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1.
Developmental Medicine and Child Neurology ; JOUR:72-73, 64(Supplement 4).
Article in English | EMBASE | ID: covidwho-2088156

ABSTRACT

Background and Objective(s): The transition to adulthood is challenging for individuals with Cerebral Palsy (CP), including the deterioration of health and wellness, loss of supports and reduced access to assistive technologies (AT). While physical, cognitive, and communication challenges may increase, we know very little about the needs for and availability of AT for function and participation. The purpose of this scoping review is to examine the needs, use, and effectiveness of AT in adults with CP. Study Design: We followed the PRISMA-Scr (2019) guidelines for this review. Study Participants & Setting: We searched 5 databases (MEDLINE, PubMed, PsycInfo, Embase, & CINAHL), for peer-reviewed prospective/retrospective studies (2005-2021) of adults (>18 years) with CP, and AT. Materials/Methods: Four independent reviewers screened articles by title/, followed by a full-text screening/ selection, using the Covidence Software. Conflicts were recorded/resolved among all reviewers. Data extraction included study objective, geographical region, design, setting, participant information, type of AT/intervention, and results. Study quality was assessed using the Downs and Black (1998) criteria. Result(s): The search revealed 4981 studies. After removal of the duplicates, titles and s of 2418 studies were screened and 99 studies were included for full-text review. Of these, 40 studies were eligible for extraction. Overall, the quality of the studies was fair. Participants were 18 to 80 years with variable functionality. Most studies did not report functionality, race/ethnicity, or SES. We thematically categorized the types of AT: seating, positioning, and mobility equipment (4);adaptive input devices (13), robotic devices (5), and communication and speech technology systems (10). Studies examined prognosis (1), usability of AT (9), training (8), and testing AT (22). Performance (speed/accuracy) was a major outcome (18), followed by physiological gains (7). Only a few studies examined patient reported ease of use and satisfaction. Overall, studies focused on control devices for interfacing with computers and mobility devices. Users highlighted that perceived comfort, social acceptability and approachability are key components for the utility of the equipment. In the case of seating/positioning/mobility equipment, the use of exoskeletons appears to be beneficial for decreasing the metabolic cost of ambulation. Systematic user training appears to be very effective. Additionally, customization of adaptation for control of mobility devices improves independence in mobility. Conclusions/Significance: There is limited data available for the use of AT technology for adults with CP. The studies had significant design and bias limitations. The need for control devices for accessing computers and mobility equipment is a primary need followed by devices related to improving physiological and participatory aspects of ambulatory ability. Training is important with individualized coaching strategies being the most effective. Many studies lack user perspective.

2.
Regional Businesses in a Changing Global Economy: The Australian Experience ; : 113-117, 2022.
Article in English | Scopus | ID: covidwho-2080715

ABSTRACT

This chapter examines some of the strategic management principles that are available to entrepreneurial businesses to build operational resilience in advance of market disruptions. The field of corporate strategy is replete with frameworks that can help discern where competitive strategy can be shaped and leveraged. The value of planning is not the plan itself but the development of scenarios that consider key operational disruptions. Operating in tropical North Queensland, Experience Co grew quickly on the back of experiential tourism. Growth through a strategy of acquisition saw it purchase Great Barrier Reef (GBR) Helicopters for $20 million in December 2017. Two years later and coinciding with the cessation of Chinese inbound tourism in December 2019, Experience Co sold the GBR Helicopter fleet to Chris Morris of Morris Aviation for $17 million. This was a talisman of what was to follow with COVID-19 just four months later. The tourism sector in Far North Queensland has also been significantly impacted by COVID-19. For many private businesses, growth occurred through backward and forward integration in the supply chain. When key markets were lost, as experienced with Chinese inbound tourism and COVID-19, the doubling-down effect magnified those losses. The surge in Merger & Acquisition (M&A) activity across Australia since COVID-19 reflects the attraction of buying distressed assets. Due diligence related to the underlying value of assets and whether they strategically suit the ‘new normal’ post COVID-19 must be considered. © (2022), (Taylor and Francis).

