Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 85
Filter
1.
Open Forum Infect Dis ; 10(1), 2023.
Article in English | PubMed Central | ID: covidwho-2212869

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) vaccine effectiveness (VE) studies are increasingly reporting relative VE (rVE) comparing a primary series plus booster doses with a primary series only. Interpretation of rVE differs from traditional studies measuring absolute VE (aVE) of a vaccine regimen against an unvaccinated referent group. We estimated aVE and rVE against COVID-19 hospitalization in primary-series plus first-booster recipients of COVID-19 vaccines. Methods: Booster-eligible immunocompetent adults hospitalized at 21 medical centers in the United States during December 25, 2021–April 4, 2022 were included. In a test-negative design, logistic regression with case status as the outcome and completion of primary vaccine series or primary series plus 1 booster dose as the predictors, adjusted for potential confounders, were used to estimate aVE and rVE. Results: A total of 2060 patients were analyzed, including 1104 COVID-19 cases and 956 controls. Relative VE against COVID-19 hospitalization in boosted mRNA vaccine recipients versus primary series only was 66% (95% confidence interval [CI], 55%–74%);aVE was 81% (95% CI, 75%–86%) for boosted versus 46% (95% CI, 30%–58%) for primary. For boosted Janssen vaccine recipients versus primary series, rVE was 49% (95% CI, −9% to 76%);aVE was 62% (95% CI, 33%–79%) for boosted versus 36% (95% CI, −4% to 60%) for primary. Conclusions: Vaccine booster doses increased protection against COVID-19 hospitalization compared with a primary series. Comparing rVE measures across studies can lead to flawed interpretations of the added value of a new vaccination regimen, whereas difference in aVE, when available, may be a more useful metric.

3.
MMWR - Morbidity & Mortality Weekly Report ; 71(5152):1625-1630, 2022.
Article in English | MEDLINE | ID: covidwho-2204208

ABSTRACT

Monovalent COVID-19 mRNA vaccines, designed against the ancestral strain of SARS-CoV-2, successfully reduced COVID-19-related morbidity and mortality in the United States and globally (1,2). However, vaccine effectiveness (VE) against COVID-19-associated hospitalization has declined over time, likely related to a combination of factors, including waning immunity and, with the emergence of the Omicron variant and its sublineages, immune evasion (3). To address these factors, on September 1, 2022, the Advisory Committee on Immunization Practices recommended a bivalent COVID-19 mRNA booster (bivalent booster) dose, developed against the spike protein from ancestral SARS-CoV-2 and Omicron BA.4/BA.5 sublineages, for persons who had completed at least a primary COVID-19 vaccination series (with or without monovalent booster doses) >=2 months earlier (4). Data on the effectiveness of a bivalent booster dose against COVID-19 hospitalization in the United States are lacking, including among older adults, who are at highest risk for severe COVID-19-associated illness. During September 8-November 30, 2022, the Investigating Respiratory Viruses in the Acutely Ill (IVY) Network assessed effectiveness of a bivalent booster dose received after >=2 doses of monovalent mRNA vaccine against COVID-19-associated hospitalization among immunocompetent adults aged >=65 years. When compared with unvaccinated persons, VE of a bivalent booster dose received >=7 days before illness onset (median = 29 days) against COVID-19-associated hospitalization was 84%. Compared with persons who received >=2 monovalent-only mRNA vaccine doses, relative VE of a bivalent booster dose was 73%. These early findings show that a bivalent booster dose provided strong protection against COVID-19-associated hospitalization in older adults and additional protection among persons with previous monovalent-only mRNA vaccination. All eligible persons, especially adults aged >=65 years, should receive a bivalent booster dose to maximize protection against COVID-19 hospitalization this winter season. Additional strategies to prevent respiratory illness, such as masking in indoor public spaces, should also be considered, especially in areas where COVID-19 community levels are high (4,5).

4.
Families in Society-the Journal of Contemporary Social Services ; 2022.
Article in English | Web of Science | ID: covidwho-2195034

ABSTRACT

The emergence and rapid spread of COVID-19 led to unprecedented changes for families and systems of care. This study sought to understand the needs of families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) before and during the pandemic and considers the impact remote service delivery has on access to an integrated behavioral health intervention to support the psychosocial needs of children and caregivers. Needs for referral varied significantly pre- and post-pandemic onset. Analyses revealed that significantly more referrals were made regarding social determinants of health after the onset of COVID-19 (13.8%) compared with prior to the COVID-19 pandemic (4.1%, p < .05). Providers' transition to telehealth services sufficiently served WIC families.

