 87(12):4897-4897, 2021.
Article in English | Web of Science | ID: covidwho-1576155
4.
Cancer Epidemiology Biomarkers and Prevention ; 30(7 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1394285

ABSTRACT

Purpose: Cervical cancer is one of the leading causes of cancer deaths among women in some countries in the Region of the Americas.1 Cervical cancer is preventable through HPV vaccination, screening and treatment of precancerous lesions, and can be effectively treated if diagnosed early.2 Methods: Under the framework of the Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem, the US National Cancer Institute (NCI), the University of Texas MD Anderson Cancer Center (MD Anderson) and the Pan American Health Organization/World Health Organization (PAHO/WHO) partnered to develop ECHO Latin America (ECHO ELA). ECHO ELA is modeled on Project ECHO® (Extension of Community Healthcare Outcomes) a hub-and-spoke knowledge-sharing approach where expert teams lead virtual didactic lectures and case discussions, amplifying the capacity for participants to deliver best practice programs to their regions. ECHO ELA consists of monthly, Spanish-language telementoring conferences about cervical cancer prevention and control. The program targets Ministries of Health, Immunization Program Managers and key cervical Sample output to test PDF Combine only cancer stakeholders in Latin American (LA) countries. Its primary goal is to assist countries in reaching their WHO cervical cancer elimination goals “90-70-90:” vaccinating 90 percent of girls against HPV by the age of 15, screening 70 percent of women for cervical cancer at ages 35 and 45, and treating 90 percent of women diagnosed with preinvasive cervical lesions or cervical cancer. Results: To date, 222 participants from 21 countries have registered. Seven sessions have been held averaging 93 participants per session. 85 participants completed the baseline survey addressing priorities, capacity, and desired outcomes. Baseline, mid-year evaluation results, within the COVID-19 context, and learned lessons will be presented. Conclusion: ECHO ELA is potentially an effective tool to convene participants from multiple countries to enhance collaboration and support countries' progress towards the elimination of cervical cancer in the Americas.

5.
Environmental Justice ; : 7, 2021.
Article in English | Web of Science | ID: covidwho-1360328

ABSTRACT

It is well established within both the scientific literature and social discourse that policing in the United States has a history of racial bias. Black people make up a disproportionate percentage of the prison population in this country-a direct result of policies such as "convict leasing" and the War on Drugs, designed to hyper-police the Black community. In this article, we explain how the development of the U.S. carceral system is inextricably linked to slavery at its foundation, how the late twentieth century saw the development of laws that discriminately impact Black people, and why policing and the carceral system must be viewed through a lens of environmental justice. Using modern case studies, we argue that the U.S. carceral system is fraught with issues of environmental injustice, both historically and in the face of new challenges, such as the COVID-19 pandemic. We aim to show that any path forward must be intersectional in its approach, and highlight that the environmental movement must incorporate social justice to address systemic issues of environmental injustice.

7.
Open Forum Infectious Diseases ; 7(SUPPL 1):S310, 2020.
Article in English | EMBASE | ID: covidwho-1185849

ABSTRACT

Background: The SARS-CoV-2 pandemic has placed a tremendous strain on the U.S. healthcare system leading to personal protective equipment (PPE) and resource shortages. Hospitals have developed contingency and crisis capacity strategies to optimize the use of resources, but, to date, community hospital preparedness has not been described. Methods: We performed a cross-sectional survey of infection preventionists in 60 community hospitals within the Duke Infection Control Outreach Network between April 22 and May 7, 2020 using Qualtrics. The survey included 13 questions related to resource availability, crisis capacity strategies and approaches to testing. Results: We received 50 responses during the study period with a response rate of 83%. Community hospitals reported varying degrees of PPE shortages (Table 1);80% of community hospitals were implementing strategies to extend and reuse N95 respirators, Powered Air-Purifying Respirators, face shields and face masks. Over 70% of facilities reported reprocessing N95 respirators (Figure 1). Almost all facilities reported universal masking at time of this survey with 90% performing daily employee screening at point of entry. Additionally, 8% of facilities restarted elective procedures at the time of this survey, but only 54% of facilities reported that they were performing preoperative testing for SARS-CoV-2. Thirty-seven percent of facilities performed one SARS-CoV-2 test before discharging an asymptomatic patient to skilled nursing facility, while 43% of facilities performed 2 tests. Conclusion: Our findings reveal differences in resource availability, crisis capacity strategies and testing approaches used by community hospitals in preparation for the SARSCOV- 2 pandemic. Lack of harmonization in approaches may be in part due to differences in state guidelines and decentralized federal approach to SARS-CoV-2 preparedness. (Table Presented).