3.
129th ASEE Annual Conference and Exposition: Excellence Through Diversity, ASEE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2046761

ABSTRACT

Science kits have been a staple of learning for some time, but in the era of COVID-19 at-home science kits took specific prominence in educational initiatives. In this paper, we delineate how kit-based education can be paired with virtual connection technology to enhance postsecondary and career exploration. The “Content, Connection and Careers” kit-based program has been developed to enable youth to explore electrical engineering principles while connecting virtually with university students to discuss engineering courses and careers. When assembled and wired up, the kit components become linear motors that use a magnetic force to pull a bolt into a pipe when youth press a button. This follows the same working principles as a doorbell or solenoid. These kits are supported by virtual learning sessions where youth connect with university students and faculty to fully understand the educational content, connect to peers and caring adults to share their learning, and explore careers that use electrical engineering skills. To investigate the effectiveness of the program, surveys were distributed to participants to understand whether the kits were simple enough for independent learning but robust enough to encourage additional self-exploration of more difficult topics with the aid of expert scientists and other adult role models. Additionally, youth were asked if the connections made with university faculty and students was beneficial in their thinking of postsecondary options and college engagement. Over 60 elementary and middle-school aged youth participated in the project. Over 80 percent of survey respondents self-reported improved knowledge of how an electromagnetic field works and how to build a simple electromagnet. Other results showed an increased understanding of engineering careers and courses required to study electric engineering in college. Before their experience in the project, very few of the young people had ever talked to university faculty or university students about their areas of research or their journey into the fields of science, technology, engineering, and math (STEM). This connection was described in the surveys as what the youth liked best about the project. © American Society for Engineering Education, 2022.

5.
Innovation in Aging ; 5:481-481, 2021.
Article in English | Web of Science | ID: covidwho-2012854
6.
Group & Organization Management ; 2022.
Article in English | Web of Science | ID: covidwho-1997274

ABSTRACT

In response to the global COVID-19 pandemic, many businesses closed their offices and asked their employees to work from home. The transition to remote work has yielded performance gains for many companies;so much so that many firms are planning to continue to use remote work after the pandemic subsides. Nevertheless, such benefits may not be distributed equally throughout the workforce. Drawing on the sociocognitive theory of socioeconomic status (SES), we predict that one's home working environment features salient signals of their social status that affect their performance. Based on a sample of 304 remote workers from within the United States collected during the COVID-19 shutdown, we find that individuals whose home offices connote higher levels of SES report a greater sense of control over their environment, which ultimately is associated with higher levels of perceived job performance. Furthermore, we find that the more time an individual spends in their home office, the stronger the relationship between their environment-based SES and their personal sense of control. Taken as a whole, our findings suggest that because home working environments are arrayed along an SES gradient, they present another mechanism by which pre-existing inequalities may be made salient as a result of the COVID-19 pandemic.

7.
Journal of General Internal Medicine ; 37:S218-S219, 2022.
Article in English | EMBASE | ID: covidwho-1995616

ABSTRACT

BACKGROUND: Understanding the impact of challenges and uncertainty due to the COVID-19 pandemic is critical to supporting US medical students' learning. The objective of this qualitative study was to gather perspectives from US medical students about stressors, tensions, and lessons learned during the pandemic. We were specifically interested in how these factors impacted personal and professional development. Additionally, we aimed to collect feedback about how undergraduate medical institutions can support their students. METHODS: Qualitative data was collected through semi-structured, one-onone telephone interviews. Interested students were recruited from 3,826 students who took a part in our previous online survey on burnout, stress, and loneliness during the early pandemic (May-July 2020). Interviews were conducted between February and June 2021. Open coding and thematic content analysis were performed using Atlas. TI software. RESULTS: Forty-four interviews were conducted with students from 22 US medical schools. Overall, 106/450 (24%) responded to the invitation to participate. 44 interviews were completed, ranging between 25-72 minutes in length, Most respondents were female (75%), white (77%), and third years (39%). Major themes centered around student responsibilities (e.g. personal, professional, societal), navigating tensions (e.g. personal risk vs. professional responsibilities, COVID-precaution conflicts), professional identity formation (e.g. commitment to medicine, caring for COVID patients) and stressors (e.g. academic, personal), emotional responses (e.g. mental health challenges) and lessons learned (e.g. examining priorities, adaptability). Student responsibilities included volunteering, patient-care, activism, public health education, and familial obligations. Tensions experienced centered around ethical concerns and prioritizing competing responsibilities. Additional findings centered on suggested resources to support student development, which included enhanced support mechanisms (e.g. structured reflection, mental health support) and recommendations for schools (e.g. clear communication, flexible policies). CONCLUSIONS: Undergraduate medical institutions should support their students through the COVID-19 pandemic and support positive personal and professional development. Medical students recommend that institutions prioritize transparent communication regarding ongoing changes in policies and curriculum. Participants also recommended giving students choices in caring for COVID patients and remaining in clinical roles. This fits into a general theme of the importance of giving students' flexibility to prioritize what is best for their own learning, safety, and wellbeing. Finally, students emphasized the importance of accessible mental health support that continues beyond the COVID-19 pandemic.