5.
Pediatr Dermatol ; 2023.
Article in English | Web of Science | ID: covidwho-2193094

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious inflammatory response associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Mucocutaneous findings are often present but remain poorly defined overall, and more precise dermatologic descriptions are not only necessary to better characterize this syndrome, but may also aid in early diagnosis and prevention of severe deterioration or death. We report the case of a 16-month-old boy presenting with a diffuse maculopapular eruption, cheilitis, and vesiculobullous lesions of the scrotum, perianal region, and distal lower extremities. Tense bullae of the genitals and lower extremities have not been previously reported in MIS-C and add to the spectrum of skin findings associated with the disorder.

6.
Open Forum Infect Dis ; 9(12), 2022.
Article in English | PubMed Central | ID: covidwho-2190082

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has demonstrated the need to share data and biospecimens broadly to optimize clinical outcomes for US military Veterans. Methods: In response, the Veterans Health Administration established VA SHIELD (Science and Health Initiative to Combat Infectious and Emerging Life-threatening Diseases), a comprehensive biorepository of specimens and clinical data from affected Veterans to advance research and public health surveillance and to improve diagnostic and therapeutic capabilities. Results: VA SHIELD now comprises 12 sites collecting de-identified biospecimens from US Veterans affected by SARS-CoV-2. In addition, 2 biorepository sites, a data processing center, and a coordinating center have been established under the direction of the Veterans Affairs Office of Research and Development. Phase 1 of VA SHIELD comprises 34 157 samples. Of these, 83.8% had positive tests for SARS-CoV-2, with the remainder serving as contemporaneous controls. The samples include nasopharyngeal swabs (57.9%), plasma (27.9%), and sera (12.5%). The associated clinical and demographic information available permits the evaluation of biological data in the context of patient demographics, clinical experience and management, vaccinations, and comorbidities. Conclusions: VA SHIELD is representative of US national diversity with a significant potential to impact national healthcare. VA SHIELD will support future projects designed to better understand SARS-CoV-2 and other emergent healthcare crises. To the extent possible, VA SHIELD will facilitate the discovery of diagnostics and therapeutics intended to diminish COVID-19 morbidity and mortality and to reduce the impact of new emerging threats to the health of US Veterans and populations worldwide.

7.
Mental Health and Physical Activity ; 24 (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-2181620

ABSTRACT

Background: Although much research has been devoted to examining the relationship between negative mental health states (e.g., depression) and physical activity, the literature is scarce in terms of associations between positive mental health states (e.g., mental wellbeing) and physical activity. The objective of this study was to examine the association between mental wellbeing measured in 2019 and physical activity measured in 2020 (including bi-directionality). Method(s): Data stem from a Danish nationally-representative panel of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to register data. The SWEMWBS scale was used to assess mental wellbeing. The outcome was >=150 min of physical activity per week (self-reported). Logistic regression models were performed, adjusting for covariates and physical activity at baseline. Result(s): Each point increase in mental wellbeing in 2019 positively predicted >=150 min of physical activity per week in 2020 (OR = 1.03, 95%CI 1.01-1.05). Compared to low mental wellbeing, moderate wellbeing was associated with higher odds (OR = 1.51, 95%CI 1.10-2.08) of engaging in >=150 min of physical activity, while the odds among those with high mental wellbeing were even higher (OR = 1.93, 95%CI 1.37-2.72). The results reflected a dose-response pattern. Finally, the reverse pathway was noted as well, i.e., physical activity in 2019 positively predicted mental wellbeing in 2020. Conclusion(s): The results show that favorable mental health status - beyond the absence of mental illness - positively predicts adherence to recommended physical activity levels in the following year. Initiatives to promote mental wellbeing may be instrumental as a means to protect and enhance general health by positively influencing engagement in physical activity. Conversely, increasing physical activity levels may protect against mental illness and further enhance population mental wellbeing. Copyright © 2022 The Authors

8.
Journal of Telemedicine & Telecare ; : 1357633X221136305, 2022.
Article in English | MEDLINE | ID: covidwho-2162118

ABSTRACT

INTRODUCTION: The Victorian COVID-19 Cancer Network (VCCN) Telehealth Expert Working Group aimed to evaluate the telehealth (TH) experience for cancer patients, carers and clinicians with the rapid uptake of TH in early 2020 during the COVID-19 pandemic.

