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1.
Sexually Transmitted Infections ; 98:A65, 2022.
Article in English | EMBASE | ID: covidwho-1956938

ABSTRACT

Introduction The COVID-19 pandemic precipitated widespread implementation of telemedicine. Initial evaluation of our telemedicine service found high satisfaction rates [1]. Anticipating continuing demand for remote services we undertook a further patient survey, gauging shifting attitudes towards telemedicine. Methods We sent an anonymised, on-line survey to all patients who received telephone consultations in a six-week period (08/02/22- 22/3/22). We collected demographic data, reasons for consultation and patient satisfaction, using the standardised telemedicine satisfaction questionnaire [2]. Results 275 responses were received (∼10% response rate). 80.4% of respondents were female. 50.5% of consultations were for contraception. 60.3% of GUM consultation respondents were female. The modal age group was 30-44 years in both categories. 65.5% of patients chose an initial telephone consultation as their preferred modality, compared to 22.9% preferring walk-in-clinics. 44% of all patients surveyed would prefer not to share genital images for remote assessment in theory, however only 16.7% of the subgroup actually asked to send an image (n=18) expressed the same. Only 22% preferred video consultations. 80% reported that they were 'overall happy' with their telemedicine consultation (agree/strongly agree). Discussion Telemedicine is more convenient for many patients, cost effective, clinically efficient and aligned to the NHS global impact agenda. It is fast becoming an integral part of modern healthcare. Survey data may disproportionately represent more engaged and technologically literate patients. However, it also has the potential to engage previously unreached patient groups. This survey supports a permanent role for telemedicine. We will continue to integrate patient feedback to build a high quality, sustainable service.(Table Presented).

2.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927815

ABSTRACT

Introduction: Interstitial lung disease (ILD) comprises a heterogeneous group of diseases affecting the lung interstitium often associated with significant morbidity and mortality. The Australasian Interstitial Lung Disease Registry (AILDR) launched in 2016 with the concurrent aims to: a) provide a valuable resource for high quality ILD research to further understanding of ILD and b) improve care for ILD patients across Australia and NZ. Consisting initially of four pilot sites, over time the registry has expanded to 21 sites across Australasia. Methods: Consecutive ILD patients attending any of the registered ILD centres across Australia and NZ are eligible to enrol in the AILDR following provision of informed consent. Comprehensive data including demographics, ILD diagnosis, objective functional markers (baseline and subsequent tests) and treatment parameters are collected and stored on a secure online platform. We report data from the AILDR since initiation in May 2016 to 30th September 2021 inclusive. Results: In total 2140 participants were enrolled from 16 sites at a mean rate of 43/month (mean age 65.8±13.3years;1185 (55.4%) male;982 (45.9%) ever-smokers;mean BMI 29.4±5.9kg/m2). Baseline functional parameters demonstrated mean FVC 85.6±21.7% predicted, mean DLCO 60.5±19.4%predicted, and mean six-minute walk test (6MWT) distance 434.3±126.5metres. ILD diagnoses included: idiopathic pulmonary fibrosis (IPF) n=545 (30.3%), connective tissue disease associated ILD (CTD-ILD) n=326 (18.1%), chronic hypersensitivity pneumonitis (CHP) n=155 (8.6%), sarcoidosis n=120 (6.7%) and unclassifiable ILD n=190 (10.6%). Patients with IPF were more likely to be male (n=403, 73.9%, p<0.001) and older (72.6±8.3years, p<0.001) compared to all other ILD subtypes. A female predominance was observed for CHP (n=92, 59%, p=0.001) and CTD-ILD (n=206, 63%, p<0.001). Baseline functional parameters were lowest for those with CHP (FVC 76.8±22.4% predicted, DLCO 54.1±16.9% predicted), significantly lower comparable to the IPF group (FVC 84.8±19.6%predicted, DLCO 58.7±17.8%predicted, p<0.001). The highest baseline functional parameters were observed in those with sarcoidosis. Conclusion: We demonstrate the feasibility of a bi-national ILD registry evidenced by steady recruitment despite the COVID-19 pandemic. In this study, lower functional baseline parameters were detected in the CHP group suggesting priority research should be afforded to this group. Through a routine approach across Australasia, the AILDR aims to improve standardisation of diagnosis and management of ILD patients.

