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1.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617061

ABSTRACT

Background: Known risk factors for child maltreatment, including parental unemployment and domestic violence (1, 2), were compounded by social isolation from school closures and restriction of home visitors during the COVID-19 lockdown. Data on the incidence of child maltreatment during the pandemic is limited. Aim: Our study aimed to compare the incidence of and characterize the types of child protection concerns among inpatients during the 2020 lockdown versus the same period in 2019. Methods: We carried out a retrospective chart review of inpatients at Children's Health Ireland (CHI) at Crumlin and CHI at Tallaght assessed for child protection concerns during the lockdown from March 13 to August 31, 2020, and the same timeframe in 2019. Results: Fewer patients with child protection concern were admitted in 2020 (n=86) compared to 2019 (n=163). Total admissions were also less in 2020 (n=4609) compared to 2019 (n=7728). Patients assessed for child protection concerns accounted for a smaller percentage of inpatients in 2020 (1.8% versus 2.1% in 2019 (p=0.35)). In 2020, there was a greater percentage of physical (52.3% versus 11% in 2019 (p<.001)) and emotional (6.9% versus 1.2% in 2019 (p=0.014)) abuse concern cases. There was also a greater percentage of neglect and sexual abuse concern cases and a lower percentage of welfare concern cases in 2020, but these differences were not statistically significant. The cases in 2020 were more complex, with 48.8% involving more than one concern type per case versus 13.4% in 2019 (p<.001). Child protection concerns increased steadily during the lockdown, peaking in July. In 2020, there were more unwitnessed injuries (34.8% versus 17.7% in 2019 (p=.002)) and parental use of physical discipline (6.9% versus 0.6% in 2019 (p=.003)). No statistically significant differences in delayed presentation and domestic violence were observed. Conclusions: While fewer inpatients were assessed for child protection concerns during the 2020 lockdown versus 2019, the 2020 cases were more complex. An increase in physical and emotional abuse concerns, unwitnessed injuries and physical disciplining highlights child protection issues specific to the pandemic.

2.
Palliative Medicine ; 35(1 SUPPL):225, 2021.
Article in English | EMBASE | ID: covidwho-1477132

ABSTRACT

Aim or goal of the work: The Necessary Discussions project developed a COVID-centric advance care planning (ACP) online training resource for nursing homes, with the aim of improving resident care at the end of life during a COVID-19 outbreak. A bespoke website has been designed to deliver information to residents, family members and nursing home staff, with the aims of increasing awareness and understanding of advance care planning, and to support communication and shared decision-making. Design, methods and approach taken: Development of the website took place between late 2020 and early 2021, and was informed by a rapid review of existing literature and support from members of the project's Expert Reference Group, comprised of practitioners, academics and public involvement representatives. Existing ACP resources were synthesised and tailored for COVID-19. Results: The resulting website is accessible and engaging, offering a COVID-19 specific resource for advance care planning. Distinct modules provide information appropriate for care staff and family members. Supplementary videos were produced offering advice from experts in the field. Further reading and additional resources are linked to from the website, and there is a strategic emphasis on self-care alongside care provision. Conclusion / lessons learned: This project demonstrates how to develop accessible information for care staff and family members in a COVID-19 context. The project also identifies effective methods of virtual team working and group collaboration during COVID-19.

3.
Palliative Medicine ; 35(1 SUPPL):57, 2021.
Article in English | EMBASE | ID: covidwho-1477088

ABSTRACT

Background: End of life conversations can be difficult for both family carers and nursing home staff and can result in 'missed conversations' regarding resident's disease progression and health status. During COVID-19, communication between family carers and nursing home staff has proven particularly difficult. Ensuring nursing home staff are educated in how to hold conversations on end of life (EoL) is essential. Aim: To educate nursing home staff to hold EoL conversations during a pandemic using the virtual learning environment CANVAS. Methods: Using a Train the Trainer approach an online training course was developed using Fleming's VARK model. This provided resources for an external facilitator to support nursing home staff in holding EoL conversations with family carers virtually. Using the Comfort Care Booklet, modules included strategies to support nursing home staff in communication, good practice and handling challenging situations. Training was provided for external facilitators across six countries who would then support nursing home staff virtually on holding conversations in a virtual environment. Training statistics and anonymised evaluation data were captured by the CANVAS platform. Results: Twelve facilitators from six countries completed online training (internal and external);Canada (n=1), Czech Republic (n=1), Netherlands (n=2), Republic of Ireland (n=1), United Kingdom (n=5). Training to date has been received well. In total 100% of participants found training to be beneficial. Preliminary feedback included 'Canvas was good and easy to navigate';'Training excellent and covered all aspects for the internal and external facilitator'. Conclusion: Supporting online education of nursing home staff is accessible and feasible to deliver at an international level. Preliminary data signals that even with social distancing restrictions, nursing home staff can still be supported to hold conversations with family carers virtually regarding resident's EoL needs.

4.
European Journal of Comparative Law and Governance ; 7(3):225-229, 2020.
Article in English | Scopus | ID: covidwho-901514
5.
Heart Lung Circ ; 29(6): e69-e77, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-664510

ABSTRACT

The global coronavirus disease (COVID-19) pandemic poses an unprecedented stress on healthcare systems internationally. These Health system-wide demands call for efficient utilisation of resources at this time in a fair, consistent, ethical and efficient manner would improve our ability to treat patients. Excellent co-operation between hospital units (especially intensive care unit [ICU], emergency department [ED] and cardiology) is critical in ensuring optimal patient outcomes. The purpose of this document is to provide practical guidelines for the effective use of interventional cardiology services in Australia and New Zealand. The document will be updated regularly as new evidence and knowledge is gained with time. Goals Considerations.


Subject(s)
Betacoronavirus , Consensus , Coronavirus Infections , Critical Care , Intensive Care Units , Pandemics , Pneumonia, Viral , Australia/epidemiology , COVID-19 , Cardiology/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Humans , New Zealand/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Practice Guidelines as Topic , SARS-CoV-2
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