9.
Cambridge Quarterly of Healthcare Ethics ; : 1-9, 2022.
Article in English | MEDLINE | ID: covidwho-2160117

ABSTRACT

After a brief overview of ethical issues in an Australian context catalyzed by the current pandemic, this article focuses on data protection in the light of recent debates about COVID-19 data tracking in Australia and globally. This article looks at the issue of trust as a fundamental principle of effective and ethical COVID-safe measures undertaken by the government. Key to ensuring such trust are Habermasian participatory dialogs, which assume trust as a condition of authentic illocution, and an emphasis on short-term data capture.

10.
Nature ; 2022.
Article in English | PubMed | ID: covidwho-2151057

ABSTRACT

Prevention of SARS-CoV-2 infection through the modulation of viral host receptors, such as ACE2(1), could represent a new chemoprophylactic approach for COVID-19 complementing vaccination(2,3). However, the mechanisms controlling ACE2 expression remain elusive. Here, we identify the farnesoid X receptor (FXR) as a direct regulator of ACE2 transcription in multiple COVID19-affected tissues, including the gastrointestinal and respiratory systems. We then use the over-the-counter compound z-guggulsterone (ZGG) and the off-patent drug ursodeoxycholic acid (UDCA) to reduce FXR signalling and downregulate ACE2 in human lung, cholangiocyte and intestinal organoids and in the corresponding tissues in mice and hamsters. We demonstrate that UDCA-mediated ACE2 downregulation reduces susceptibility to SARS-CoV-2 infection in vitro, in vivo and in human lungs and livers perfused ex situ. Furthermore, we illustrate that UDCA reduces ACE2 expression in the nasal epithelium in humans. Finally, we identify a correlation between UDCA treatment and positive clinical outcomes following SARS-CoV-2 infection using retrospective registry data, and confirm these findings in an independent validation cohort of liver transplant recipients. In conclusion, we identify a novel function of FXR in controlling ACE2 expression and provide evidence that modulation of this pathway could be beneficial for reducing SARS-CoV-2 infection, paving the road for future clinical trials.

11.
Asia-Pacific Journal of Clinical Oncology ; 18(Supplement 3):86, 2022.
Article in English | EMBASE | ID: covidwho-2136597

ABSTRACT

Aim: Peoplewith cancer living in regional Victoria are less likely to participate in a clinical trial than metropolitan patients.We established a new geographically based trials network with the gaol of increasing the number of regional cancer patients recruited to clinical trials. Method(s): Initially six regional services and Cancer Trials Australia (CTA) collaborated to form Regional Trials Network Victoria (RTNV). Two more sites, Latrobe Regional Hospital and Mildura Public Hospital were added in 2021. This network represents a population of 1.9 million people and approximately 8000 new cancer diagnoses each year. Access to cancer clinical trials at regional sites was achieved by: Building capacity of regional clinical trial units Improving the efficiency of clinical trial conduct Implementing the COSA teletrial framework Investing in the capability of staff Increasing the number of clinical trials Results: In 2017, the CCV Clinical Trial Management Scheme (CTMS) recorded 1587 Victorians recruited to cancer clinical intervention trials. 428 resided in regional Victoria, but only 81 of these participated at a regional site, with others needing to travel. In 2017, 135 patients were recruited to RTN sites (regional plus Geelong) across 55 trials. By 2021, despite the impacts of the COVID19 pandemic the number of recruiting clinical trials increased by 54% and the number of regional patients recruited to CTMS studies in the network increased to 179. Driven by uptake of teletrials and registry trials total recruitment increased to 620 patients. RTNV leveraged funding to sustain core activity and was awarded $18.5 million from the Medical Research Future Fund to conduct health services research over the next 5 years. Conclusion(s): The RTNV is a successful implementation of a regionally based clinical trials network, improving access and participation of regional patients. Much of the increase was driven by the use of COSA Teletrials methodology.