3.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927704

ABSTRACT

RATIONALE4,4-44,4% of children suffer from post-COVID syndrome, commonly known as long- COVID, after an acute SARS-CoV-2 infection. However, an uniform clinical definition, and guidelines to diagnose or treat children suspected of long-COVID are lacking. Multiple careprograms have been initiated worldwide. In this study, we aimed to assess the currently available pediatric international long-COVID care programs and explore the characteristics of their patient cohorts.METHODSWe established an international network (IP4C) and performed a crosssectional analysis from aggregated data collected by its members using a survey. Topics included: the used definition for long-covid in children, the organization of pediatric long-COVID clinics and long-COVID patients characteristics. Descriptive analysis of the aggregated data was used to summarize and compare each of these categories across countries. RESULTSWe included data concerning organization of care from 17 cohorts based in 13 different countries. A wide range of definitions for long COVID was used, which differed mostly in duration of symptoms and the necessity of microbiologically proven SARS-COV-2 infection. 66,6-100% of patients in the long- COVID cohorts suffered from complaints for more than twelve weeks, and 49,5-97,3% of patients had a positive RT-PCR or serology for SARS-CoV-2. Most long-COVID care programs consisted of real-life visits with multidisciplinary teams, consisting of general pediatricians, pediatric lung specialists, cardiologists and infectiologist, a physiotherapist and psychologist. The type of investigations performed at the long-COVID clinics ranged from assessment of medical history (100%) and standardized questionnaires (91%) to in depth evaluation of organ functioning (e.g. spirometry performed in 0-100% of patients). Aggregated data of 431 long-COVID patients from 11 dedicated long-COVID care programs were analyzed. Mean age of patients ranged from 6,5-16,4 years old. Girls were overrepresented in most cohorts (20-65%). 28-81,8% of patient had a positive medical history, most commonly atopic syndrome, asthma and prematurity. Most patients (90- 100%) suffered from asymptomatic or mild acute COVID-19. Frequent long-COVID symptoms were fatigue, headaches, concentration difficulties, dyspnea and sleep disturbances. 5-37% of patients had severe limitations in daily life. CONCLUSIONSThis is the first study to describe the organization of pediatric long-COVID care. It demonstrates that pediatric long-COVID is recognized worldwide as a multisystemic disease, but its definition and care programs for pediatric long- COVID patients differ between cohorts. A clear definition of pediatric long-COVID is needed to improve international scientific collaboration and patient care. Our international network will facilitate further collaboration in investigation pathophysiology and therapeutic interventions in order to provide evidence based medical care for these patients.

5.
Annals of Behavioral Medicine ; 56(SUPP 1):S670-S670, 2022.
Article in English | Web of Science | ID: covidwho-1848983
6.
Annals of Behavioral Medicine ; 56(SUPP 1):S205-S205, 2022.
Article in English | Web of Science | ID: covidwho-1848901
7.
Learning Organization ; : 20, 2022.
Article in English | Web of Science | ID: covidwho-1799379

ABSTRACT

Purpose This study investigates the processes that the US universities and colleges used to learn during the COVID-19 pandemic and the factors that facilitated and impeded their learning processes. Design/methodology/approach To address this study's research questions, this study used a crisis communication and learning lens to interview crisis response team members from 30 US higher education institutions in May 2020 (the first pandemic semester). In October 2020 (the second pandemic semester), this study conducted follow-up interviews with 25 of the original interviewees. Overall, this study conducted 55 interviews. Findings Learning during the COVID-19 pandemic is facilitated by a recognition of a serious deficiency in the current system and impeded by the need to act quickly. The findings demonstrate the process by which decisions, actions and strategies emerged during crises. Originality/value This investigation illustrates how crises can prompt organizational learning while demonstrating the critical role of internal and external resources in the learning process.

