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1.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925444

ABSTRACT

Objective: The aim of this study was to characterize patients hospitalized with COVID-19 and cerebrovascular disease, with a focus on young patients diagnosed with CVST and ICH/SAH. Background: There have been many reported neurologic manifestations of coronavirus disease 2019 (COVID-19) including cerebrovascular events such as ischemic stroke, hemorrhagic stroke including intracerebral hemorrhage/subarachnoid hemorrhage (ICH/SAH) and central venous sinus thrombosis (CVST). However, there has not been much focus on this topic in young adults aged under 50. Design/Methods: Retrospective chart review was used to obtain parameters of patients hospitalized in Chicago area hospitals with COVID-19 and a neurologic diagnosis including acute ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, and cerebral venous sinus thrombosis. Data including patients' comorbidities and disease course was entered into a secure database by representatives from 4 different tertiary care centers. Results: A total of 27 patients aged 18 to 50 were hospitalized in Chicago land tertiary care centers from March 30, 2020 to February 1, 2021 with cerebrovascular disease and concurrently tested positive for COVID-19. Of these patients, 2 were found to have venous sinus thrombosis. 9 patients had hemorrhagic strokes, of these, 4 patients with ICH were thought to have had spontaneous hemorrhages. 9 of 27 patients had no past medical history. Conclusions: This population had a large portion, 11 out of 27 patients, with non-ischemic cerebrovascular insults such as CVST, ICH, or SAH while concurrently infected with COVID-19. Unlike most classic patients who develop these conditions, our population did not have traditional risk factors such as smoking or hypertension. Systemic inflammation, hypoxia, platelet dysfunction, or hyper-coagulability due to COVID-19 are theorized as the cause of these cerebrovascular manifestations in the absence of traditional risk factors. Spontaneous cerebrovascular manifestations of COVID-19 continue to be investigated, particularly in younger patients without traditional risk factors.

2.
ACIAR Final Reports 2021. (FR2021/019):80 pp. 4 ref. ; 2021.
Article in English | CAB Abstracts | ID: covidwho-1897735

ABSTRACT

This project set out to review and update the "Making Value Chains Work Better for the Poor" Toolbook (M4P Toolbook) and the ACIAR Agribusiness Master Class (AMC) capacity development program. These revisions had a particular focus on mainstreaming and integrating contemporary thinking and approaches about value chain research, as well as gender equity, social inclusion, and women's economic empowerment. The SRA also sought to explore more sustainable delivery models that integrate rapidly evolving remote and online learning approaches and technologies. An important rationale for this project was the need to progress capacity development programs such as the AMC, that are more cost-efficient, more flexible, and more accessible to a wider range of remotely located participants. The project aim therefore was to develop innovative agribusiness research learning resources and delivery models for the Asia Pacific that specifically mainstreams contemporary gender equity, social inclusion and women's economic empowerment principles and approaches. The project had three main objectives: 1. Review and update the M4P Value Chain Toolbook and case studies: 2. Review and improve the content, format, and delivery of the Agribusiness Master Classes;and 3. Develop a community of practice and explore business models for delivery of M4P Value Chain Toolbook and Agribusiness Master Class program throughout the Asia-Pacific The project contributes towards a wider goal of building capacity in agribusiness researchfor-development methods of young researchers, development specialists and innovative agribusiness operators. A fully revised print-ready 4th edition of the "Making Value Chains Work Better for the Poor" (M4P Toolbook) has been completed. It will be published in English1 and Vietnamese2 . The Toolbook provides value chain practitioners with updated practical tools for value chain analysis, with a stronger focus on poverty, gender, and social inclusion. This updated Toolbook provides robust analytical tools to identify value chain interventions that are inclusive and beneficial to the poor, to both women and men, or to other disadvantaged groups. The Toolbook will provide a valuable reference to research and development professionals for many years and is an added resource for the AMC program. As part of this project the AMC program and materials have been revised, updated, and reformatted. Numerous case-studies and activities have been included. Delivery Notes have been provided for all presentations. These materials have been adapted and suitable for both face-to-face and online delivery. The COVID -19 pandemic has prompted a surge in improvements and adoption of video conferencing, online collaboration, and webinar software apps to support remote engagement and learning. This provides a huge opportunity for ACIAR, University partners and remote collaborators to deliver new high quality, online and blended agribusiness learning, and capability development programs for developing country participants. Platforms such as Microsoft Teams and Zoom also provide the opportunity to efficiently engage external facilitators and mentors, as well as world class researchers and agribusiness specialists in a learning program. However, remote, and online collaboration and learning, cannot always replace the richness of face-to-face interaction and relationship building, along with the considerable benefit of peer-to-peer learning. Which is why experiential components such as the Mini-Project, agribusiness, field, and market visits, and visiting speaker contributions remain very important for adult learning.

