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2.
Age and ageing ; 50(Suppl 3), 2021.
Article in English | EuropePMC | ID: covidwho-1601897

ABSTRACT

Background Nationally agreed standards improve the level of care delivered to all older, frail, multi-morbid patients presenting with hip fractures. Dedicated Orthogeriatric services allow for these standards to be achieved in a multi-disciplinary team (MDT) setting. As the COVID-19 pandemic reached our shores, the model of care set out by the Irish Hip Fracture Standards (IHFS) was under threat. Our dedicated Orthopaedic Trauma ward became an acute COVID ward and the Orthogeriatric service was re-deployed to acute medicine for Quarter 2. Methods Using the Irish Hip Fracture Database, local data was analysed and compared with national data from Quarter 1 to 4 (Q1–4) in 2020. Results When comparing local IHFS’s with national figures, ongoing challenges and future goals are highlighted. In 2020, there were 222 hip fracture patients (mean age 81.8 years) in our hospital. Standard 1, time to the ward <4 hours, stands at 71% locally (national average 33%). Standard 2, time to theatre <48 hours, is an ongoing challenge and remains at 66% (national average 75%). Standard 3, pressure ulcer rate, was the same as the national average at 3%. Standards 4, 5 and 6 in our hospital stand at 87% (national averages of 82%, 91% and 85% respectively). In Q1, 56%, or over 1 in every 2 patients with hip fractures, met all of the Irish Hip Fracture Standards in our hospital. In Q2, only 18% of patients met all of the IHFS’s. Q3 saw improvements with 47% of all hip fracture patients achieving all IHFS’s. Q4 showed maintenance with 45% of all patients achieving all IHFS’s. Conclusion These findings highlight the need for a dedicated Orthogeriatric Service and Orthopaedic ward at all times. Going forward with the risk of future waves and the emergence of new variants, every effort should be made to maintain a comprehensive orthogeriatric service to minimise a negative impact on patient care.

3.
PUBMED; 2021.
Preprint in English | PUBMED | ID: ppcovidwho-293159

ABSTRACT

All coronaviruses (CoVs) contain a macrodomain, also termed Mac1, in non-structural protein 3 (nsp3) which binds and hydrolyzes ADP-ribose covalently attached to proteins. Despite several reports demonstrating that Mac1 is a prominent virulence factor, there is still a limited understanding of its cellular roles during infection. Currently, most of the information regarding the role of CoV Mac1 during infection is based on a single point mutant of a highly conserved asparagine-to-alanine mutation, which is known to largely eliminate Mac1 ADP-ribosylhydrolase activity. To determine if Mac1 ADP-ribose binding separately contributes to CoV replication, we compared the replication of a murine hepatitis virus (MHV) Mac1 mutant predicted to dramatically reduce ADP-ribose binding, D1329A, to the previously mentioned asparagine mutant, N1347A. D1329A and N1347A both replicated poorly in bone-marrow derived macrophages (BMDMs), were inhibited by PARP enzymes, and were highly attenuated in vivo . However, D1329A was significantly more attenuated than N1347A in all cell lines tested that were susceptible to MHV infection. In addition, D1329A retained some ability to block IFN-beta transcript accumulation compared to N1347A, indicating that these two mutants impacted distinct Mac1 functions. Mac1 mutants predicted to eliminate both binding and hydrolysis activities were unrecoverable, suggesting that the combined activities of Mac1 may be essential for MHV replication. We conclude that Mac1 has multiple roles in promoting the replication of MHV, and that these results provide further evidence that Mac1 could be a prominent target for anti-CoV therapeutics. IMPORTANCE: In the wake of the COVID-19 epidemic, there has been a surge to better understand how CoVs replicate, and to identify potential therapeutic targets that could mitigate disease caused by SARS-CoV-2 and other prominent CoVs. The highly conserved macrodomain, also termed Mac1, is a small domain within non-structural protein 3. It has received significant attention as a potential drug target as previous studies demonstrated that it is essential for CoV pathogenesis in multiple animal models of infection. However, the various roles and functions of Mac1 during infection remain largely unknown. Here, utilizing recombinant Mac1 mutant viruses, we have determined that different biochemical functions of Mac1 have distinct roles in the replication of MHV, a model CoV. These results indicate that Mac1 is more important for CoV replication than previously appreciated, and could help guide the development of inhibitory compounds that target unique regions of this protein domain.