8.
International Journal of Gynecological Cancer ; 30(SUPPL 3):A25, 2020.
Article in English | EMBASE | ID: covidwho-1177563

ABSTRACT

Introduction Cervical cancer is the primary cause of cancer among women in Mozambique. There is a shortage of providers trained to deliver cervical cancer screening and manage pre-invasive lesions. We describe a training program to build local capacity to deliver quality cervical cancer prevention services in Mozambique. Methods The program includes training courses led by faculty from the United States (US) and Brazil, and consists of lectures followed by hands-on training stations to practice colposcopy, cervical biopsy, ablation and loop electrosurgical excision procedure (LEEP) using innovative training models. Participants then perform the procedures in clinic with supportive supervision from the international faculty. The courses are complemented by monthly videoconference telementoring sessions, held in Portuguese using the Project ECHO® (Extension for Community Healthcare Outcomes) model. Results From 2016 to 2020, 10 courses were held in the cities of Maputo (n=8), Beira (n=1) and Nampula (n=1). There were 347 participants with an average of 34 participants per course. The courses have recently transitioned from only international faculty to include Mozambican gynecologists, including two fellows from the IGCS Global Curriculum program. A total of 15 ECHO sessions were held with ∼25 participants/ session, 30 patient cases discussed and 14 lectures delivered. Conclusion This collaboration between Mozambique, Brazil and the US is building local capacity to prevent cervical cancer through training, mentoring and support of local providers. Due to the COVID-19 pandemic, the courses are being transitioned to a virtual format led by the Mozambican doctors with the international faculty joining remotely.

11.
AHURI Final Report ; (340)2020.
Article in English | Scopus | ID: covidwho-914878

ABSTRACT

We have not yet seen the full effect of COVID-19 and the subsequent economic crisis, but this early analysis of the COVID19 module of the Australian Rental Housing Conditions Dataset (ARHCD) suggests that the rental sector will be where many of the upcoming challenges for Australia overlap. • The COVID-19 module captures a 'snapshot' of circumstances for Australian renters. The initial findings, presented here, suggest a policy-important cohort of tenants in Australia are lined up on the brink of a financial precipice. Many renters are currently buffered from the full economic effects of the pandemic by their savings, their superannuation, and rent deferment, as well as temporary government supports in the form of eviction moratoriums, JobKeeper and JobSeeker. • The impacts of COVID-19 across the rental sector are, in many respects, still emerging, and this presents a real challenge for policymakers in developing targeted and effective assistance. While policy responses may, in the short term, focus on protective mechanisms, such as eviction moratoriums, the systemic nature of the challenges faced by renters suggests that long-term recovery will be most effectively realised through system-wide policy shifts. • Challenges for effective policy response include the need to provide targeted assistance quickly, to provide a framework of certainty that enables all stakeholders in the rental sector to plan for the future (e.g. tenants, landlords, housing providers, social services), and to anticipate what issues may evolve in an extended pandemic. • Without control of COVID-19 and the associated health risks, there can be no recovery for the Australian economy. Housing is at the frontline of interventions-and, as such, is a potential weakness in recovery. © Australian Housing and Urban Research Institute Limited 2020

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