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1.
European Urology ; 79:S262-S263, 2021.
Article in English | EMBASE | ID: covidwho-1747435

ABSTRACT

Introduction & Objectives: The impact of the COVID-19 pandemic on health care access and delivery in the US has been reported for hospital admissions and in the outpatient setting for a few selected health conditions. However, the impact on specialty care has not been adequately characterized. We therefore aimed to determine trends in outpatient urologic care visit and procedural volume in 2020, using a specialty-wide, community-based registry. Materials & Methods: The American Urological Association Quality (AQUA) Registry collects data via automated extraction from electronic health record systems at 157 urology practices representing 3,165 providers (roughly one-quarter of US urologists) across 48 US states and territories. We analyzed trends in care delivery from February 2020 to July 2020 based on patient, practice, and local/regional demographic and pandemic response features. The primary outcomes were mean visit volume and procedure volume per practice per week, and we compared each week to the corresponding week in 2019. Results: There were 2,750,001 patients in our cohort, accounting for 8,953,832 outpatient visits and 1,570,161 procedures. We found large (>40%) declines in outpatient visits from March to April 2020 across all demographic groups and US states, regardless of timing of stay-at-home orders. Visits recovered through May and early June, but began falling again by early July (see Figure). Non-urgent visits and procedures decreased more (39–47%) than visits for urgent diagnoses (29–43%);surgical procedures for non-urgent conditions also decreased more (37–53%) than those for potentially urgent conditions (13–21%). African American and Hispanic patients had smaller decreases in visits compared with Asian and Caucasian patients, but also slower recoveries back to baseline. Medicare-insured patients (mostly over 65 years old) had the steepest declines (50%) while those on Medicaid (generally low-income) had among the lowest percentage of recovery to baseline (84.4%). Practices in zip codes with lower median incomes, higher poverty levels, and lower urologist to population ratios had smaller decreases in outpatient visits. (Figure Presented) Conclusions: This study provides timely, real-world evidence on the magnitude of decline in the provision of urological care across demographic groups and practice settings, and demonstrates a differential impact on the utilization of urologic health services by sociodemographic strata and specific diagnoses.

4.
Irish Medical Journal ; 114(9), 2021.
Article in English | Scopus | ID: covidwho-1710480

ABSTRACT

The COVID-19 pandemic has impacted considerably on elite athletes’ performance. In this paper, we aim to examine how the psychosocial effects of COVID-19 may impact on athletes. First, mental health problems are as common among elite athletes as among the general population. Second, the mental health effects of COVID-19 are common in adolescents and young adults. Third, there are recognised gender differences in mental health related help-seeking behaviour. There is emerging evidence that these issues may be exacerbated by the pandemic. While there is little evidence on what interventions may help to address this problem, it is possible that optimising the identification and treatment of mental health problems (in an appropriate and acceptable manner) and promoting team cohesion and interaction may be effective. Addressing this issue is important for all team doctors and healthcare professionals associated with sports teams (both elite and non-elite). © 2021, Irish Medical Association. All rights reserved.

5.
Safety and Health at Work ; 13:S167, 2022.
Article in English | EMBASE | ID: covidwho-1677034

ABSTRACT

Introduction: Workers quickly adapted during the COVID-19 pandemic to comply with updated work arrangements, control measures and policies. Understanding adaptation difficulties/fatigue and mental health issues among workers is crucial for OSH professionals to plan for future emergencies. Materials and Methods: As part of a larger COVID-19 workplace study, 16 two-hour focus groups (4-6 participants each) were conducted with OSH professionals (n=60) in Ireland, covering four predetermined themes (organisational preparedness;organisational impacts;worker adaptation behaviour;and the future of OSH post-pandemic). Thematic analysis was conducted using Nvivo. Results: OSH professionals observed many workers rapidly adapted and became involved in organisational COVID-19 outbreak prevention and long-term adaptation, in contrast to some workers that exhibited mental health problems as they struggled to adapt. Adaptation fatigue was observed when staff were sent home to work due to a range of factors: 1) isolation at home 2) no boundary between work and life;and 3) inability to disconnect from negative media coverage. The situation can be alleviated by 1) increasing informal communication to cope with isolation;2) Employee Assistance Programmes;and 3) additional consultation regarding their COVID-19 concerns. Conclusion: Most Irish workplaces focused more on employees’ physical safety rather than their mental wellbeing. The experiences shared by OSH professionals in this study illustrate their agility and ability to apply their risk management and control skills to any unanticipated public/occupational health crisis that arises.