12.
Developmental Medicine and Child Neurology ; 64(Supplement 4):128-129, 2022.
Article in English | EMBASE | ID: covidwho-2088168

ABSTRACT

Background and Objective(s): Although the overall rates of preterm birth decreased, the proportion of infants born preterm was high among Black, Indigenous, and other People of Color (BIPOC) during the COVID pandemic. This study aims to identify barriers/facilitators to study enrollment and assessment completion. Study Design: Cohort study. Study Participants & Setting: Fifty-seven very preterm infants (<29 weeks gestation) enrolled in the Supporting Play, Exploration, and Early Development Intervention trial while in a participating Neonatal Intensive Care Unit (NICU). Comparisons of two time periods for enrollment and 2 for assessments were compared;pre-COVID (Before 03/12/20), COVID (03/13/20 -03/ 12/21), and late-COVID (after 03/12/21). Materials/Methods: The proportion of eligible infants that enrolled and completed planned assessment visit was extracted from detailed enrollment and visit completion notes. A combination of assessments including the General Movement Assessment, Test of Infant Motor Performance (TIMP), Bayley Scales of Infant and Toddler Development 3rd edition (BSID), Gross Motor Function Measure (GMFM), Hammersmith Infant Neurological Exam (HINE), 5-minute observation of Parent-child interaction, and Assessment of Problem Solving in Play (APSP) were completed based on age at 5 visits over 24 months. The GMFM, APSP, and the parent child observations were completed via telemedicine (after contactless drop off of manipulatives to the family). The assessment protocols were modified to facilitate completion of as much of the assessment as possible via telemedicine. During the end of the COVID period hybrid visits, with only the BSID completed in person were included if the in-person contact was less than 60 minutes. All analysis are descriptive due to small samples. Result(s): Eligibility and enrollment was impacted by COVID with 48% and 60% of eligible infants enrolling pre-COVID decreasing to 33% and 46% during COVID. The proportion of infant that enrolled who were non-White changed, decreasing from 70 to 60% in an urban hospital and increasing from 12 to 20% in a rural hospital. The rate of in-person assessments during COVID (59%) was lower than pre-COVID (100%) or late-COVID (96%) period. Conclusions/Significance: Caregiver engagement while in the NICU and persistent study coordinators making multiple phone calls to provide ample opportunities for enrollment helps to maintain a high level of enrollment during the COVID periods. NICU visitation restrictions, children at home, and role of essential workers, who are more likely to be BIPOC, may have impacted enrollment. Quick adaptation of assessors to telehealth via training sessions and standardized protocols were identified as facilitators to enrollment and assessment completion. The GMA, APSP, Parent child observation and GMFM were performed in person as well as through telehealth with additional planning and parent engagement required. Whereas BSID, TIMP, and HINE could be performed only in-person resulting in missing data. The impact of the pandemic on research is important to understand.

13.
Developmental Medicine and Child Neurology ; 64(Supplement 4):125, 2022.
Article in English | EMBASE | ID: covidwho-2088165

ABSTRACT

Background and Objective(s): In pediatric-onset conditions such as cerebral palsy (CP), physical function may continue to decline with age. For many individuals, however, these changes may not be addressed by health care providers once patients transition to adulthood. This has been further exacerbated by COVID-19 which has limited or suspended non-essential, in-person clinical visits. As a result, remote delivery of health care has taken on greater importance. The purpose of this study was to determine the feasibility of remotely assessing physical function in adults with cerebral palsy. The Short Physical Performance Battery (SPPB) was used as the primary outcome assessment since it covers balance, functional strength, and mobility. Study Design: Prognosis study with a cross-sectional design. Study Participants & Setting: Twenty adults with CP (Mean age=44.1+/-10.8) and GMFCS I to III were recruited using CP support groups on social media sites. The assessments were performed in the participant's home and monitored using video conferencing software. Participants were given written instructions as to how to set up their at-home testing area so that their movements could be properly observed. Materials/Methods: All components of the SPPB were administered, including timed measures of balance (side by side, semi-tandem, tandem), gait speed, and repeated chair stand. Additional tests included the Timed Up and Go, the Romberg Test, and the reaching and manipulation components of the Wolf Motor Function Test (WMFT). Result(s): Feasibility was assessed based on the number of participants who were able to complete all assessments, do so safely without any adverse events such as loss of balance, and complete the assessments so that their scores fell within the standardized norms. The average testing time was 32 +/-6.9 min. Nineteen adults (95%) completed all assessments. Sixteen (80%) adults were able to complete the assessments without any adverse events (momentary loss of balance). Ten adults had SPPB scores that fell within the normative SPPB range. Lower SPPB scores were indicative of a slower working pace or the use of an assistive device (e.g., posterior walker). All 20 participants fell within the normative values for the 9 WMFT items. Conclusions/Significance: This feasibility study shows that remote assessment of physical function can be performed accurately and efficiently in adults with CP who do not use assistive devices. For those with more limited mobility, assessing function remotely may still be of value. However, it is important that assessments of physical function are designed or adapted for those with mobility differences. Future studies are needed that incorporate modifications to existing assessment methods to gain a better understanding of physical ability in adults with CP regardless of functional status.

