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1.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617071

ABSTRACT

Background: There is little data available on vaccine hesitancy rates in Irish parents, particularly in relation to the influenza vaccine (InV). Evidence to date would suggest that the morbidity from COVID-19 is lower in paediatric populations than that from influenza. Vaccination strategies are likely to be required for both infections, and as such, understanding parental perception of both vaccines is essential. Aims: We hoped to identify vaccination hesitancy rates for routine childhood vaccines (RCV) and for the influenza vaccine (InV). We then sought to identify intended uptake rates of the InV and any potential paediatric COVID-19 vaccine and review this data to try to identify trends in vaccination perceptions. Methods: A 10 item anonymised questionnaire was distributed to parents of all patients admitted under the General Paediatric team in a large tertiary centre in Dublin for 4 weeks during November 2020. Results were compiled and analysed, with scoring averages used to determine perceived vaccine efficacy scores (PVES) from a minimum of 1 to a maximum of 5 amongst the population and its subgroups. Results: A total of 214 questionnaires were analysed. The average age was 59.45 months, with the median being 34 months. Of those due to have commenced their RCV schedule, 92.98% were up to date, with 2.7% having received no vaccinations. The average PVES for RCV and the InV was 4.67 and 4.31, respectively. Of those eligible to receive the InV this year (n=143), 37.8% were either very likely or likely to receive the vaccine, with 47.6% unsure, unlikely, or very unlikely. PVES decreased steadily with increasing hesitancy, to a nadir of 4.13 for RCH and 3 for the InV in the very unlikely subgroup. The average likelihood to receive a COVID-19 vaccination, if one were available, was 3.67. Only 23.83% were likely or very likely to vaccinate against influenza and COVID-19 simultaneously. With regards to preferable vaccination, 22.9% would prefer COVID-19 vaccination, 20.56% would prefer Influenza vaccination, 41.59% had equal preference, and 13.55% wanted neither. Discussion: Our study showed high PVES for both RCV and InV as well as high vaccination rates, but comparatively low intended rates of uptake of the Influenza vaccine and a potential COVID-19 vaccination. More research as to the reasoning behind this is needed in order to plan potential vaccination strategies.

2.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617070

ABSTRACT

Background: The COVID-19 pandemic posed unique challenges in the delivery of patient care across all subspecialties, including the paediatric cystic fibrosis (CF) service. In our Irish tertiary centre we sought to utilise technology to deliver the same standard of care to our patients whilst minimising their COVID-19 exposure risk. Methods: We established virtual CF outpatient appointments consisting of a consultant phone-call and subsequent contact with the different members of the multi-disciplinary team (MDT). Our "Drop-In" review service continued, with COVID-19 precautions added. Patient experiences of these clinics were evaluated using a five-point online questionnaire issued to parents at the end of 2020. Results: We achieved a response rate of 82 out of 125 (65.6%). A total of 50/82 (61%) found it "easy" to maintain contact with the CF team, with 7/82 describing it as either "somewhat difficult" or "difficult". In terms of OPD satisfaction as an alternative to face-to-face medical review, 67/82 (81.7%) described themselves as either "satisfied" or "somewhat satisfied" with the clinics. Only 2/82 (2.4%) were "dissatisfied" with the OPDs. A total of 66/82 (80.5%) felt it would be helpful to retain an element of the clinics going forward. The majority of respondents, 53/82 (64.6%), said that the pandemic had "no real effect" on their likelihood of attending for an in-person medical review, with 14/82 (17.1%) saying they were "much less likely" to attend. Only 3/82 were "more likely" to attend. Individualised comments were varied, with the increased use of technology, anxiety regarding COVID-19 exposure, and a desire to avoid the hospital, all frequent themes. Conclusion: Our results and feedback indicated a consistent parental desire to avoid the hospital and the perceived infection risk during the pandemic. However, our clinic arrangements did not increase parental feelings of isolation. The potential use of these clinics in conjunction with face-to-face visits should be considered as a viable option in paediatric CF outpatient management.