6.
Safety and Health at Work ; 13:S166, 2022.
Article in English | EMBASE | ID: covidwho-1677031

ABSTRACT

Introduction: There is an ongoing need for targeted disease prevention and control efforts in high-risk occupational settings. This study aimed to develop, pilot, and validate an instrument for surveying occupational COVID-19 infection prevention and control (IPC) measures available to the global workforce. Material and Methods: A 44-item QualtricsXM survey was developed, translated, and validated for face, content, and cross-cultural validity according to literature review, expert consultation, and pre-testing. The survey was piloted with 890 workers from diverse industries and countries. Exploratory factor analysis (EFA) was conducted, and internal consistency reliability verified with Cronbach’s alpha. Hypothesis testing and Pearson correlation coefficients verified construct validity (i.e., known-groups technique, discriminant validity), and criterion validity. Results: EFA revealed nine key IPC domains relating to: environmental adjustments, testing and surveillance, education, costs incurred, restricted movements, physical distancing, masking, isolation strategies, and areas for improvement. Each domain showed sufficient internal consistency reliability (Cronbach’s alpha ≥ 0.60). Hypothesis testing confirmed construct validity (p < 0.001), criterion validity (p ≤ 0.03), and discriminant validity (r = -0.45). Conclusions: The occupational IPC measures survey showed strong validity and reliability. It can be used by decision makers in the distribution of IPC resources, and to guide occupational health and safety (OSH) recommendations for preventing COVID-19 and future infectious disease outbreaks.

7.
Safety and Health at Work ; 13:S115-S116, 2022.
Article in English | EMBASE | ID: covidwho-1677003

ABSTRACT

Introduction: An investigation of Irish workplace adaptation to COVID-19 was conducted to assess impact to workers, their organisations and to develop new OSH adaptation mechanisms for future health emergencies. Materials and Methods: As part of the study, OSH professionals (n=60), each representing their workplace, took part in a series of semi-structured online focus groups. Each focus group incorporated twenty quantitative questions (covering four themes: organisational preparedness;organisational impacts;worker impacts;and the future of OSH) that were answered anonymously via a poll function. Results: 59 participants completed the questions. 58% of workplaces began pandemic preparations prior to COVID-19 emerging in Ireland. 66% of workplaces remained open while 27% were partially closed. 34% of workplaces had more than half their workforce working from home (5% pre-pandemic). 37% of workplaces had a working from home policy with 54% of workplaces having risk assessments for infectious diseases in place prior to the pandemic. 41% of workplaces had identified a viral pandemic scenario as part of its emergency planning prior to COVID-19. OSH professionals indicated that the majority (63%) of their colleagues understood the control measures instigated as a response to COVID-19 with a greater majority (90%) more willing to accept future workplace changes if they know it is to keep them safe and healthy. Conclusion: Irish workplaces adapted well to the changing OSH landscape that emerged in response to COVID-19. Irish workplaces are now more likely to be able to adapt and respond well to future public health emergencies.

8.
Eur J Public Health ; 32(1): 140-144, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1672190

ABSTRACT

BACKGROUND: As most COVID-19 transmission occurs locally, targeted measures where the likelihood of infection and hospitalization is highest may be a prudent risk management strategy. To date, in the Republic of Ireland, a regional comparison of COVID-19 cases and hospitalizations has not been completed. Here, we investigate (i) the variation in rates of confirmed infection and hospital admissions within geographical units of the Republic of Ireland and (ii) frequency of deviations in risk of infection or risk of hospitalization. METHODS: We analyzed routinely collected, publicly available data available from the National Health Protection and Surveillance Centre and Health Service Executive from nine geographical units, known as Community Health Organization areas. The observational period included 206 14-day periods (1 September 2020-15 April 2021). RESULTS: A total of 206 844 laboratory-confirmed cases and 7721 hospitalizations were reported. The national incidence of confirmed infections was 4508 [95% confidence interval (CI) 4489-4528] per 100 000 people. The risk of hospital admission among confirmed cases was 3.7% (95% CI 3.5-3.9). Across geographical units, the likelihood that rolling 14-day risk of infection or hospitalization exceeded national levels was 9-86% and 0-88%, respectively. In the most affected regions, we estimate this resulted in an excess of 15 180 infections and 1920 hospitalizations. CONCLUSIONS: Responses to future COVID-19 outbreaks should consider the risk and harm of infection posed to people living in specific regions. Given the recent surges of COVID-19 cases in Europe, every effort should be made to strengthen local surveillance and to tailor community-centred measures to control transmission.