14.
Developmental Medicine and Child Neurology ; 64(Supplement 4):128, 2022.
Article in English | EMBASE | ID: covidwho-2088164

ABSTRACT

Background and Objective(s): Preterm birth is associated with a significant health, emotional, and financial burden on families. Racial, ethnic, and social inequities in the United States during COVID-19 did not spare infants born preterm and their families. While the rates of preterm birth declined during the lockdown, the highest proportions of preterm births continued to be in the Black, Indigenous, and other People of Color (BIPOC) groups. Limited data exists on factors influencing access to rehabilitation services for high-risk infants during COVID-19. We aim to identify barriers and facilitators impacting access to intervention in parents of preterm infants as measured by enrollment and retention in an intervention arm of a multisite rehabilitation clinical trial. Study Design: RCT. Study Participants & Setting: Fifty-seven extremely to very preterm infants (<29 weeks gestation) participating in an ongoing Supporting Play, Exploration, and Early Development (SPEEDI) trial. Intervention was conducted in the neonatal intensive care unit (NICU), home, and/or via telehealth. Materials/Methods: All infants were recruited in the NICU and randomized into SPEEDI intervention or usual care group. The intervention group received 10 sessions of therapist-guided, parent-provided intervention, delivered in two phases (5 sessions per Phase) across 4 months. Both groups continued to receive early intervention services in the community. The intervention was adapted to telehealth in response to COVID-19 and an online platform with videos and activities was created for parents. Enrollment and retention were descriptively analyzed in two time periods;pre-COVID (Before 03/12/20), and COVID (03/13/20 -03/ 12/21) with emphasis on distinctions between in-person vs telehealth participation. Result(s): Enrollment during the COVID period was reduced by 41.18% compared to pre-COVID. Thirty-five preterm infants participated in the intervention during both periods, of which 54% were white and 46% belonged to BIPOC groups. The overall completion rate (i.e.10/10 intervention sessions completed) was 65%, 11% missed >=1 visit, and 26% either withdrew from intervention or were lost to follow-up. The completion rates did not differ for pre-COVID (99%) and COVID (98%) periods. For withdrawals, 55% occurred during COVID, 66% of participants who withdrew self-identified as Black, and 77% had a sibling at home. Of the 63 sessions scheduled during COVID, 31.7% were in-person and 68.2% via telehealth. There was a 68% decline in in-person sessions during COVID compared to pre-COVID. The completion rate for telehealth during COVID was 97% (42/43). Conclusions/Significance: Caregiver engagement in intervention, provision of intervention materials online, and quick adaptation of interventionists to telehealth via training sessions and standardized protocols were identified as facilitators to retention. Navigating siblings at home and the burden of COVID were the primary barriers to retention. The impact of race on retention and participation in intervention and research for high-risk infants should be monitored.