3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335419

ABSTRACT

Objective: To characterize adherence patterns to antiretroviral therapy (ART) and identify factors affecting optimal adherence among adolescents living with HIV (ALHIV) in Kingston, Jamaica during the Covid-19 pandemic. Design: and Methods: During August-October 2021, we conducted a cross-sectional study on adherence (no missed doses in preceding four days) among adolescents 10-18 years attending three outpatient departments in the Kingston Metropolitan Area. Adherence factors were evaluated using a self-administered, interviewer-assisted structured questionnaire. Biochemical and clinicopathological information were retrieved from patients’ medical records. Multivariate logistic regression was used to determine likelihood of adherence for given adherence factors. Results: : Of 65 participating clients, 92.3 % were perinatally infected, mean (SD) age 15.4 (2.0) years and 61.5% were female. Overall self-reported adherence was 66.1% (43/65) and higher among adolescents in residential care versus family care (p=0.002). Median (IQR) viral load 19 copies/ml/10 3 (IQR 19-51) was lower (p=0.010) and median (IQR) CD4 + count 701 cells per µL (IQR 501-1052) higher (p= 0.016) among adolescents in residential care compared to family care. Adherence was 4 times more likely among adolescents at UHWI (OR=4.53, 95% CI (1.25, 16.43), knowledgeable about ARVs (OR= 4.31, (1.09,17.04), and with reduced appointments due to Covid-19 pandemic (OR= 5.36, (1.09, 26.41) and 4 times less likely if cared for by relatives, experiencing side effects, higher pill burden or hospitalized with complications. Conclusions: : Medication, caregiver-related and health system management factors are both enablers and barriers of adherence for ALHIV, and the importance of caregivers’ support, treatment literacy and simplified treatment regimens are highlighted.

6.
Stroke ; 52(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1234361

ABSTRACT

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is associated with stroke. The role of sex on stroke outcome has not been investigated. We describe the characteristics of a diverse cohort of acute stroke patients with COVID-19 disease, and investigate the role of sex on outcome. Methods: This is a retrospective study of patients with acute stroke and SARS-CoV-2 infection admitted between March 15 to May 15, 2020 to one of the six participating comprehensive stroke centers from Chicago metropolitan area. Baseline characteristics, stroke subtype, workup, treatment and outcome are presented as total number and percentage. Outcome at discharge was determined by the modified Rankin Scale Score (mRS). Variables and outcomes were compared for males and females using univariate and multivariate analysis. Results: The study included 83 patients. Median age was 64 years and the majority were Blacks (47%) followed by Hispanics (28%) and whites (16%). Approximately 89% had at least one preexisting vascular risk factor (VRF). The most common complications were respiratory failure (59%) and septic shock (34%). Higher proportions of male experienced severe SARS-CoV-2 symptoms requiring ICU hospitalization (73% vs. 49%;p=0.04). When divided by stroke subtype, there were 77% ischemic, 19% intracerebral hemorrhage and 3% subarachnoid hemorrhage. The most common ischemic stroke etiologies were cryptogenic (39%) and cardioembolic (27%).Compared to female, males had higher mortality (38% vs. 13%;p=0.02) and were less likely to bedischarged home (12% vs. 33%;p=0.04). After adjustment for age, race/ethnicity, and number ofVRFs, mRS was higher in males than in females (OR=1.47, 95% CI=1.03-2.09) Conclusion: In this cohort of SARS-CoV-2 stroke patients, most had clinical evidence ofcoronavirus infection on admission and preexisting VRFs. Severe in-hospital complications andworse outcomes after ischemic strokes were higher in males, than females.

7.
J Stroke Cerebrovasc Dis ; 29(11): 105314, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-753197

ABSTRACT

BACKGROUND AND PURPOSE: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is associated with stroke. The role of sex on stroke outcome has not been investigated. To objective of this paper is to describe the characteristics of a diverse cohort of acute stroke patients with COVID-19 disease and determine the role of sex on outcome. METHODS: This is a retrospective study of patients with acute stroke and SARS-CoV-2 infection admitted between March 15 to May 15, 2020 to one of the six participating comprehensive stroke centers. Baseline characteristics, stroke subtype, workup, treatment and outcome are presented as total number and percentage or median and interquartile range. Outcome at discharge was determined by the modified Rankin Scale Score (mRS). Variables and outcomes were compared for males and females using univariate and multivariate analysis. RESULTS: The study included 83 patients, 47% of which were Black, 28% Hispanics/Latinos, and 16% whites. Median age was 64 years. Approximately 89% had at least one preexisting vascular risk factor (VRF). The most common complications were respiratory failure (59%) and septic shock (34%). Compared with females, a higher proportion of males experienced severe SARS-CoV-2 symptoms requiring ICU hospitalization (73% vs. 49%; p = 0.04). When divided by stroke subtype, there were 77% ischemic, 19% intracerebral hemorrhage and 3% subarachnoid hemorrhage. The most common ischemic stroke etiologies were cryptogenic (39%) and cardioembolic (27%). Compared with females, males had higher mortality (38% vs. 13%; p = 0.02) and were less likely to be discharged home (12% vs. 33%; p = 0.04). After adjustment for age, race/ethnicity, and number of VRFs, mRS was higher in males than in females (OR = 1.47, 95% CI = 1.03-2.09). CONCLUSION: In this cohort of SARS-CoV-2 stroke patients, most had clinical evidence of coronavirus infection on admission and preexisting VRFs. Severe in-hospital complications and worse outcomes after ischemic strokes were higher in males, than females.


Subject(s)
Brain Ischemia/epidemiology , Coronavirus Infections/epidemiology , Health Status Disparities , Intracranial Hemorrhages/epidemiology , Pneumonia, Viral/epidemiology , Stroke/epidemiology , Aged , Aged, 80 and over , Brain Ischemia/diagnosis , Brain Ischemia/therapy , COVID-19 , Chicago/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Female , Humans , Intracranial Hemorrhages/diagnosis , Intracranial Hemorrhages/therapy , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Sex Factors , Stroke/diagnosis , Stroke/therapy , Time Factors
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