Subject(s)
COVID-19 , Disease Outbreaks , Hospitalization , Humans , Ireland/epidemiology , SARS-CoV-2
9.
European Journal of Public Health ; 31:113-113, 2021.
Article in English | Web of Science | ID: covidwho-1610049
10.
European Journal of Public Health ; 31:274-274, 2021.
Article in English | Web of Science | ID: covidwho-1609821
12.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514816

ABSTRACT

Background COVID-19 has had a significant impact on workers, arising from adaptations to control measures and consequent behaviour changes that minimise disease spread in the workplace. From an occupational safety & health (OSH) perspective, understanding how adaptations and behaviour changes have impacted workers is relevant to how organisations can preserve the health of their workers when adapting to future health emergencies. Methods Semi-structured qualitative focus groups were conducted during April/May 2021. Participants were Irish OSH practitioners. Participants volunteered from industrial sectors (public & private) as defined by the Central Statistics Office. Participants (n = 60) partook in one of sixteen, two-hour focus groups (4-6 participants per focus group) with each comprising four themes for discussion: organisational preparedness;organisational impacts;worker impacts;and the future of OSH. Thematic analyses were performed using NVivo. Results Most participants started developing adaptation measures in February/March 2020. Organisations with an international presence started developing adaptation measures earlier. As OSH professionals, most participants felt personally prepared for the challenges induced by the pandemic but did not anticipate the impact it had on their workload. Nearly all participants indicated that isolation, loneliness, fear, and anxiety had a negative impact on their co-workers' mental health. Many OSH practitioners indicated that their co-workers had responded well to the pandemic, and that positive behaviour changes and new adaptation measures had been sustained from the first wave through the third wave of the pandemic in Ireland. Conclusions Workplace mental health evaluations and worker wellbeing initiatives must be prioritised post-pandemic. OSH will need to re-evaluate its relationship with organisational human resources in the future. Key messages Irish OSH practitioners responded well to the challenge presented by COVID-19 to protect their co-workers and maintain organisational continuity. COVID-19 has had a negative impact on the mental health of Irish workers as they respond to preserve their organisation’s operations. This will need to be addressed by organisations post-pandemic.

13.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514650

ABSTRACT

Workplaces are high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities. A rapid review and meta-analysis were conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021. Medline, Embase, PubMed, and Cochrane Library were searched for studies that quantitatively assessed the effectiveness of workplace COVID-19 IPC measures. Included studies comprised varying empirical designs and occupational settings. Measures of interest included surveillance measures, outbreak investigations, personal protective equipment (PPE), changes in work arrangements, and worker education. Sixty-three studies from international healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for ∼280,000 employees. Meta-analyses showed that comprehensive measures (0.2% positivity;95%CI 0-0.4%) were associated with lower post-intervention employee COVID-19 positivity estimates than single measures like asymptomatic PCR testing (1.7%;95%CI 0.9-2.9%) and universal masking (24%;95%CI 3.4-55.5%). Modelling studies showed that combinations of (i) timely and widespread contact tracing and case isolation, (ii) facilitating smaller worker cohorts, and (iii) effective use of PPE can reduce workplace transmission. Comprehensive COVID-19 IPC measures incorporating swift contact tracing and case isolation, PPE, and facility zoning, can effectively prevent workplace outbreaks. Masking alone should not be considered as sufficient protection from SARS-CoV-2 outbreaks in workplace environments at high risk of virus transmission. Key messages Comprehensive contact tracing, syndromic surveillance, regular testing, PPE, and zoning measures can prevent COVID-19 outbreaks in the workplace. Masking alone should not be considered as sufficient protection from SARS-CoV-2 outbreaks in workplace environments at high risk of virus transmission.

14.
Journal of Urology ; 206(SUPPL 3):e1065, 2021.
Article in English | EMBASE | ID: covidwho-1483654

ABSTRACT

INTRODUCTION AND OBJECTIVE: We determined the national impact over time of the COVID-19 pandemic on outpatient urology visits and procedural volume. METHODS: We examined temporal changes in urologic care delivery in the United States from February 2020 to July 2020 based on patient, practice, and local/regional demographic and pandemic response features using real-world data from the American Urological Association Quality (AQUA) Registry, which is a Qualified Clinical Data Registry. Data are collected via automated extraction from practices' electronic health record systems. RESULTS: There were 2,750,001 unique patients represented in our study cohort, accounting for 8,953,832 total outpatient visits and 1,570,161 procedures;data represented 157 outpatient urologic practices and 3,165 providers across 48 US states and territories. We found large (>40%) declines in outpatient visits from March 2020 to April 2020 across all patient demographic groups and across states, regardless of timing of state stay-at-home orders. Visits recovered through May and early June, but began falling again by early July. Non-urgent outpatient visits decreased more across various non-urgent procedures (39e47%) than for procedures performed for urgent diagnoses (29e43%);surgical procedures for non-urgent conditions also decreased more (37e53%) than those for potentially urgent conditions (13e21%) (Table). African American and Hispanic patients had smaller decreases in outpatient visits compared with Asian and Caucasian patients, but also slower recoveries back to baseline. Medicare-insured patients had the steepest declines (50%) while those on Medicaid had among the lowest percentage of recovery to baseline (84.4%). Practices in zip codes with lower median incomes, higher poverty levels, and lower urologist to population ratios had smaller decreases in outpatient visits. CONCLUSIONS: This study provides timely, real-world evidence on the magnitude of decline in the provision of specialty care across demographic groups and practice settings, and demonstrates a differential impact on the utilization of urologic health services by sociodemographic strata and specific diagnoses.