15.
Chest ; 162(4):A1135, 2022.
Article in English | EMBASE | ID: covidwho-2060779

ABSTRACT

SESSION TITLE: Post-COVID-19 Outcomes SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has caused an influx of hospitalized patients with acute disease, as well as an influx of outpatient visits for long-term symptoms. There is still much to learn about symptom patterns in different patient groups based on age, race, sex, and illness severity. Patients with post-acute COVID-19 syndrome (PACS), colloquially called long-haulers, are another group who may have unique symptom profiles. We conducted this study to characterize patients’ experiences with COVID-19 symptoms in both the acute and long-term phase. METHODS: Participants were recruited using existing research panel through Qualtrics, a national consumer insights platform. Eligible participants included those who reported a positive COVID-19 test sometime in 2021 and sought some type of medical care. In an online survey, participants were asked about the three most bothersome physical symptoms they experienced out of body aches or joint pain, “brain fog”, chest pain, cough, fatigue or feeling tired/weak, fever/chills/sweating, GI issues such as vomiting/diarrhea, headache, loss of taste or smell, shortness of breath, and insomnia. This list of physical symptoms was sourced by qualitative, in-depth interviews with 55 hospitalized and recovered COVID-19 patients. In addition, participants reported basic demographics, hospitalizations, and whether they considered themselves long-haulers. RESULTS: Of these patients, 29.8% considered themselves long-haulers. There were 2570 survey respondents who participated, of which 61% were female, 48% were male, and 1% were nonbinary. The patients were all age 18 years or older with 14% Hispanic/Latino/a/x/or Spanish origin, and 25% were non-white. Of those who sought medical treatment through a hospital, 59% reported that they sought treatment for COVID-19 in the emergency room, 32% were hospitalized, and 9% were hospitalized in the Intensive Care Unit (ICU). The most bothersome symptoms reported overall were cough, fatigue/feeling weak, and body aches. We compared bothersome symptoms by hospitalization location and long-haul status descriptively. For 18% of participants hospitalized in the ICU, the most bothersome symptom was shortness of breath compared to 11% of those hospitalized on the general floor, and 11% of those seen in the emergency room. Among participants who reported that they consider themselves long-haulers, the most common symptom reported most bothersome was cough. CONCLUSIONS: Data indicate that symptom patterns may differ by illness severity, age, and race. Patients who consider themselves long-haulers also have a different symptom pattern from those who do not report long-term symptoms. CLINICAL IMPLICATIONS: Our findings contribute to the understanding of patient experience with COVID-19 symptoms both in the acute and long-term phase. DISCLOSURES: No relevant relationships by Samuel Brown No relevant relationships by Jorie Butler no disclosure on file for Hirshberg Elliotte;No relevant relationships by Danielle Groat No relevant relationships by Kathryn Hendrickson No relevant relationships by Stephanie Stokes

16.
Journal of Pediatric Gastroenterology and Nutrition ; 75(Supplement 1):S258-S259, 2022.
Article in English | EMBASE | ID: covidwho-2058386

ABSTRACT

Background: NASPGHAN guidelines for fellowship training in pediatric gastroenterology (GI) highlight the importance of multidisciplinary treatment across GI conditions. Specific required medical knowledge for pediatric GI fellows includes (1) understanding of the biopsychosocial model and brain-gut axis involvement in functional GI disorders (FGIDs) and (2) familiarity with the role of psychological evaluation and interventions within the multidisciplinary management of FGIDs. Pediatric psychologists are well-suited to provide this training as education of interdisciplinary professionals is a defining competency in pediatric psychology. While pediatric GI psychologists may be informally involved in the training of GI fellows through shared multidisciplinary patient care, we sought to develop a didactic series to formalize a GI Psychology curriculum consistent with clinical training guidelines and the expressed interests of fellows at our institution. Method(s): GI psychologists and GI chief fellows at Children's Hospital of Philadelphia (CHOP) developed an 8-lecture didactic series to be incorporated into an existing weekly didactic meeting for all GI fellows. GI psychologists presented a topic quarterly over the course of 2 training years (FY20-FY21). Topics for the inaugural 2-year series were: Introduction to GI Psychology, Giving the Positive Functional Diagnosis, Cognitive Behavioral Therapy for Functional Abdominal Pain Disorders, Behavioral Interventions for Constipation and Encopresis, Psychosocial Adjustment in Inflammatory Bowel Disease, Behavioral Treatment of Rumination Syndrome, Somatic Symptom Disorders, and Treatment Adherence. In summer 2020, GI psychologists also presented an unplanned didactic session related to coping with secondary traumatic stress during the COVID-19 pandemic. For the next iteration of the 2-year series (FY22-FY23), GI psychologists selected a new topic of Feeding and Eating Difficulties: Role of GI Psychology to replace Introduction to GI Psychology. Introduction to GI Psychology was moved to a fellow orientation session. Fellows participated in the first three years of the program which spanned the inaugural 2-year series and 1 year of a second series (n = 12, 11, 11). Attendance at specific didactic sessions was not recorded. At the end of each training year, fellows completed an anonymous program evaluation survey via REDCap for ongoing quality improvement. Fellows rated 5 items assessing the impact of the didactics on their knowledge of the biopsychosocial approach, delivery of clinical impressions and recommendations, confidence with description of psychological goals and strategies, and recommendations for continuation of the GI Psychology didactics. Items were scored on a 5-point Likert scale ranging from Strongly Agree to Strongly Disagree. During the inaugural 2-year series, the survey also included items rating the value of each didactic topic. Each year the survey allowed for open-ended suggestions for additional topics. Result(s): The GI Psychology didactic series for GI fellows has been implemented successfully at CHOP for an inaugural 2-year series (FY20-FY21) with a second series currently in progress (FY22-FY23). Although survey response rate was low (33% FY20;9% FY21;45% FY22), 100% of the fellows completing the survey Agree/Strongly Agree the didactic series increased their knowledge of the biopsychosocial approach to managing GI conditions, informed how they deliver clinical impressions and treatment recommendations for patients/families, recommended continued GI Psychology involvement in GI fellow didactics and recommended other institutions consider Psychology involvement in GI fellow didactic education. Additionally, 80% of the fellows Agree/Strongly Agree the didactic series increased their confidence to describe common goals and strategies within psychological treatment for patients with GI conditions. Conclusion(s): We describe development of a novel GI Psychology curriculum for GI fellows at CHOP focused on core topics to enhance competency in the biopsychosocial approach across GI conditions, which was favorably evaluated by GI fellows. Fellowship training programs in pediatric GI may wish to consider a similar approach to incorporating didactic training from pediatric psychologists. Doing so may increase relevant medical knowledge and facilitate experience with and use of a multidisciplinary approach to evaluation and management across GI conditions, consistent with NASPGHAN clinical training guidelines and calls for best practice to incorporate integrated psychological care across GI conditions.

