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1.
Journal of Mental Health Policy and Economics ; 25:S23-S23, 2022.
Article in English | Web of Science | ID: covidwho-1866051
2.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329099

ABSTRACT

Oncology has been undergoing a profound transition in the last ten years or more with the increased usage in oral anti-cancer medication (OAM). Approximately 25% of all anti-cancer medication is now designed for oral use and this is likely to increase prospectively. Oral anti-cancer medications have the potential to alleviate capacity issues in cancer treating units as patients receive their treatment at home. There remains however a requirement for safe and efficient assessment and monitoring but this does not necessarily require them to repeatedly attend a hospital day unit. Therefore the opportunity exists to transition this cohort to a community-based setting to be assessed by a specialist such as an Advanced Nurse Practitioner (ANP) in nurse-led clinics. Having an OAM assessment closer to their home would be more convenient to the patient. Furthermore, this could help alleviate hospital capacity issues which were brought into sharp focus with the onset of the COVID-19 pandemic and the use of nurse-led clinics are promoted in the aims of the current healthcare system reform process in Ireland. Within the context of the Irish healthcare system reform and the COVID-19 pandemic this protocol will outline a collaboration between an Oncology Department in Letterkenny University Hospital in Ireland and the National University of Ireland, Galway aimed to develop and pilot a community-based Advanced Nurse Practitioner-led integrated oncology care model for adults receiving OAM. Phase 1 of this two-phase study commenced in September 2020 and comprised a scoping review, a benchmarking exercise and a qualitative analysis of relevant stakeholders. This protocol paper presents a pilot to be undertaken in phase 2 as OAM care is transitioned to an ANP-led community-based model, which is a radical shift for oncology care in Ireland. The pilot outlined will provide data that will identify potential refinements to the model and address specific uncertainties about a definitive trial.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315103

ABSTRACT

Policy makers have implemented multiple non-pharmaceutical strategies to mitigate the COVID-19 worldwide crisis. Interventions had the aim of reducing close proximity interactions, which drive the spread of the disease. A deeper knowledge of human physical interactions has revealed necessary, especially in all settings involving children, whose education and gathering activities should be preserved. Despite their relevance, almost no data are available on close proximity contacts among children in schools or other educational settings during the pandemic. Contact data are usually gathered via Bluetooth, which nonetheless offers a low temporal and spatial resolution. Recently, ultra-wideband (UWB) radios emerged as a more accurate alternative that nonetheless exhibits a significantly higher energy consumption, limiting in-field studies. In this paper, we leverage a novel approach, embodied by the Janus system that combines these radios by exploiting their complementary benefits. The very accurate proximity data gathered in-field by Janus, once augmented with several metadata, unlocks unprecedented levels of information, enabling the development of novel multi-level risk analyses. By means of this technology, we have collected real contact data of children and educators in three summer camps during summer 2020 in the province of Trento, Italy. The wide variety of performed daily activities induced multiple individual behaviors, allowing a rich investigation of social environments from the contagion risk perspective. We consider risk based on duration and proximity of contacts and classify interactions according to different risk levels. We can then evaluate the summer camps' organization, observe the effect of partition in small groups, or social bubbles, and identify the organized activities that mitigate the riskier behaviors. [...]

4.
Cancer Epidemiology Biomarkers and Prevention ; 31(1 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1677421

ABSTRACT

Introduction: Community Scientist (CS) programs - often referred to as Citizen Scientist programs - that facilitate direct engagement between scientific researchers and community members have emerged as effective strategies for building community trust in scientists and better informing research design and dissemination to address true community needs. While population health research has increasingly incorporated community stakeholders into the research continuum, basic and translational sciences struggle to do the same and may contribute to cancer disparities. We designed and implemented a virtual CS program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University (LCC). We report barriers, facilitators, and lessons learned. Methods: Translational scientists (TSs) were recruited from among LCC investigators, and CSs were identified for participation from among LCC community networks. We sought to recruit a CS cohort representing LCC's catchment area and a TS cohort whose research focuses on cancers most impacting LCC catchment. CS program interactions included monthly meetings between two CSs and one TS wherein the CS-TS triad discuss TS research in lay terms and work together to co-create educational infographics suitable for dissemination to the catchment and LCC scientists. Virtual attendance was tracked and meeting recordings retroactively reviewed to identify and create product development. Results: Six CSs and three TSs agreed to participate in the CS program. The CS cohort includes cancer survivors, patient advocates, community organization leaders, a nurse, and an educator, while the TS cohort includes breast, prostate, and lung cancer researchers. Currently, 11 of 18 triad meetings have been completed, with attendance averaging 97%. Barriers to program implementation have included technological difficulties, restrictions on in-person meeting, scheduling conflicts, time limitation, and language barriers, while facilitators have included small group meetings to promote comfortable group-member contribution, presence of a trained facilitator, articulation of achievable meeting goals and mission for product creation, and clear assignment of team roles. Conclusion: The COVID-19 pandemic has illuminated pre-existing needs for improved connectivity between communities impacted by cancer disparities and cancer researchers. By identifying current barriers and facilitators to successful virtual CS program implementation, our findings can be used to guide development and implementation of similar programs at LCC and other cancer centers that are aimed at mitigating cancer health disparities.