8.
British Journal of Diabetes ; 21(2):301, 2021.
Article in English | EMBASE | ID: covidwho-1737420

ABSTRACT

Introduction: Diabetes is an established risk factor for poor outcome in COVID-19. Additionally, the pandemic has resulted in patients delaying hospital attendance with emergencies such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS). We examined adult admissions for hyperglycaemic emergencies to Newham University Hospital during the first and second COVID-19 waves. Results: 38 adults presented in wave ( March to 3 May 2020): DKA, 4 HHS, 3 mixed DKA/HHS. Median age was 62 years and 58% were male. 63% were Afro-Caribbean,13% Caucasian,11% Asian. 68% had known T2DM, 6% known TDM and 6% newly diagnosed diabetes. Mean BMI was 27.3 kg/m2, mean HbA1c (within one year) was 90.6 mmol/mol. 6 patients (42%) had PCR-confirmed COVID-19 on admission. In wave 2 ( November 2020 to 28 February 202) 59 adults presented: 34 DKA, 2 HHS, 3 mixed DKA/HHS. Median age was 55 years and 6 % were male. 39% were Afro-Caribbean, 27% Caucasian, 7 % Asian. 6 % had known T2DM, 29% known TDM and 0% newly diagnosed diabetes. Mean BMI was 27.9 kg/m2, mean HbA1c was 96 mmol/mol. 8 patients (3%) had PCR-confirmed COVID-19 on admission. In both waves most patients were male, had T2DM with poor pre-admission glycaemic control and most were overweight/obese. Mixed DKA/HHS was unusually prevalent. During wave 2, patients were younger, COVID-19 was less frequent, more patients with TDM were admitted, when DKA predominated and only two patients with TDM had COVID-19. Hyperglycaemic emergency admissions differed between the two waves, with wave 2 seeing increased TDM admissions and more presentations independent of COVID-19 . Discussion: Better understanding of factors underlying these presentations could help to improve patient support during this time.

9.
MEDLINE;
Preprint in English | MEDLINE | ID: ppcovidwho-326602

ABSTRACT

Background: South Africa implemented rapid and strict physical distancing regulations to minimize SARS-CoV-2 epidemic spread. Evidence on the impact of such measures on interpersonal contact in rural and lower-income settings is limited. Methods: We compared population-representative social contact surveys conducted in the same rural KwaZulu-Natal location once in 2019 and twice in mid-2020. Respondents reported characteristics of physical and conversational ('close interaction') contacts over 24 hours. We built age-mixing matrices and estimated the proportional change in the SARS-CoV-2 reproduction number (R 0 ). Respondents also reported counts of others present at locations visited and transport used, from which we evaluated change in potential exposure to airborne infection due to shared indoor space ('shared air'). Results: Respondents in March-December 2019 (n=1704) reported a mean of 7.4 close interaction contacts and 196 shared air person-hours beyond their homes. Respondents in June-July 2020 (n=216), as the epidemic peaked locally, reported 4.1 close interaction contacts and 21 shared air person-hours outside their home, with significant declines in others' homes and public spaces. Adults aged over 50 had fewer close contacts with others over 50, but little change in contact with 15-29 year olds, reflecting ongoing contact within multigenerational households. We estimate potential R 0 fell by 42% (95% plausible range 14-59%) between 2019 and June-July 2020. Discussion: Extra-household social contact fell substantially following imposition of Covid-19 distancing regulations in rural South Africa. Ongoing contact within intergenerational households highlighted the limitation of social distancing measures in protecting older adults. Funding: Wellcome Trust, UKRI, DFID, European Union.

10.
Wellcome Open Research ; 6:1-15, 2021.
Article in English | Scopus | ID: covidwho-1485515

ABSTRACT

Background: Miniaturised bioassays permit diagnostic testing near the patient, and the results can be recorded digitally using inexpensive cameras including smartphone and mobile phone cameras. Although digital cameras are now inexpensive and portable, the minimum performance required for microfluidic diagnostic bioassays has not been defined. We present a systematic comparison of a wide range of different digital cameras for capturing and measuring results of microfluidic bioassays and describe a framework to specify performance requirements to quantify immunoassays. Methods: A set of 200 μm diameter microchannels was filled with a range of concentrations of dyes used in colorimetric and fluorometric enzyme immunoassays. These were imaged in parallel using cameras of varying cost and performance ranging from <£30 to >£500. Results: Higher resolution imaging allowed larger numbers of microdevices to be resolved and analysed in a single image. In contrast, low quality cameras were still able to quantify results but for fewer samples. In some cases, an additional macro lens was added to focus closely. If image resolution was sufficient to identify individual microfluidic channels as separate lines, all cameras were able to quantify a similar range of concentrations of both colorimetric and fluorometric dyes. However, the mid-range cameras performed better, with the lowest cost cameras only allowing one or two samples to be quantified per image. Consistent with these findings, we demonstrate that quantitation (to determine endpoint titre) of antibodies against dengue and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viruses is possible using a wide range of digital imaging devices including the mid-range smartphone iPhone 6S and a budget Android smartphone costing <£50. Conclusions: In conclusion, while more expensive and higher quality cameras allow larger numbers of devices to be simultaneously imaged, even the lowest resolution and cheapest cameras were sufficient to record and quantify immunoassay results. © 2021. Jégouic SM et al.