17.
Australasian Leisure Management ; 142:60-63, 2021.
Article in English | CAB Abstracts | ID: covidwho-2033796

ABSTRACT

This article explains how attractions can re-imagine the guest journey in a post-COVID-19 world. It is indicated that guests will expect a more in-depth level of interaction with operators that provides reassurance of their safety, with satisfaction being a top priority. Some pieces of advice on engaging and communicating with guests before, during and after the visit, and managing the in-park experience, are presented.

18.
Gastroenterology ; 162(7):S-292, 2022.
Article in English | EMBASE | ID: covidwho-1967289

ABSTRACT

The COVID-19 pandemic impacted the life of people worldwide. We used a cross-sectional survey to evaluate the effects of pandemic on inflammatory bowel disease patients registered with Johns Hopkins. We assessed the methods used to minimize the risk of infection, coping mechanisms, changes in disease activity and management in the first 6 months of pandemic. Of the 405 patients who completed the questionnaire, 240 (58.8%) had Crohn's disease, 132 (32.6%) ulcerative colitis and 35 (8.6%) unclassified IBD.The median (IQR) age was 49 (28, 71). Two hundred seventy-three (67.4%) received biologics including patients on hospital-based (4.2%) infusions, outpatient-based infusions (26.7%) and home infusion (22.2%). Majority had other comorbidities, either heart (142/35.1%) or lung disease (19/ 4.7%), diabetes (22/5.4%), hypertension (77/19%), or obesity (13/3.2%). Most patients were at low risk for infection as they lived in a non-metropolitan area (291 patients, 71.8%), did not report close contact with a confirmed COVID-19 individual (373, 92.1%), did not travel to an area with high rates of COVID-19 (381, 94.1%) and did not use public transportation (379, 93.6%). All but 2 were taking protective measures such as use of N-95 mask (90, 22.2%), commercially (271, 66.9%) or homemade mask (208, 51.4%), sanitizer (363, 89.6%) or gloves (96, 23.7%). Additionally, patients used dietary/herbal supplements (55, 13.6%), dietary modifications (98, 24.2%) to support immunity (35, 8.6%), prevent an IBD flare (28, 6.9%), or minimize medications (48, 11.9%). The most common supplement used was Vitamin C (28, 50.9%), and D (42, 76.4%). Most (344, 84.7%) had no adjustments to their medications during pandemic, 31 (7.7%) discontinued their medication and 31 (7.7%) had to add a medication. Pandemic had, reportedly, no effect to the lives of 44 (20.9%) patients but 28 (13.3%) felt depressed, 70 (33.2%) anxious, 9 (4.3%) lost their income and 60 (28.4%) had other non-specified effects. The most common stress reduction techniques used were exercise (261, 64.4%), yoga (76, 18.8%), art therapy (23, 5.7%), music therapy (40, 9.9%), journaling (28, 6.9%), and guided Imagery (18, 4.4%). Fifty-eight (14.3%) used stress reduction medications. Eight (2%) reported SARS-CoV-2 infection. Median (IQR) age was 39 years (22,50)(Table 1). The majority had CD (6, 75%) and the infection was treated at home (6, 75%). One required admission to ICU. Infection led to worsening of the disease in 2 (25%). One (12.5%) discontinued IBD treatment. Our data suggest that most IBD patients followed low risk activities and were adherent to personal protective equipment and used stress reduction techniques and dietary supplements to cope with pandemic and avoid flares. Infection rates were low and the majority did not require admission to the hospital. In the majority infection did not cause an IBD exacerbation. (Table Presented)

