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1.
Journal of Cystic Fibrosis ; 20:S108, 2021.
Article in English | EMBASE | ID: covidwho-1735128

ABSTRACT

Objectives: The COVID-19 pandemic ushered in a whole new range of changes and challenges for cystic fibrosis (CF) teams which wereintroduced at a rapid rate. A proposal was put forward for UK CF SocialWorkers (SW) to meet virtually to discuss emerging issues for people withCF, professional and personal impacts of COVID-19. We aimed to exploreSWexperiences of new ways of working during COVID-19.Methods: All 45 UKCF, SWwere invited to complete an online anonymised24 item questionnaire with a mix of Likert scale matrix and open-endedquestions. There was a focus on transition to homeworking, what workedwell and what didn’t, and an exploration of what practices developedduring the pandemic SW would like to see employed permanently.Results: Response rate = 38% (17/45) Paediatric (3) Adult (13) Lifespan (1).Pre-COVID-19, 76% of SW had never worked from home (WFH);now 47%were entirely home-based with a further 29% WFH a few days per week.57% felt the transition to homeworking went smoothly and 75% feltmanagement were supportive. 76% ceased all face-to-face contact withpatients with increased use of video technology to facilitate remoteconsultations. 65% expressed concerns about returning to pre-COVIDworking patterns and most wanted flexible working arrangements tocontinue. 82% attended at least one virtual meeting, 76% found thesemeetings very useful and 100% felt they should continue.Conclusions: Attendance at the SW virtual meetings has grown, indicatingSWvalue the sharing of insights and experience. In light of the escalation ofremote working and working in isolation, CF SW are rethinking peersupport and online learning events. Initially informal in content, thesemeetings have evolved into a structured format with plans to broaden thecontext to make them more purposeful. Plans for future working anddiscussing emerging needs for patients with CF will need to be exploredfurther

2.
Spatial Information Research ; : 1-17, 2022.
Article in English | EuropePMC | ID: covidwho-1615358

ABSTRACT

Graphical Human-induced alterations of the landscape and the same driven climate changes are seriously making drastic changes in the processes on the Earth's surface, regionally and globally. Visible Infrared Imaging Radiometer Suite (VIIRS) night-time light datasets can precisely detect the intensity and scope of human activities. Accurate and temporal monitoring of urban areas and urban sprawls is highly imperative to the detection and assessment of regional development of a region. This study quantitatively assessed and mapped the light extents and urban region in Kerala, one of the southwest Indian states from 2012 to 2020 with the help of low light imaging day/night band data collected from the VIIRS and utilised VIIRS night time Lights V.2 time series from the monthly averages with filtering to eliminate extraneous features such as aurora, biomass burning, and background. ISOCLUSTER based classification and the threshold methods are used for the light extent and urban region extraction respectively. The result indicated that the Kerala State experienced very high urbanization from 2012 to 2019. But in the case of 2020, there was a decrement in the radiance due to the lockdown and night curfews followed by the COVID-19 global pandemic. Normal life including transportation, industries, and business, etc. was affected much before the national lockdown in Kerala. It was proved with the help of time series data generated from mid-2019 to the end of 2020. The time-series data was generated with 580 night light datasets of NASA’s Black Marble VNP46A2 from 1st June 2019 to 31st December 2020 on daily basis.

3.
Journal of the American Society of Nephrology ; 32(12):2977-2978, 2021.
Article in English | Scopus | ID: covidwho-1566581
4.
Journal of Clinical and Diagnostic Research ; 15(11):JC01-JC04, 2021.
Article in English | EMBASE | ID: covidwho-1527010