11.
Diabetic Medicine ; 38:1, 2021.
Article in English | Web of Science | ID: covidwho-1237159
12.
International Journal of STD and AIDS ; 31(SUPPL 12):81-82, 2020.
Article in English | EMBASE | ID: covidwho-1067089

ABSTRACT

Introduction: The COVID 19 pandemic resulted in significant restrictions for routine, non urgent clinical services, including sexual health. In line with national guidance we suspended all routine walk-in services. To preserve services for as many patients as possible we immediately implemented a remote access telemedicine service. Anticipating that this might evolve to become a permanent future model for service delivery we also sought patient opinion of the new service. Methods: All patients who received a telephone consultation between 8th April-15th May 2020 received a text message with an anonymised patient satisfaction questionnaire. Patients who did not attend and those reporting sexual assault were excluded. Results: 898 patients were sent the survey with 174 completed responses, ∧20% response rate. Of responders, the majority were female - female 82.2% male 17.8%, reflecting our integrated contraception and GUM service. Overall, 93.7% (163/174) would use the service again, 26.2% (46/174) would prefer a face to face appointment and 4.6% (8/174) reported their needs were not met by a telephone consultation. Discussion: Previously there has been encouraging research into the use of digital technologies for medical consultations. There is limited existing evidence for application of these within the field of Sexual Health. Whilst telemedicine will not be appropriate for a minority of patients our early experience suggests that this modality works well for the majority of users. 93.7% would use the service again. Additionally, this service not only accommodates users but it also allows clinical staff to work remotely. This reduces footfall onto clinical sites and allows higher risk staff to continue effective working.

13.
Facets ; 5(1):1019-1036, 2021.
Article in English | Scopus | ID: covidwho-1015721

ABSTRACT

In the event of the current COVID-19 pandemic and in preparation for future pandemics, open science can support mission-oriented research and development, as well as commercialization. Open science shares skills and resources across sectors;avoids duplication and provides the basis for rapid and effective validation due to full transparency. It is a strategy that can adjust quickly to reflect changing incentives and priorities, because it does not rely on any one actor or sector. While eschewing patents, it can ensure high-quality drugs, low pricing, and access through existing regulatory mechanisms. Open science practices and partnerships decrease transaction costs, increase diversity of actors, reduce overall costs, open new, higher-risk/higher-impact approaches to research, and provide entrepreneurs freedom to operate and freedom to innovate. We argue that it is time to re-open science, not only in its now restricted arena of fundamental research, but throughout clinical translation. Our model and attendant recommendations map onto a strategy to accelerate discovery of novel broad-spectrum anti-viral drugs and clinical trials of those drugs, from first-in-human safety-focused trials to late stage trials for efficacy. The goal is to ensure low-cost and rapid access, globally, and to ensure that Canadians do not pay a premium for drugs developed from Canadian science. © 2020 Bubela et al. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

14.
Proc. Eur. Conf. Innov. Entrepren., ECIE ; 2020-September:773-780, 2020.
Article in English | Scopus | ID: covidwho-995244

ABSTRACT

In the wake of the COVID-19 pandemic, there is an increased acknowledgement of the importance of mental health in retaining a healthy and productive workforce. In the months following the pandemic, a number of prominent companies have begun offering wellbeing programs that go beyond physical health benefits that have been a stable employee benefit, to include other types of health benefits, including mental health supports. While it appears that the trend in offering workplace wellbeing programs is growing, is it sustainable? Those seeking to navigate this space and sell to corporate (B2B) customers will face stiff competition from other providers. Do we understand what organizations are expecting to gain from bringing these interventions into the workplace? Do they get what they expect? What are the challenges in bringing wellbeing programs into workplace settings? How can entrepreneurs and innovators increase the likelihood of success in retaining new corporate clients? How can we encourage clients to retain these services after short-term pandemic-related demand has passed? To provide insight to these questions, the authors will discuss and reflect upon a pre-COVID-19 implementation of a wellbeing program at a Fortune 500 Company. The case study will walk the reader through processes the authors and their client went through in implementing and evaluating a wellbeing program offered to employees at a Fortune 500 Company. This case study includes a summary of the process and challenges the startup company faced in implementing their program as a third-party provider of a wellbeing program to a large corporation. The case study also includes a summary of the program outcome, including quantitative program benefits identified and how these were obtained. Additional qualitative data further informs on aspects of the case study, including qualitative feedback from participants in the wellbeing programs and the hiring manager. Perspective from the startup entrepreneurial firm that developed and provided the wellbeing program is also included. In discussing the scenario to its conclusion, we provide a thoughtful discourse for consideration on how to leverage what was learned through this case study to improve product development and implementation for other entrepreneurs. © 2020 Academic Conferences and Publishing International Limited. All rights reserved.

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