15.
Journal of Urology ; 206(SUPPL 3):e856, 2021.
Article in English | EMBASE | ID: covidwho-1483643

ABSTRACT

INTRODUCTION AND OBJECTIVE: We used data from a specialty-wide, community-based urology registry to determine trends in outpatient prostate cancer (PCa) care during the COVID-19 pandemic. METHODS: 3,165 (w 25%) of US urology providers, representing 48 states and territories, participate in the American Urological Association Quality (AQUA) Registry, which collects data via automated extraction from electronic health record systems. We analyzed trends in PCa care delivery from 156 practices contributing data in 2019 and 2020. Risk stratification was based on prostate-specific antigen (PSA) at diagnosis, biopsy Gleason, and clinical T-stage, and we used a natural language processing algorithm to determine Gleason and Tstage from unstructured clinical notes. The primary outcome was mean weekly visit volume by PCa patients per practice (visits defined as all MD and mid-level visits, telehealth and face-to-face), and we compared each week in 2020 through week 44 (November 1) to the corresponding week in 2019. RESULTS: There were 267,691 PCa patients in AQUA who received care between 2019 and 2020. From mid-March to early November, 2020 (week 10 - week 44) the magnitude of the decline and recovery varied by risk stratum, with the steepest drops for lowrisk PCa (Table). For 2020, overall mean visits per day (averaged weekly) were similar to 2019 for the first 9 weeks (w25). Visits declined to week 14 (18.19;a 31% drop from 2019), recovered to 2019 levels by week 23, and declined steadily to 11.89 (a 58% drop from 2019) as of week 44, the cut off of this analysis. CONCLUSIONS: Access to care for men with PCa was sharply curtailed by the COVID-19 pandemic, and while the impact was less for men with high-risk disease compared to those with low-risk disease, visits even for high-risk individuals were down nearly one-third and continued to fall through November. This study provides real-world evidence on the magnitude of decline in PCa care across risk groups. The impact of this decline on cancer outcomes should be followed closely.

16.
Journal of Urology ; 206:E1065-E1065, 2021.
Article in English | Web of Science | ID: covidwho-1411280
18.
Eur J Public Health ; 32(1): 140-144, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1413557

ABSTRACT

BACKGROUND: As most COVID-19 transmission occurs locally, targeted measures where the likelihood of infection and hospitalization is highest may be a prudent risk management strategy. To date, in the Republic of Ireland, a regional comparison of COVID-19 cases and hospitalizations has not been completed. Here, we investigate (i) the variation in rates of confirmed infection and hospital admissions within geographical units of the Republic of Ireland and (ii) frequency of deviations in risk of infection or risk of hospitalization. METHODS: We analyzed routinely collected, publicly available data available from the National Health Protection and Surveillance Centre and Health Service Executive from nine geographical units, known as Community Health Organization areas. The observational period included 206 14-day periods (1 September 2020-15 April 2021). RESULTS: A total of 206 844 laboratory-confirmed cases and 7721 hospitalizations were reported. The national incidence of confirmed infections was 4508 [95% confidence interval (CI) 4489-4528] per 100 000 people. The risk of hospital admission among confirmed cases was 3.7% (95% CI 3.5-3.9). Across geographical units, the likelihood that rolling 14-day risk of infection or hospitalization exceeded national levels was 9-86% and 0-88%, respectively. In the most affected regions, we estimate this resulted in an excess of 15 180 infections and 1920 hospitalizations. CONCLUSIONS: Responses to future COVID-19 outbreaks should consider the risk and harm of infection posed to people living in specific regions. Given the recent surges of COVID-19 cases in Europe, every effort should be made to strengthen local surveillance and to tailor community-centred measures to control transmission.


Subject(s)
COVID-19 , Disease Outbreaks , Hospitalization , Humans , Ireland/epidemiology , SARS-CoV-2
19.
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