ABSTRACT

Introduction: Due to the Coronavirus Disease-2019 (COVID-19) lockdown implemented by the government, we had to transform our classes into the online sphere. The most commonly used methods of online teaching in Government Medical College, Thrissur were, live online lectures, PowerPoint presentations with narrations, prerecorded videos and assignments. Aim: To assess the logistical aspects, merit and demerits of different online teaching-learning methods among phase-1 medical student in a tertiary care teaching hospital during COVID-19 lockdown Materials and Methods: This cross-sectional study was conducted from July 2020 to September 2020, among phase-1 MBBS students of Government Medical College, Thrissur, Kerala, India. Data was collected from 161 students through a questionnaire consisting of two parts. The first part dealt with logistical aspects, like net connectivity, gadget, expenditure, financial burden, residence and eye strain with online teaching learning methods. The second part dealt with the merits and demerits of each type of teaching learning methods, according to the students. All statistical data was analysed using the Statistical Package for the Social Sciences (SPSS) software version 16. Qualitative data was expressed as a percentage. Results: A total of 97.5% population of students was able to frequently access the online classes. Online learning strained the eyes of 47.8% of students. Mobile phones were used by 92.5% of students for attending online classes internet connectivity was mainly through 4G (71.4%) followed by Wi-Fi (19.9%) connections. Their most preferred method of online learning was online live lectures (35.4%) followed by PowerPoint presentations with narrations (33.5%). Blended learning (online and traditional together) was best preferred method of learning (46.6%). Conclusion: Live online lectures and blended learning were preferred by the majority of students. Thus, the online classes can be continued along with the traditional teaching in future.

5.
Journal of Cystic Fibrosis ; 20:S108-S109, 2021.
Article in English | EMBASE | ID: covidwho-1368852

ABSTRACT

Background: Our paediatric cystic fibrosis (CF) team's pathway to address the educational needs of children with CF was based on a systems approach that benefited from coordinated, holistic, personalised foci adapting multidisciplinary and inter-agency working (BASW'20). Issues arising in the UK from shielding during the COVID-19 pandemic highlighted the unequal effect of lockdown on children's learning (Lancet'21). In addition, arrangements for supporting pupils at school and ensuring good education provision for children with long-term medical needs (DoE'13,’15,’20) necessitated piloting and reviewing our Enhanced Education Pathway through the pandemic. Methods: Six children with CF who were considered clinically, educationally, emotionally and socially most vulnerable were reviewed via patient notes, psychosocial meetings, multidisciplinary and multi-agency meetings along with the child, parent and schools. A qualitative thematic synthesis of this pilot cohort examined the potential impact of disruptive access to education to educational outcomes. This informed the development of the CF enhanced education pathways. Results-thematic synthesis: Recurring emergent themes identified as potentially impacting educational outcomes included: facilitating decisionmaking;access to quality teaching and technology, parental literacy and capacity to monitor and support learning;robustness of trusting relationship;and advocacy for enhanced education provision. Conclusion: This pilot helped to support equal and fair access to education for our children with CF by prioritising access to blended learning, teaching, access to technology and addressing parenting challenges. The collaborative working with children, their families, CF clinical and psychosocial teams, along with Hospital Education team and schools, have highlighted the added value of multidisciplinary and inter-agency working to further develop enhanced education pathways.

6.
Int J Tuberc Lung Dis ; 25(5): 358-366, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1225922

ABSTRACT

BACKGROUND: Barts Health National Health Service Trust (BHNHST) serves a diverse population of 2.5 million people in London, UK. We undertook a health services assessment of factors used to evaluate the risk of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection.METHODS: Patients with confirmed polymerase chain reaction (PCR) test results admitted between 1 March and 1 August 2020 were included, alongwith clinician-diagnosed suspected cases. Prognostic factors from the 4C Mortality score and 4C Deterioration scores were extracted from electronic health records and logistic regression was used to quantify the strength of association with 28-day mortality and clinical deterioration using national death registry linkage.RESULTS: Of 2783 patients, 1621 had a confirmed diagnosis, of whom 61% were male and 54% were from Black and Minority Ethnic groups; 26% died within 28 days of admission. Mortality was strongly associated with older age. The 4C mortality score had good stratification of risk with a calibration slope of 1.14 (95% CI 1.01-1.27). It may have under-estimated mortality risk in those with a high respiratory rate or requiring oxygen.CONCLUSION: Patients in this diverse patient cohort had similar mortality associated with prognostic factors to the 4C score derivation sample, but survival might be poorer in those with respiratory failure.


