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Journal of the Intensive Care Society ; 24(1 Supplement):7-8, 2023.
Article in English | EMBASE | ID: covidwho-20240667


Introduction: Critical care patients commonly have disrupted sleep patterns, with reduction of REM sleep, duration of sleep, increased fragmentation and loss of circadian rhythm.1 Causes include the patients' pathophysiology, medications administered and the busy critical care environment. Data collection showed that our patients were sleeping, on average, for a single block of sleep of 3.5 hours. Delirium rates and its known deleterious effects are highly associated with poor sleep, as well as an impairment of psychomotor performance and neurocognitive dysfunction. Sleep deprivation in the healthy population impairs lymphocyte action, cytokine production and pro-inflammatory balance, as well as a reduction in respiratory function and prolongation of respiratory support.2 Objectives: To firstly measure the sleep quality and explore the reasons behind poor sleep from the patients themselves and to gauge the MDT knowledge and interest in sleep, as a fundamental component of patient management. Then using the results we aimed to improve the duration and quality of the patients sleep on high dependency unit. Method(s): The Adapted Richard Campbell Sleep Questionnaire was given to all patients in the HDU over a 4 week period. Results were analysed, then stored for post intervention comparison. The duration of sleep was documented for all patients and a staff questionnaire was done to assess knowledge and concern of staff. Interventions included a staff sleep awareness week with education and prompts attached to the charting tables promoting sleep. Face masks and ear plugs were freely available to be distributed at the evening ward round. The critical care pharmacist identified medications that could alter the patients ability to achieve REM sleep - e.g. evening administered PPIs, and melatonin was commenced early when sleep was troublesome. Estates fixed soft close doors and soft closed bins supplied for clinical areas. After interventions, there was a further 4 week study period where the above factors were repeated. The need for natural light was highlighted and thus this was optimized in the ward environment and those physiologically able were offered trips outdoors to facilitate normal day night wake cycle. With the COVID pandemic ongoing we also endeavored to limit movement overnight of venerable patients. Result(s): The original data collection was of 45 patients with multiple data points, and the second of 27 patients with multiple data points. Results from the Adapted Richard Campbell Sleep Questionnaire were compared using a one tailed students t test. There were significant increases in the subjective quality of sleep (p=0.046) and quantity of sleep (p=0.00018). Reasons given as to improvement of sleep were reduction in discomfort from monitoring and the bed (p=0.026), reduced ambient light (p=0.031) and reduced impact from the presence of other patients (p=0.002). Conclusion(s): There was marked improvement in the awareness of the importance of sleep within the critical care team after education promoting a change in attitude and culture towards sleep. We are planning a second iteration targeting sedation, noise from monitors and staff and overnight interventions. Although this has been done with level 2 patients, extension to level 3 areas would be beneficial.

8th International Conference on Wireless and Telematics, ICWT 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2136348


During the COVID-19 pandemic, there has been an increase in communication through social media. However, this is not accompanied by the level of citizen discipline where the high spread of false issues causes problems in the social and political fields. This study aims to look at the views of the community during the COVID-19 pandemic regarding Social and Political. The research method uses Latent Dirichlet Allocation Analysis to extract topic cluster of political and social during COVID-19 pandemic in Indonesia. The results of this study indicate a public view that considers the COVID-19 pandemic to be a tool, interest, or political game, and social concerns have increased considerably during the COVID-19 pandemic. During COVID-19, the increase in public communication through social media has become a driving force for other social activities that can ease the burden on the community. Besides that, the community seems wise enough to choose which news is fake and what is true. © 2022 IEEE.

South African Journal of Science ; 117(9-10):46-52, 2021.
Article in English | Web of Science | ID: covidwho-1472521


The novel coronavirus has revealed major impediments in South African food distribution. Existing challenges will be greatly exacerbated by an economic recession projected to be worse than the Great Depression. Home gardens are decidedly utilised to fortify food security and economic resiliency in the face of crises, especially in impoverished communities. For these communities, home garden produce favourably augments diets consisting predominantly of industrially produced staples and the surplus yield can be sold. Despite many campaigns to alleviate food insecurity - some aimed at developing industrial agriculture and others to establish and uplift home gardens - malnutrition and hunger still plague the impoverished. Dissection of these campaigns reveals common flaws in those that failed and key aspects related to those that succeeded, with successful projects even managing to provide a household's total supply of vegetables. One of the crucial failings was a 'top-down' approach that condescended to participants, ignoring existing knowledge, preferences and social consolidation whilst focusing on meticulously consistent packaged methodologies. Successful projects exalted recipients' own bid for food sovereignty and increased individual and community capacity by providing insightful consultation and access to requested necessary inputs. Obstacles especially present in South Africa include drought and collapse of social capital after withdrawal of institutional support. It has been proven possible that these can be overcome with application of technologies, such as rainwater harvesting, and the creation of common cause such as in national drives. This review of the literature clearly reveals that purposefully uplifted home and community gardens alleviate food insecurity. Significance: Citizens aim for food sovereignty in times of economic crises such as will be brought about by the novel coronavirus. We assess the potential of the establishment of home and community gardens to alleviate food insecurity in South Africa. Home gardens should mainly target the alleviation of malnutrition, producing vegetables to augment cereal-based diets. Protection of social capital by institutional networks ensures durability and long-term success of campaigns. Rainwater harvesting technology is immensely influential for the success of home gardens in a South African context.

Br J Dermatol ; 183(1): 1-2, 2020 07.
Article in English | MEDLINE | ID: covidwho-628893