9.
Journal of the International Aids Society ; 25:165-165, 2022.
Article in English | Web of Science | ID: covidwho-1980250
10.
IEEE Frontiers in Education Conference (FIE) ; 2021.
Article in English | Web of Science | ID: covidwho-1978332

ABSTRACT

Machine learning and Artificial Intelligence (AI) are national priority areas for research, education and workforce development. This work in progress paper describes a Research Experiences for Teachers program in sensors and machine learning launched in the summer of 2020. Motivated by national AI workforce needs, we designed a program that engaged high school teachers from STEM fields in machine learning research. In 2020, the program focused on AI algorithms for solar energy systems. Because of the COVID-19 conditions, the research experience was virtual and ran with a smaller teacher group than originally planned. The program included development of training content, algorithm and software training, research in solar energy monitoring, development of research reports and lesson plans, research presentations, and assessment. The assessment of the program included surveys, interviews, presentation observations, and follow-up in high school content delivery.

11.
Gates Open Research ; 5, 2022.
Article in English | EMBASE | ID: covidwho-1969796

ABSTRACT

Background: A potential explanation for the fact that the high rate of infection of SARS-CoV-2 in South Africa did not translate into high rates of severe illness and death may be the presence of cross-reactive immunity induced by common cold coronaviruses (CCoV). Methods: We used SARS-CoV-2 peptide pools and whole virus antigen to stimulate peripheral blood mononuclear cells collected pre-2020 from South African women. Dual-colour FluoroSpot assay was used to measure interferon gamma (IFNγ) and interleukin 2 (IL2) production. Results: Among the 97 study participants, IFNγ responses were observed in 29.9% of the women and IL2 among 39.2%. Overall, 51.6% of women demonstrated response to at least one stimulant. Conclusion: We demonstrate the presence of cross-reactive immunity to SARS-CoV-2, which might have been induced by past exposure to CCoV.

12.
Journal of Clinical Urology ; 15(1):93-95, 2022.
Article in English | EMBASE | ID: covidwho-1957026

ABSTRACT

Introduction: The Covid-19 pandemic in the UK led to much un-certainty about the delivery of cancer services. A shift from established therapy (and its timing) in patients with Muscle invasive Bladder Cancer (MIBC) has potential deleterious consequences. To understand outcomes, we formed a collaborative to measure overall and diseasefree survival at 3-years in patients with non-metastatic MIBC (Figure 1) treated during the UK's first wave of Covid-19. Secondary aims included comparison between treatment modalities and pre-Covid controls. Patients and Methods: The collaborative included clinicians from 13 major centres, representing 3 UK nations. A prospective clinical audit, endorsed by the National Cancer Research Institute, was started to collect comprehensive data. MIBC patients discussed at the multidisciplinary meeting (MDM) between 1/3/2020-30/06/2020 were included. Results: At submission, data were available from 12 centres for 299 patients. The mean age was 69.3 years (27- 90), and there were 72 female and 227 male patients. Mean Charlson Co-morbidity Index was 5 (1-12). Preliminary analysis of available data indicate the following: MDM recommendations for (at least) 1 in 4 patients were deemed as being modified from standard practice. Twenty six patients received neoadjuvant chemotherapy. In total (from available data), 99 received radical radiotherapy and 146 underwent radical cystectomy (65 and 74 specified as open and robotic assisted, respectively). Preliminary analysis suggests that 1 in 3 patients had died within 1 year. Conclusions: Preliminary Results indicate that recommendations for MIBC patients were significantly altered consequent to the pandemic and mortality was high. Analyses towards endpoints are awaited.