3.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617063

ABSTRACT

Background: Whilst the Irish Health Service Executive (HSE) currently recommends COVID-19 screening for all adult hospital admissions, current guidelines state that the screening of asymptomatic paediatric admissions is not necessarily required. However, clinically determining who requires testing can be difficult and subject to inter-carer variability. We sought to audit our acute admissions and swab results to determine rates of testing, characteristics of those being tested, and rates of positivity in a busy Irish tertiary paediatric unit. Methods: We reviewed the charts of 122 patients admitted acutely to our unit over the course of July 2021 to determine whether or not they had undergone COVID-19 screening using a nasopharyngeal PCR test and the clinical indication for testing. The clinical presentation of these admissions was analysed to try to determine positive predictive factors for COVID-19 screening and better streamline surveillance criteria. Results: A total of 122 admissions were analysed, with 74 (60.7%) having had a COVID-19 PCR test performed at the point of admission. Of these, 1 patient was found to be COVID-19 positive, giving an overall positivity rate of 0.8% amongst admissions analysed and 1.4% for admissions screened. The patient who returned a positive result was febrile at presentation but did not have any respiratory symptoms. Respiratory symptoms were documented for 45 of the 122 admissions (36.9%), and 42 of these underwent COVID-19 screening (93.3%). All swabs were negative. A total of 59 out of 122 were febrile at presentation, 55 (93.2%) of whom underwent screening. As above, 1 case tested positive. Of the afebrile patients, 19 out of 64 underwent COVID-19 screening. COVID-19 screening was performed in 12 patients who did not have a fever or respiratory symptoms at the time of presentation. In terms of non-respiratory presentations, screening was performed in 12 out of 14 (85.7%) presenting with gastritis/gastroenteritis, and 9 out of 12 (75%) presenting with a history and examination consistent with a UTI/pyelonephritis. Of 18 patients who were admitted with primarily psychiatric presentations, none had either a fever or respiratory symptoms at presentation, and none underwent COVID-19 screening. Conclusion: Our results reflect the existing data that COVID-19 appears to be less pathogenic in paediatric populations than in adult ones. Our low positivity rate compared to a high swab rate has repercussions in terms of bed allocation and isolation status. There is variation in terms of clinical criteria being viewed as sufficient to justify screening. Further study is required to determine consensus guidelines for COVID-19 surveillance in acute paediatric hospital admissions.

4.
Multiple Sclerosis Journal ; 27(2 SUPPL):271-272, 2021.
Article in English | EMBASE | ID: covidwho-1496034

ABSTRACT

Introduction: The COVID-19 pandemic has had a significant impact on research and health care in MS. This study-within-atrial (SWAT) takes place within a host trial investigating the feasibility of the Cognitive-Occupation-Based programme for people with MS (COB-MS) that was originally designed to be delivered in-person but was amended to an online environment. As such, reliable remote cognitive testing could provide safer and more convenient care for MS patients. Aims: The SWAT examines the reliability of delivering the Brief International Cognitive Assessment for MS (BICAMS) and the Trail-Making Test (TMT) remotely to people with MS. Objectives: Performance on BICAMS measures and the TMT administered remotely are compared with performance on tests administered in-person. BICAMS measures include the California Verbal Learning Test, Second Edition (CVLT-II), the Symbol Digit Modality Test (SDMT) and the Brief Visuospatial Memory Test-Revised (BVMT-R). Method: Independent samples t-tests were conducted on a sample of 68 participants to investigate differences in performance between Group 1 (11 males, 23 females), who were visited by a research assistant in their homes before the pandemic and Group 2 (10 males, 24 females) who received online testing only via teleconference platform Zoom. Within-group differences for Group 1 who also received virtual testing after a six-month interval were also examined. Results: The analysis revealed no significant differences in scores between virtual and in-person administrations of the CVLT-II, TMT and SDMT. Strong positive correlations were found for inperson and virtual tests within Group 1 after a six-month interval on the CVLT-II, SDMT, TMT-A and TMT-B. BVMT-R scores were significantly higher for virtual testing (M = 20.59, SD = 6.65) compared to in-person testing (M = 16.35, SD = 6.05). However, this discrepancy may be attributed to inter-rater differences, rather than enhanced performance for online testing. In-person and virtual assessments within Group 1 were also strongly correlated (r = .72). Conclusions: The findings support the reliability of remote administration of BICAMS and the TMT in people living with MS.

5.
Multiple Sclerosis Journal ; 27(2 SUPPL):724, 2021.
Article in English | EMBASE | ID: covidwho-1496003

ABSTRACT

Introduction: Traditionally, public and patient involvement (PPI) in research has included people with MS in consultation roles rather than deeper levels of 'involvement'. There has also been limited evidence regarding the impact that such involvement has on the person living with MS or on trials which employ people living with MS, as part of the research team. Here we report on the experiences of a person living with MS who is embedded in a clinical trial throughout the lifetime of the project- an embedded patient researcher (EPR). Aims & Objectives: The aim of this research is to explore and present an embedded patient researcher's (EPR) perspective on PPI integration within a feasibility trial of a Cognitive Occupation- Based programme for people living with MS (COB-MS), with respect to the PPI impact on trial feasibility and potential success. Methods: This presentation is focused on three specific examples of EPR impact, participant recruitment, trial materials and adapting to the impact of the SARS-Cov-2 pandemic on the trial. Due to the high level of PPI integration within COB-MS, significant amendments were made. Results: As a result of a high level of PPI integration, the research team identified the recruitment of between 34% - 62% of participants as a result EPR involvement, which also influenced the decision to extend the role of the EPR to include Patient Advocacy. The EPR's involvement facilitated the development of more accessible trial materials for participants with MS and the development of online protocols for the treatment and assessment of participants. Conclusion: When fully integrated into a trial, PPI - along with the inclusion of an EPR - has the potential to improve participant recruitment, trial material development and adaptability as a result of external factors impacting the trial (with respect to being more suitable for participants with MS.) It has also encouraged the EPR to develop further as a Patient Advocate, by sharing their experience with patients wanting to become more involved in research as well as researchers and educators who want to incorporate PPI in their research or training.

6.
Pediatr Res ; 89(7): 1604-1605, 2021 05.
Article in English | MEDLINE | ID: covidwho-1428794
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