5.
Irish Journal of Medical Science ; 190(SUPPL 6):S249-S250, 2021.
Article in English | Web of Science | ID: covidwho-1610263
6.
Asia Policy ; 16(4):66-76, 2021.
Article in English | Scopus | ID: covidwho-1596271

ABSTRACT

U.S. president Joe Biden has announced that “America is back,” and in contrast to his predecessor’s unilateral and transactional “America first” policy, he has sought to assure world leaders of the U.S. commitment to multilateralism and renewed engagement with allies and partners. The Biden administration, however, has taken office at a time when Southeast Asian perceptions of U.S. power have declined dramatically. According to the ISEAS–Yusof Ishak Institute’s “State of Southeast Asia: 2021 Survey Report,” 49% of Southeast Asian elites view China as the region’s most influential political and strategic power compared to only 30% for the United States, a marked shift from a decade ago.1 Rising Southeast Asian concerns about China’s growing economic and strategic influence, combined with a desire for assistance in overcoming the Covid-19 health and economic crises, create opportunities for the Biden administration to enhance ties in the region. At the same time, long-standing concerns about U.S. commitment to the region and a fear that the intensifying U.S.-China rivalry will pressure Southeast Asian states to choose sides are key obstacles to strengthening ties. China is the largest trading partner of most Southeast Asian states and a leading source of investment across the region. Leaders seeking to maintain their strategic autonomy in an increasingly complex external environment may welcome the Biden administration’s pledge of renewed attention and support for allies and partners, but no state wants to be forced into a binary choice between Washington and Beijing. © 2021, Asia Policy. All Rights Reserved.

8.
Thorax ; 76(Suppl 2):A76, 2021.
Article in English | ProQuest Central | ID: covidwho-1506807

ABSTRACT

Introduction and ObjectivesThe Covid-19 pandemic has driven forward a number of remote monitoring schemes (virtual wards) across the country to support the early discharge of patients with covid-19. Technology can assist clinical teams to deliver comprehensive care in the community. In this study we aim to evaluate the safety and effectiveness of an innovative, telehealth-led virtual ward for Covid-19.MethodsPatients discharged from hospital respiratory wards with a diagnosis of Covid-19 and deemed at risk of readmission (or requiring home oxygen weaning) were eligible for referral. Monitoring equipment (thermometers and digital pulse oximeters) was provided and patients were on-boarded into a telehealth platform prior to discharge. Smartphones and tablets were supplied by the service if required. A Covid-19 digital clinical question set and triaging algorithm was developed locally. Patients were instructed to complete it daily remotely during follow-up and to enter their observations three times daily. Clinical data fed into a dashboard reviewed daily by the community respiratory specialist team who would contact and assess patients submitting symptoms of concern. Monitoring lasted for up to 14 days, and escalation processes to the acute Trust were in place for those patients showing evidence of deterioration.Results218 patients were monitored between December 2020 and May 2021, 29 for oxygen weaning. 41% were female, mean age 57 years old (minimum 21, maximum 89). Average oxygen weaning time was 11 days, with 319 days of hospital bed days saved by the oxygen weaning service and an estimated £127,600 cost saving to the system. Only 10 patients (4.9%) were readmitted after 14 days (versus 9% in usual care from hospital Covid-19 wards). Four patients (1.8%) died in hospital after a readmission. 83% of patients felt ‘very supported’ by the service and 73% expressed that it had ‘fully’ improved their confidence. Average score of satisfaction with the service, measured by a self-reported questionnaire, was 9.9/10.ConclusionsA telehealth-assisted remote monitoring service for Covid-19 is a safe way to provide specialist care at home and can reduce hospital readmissions whilst improving patient experience.