13.
Journal of Clinical Urology ; 15(1):70-71, 2022.
Article in English | EMBASE | ID: covidwho-1957021

ABSTRACT

Introduction: COVID-19 has caused disruption to medical services, which may have led to delayed cancer diagnoses. This study aims to compare the number and stage of new cancer diagnoses before and during the COVID-19 pandemic. Methods: A hospital-based cancer registry of patients who were diagnosed with Urological (ie, Kidney, Uppertract, Bladder, Prostate, Testis and Penis) between January 2019 and February 2020 Pre-COVID) and March 2020 and September 2021 (During COVID). Monthly numbers of patients with newly diagnosed cancer were compared in Pre-COVID and During-COVID groups. Results: 849 patients (753 men [89%];96 women [11%]) (n = 385 Pre-COVID [45%];n = 464 during-COVID [55%] were included. During-COVID there was a significant 11.2% reduction in monthly new cancer diagnoses (Monthly new diagnoses: Pre-COVID of 27.5 [SD 5.54];During-COVID 24.4 [SD 6.97];p < 0.001). The number of cases & T-staging at diagnosis in the pre- COVID-19 period and the During-COVID period were compared (Figure 1) There is a significant increase in the TNM stage at diagnosis of bladder cancer (Pre-COVID 0.85 [SD 1.0] vs During COVID 1.2 [SD 1.0]) and Upper Tract (Pre-COVID 2.5 [SD 1.1] vs During-COVID 3.5 [SD 0.7] in patients diagnoses during the COVID-19 pandemic compared to beforehand. No difference was found for Prostate, Kidney, Testicular or Penile cancers. Conclusions and Relevance There has been a significant 11% reduction in the total number of monthly urological cancers diagnoses during COVID. Patients with Upper tract and Bladder cancer were diagnosed at a significantly higher stage during the COVID-19 pandemic than beforehand.

14.
BJOG: An International Journal of Obstetrics and Gynaecology ; 129:114-115, 2022.
Article in English | EMBASE | ID: covidwho-1956652

ABSTRACT

Objective: To study the impact of national recommendations on the method of screening used for GDM during the COVID-19 pandemic, and evaluate differences in maternal and fetal outcomes among women with first-time GDM (ftGDM). Design: A retrospective observational study in a single Tertiary London Hospital. During the pandemic, the RCOG recommended an amended GDM screening protocol to reduce hospital attendance and risk of virus transmission (fasting blood glucose level ≥5.3 and/or HbA1c ≥39 at 28 weeks of gestation). Our Trust did not adopt this due to concerns regarding its sensitivity. We adopt a 2-step approach to universal GDM screening using a 50g glucose challenge test, and refer those screening positive for a full oral glucose tolerance test. Method: Outcomes were reviewed for women with ftGDM delivering a singleton at ≥24 weeks gestation between 01/04/20 -28/ 5/21. Our primary aim was to determine the impact of the change in COVID-19 GDM screening policy, had it been implemented. Our secondary outcomes included GDM management method, maternal and perinatal complications. We excluded women with a booking HbA1c ≥42 (indicative of pre-diabetes) and those who had bariatric surgery. Demographic and outcome data were obtained from electronic databases. Results: 247 women were diagnosed with ftGDM using local screening methods. Only 23 of these women had a HbA1c ≥39 at time of diagnosis and a further 12 had FBG ≥5.3. There was no significant difference in age or ethnicity between the two groups. The locally diagnosed group had a statistically significantly lower booking BMI (P<0.001) and were less likely to require pharmacological management of GDM (P<0.001). There were no significant differences in rates of induction of labour, gestation at delivery, birth weight or any perinatal adverse outcome. However, the women in the Covid-19 GDM screening group were significantly more likely to be delivered by Emergency Caesarean Section (p = 0.03) and have gestational hypertensive disease (p = 0.025). Conclusions: If we had implemented RCOG HbA1c screening, we would have not diagnosed 207 women with GDM, 41% of whom required pharmacological treatment. It is not surprising that women with higher HbA1c values had higher rates of maternal complications, due to the well-established association between maternal hyperglycaemia and adverse obstetric outcomes. As such, it is imperative that more sensitive screening protocols such as the 50g screen are considered in any future pandemics, such that women with GDM can be identified and maternal hyperglycaemia treated to benefit in-utero fetal programming.