4.
United European Gastroenterology Journal ; 9(SUPPL 8):317-318, 2021.
Article in English | EMBASE | ID: covidwho-1490991

ABSTRACT

Introduction: UBT is the most accurate non-invasive test for H.pylori infection. The orally given urea, labelled with C13, is hydrolysed by the enzyme urease of H.pylori and C13O2 is measured expired in breath. UBT was our gold standard diagnostic test for H.pylori. This practice changed abruptly in March 2020, when our first wave of coronavirus -2 (SARS-CoV-2) started. UBT carries the risk of contamination by SARS-CoV-2 in the aerosol droplets generated by exhaled air. The British Society of Gastroenterology guideline at that time graded UBT as Aerosol Generating Procedure and therefore at high risk for transmission. Only emergency gastroenterology high risk procedures were recommended during restrictions which effectively terminated our standard UBT service. To maintain a non-invasive diagnostic option we developed a novel virtual test. C13 UBT At Home, is performed by patients at home with step by step instructions involving live video conference interaction between the patients and technicians. Aims & Methods: To determine the acceptability and the accuracy of the novel C13 UBT At Home service. Patients on a UBT waiting list were contacted and invited to undergo the alternative virtual breath test. Willing participants were pre assessed over phone to explain the process. Technical aspects (internet, smart phone or laptop requirements), navigation through the video call system attendanywhere and routine clinical parameters including PPI and antibiotic use were discussed. Suitable patients collected a Home UBT kit (Patient information sheet, test documentation, pre and post collection tubes, collection straw, urea tablet and feedback questionnaire) from a drop off point up to a week prior to their scheduled appointment. The test was performed as standard by the patient at home with live interaction for all active steps. The 20 minute rest between samples 1 and 2 collection was offline which allowed technicians to do concurrent cases. Patients were requested to fill in a feedback questionnaire after the test and to return it with the samples to the drop off point within 48 hours for analysis. The questionnaire included 6 questions covering pre procedure, procedure and post procedure domains. In addition to patient satisfaction, positivity rate, sample error rate and activity numbers were compared between UBT at home and a standard UBT cohort which was reinstated in 2021. Results: 300 patients were enrolled, mean age 41 years (range 7-85), 177 female (59%). Overall response rate was 96% (288), 96% (285) rated the entire UBT at home process as either excellent or good. All other parameters except connection to the hospital video call system, which was subject to external factors were also rated excellent/good by >90%. Accuracy between UBT tests was similar: positivity rate 23% (69/299) versus 22% (74/326), sample error rate 0.33% (1/300) versus 0.6% (2/326) for the UBT at home and standard tests respectively. Currently 3 of every 4 UBT's is now virtual despite reduced restrictions. Conclusion: UBT at home is possible and acceptable to patients with equivalent accuracy to standard UBT and should be continued to improve patient choice and satisfaction.

5.
UNSCN News ; 45:83-86, 2020.
Article in English | CAB Abstracts | ID: covidwho-1308720

ABSTRACT

This article aims to discuss the role of a novel app, called Food2Share, developed at New York University (NYU). The study describes the potential of the app to alleviate hunger and food insecurity and simultaneously reduce food waste. The app is an example of a digital marketplace, designed to connect stakeholders and local communities, to help vulnerable New York City populations to obtain food. The app will be instrumental in scaling up efforts to combat food insecurity and to provide safe and nutritious foods through widespread local community outreach. Lastly, the study discusses how the Food2Share app may be adapted for global settings- particularly relevant during the COVID-19 pandemic. The Public Health Nutrition research group and technology experts at New York University have partnered to develop a prototype app, Food2Share, which connects food-insecure individuals with food establishments. Food salvaging is a strategy to recover food that would otherwise go to waste from restaurants, supermarkets and other food establishments and redistribute it to local food programmes and communities. The aim of the app is to improve and scale up food salvaging and redistribution efforts. To ensure that everyone has access to sufficient food, they must innovate by developing technology-enabled initiatives to increase food security and reduce food waste. Public-private partnerships can yield initiatives that can be replicated globally. Digital platforms need to be piloted to ensure that they are scalable and sustainable. Evaluation must ensure access to vulnerable, food-insecure populations. During the COVID-19 pandemic, with food establishments forced to close, many owners have risen to the challenge of providing food to those in need and to front-line responders through grassroots food-distribution initiatives. Scaling up these initiatives using technology and applying them to the global context could expand the efforts they have witnessed during the crisis. The Food2Share app is one illustration of a community initiative that connects food-insecure individuals with food establishments with excess prepared food and individuals willing to engage in helping those in need.