Subject(s)
COVID-19 , State Medicine , Aged , Female , Hospitalization , Humans , London/epidemiology , Male , Risk Factors , SARS-CoV-2
7.
Journal of Gastroenterology and Hepatology (Australia) ; 35(SUPPL 1):201, 2020.
Article in English | EMBASE | ID: covidwho-1109579

ABSTRACT

Background and Aim: During the outbreak of coronavirus 2019 disease (COVID-19), major restrictions to in-person consultations were introduced. This led to a change in outpatient clinic delivery through the roll-out of telehealth appointments, with phone consultations being the most convenient modality. We postulated that an indirect benefit of phone consultations would be a better clinic attendance rate. This study aimed to assess if the “failure-to-attend” (FTA) rate for the two endoscopy-related clinics at our institution improved with phone consultations during the COVID-19 outbreak. Methods: Data from consecutive patients booked to attend any of the two weekly endoscopy-related clinics between 15 April and 27 May 2020 were prospectively assessed for the phone clinic cohort. For the in-person clinic cohort, attendance rates from both clinics held between 15 April and 29 May 2019 were retrospectively assessed. Based on observation of the first few endoscopy-related outpatient clinics held in March 2020 at our hospital, we anticipated an expected difference of 8% in FTA rate, leading to a calculated sample size of 150 patients (allowing for a 10% safety margin). The main outcome was the difference in FTA rates between the phone and in-person clinic cohorts. Secondary outcomes included subanalysis of the low-complexity (Post-Endoscopy) and high-complexity (Advanced Endoscopy) clinics and evaluation of patients' and doctors' satisfaction. Satisfaction was assessed based on questionnaires used in a previous study on telehealth consultations and mostly used the Likert scale (“strongly disagree” to “strongly agree”), where the closer the response was to “strongly agree,” the more satisfied the individual. Results: A total of 691 patients were booked for appointments in our endoscopy clinics during the study periods (318 in 2019 and 373 in 2020). The average age was similar between both cohorts (60.6 vs 61.9 years, P = 0.34), as was the proportion of male patients (43.4% vs 48.7%, P = 0.07). The average phone consultation duration was slightly longer for the Post-Endoscopy clinic (11 min vs 14 min, P < 0.01), which also had a higher proportion of first consultations with gastroenterology (22.2% vs 30.8%, P = 0.06). FTA rates were better for both clinics with the adoption of phone consultations (Table 1). The satisfaction profiles of patients and doctors are summarized in Figures 1 and 2, respectively. Although both describe high levels of satisfaction, the rate of agree/strongly agree was lower for patients (78.4% vs 91.9%, P < 0.01). The doctors' overall satisfaction (0-100%) score was high for both clinics but slightly higher for the Advanced Endoscopy clinic (97.6% vs 93.1%, P < 0.01). In only 3.5% of cases was a follow-up consultation suggested to be carried out in person. Conclusion: The use of phone consultations in endoscopy-related clinics during the COVID-19 outbreak has improved FTA rates in our institution while maintaining high satisfaction rates for both patients and doctors. The need for in-person follow-up consultations was low. These data suggest that employing telehealth for endoscopy-related clinics is a viable alternative that is cost-effective and a widely accepted modality of communication for both patients and clinicians.1.

8.
International Journal of Health and Allied Sciences ; 9:104-106, 2020.
Article in English | Web of Science | ID: covidwho-1106184

ABSTRACT

In the middle of COVID-19 crisis in India and the psychological impact on millions of peoples, is it time to reconsider psychiatry training for Indian medical graduate under the new competency-based curriculum? India has one of the highest numbers of medical colleges in the world and also has over a million doctors, including MBBS graduates working at the primary health-care centers who are important pillars for health-care delivery. In a major drawback that also plagued the earlier curriculum, the new competency-based curriculum has not incorporated a single mandatory skill in psychiatry which a medical trainee has to demonstrate to become doctor. Mental health and the COVID-19 pandemic are interlinked in a complex manner. Hence, millions are likely to have mental health consequences. With no skill required in psychiatry as a must for a medical trainee to become an MBBS doctor, the mental health services during or aftermath of a disaster are severely compromised and need urgent reconsideration under the new curriculum.