15.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927696

ABSTRACT

Importance Pulmonary rehabilitation (PR) is the guideline-recommended most effective nonpharmacological therapy for people with chronic obstructive pulmonary disease (COPD) improving all outcomes. Despite the proven benefits, PR programs have low participant uptake, insufficient attendance, and high drop-out rates. Home programs are proposed as a solution: however, there is no randomized study to date in the US to inform remote programs.Objective To determine whether unsupervised home-based rehabilitation with technology and health coaching improve physical and emotional disease specific quality of life, daily physical activity, and self-management in patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD).Design, Setting, and Participants This multicenter, randomized, allocation-concealed, clinical trial enrolled 235 adult patients with COPD, of a planned sample size of 200, between March 2018 and December 2021 from two major health care systems in the US.Interventions Participants were randomized to unsupervised home-based rehabilitation with health coaching (N=116) or standard care (n = 119).Main Outcomes and Measures The primary outcome were disease-specific physical and emotional quality of life after the 12-week intervention. Prespecified secondary outcomes included measured daily physical activity, selfmanagement abilities, sleep, and symptoms of depression and anxiety.Results Among 307 patients who were randomized (mean age, 69 years;56% women) 235 (77%) completed the intervention and had measures. The was a significant difference in the intervention compared to the control group in the primary outcomes, daily physical activity, self-management, sleep, and depression scores: (adjusted Difference, Mean Change (95% CI) 0.47 points (0.27, 0.67) p<0.001, 0.48 (0.27, 0.69)p<0.001 for the physical and emotional quality of life respectively. Daily steps 655.83 (148.03, 1163.64) p<0.0116, selfmanagement 3.83 (1.85, 5.79) p<0.001, depression PHQ-9 -1.2 (-2.04, -0.35) p<0.0056 and total sleep time 54 min (6.74, 102.96) p<0.025 .Conclusions and Relevance Among patients with moderate to severe COPD, unsupervised home-based rehabilitation with monitoring technology and health coaching improved quality of life, daily physical activity, and self-management. This intervention represents an opportunity to increase the uptake of rehabilitation in COPD and to inform options of remote care that are now in increased demand in the context of the COVID-19 pandemic. (Figure Presented).

16.
Value in Health ; 25(7):S561, 2022.
Article in English | EMBASE | ID: covidwho-1926736

ABSTRACT

Objectives: Angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs) are recommended for patients with comorbid diabetes mellitus and hypertension due to their favorable impact on microvascular and macrovascular events, cardiovascular outcomes, and mortality. Poor adherence to ACEI/ARB is a major public health concern. Motivational interviewing (MI) intervention is an effective patient-centered approach to improve adherence. The objective of this study was to evaluate the effectiveness of a telephonic MI intervention conducted by pharmacy students, tailored by the past ACEI/ARB adherence trajectories among nonadherent patients with comorbid diabetes mellitus and hypertension. Methods: Patients continuously enrolled in a Medicare Advantage Plan from July 2017-July 2021 with an ACEI/ARB prescription between July 2017-December 2017 were identified. Group-based trajectory modeling (GBTM) was used to identify 4 distinct patterns of ACEI/ARB adherence: adherent, gaps in adherence, gradual decline, and rapid decline in adherence. Patients from the 3 nonadherent trajectories were randomized either into MI intervention or control group. The intervention group received an initial call followed by 5 follow-up calls. The primary outcome was adherence measured as proportion of days covered (PDC) ≥ 0.80 for 1-year post-MI implementation. Multivariable logistic regression model evaluated the effect of the intervention on ACEI/ARB adherence. Results: This study included 240 patients who received intervention and 480 randomly selected controls. Patients who had received ≥ 4 calls were more likely to be adherent than those who received ≤ 3 follow-up calls (OR=2.01;P=0.01) despite the gaps in follow-up calls due to the COVID-19 outbreak. Other significant predictors of adherence were baseline adherence trajectories, number of other medications on the index date, prevalent users, regimen complexity, and CMS risk score. Conclusions: At 1 year, patients who received ≥ 4 calls had significantly better adherence than controls. MI intervention by pharmacy students has been demonstrated to improve adherence on a long-term basis.