9.
Journal of Urology ; 206(SUPPL 3):e427-e428, 2021.
Article in English | EMBASE | ID: covidwho-1483612

ABSTRACT

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic altered the landscape of the 2020-2021 urology residency application cycle in a myriad of ways. The need for social distancing and travel limitations shifted in-person away rotations to virtual rotations and the in-person interview to a new virtual format. Previous surveys had suggested that aspects of this might be favorable for students, as 20% of applicants in previous years had limited the number of interviews they attended for financial reasons. At the same time, concerns were raised about how these changes would affect the overall match rate and the geographic diversity of applicants. Our study aimed to assess the effect of the COVID-19 pandemic by looking at Match outcomes by student location. METHODS: Using residency websites, Twitter, and publicly available documents, we gathered the previous five years of match data (2015-2020) from all urology residency programs across the United States and documented the number of residents each program kept from its affiliated medical school. We also documented the number of residents each program took from within its associated AUA section compared to the students it took from other AUA sections for the past five years. We then compared the 2015-2020 match data to the 2020- 2021 match data. RESULTS: There were 357 residency positions offered in the 2020-2021 match year and a total of 1,632 residency spots offered from 2015-2020. For the 2020-2021 match year, residency programs matched 19.7% of students from their home institution;significantly more compared to programs from 2015-2020 only keeping 15.6% (p=0.046). Significantly more programs kept students from within their AUA section in 2020-2021 at 48.6% compared to 41.61% from 2015- 2020 (p=0.018). Despite the largest number of applicants in 7 years, the 2021 urology match had a 74% match rate, no unfilled residency spots, and 85% match rate for female applicants. CONCLUSIONS: We found that programs kept significantly more students from their home medical school this year than the past five years and programs also accepted significantly more students from within their AUA section. It is possible that protective and long-term relationships within home institutions and AUA sections may have had a larger impact without the usual away rotations or in-person interviews. It is also relevant to reflect on the mammoth adjustments made to the process this year, especially considering some of them may be popular among applicants seeking to maximize applications submitted and minimize money spent.

10.
Colorectal Disease ; 23(SUPPL 1):107, 2021.
Article in English | EMBASE | ID: covidwho-1457738

ABSTRACT

Purpose: Acute appendicitis is the most common cause of an acute abdomen. The COVID-19 pandemic has affected the management of acute appendicitis. Initial guidelines advised the use of laparoscopy only if benefits substantially exceeded the risk of potential viral transmission. The main aim of this study was to evaluate the trends in surgical management of appendicitis in the first year of COVID-19 in a tertiary referral centre in Ireland. Methods: A retrospective review of all appendicectomies in a tertiary hospital from January to December 2020 was performed. Basic demographic data was collected along with information on operative approach, conversion to open, laboratory and radiological investigations and histopathology. Results: 452 appendicectomies were identified. More males were affected, at 52.5%. The mean age was 25 years (range: 3-85 years). Laparoscopic appendicectomy was performed in 97% of cases (n = 438). All appendicectomies in January and February were laparoscopic. 66.6% of all open appendicectomies performed were in March and April (n = 4). Regarding these 4 open appendicectomies, none were perforated and 3 were paediatric patients. Open appendicectomies outside of these months (n = 2) were for complicated appendicitis. A combination of laparoscopic and open technique was required in 9 cases. Conclusion: The first phase of Covid-19 in Ireland resulted in a significant increase in the number of open appendicectomies, when concerns surrounded the potential aerosolisation of the virus during laparoscopic procedures. It was not a result of case complexity. This was not mirrored in Phase 2 of the pandemic in September and October.

11.
18th ACM Conference on Embedded Networked Sensor Systems, SenSys 2020 ; : 760-761, 2020.
Article in English | Scopus | ID: covidwho-1452962

ABSTRACT

Devices to support social distancing must be energy-efficient and accurate. Bluetooth Low Energy (BLE) meets the first criteria but falls short on the latter. Ultra-wideband (UWB) measures distances with <10 cm error but with relatively high consumption. Therefore, we built Janus, a dual-radio protocol that uses the strengths of each. © 2020 Owner/Author.