6.
Annals of Oncology ; 32:S202, 2021.
Article in English | EMBASE | ID: covidwho-1287491

ABSTRACT

Background: The emergence of the COVID-19 virus in 2020 led to unprecedented challenges in the way oncologic care is organized to guarantee treatment continuation for patients with cancer. The SCOPE COVID-19 survey aimed to assess the impact of the COVID-19 pandemic on third-line treatment goals in patients with metastatic colorectal cancer (mCRC) and compare it with daily practice patterns from the pre–COVID-19 era. Methods: An expert panel of gastrointestinal oncologists developed the survey, which was undertaken between October 2020–January 2021. Questions were designed to evaluate the practice patterns during this time and assess the future impact of COVID-19 on treatment decisions. The survey was conducted online using FocusVision Decipher. Oncologists from 14 countries, the majority of which were in Europe, participated. Results: As of 31 January 2021, there were 228 respondents. The majority were medical oncologists (89%), aged between 35–55 years (62%), practiced in a university hospital (49%), and saw between 10–29 patients with mCRC/month (53%). Overall, few restrictions affecting cancer patient management, such as staff being redeployed, were reported by the majority of oncologists (84%). That said, there were a number of changes to practice patterns: the most frequent were a reduction in the number of hospital visits (83%), increased use of virtual consultations/telemedicine (82%), increased frequency of prescribing oral versus intravenous (IV) treatments (73%), and an increase in follow-up/monitoring procedures done closer to home (73%). The third-line treatment goals remained similar to the pre-COVID era;preserving quality of life remained the singular most common primary goal (36%), while 42% of respondents cited efficacy-focused goals, such as prolonging overall survival and improving progression-free survival as their main aim. Overall, 93% of oncologists opined that treatment decisions over the next 12 months will be influenced by the pandemic. While 86% predicted a return to normal for the initial visits for new patients, thereafter and for ongoing patients, 83% foresee that there will be a continued increase in the use of virtual consultations/telemedicine, 80% envision reduced frequency of hospital visits, and 74% foresee the increased frequency of prescribing oral versus IV treatments to be maintained, as well as follow-up being undertaken closer to home. In total, 40% of oncologists believe that the changes to existing protocols, incurred as a result of the pandemic, will be in effect for at least a year. Conclusions: The main third-line treatment goals for patients with mCRC remained the same during the COVID-19 pandemic. However, there were changes to the daily practice patterns. There was an increased use of oral versus IV therapies, and more follow-up and monitoring procedures were undertaken closer to home. Patients visited hospitals less frequently, with a shift toward virtual consultations/telemedicine, practices that are thought to continue for the foreseeable future. The latter observation suggests there is a need to further develop and invest in all aspects of digital health. Editorial acknowledgement: Medical writing support was provided by Joanne Franklin, PhD, CMPP, from Aptitude Health, The Hague, the Netherlands, and funded by Les Laboratoires Servier, France. Legal entity responsible for the study: The authors. Funding: Les Laboratoires Servier, France. Disclosure: G. Prager: Advisory / Consultancy: Merck, Roche, Amgen, Sanofi, Lilly, Bayer, Servier, Taiho, CECOG, MSD, BMS, Pierre Fabre. F. Rivera Herrero: Honoraria (Institution): Roche, Merck-Serono, Amgen, Sanofi, MSD, BMS, Servier;Advisory / Consultancy: Roche, Merck-Serono, Amgen, Sanofi, MSD, BMS, Servier;Research grant / Funding (self): Roche, Merck-Serono, Amgen, Sanofi, MSD, BMS, Servier;Research grant / Funding (institution): Roche, Merck-Serono, Amgen, Sanofi, MSD, BMS, Servier. H. Wasan: Honoraria (self): Servier, Incyte, Pierre Farbre;Advisory / Consultancy: Servier, Incyte, Pierre Farbre;Speaker Bure u / Expert testimony: Servier, Incyte, Pierre Farbre;Research grant / Funding (institution): Pfizer, Sirtex;Travel / Accommodation / Expenses: Servier, Incyte, Pierre Farbre. All other authors have declared no conflicts of interest.

9.
Irish Journal of Medical Science ; 190(SUPPL 1):S14-S14, 2021.
Article in English | Web of Science | ID: covidwho-1063833
10.
Cultural Trends ; 2020.
Article in English | Scopus | ID: covidwho-891411

ABSTRACT

Australia has witnessed long-standing cuts in the arts and culture federal budget. Most recently, the disappearance of the arts portfolio into a “super-ministry” along with infrastructure, transport, regional development and communications further signals the lack of support, both ideologically through public rhetoric, and financially through (absent) support packages, the current federal government holds towards the arts and arts workers. This paper accounts for how such ideological fractures have underserved freelancers, casuals, temporary and part-time workers in the arts who missed out on the critical initial support packages, and how state governments were more willing to make up for this initial shortfall. This paper further accounts for how the federal government lacks the necessary understanding of working patterns of those engaged in creative occupations, and over emphasizes funding bailouts for primary industry. This also has broader implications for how women are disproportionately impacted by sectors the federal government chooses to support. © 2020 Informa UK Limited, trading as Taylor & Francis Group.

11.
Cultural Trends ; 2020.
Article in English | Scopus | ID: covidwho-891410

ABSTRACT

In this introduction, we outline the context for the international emergence of cultural policy responses to the COVID-19 pandemic. Our article first offers a general account of how arts and culture have been affected by the pandemic, before looking at some of the state interventions (bailouts’) to support the professional sector, and the present and future conditions they might be seeking to preserve or occasion. We then examine the UK as a particular case study. In rejecting a politics of “bailout” and “return”, and in synchrony with others seeking to situate culture in a re-vitalised political economy, we argue that professional arts and culture needs to move forward with a “new deal” in hand;one that can enhance culture’s potential and multipart value, as well as help the sector progressively engage with the many social, economic and environmental challenges ahead and beyond C-19. © 2020 Informa UK Limited, trading as Taylor & Francis Group.

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