9.
Archives of Mental Health ; 21(2):101-106, 2020.
Article in English | Scopus | ID: covidwho-1069905

ABSTRACT

Introduction: Novel coronavirus disease (COVID-19) pandemic and resultant lockdown are likely to cause a significant negative impact on mental health of people all over the world. Aim: To assess psychological distress due to COVID-19 pandemic among Indian adults and its possible correlates. Subjects and Methods: An online survey using nonprobability snowball sampling technique was carried out. The survey included willing adult residents of India with access to internet. Health-care professionals, people with COVID-19 or those with a relative having COVID-19, and those receiving treatment for any psychiatric disorder currently were excluded. Psychological distress was assessed using COVID-19 Peritraumatic Distress Index (CPDI). Results: Majority of participants were young (age group, 18-40 years) (71.8%), males (72%), married (69.9%), graduate (51.8%), and semiprofessionals and professionals (56.5%). Majority of the participants did not have family members of age up to 5 years or less (64.8%) or age 60 years and above (61.9%) in their families. There was no COVID-19-positive patient in town or district of majority of participants (53.9%). Based on CPDI score, 22% of the participants had mild psychological distress and 1.6% had severe distress. CPDI score showed a positive correlation with size of family of participants. Other demographic variables did not show any association/correlation with CPDI score. Conclusions: Nearly a quarter of participants were found to have psychological distress due to COVID-19 pandemic. Anxiety and psychological distress might worsen with further worsening of pandemic and downfall of global economy. It is imperative to implement preventive and early intervention measures to safeguard mental health of people. © 2020 Archives of Mental Health ;Published by Wolters Kluwer - Medknow

10.
Multiple Sclerosis Journal ; 26(3 SUPPL):212-213, 2020.
Article in English | EMBASE | ID: covidwho-1067118

ABSTRACT

Background: Whilst the introduction of disease modifying treatments (DMTs) has transformed the management of people with early/relapsing MS (pwRMS), the use of DMTs in people with MS who are largely or completely wheel chair-dependent (EDSS>6.5) remains controversial. Evidence suggests that slowing or stopping disease deterioration is possible even past this arbitrary (loss of ambulatory function) threshold. Pathology and anecdotal clinical data support the hypothesis that even at an advanced stage of MS (AMS) inflammatory activity is a key driver of functional decline and that effective immunotherapy may halt this process. Cladribine tablets are a highly effective and central nervous system (CNS) penetrant DMT for people with highly-active RMS. It effectively depletes B cells, particularly memory B cells, a likely key mechanism of disease control in MS. Evidence, suggesting that (i) a significantly higher number of CNS axons supply upper compared to lower limb functions and (ii) longer axons are more vulnerable to the effects of focal inflammatory demyelination than shorter ones, corroborate our hypothesis that upper limb function can be protected even beyond EDSS=6.5. Objectives: Primary Objective: To investigate whether cladribine tablets over 24 months is an effective DMT in people with AMS (pwAMS;EDSS=6.5-8.5) as measured using the 9-hole peg test (9HPT) peg speed. Secondary Objectives: To establish whether there is a difference in pwAMS between treatment with cladribine tablets or placebo in (i) blood/serum biomarkers of inflammation (lymphocyte subsets) and/or neurodegeneration (neurofilament light chain), (ii) MRI loss of brain volume and spinal cord cross sectional area, (iii) T2 lesion burden, (iv) hypointense lesions on T1 weighted scans, (v) quality of life, and (vi) whether cladribine is a cost-effective treatment for pwAMS. Methods: Randomised, double-blind, placebo-controlled phase IIb trial. To detect a 15% treatment effect in 9HPT peg speed with 90% power at 5% significance and 20% drop-out over 104 weeks n=200 pwAMS will be recruited across 20 UK MS centres. Results: Protocol and ancillary documents have been submitted for ethics approval. So far 17 centres have agreed to recruit pwAMS for ChariotMS. Due to the COVID-19 pandemic start of recruitment has been deferred to 04 Jan 2021. Conclusions: ChariotMS will be the first DMT-trial focussing on pwAMS. If successful, ChariotMS would expand the DMT landscape to include pwAMS and provide a platform for add-on therapies.