17.
New England Journal of Medicine ; 386(13):1, 2022.
Article in English | Web of Science | ID: covidwho-1925181
18.
Palliative Medicine ; 36(1 SUPPL):20-21, 2022.
Article in English | EMBASE | ID: covidwho-1916760

ABSTRACT

Background/aims: One-fifth of conveyances to the emergency department (ED) are due to acute-on-chronic breathlessness. Paramedic breathlessness management may ease distress quicker and/or reduce ED conveyances. We evaluated the feasibility of a full trial of a paramedic delivered intervention to reduce avoidable conveyances (recruitment, randomisation, consent, training and intervention acceptability, adherence, data quality, best primary outcome, sample size estimation). The intervention comprised evidence-based non-drug techniques and a self-management booklet. Methods: This mixed-methods feasibility cluster randomised controlled trial (ISRCTN80330546) with embedded qualitative study about trial processes, training and intervention delivery, randomised paramedics to usual care or to intervention + usual care. Retrospective patient consent to use call-out data and prospective patient/carer consent for follow-up was sought. Potential primary outcomes were breathlessness intensity (numerical rating scale) and ED conveyance. Follow-up included an interview for patients/carers and questionnaires at 14 days, 1 and 6 months and paramedic focus groups and survey. Results: Recruitment was during the COVID-19 pandemic, leading to high demands on paramedics and fewer call-outs by eligible patients. We enrolled 29 paramedics;9 withdrew. Randomisation and trial procedures were acceptable. Paramedics recruited 13 patients;8 were followed up. Data quality was good. The intervention did not extend call-out time, was delivered with fidelity and no contamination and was acceptable to patients, carers and paramedics. There were no repeat call-outs < 48 hours. Recruitment stop-go criteria were not met. We had insufficient data for sample size estimation. Conclusions: A full trial in the same circumstances is not feasible. However, valuable information was gained on recruitment, attrition, consent, training and intervention acceptability and adherence, and patient-reported data collection.

19.
Journal of Neurology, Neurosurgery and Psychiatry ; 93(6):96-97, 2022.
Article in English | EMBASE | ID: covidwho-1916425

ABSTRACT

Objective Our aim was to report neurological manifestations of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Methods Patients (<18yrs) presenting to Great Ormond Street Hospital between March 1, 2020, and June 21, 2020 fulfilling RCPCH PIMS-TS criteria, were included. Clinical and paraclinical features were retrieved retrospectively from electronic patient records. Results New-onset neurological symptoms/signs were reported in 23/45 (51.1%);headaches (n=16), encephalopathy (n=7), dysarthria/ dysphonia (n=6), hallucinations (n=4), ataxia (n=4), peripheral nerve involvement (n=3), and seizures (n=1). Five (21.7%) patients had CSF analysis;1 patient had 118 leukocytes in CSF. Splenium signal changes were seen in 4/14 patients who had brain MRI. A mild excess of slow activity was found in 10/10 who had an EEG and mild myopathic and neuropathic changes were seen 4/5 who underwent nerve conduction studies and electromyography. Children with neurological involvement had higher peak inflammatory markers and were more likely to be ventilated and require inotropic support in PICU (p<0.05). Conclusions Children with PIMS-TS presented with new neurological symptoms involving both the central and peripheral nervous systems, in the absence of respiratory symptoms. Neurological symptoms were seen more frequently in more severe presentations.

20.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY ; 129:116-117, 2022.
Article in English | Web of Science | ID: covidwho-1905378
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