19.
BMC Public Health ; 22(1): 889, 2022 05 04.
Article in English | MEDLINE | ID: covidwho-1951135

ABSTRACT

BACKGROUND: Following the emergence of COVID-19 in the UK, on March 18th 2020 the majority of schools in England closed and families and teachers were tasked with providing educational support for children and adolescents within the home environment. Little is known, however, regarding the impact of remote teaching and learning on the mental wellbeing of parents/carers and teaching staff. METHODS: The Coronavirus Education (COV-ED) online survey explored the practicalities of learning and teaching from home for 329 parents/carers and 117 teachers of 11-15 year old adolescents in England, during June/July 2020, and the associated impact on their mental wellbeing. Participants were recruited through schools and via University of Warwick social media channels. Data was analysed using a series of Multiple Linear and Multivariate Regressions. RESULTS: Despite coping well with the challenges of remote learning, a third of teachers reported below average mental wellbeing on the Warwick-Edinburgh Mental Wellbeing Scale. Multivariate regression revealed that wellbeing was associated with access to resources and confidence to teach from home. Almost half of parents/carers surveyed reported below average wellbeing. Multivariate regression revealed that poor wellbeing was more common in those who were also working from home and who lacked support for their own mental health. Concerns about their child's mental health and lack of access to electronic devices and workspace were also significantly associated with the mental wellbeing of parents/carers. CONCLUSIONS: Whilst young people's mental health and wellbeing has, and continues to be a national priority, the mental health and wellbeing of the families and teachers supporting them has not previously been explored. Our survey population was of predominantly white British heritage, female and living in the West Midlands UK, therefore, findings should be treated with caution. Findings provide a snapshot of factors that may be of significance to families and schools in supporting the mental wellbeing of those tasked with learning from home. They will help i) increase knowledge and awareness with regard to future support of families and teachers during similar crises; ii) enable the design and development of practical solutions in the delivery of remote teaching and learning; and, iii) help address the mental wellbeing needs of those tasked with supporting adolescents.


Subject(s)
COVID-19 , Mental Health , Adolescent , COVID-19/epidemiology , Caregivers/psychology , Child , Communicable Disease Control , Female , Humans , Parents/psychology
20.
New England Journal of Entrepreneurship ; 2022.
Article in English | Scopus | ID: covidwho-1932047

ABSTRACT

Purpose: The purpose of this paper is to provide an overview of a successful model on how to prepare business students to be successful in a new, post-pandemic world that faces enormous social challenges. Design/methodology/approach: The article discusses the current business and social movements that suggest the relevance of social entrepreneurship and explain the pedagogical model developed at the Center for Nonprofits at Sacred Heart University. Findings: The article suggests how this pedagogical model may provide students with the skills, attitudes and values required for successful social entrepreneurship processes. Research limitations/implications: The article presents the current picture which will undoubtedly change over time. Thus the context is time constrained. The article presents one model to develop leaders’ skills. There are many other models and experiences that should be considered and evaluated. Practical implications: The case explains a key initiative that can help universities improve pedagogical tools on building students' social entrepreneurship skills and extend this impact to their success in the post-pandemic environment and impact on surrounding communities. Social implications: There is a growing need for business leaders to have sophisticated business skills and purpose beyond financial profit. The article looks at the dual roles of social entrepreneurs as a model for the leaders and the Nonprofit Center at Sacred Heart University to develop the skills of the future leaders. Originality/value: The article presents a new vision of the skills necessary for a leader in today's environment. It draws from the literature on social entrepreneurship. It also presents one model that has been successful for 15 years and the pedagogical underpinnings of that model. © 2021, Stephen M. Brown and Martha Crawford.

SELECTION OF CITATIONS
SEARCH DETAIL