13.
Journal of Urology ; 206:E427-E428, 2021.
Article in English | Web of Science | ID: covidwho-1407750
14.
British Journal of Dermatology ; 185:121-121, 2021.
Article in English | Web of Science | ID: covidwho-1396164
15.
Irish Medical Journal ; 114(5), 2021.
Article in English | EMBASE | ID: covidwho-1326484

ABSTRACT

Aims Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China in 2019 and is responsible for the condition known as COVID-19. COVID-19 was first reported in Ireland in February 2020 with University Hospital Limerick’s (UHL) first paediatric case reported on 4th March 2020. Studies have shown clinical manifestations of children’s cases are generally less severe than those of adults. UHL serves a catchment population of approximately 100,000 children. We aimed to describe the clinical presentation, and prevalence of SARS-CoV-2, in children requiring inpatient hospitalization during the initial phase of the pandemic in Ireland. Methods Data were examined relating to all inpatients aged 0 – 16 years admitted with a queried or confirmed diagnosis of COVID-19 from 8th February 2020 to 8th June 2020. Emergency Department notes and inpatient records along with laboratory and radiology records were reviewed. Results 220 paediatric inpatients were tested by PCR for SARS-CoV-2 during this period;101 (45.9%) were female. Ninety-five (43.2%) were diagnosed with ‘viral illnesses’. Seven (3.2%) had laboratory-confirmed SARS-CoV-2, with an average age of 8.1 years (range: 0.59 years to 13.77 years). There were two Kawasaki-like illnesses admitted;both tested negative for SARS-CoV-2 on PCR. In our SARS-CoV-2 positive cohort, there was no associated significant morbidity and no associated mortality. Conclusion During the initial phase of the COVID-19 pandemic, prevalence of confirmed SARS-CoV-2 in symptomatic hospitalised children was low at 3.2%.

18.
Journal of the American College of Cardiology ; 76(17):B98-B99, 2020.
Article in English | EMBASE | ID: covidwho-887093

ABSTRACT

Background: The coronavirus disease-2019 pandemic has restricted availability of intensive care unit resources. Symptomatic patients with coronary artery disease considered surgical candidates have therefore needed revascularization with percutaneous coronary intervention (PCI). We describe demographics/in-hospital clinical outcomes of this novel cohort. Methods: From March 1, 2020, to May 31, 2020, anonymized data of 171 patients in 38 U.K. centers were enrolled in a prospective registry. All were considered surgical candidates. Results: Tables 1-3 show demographics, procedural characteristics, and outcomes. A comparison with routine PCI (British Cardiovascular Intervention Society data) and U.K. coronary bypass surgical data are listed if available and appropriate. There was significantly more prior myocardial infarction, PCI, and coronary artery bypass graft in the routine PCI database than in ReVasc Registry patients, suggesting more acute presentation in latter group. However, these were complex patients — mean SYNTAX score of 27.8 (range 9 to 65);and >20 times the number of LMS plus multivessel disease compared to the routine PCI group, with high use of adjunctive imaging. Radial use was high at 94.1%. PCI success was 97.0%. Complete revascularization was 52% and residual SYNTAX score 1.42 (0 to 20). The 2 deaths were acute, and mortality rate comparable to published surgical data. A 50% reduction in in-patient stay was observed. [Formula presented] Conclusion: In this multicenter U.K. registry, in-hospital outcomes with PCI for patients with complex coronary disease, normally treated with coronary artery bypass graft, compared well with surgical data suggesting the role of PCI could be extended. Future long-term follow-up is planned. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)

19.
Journal of Investing ; 29(5):121-130, 2020.
Article in English | Scopus | ID: covidwho-879682

ABSTRACT

This article evaluates several investment scenarios that could result from the rather dire economic situation existing in early 2020 caused by the coronavirus pandemic that is restricting economic production of goods and services at the same time that cost-push factors and the unlimited creation of money by central banks worldwide create upward inf lationary pressures. Just as during the similar situation in Germany in 1923, the nominal prices of both equities and fixed-rate instruments might be propped up, but all security investments would generate highly negative real returns short-term. Only stock prices might eventually match the inflation rate. Copyright © 2020 Pageant Media Ltd.

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