12.
Eurohealth ; 26(2):68-72, 2020.
Article in English | GIM | ID: covidwho-942065

ABSTRACT

During the COVID-19 pandemic, hospitals face the concurrent challenges of maintaining routine services while attending to COVID-19 patients. This article shares approaches taken in six countries to resume hospital care after the first wave of the pandemic by surveying country experts and using data extracted from the COVID-19 Health Systems Response Monitor (HSRM). Four strategies were observed in all six countries: prioritisation or rationing of treatments, converting clinical spaces to separate patients, using virtual treatments, and implementing COVID-19 free hospitals or floors. Clear guidance about how to prioritise activities would support hospitals in the next phases of the pandemic.

13.
Demography India ; 49(Special Issue):27-36, 2020.
Article in English | CAB Abstracts | ID: covidwho-923193

ABSTRACT

Humanity has often been taken by surprise by new strains of microorganisms that adversely affect human life expectancy. The coronavirus outbreak is causing an unprecedented global health emergency and a global economic slowdown. Epidemiologists are aware of various specimens of viruses like the ones that cause Malaria, for instance, and scientists have been able to meet such threats by introducing drugs that make them perish at a rapid pace so that the natural human resistance to meet such attacks become sufficient for the patients to return to normal health. But viruses also try to survive by transmuting themselves into different strains that are capable of overcoming the existing antiviral drugs. Probably, COVID-19 may be one such transmutation. Hence the main objectives are to study how the COVID-19 virus affects the population and at what stage and time the epidemic will abate. As primary data is challenging to get, we use ICMR and other Govt. publications for the related information. Simple demographic and statistical methods are used for the analysis. At the early stages of the infection, we have no protocol on how to approach the virus. But now the health department has the protocol and thus even though we have no medicine, we are able to increase the recovery rate and flatten the mortality. Thus by following government and health workers' directions - Break the Chain movement - one can make sure that one is safe and also the people around him. So governments need to take measures for testing as many people under observation as possible and assess their COVID-19 status at the earliest.

14.
J Biomol Struct Dyn ; 40(2): 903-917, 2022 02.
Article in English | MEDLINE | ID: covidwho-759734

ABSTRACT

COVID-19, which has emerged recently as a pandemic viral infection caused by SARS-coronavirus 2 has spread rapidly around the world, creating a public health emergency. The current situation demands an effective therapeutic strategy to control the disease using drugs that are approved, or by inventing new ones. The present study examines the possible repurposing of existing anti-viral protease inhibitor drugs. For this, the structural features of the viral spike protein, the substrate for host cell protease and main protease of the available SARS CoV-2 isolates were established by comparing with related viruses for which antiviral drugs are effective. The results showed 97% sequence similarity among SARS and SARS-CoV-2 main protease and has same cleavage site positions and ACE2 receptor binding region as in the SARS-CoV spike protein. Though both are N-glycosylated, unlike SARS-CoV, human SARS-CoV-2 S-protein was O-glycosylated as well. Molecular docking studies were done to explore the role of FDA approved protease inhibitors to control SARS-CoV-2 replication. The results indicated that, Ritonavir has the highest potency to block SARS-CoV-2 main protease and human TMPRSS2, a host cell factor that aids viral infection. Other drugs such as Indinavir and Atazanavir also showed favourable binding with Cathepsin B/L that helped viral fusion with the host cell membrane. Further molecular dynamics simulation and MM-PBSA binding free energy calculations confirmed the stability of protein-drug complexes. These results suggest that protease inhibitors particularly Ritonavir, either alone or in combination with other drugs such as Atazanavir, have the potential to treat COVID 19.Communicated by Ramaswamy H. Sarma.


Subject(s)
COVID-19 , Protease Inhibitors , Humans , Molecular Docking Simulation , Pandemics , SARS-CoV-2
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