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1.
Fordham Journal of Corporate & Financial Law ; 26(2):277-358, 2021.
Article in English | ProQuest Central | ID: covidwho-1405705

ABSTRACT

The pandemic and the social issues which have been brought into focus this year have strengthened the importance of this larger conversation, and today's program aims to foster a meaningful dialogue concerning the history, present state, and future of environmental, social, and economic governance criteria as a measure of corporate performance. In Europe, you go from jurisdictions where employees are required to have a seat on the board-in certain cases, at least three seats on the board-and therefore, have meaningful participation through their representatives in the actual corporate governance of the company itself. There is a shift these days to refocusing on the actual language that describes these fiduciary duties and focusing on other aspects of the company-on the input of employees and other stakeholders-and so, I would say that given that starting point, there is far less concern with the topic of liability of directors for not exclusively promoting shareholder value. The dominant view of corporate law was that the purpose of the corporation was solely to benefit the financial interests of shareholders.

2.
J Acad Consult Liaison Psychiatry ; 62(6): 588-594, 2021.
Article in English | MEDLINE | ID: covidwho-1246008

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, there have been an increasing number of emergency department visits for behavioral health reasons, even as overall emergency department volumes have decreased. The impact of the pandemic and related public health interventions on specialized psychiatric emergency services has not been described. These services provide high-intensity care for severely ill patients who are likely to be homeless and underserved. OBJECTIVE: We describe the change in total volume and psychiatric hospitalization rates among three psychiatric emergency services across the United States. METHODS: Changes in volumes and hospitalization were assessed for statistical significance using a seasonal autoregressive integrated moving average with exogenous factors model from January 2018 to December 2020. RESULTS: The pandemic's impact on volumes and hospitalization varied by site. In Denver (CO), there was a statistically significant 9% decrease in overall volumes, although an 18% increase in hospitalizations was not significant. In New York City (NY), there was a significant 7% decrease in volumes as well as a significant 6% decrease in hospitalizations. In Portland (OR), volumes decreased by 4% and hospitalizations increased by 6% although differences did not reach statistical significance. CONCLUSIONS: There has been a decrease in volume at these services after the pandemic, but there are substantial variations in the magnitude of change and demand for hospitalization by region. These findings suggest a need to understand where patients in crisis are seeking care and how systems of care must adapt to changing utilization in the pandemic era.


Subject(s)
COVID-19 , Emergency Services, Psychiatric , Hospitalization , Hospitals , Humans , Pandemics , SARS-CoV-2 , United States/epidemiology
3.
J Acad Consult Liaison Psychiatry ; 62(5): 493-500, 2021.
Article in English | MEDLINE | ID: covidwho-1246006

ABSTRACT

BACKGROUND: As the science of consultation-liaison psychiatry advances, the Academy of Consultation-Liaison Psychiatry's Guidelines and Evidence-Based Medicine Subcommittee reviews articles of interest to help academy members remain familiar with the latest in evidence-based practice. OBJECTIVE: We identify the 10 most important articles for clinical practice in consultation-liaison psychiatry from 2020 using the new Importance and Quality instrument for assessing scientific literature. METHODS: The subcommittee published annotated abstracts for 97 articles on the academy website in 2020. Reviewers then rated all articles on clinical importance to practice and quality of scholarship using the Importance and Quality instrument. We describe the 10 articles with the highest aggregate scores and analyze the reliability of Importance and Quality instrument. RESULTS: Twenty-four raters identified the top 10 scoring articles of 2020. These articles provide practical guidance on key areas of consultation-liaison psychiatry including management of COVID-19, lithium treatment for complex patients, medical risks among patients with severe mental illness, and substance use disorders in medical settings. The assessment instrument demonstrated good to excellent interrater reliability. CONCLUSION: These articles offer valuable guidance for consultation-liaison psychiatrists regardless of their practice area. Collaborative literature reviews with standardized assessments help clinicians deliver evidence-based care and foster a high standard of practice across the specialty.


Subject(s)
Psychiatry , Referral and Consultation , COVID-19/psychology , Cannabis/adverse effects , Delirium/classification , Encephalitis , Evidence-Based Medicine , Humans , Lithium Compounds/adverse effects , Lithium Compounds/therapeutic use , Mental Disorders/complications , Mental Disorders/mortality , Mindfulness , Neoplasms/complications , Neoplasms/mortality , Neoplasms/psychology , Reproducibility of Results , Sexually Transmitted Diseases/epidemiology
4.
Cureus ; 13(4): e14716, 2021 Apr 27.
Article in English | MEDLINE | ID: covidwho-1232684

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has upended psychiatric practice and poses unprecedented challenges for maintaining access to quality care. We discuss the ethical challenges of treating a patient with schizophrenia in need of hospitalization but who declined severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surveillance testing. The traditional framework of capacity assessment depends on the patient's ability to weigh risks and benefits, but this framework is of limited utility in context of the COVID-19 pandemic; the personal benefits of testing for the patient are unclear and in fact may not outweigh the risk of being declined psychiatric care. Moreover, classic capacity assessment does not well account for physicians' obligations to other patients and the public health. We conclude that physicians cannot coerce surveillance testing, and we consider the implications of requiring SARS-CoV-2 testing for accessing mental health treatment.

5.
J Orthop Sports Phys Ther ; 51(5): 197-200, 2021 05.
Article in English | MEDLINE | ID: covidwho-1209238

ABSTRACT

SYNOPSIS: The term long COVID was coined by patients to describe the long-term consequences of COVID-19. One year into the pandemic, it was clear that all patients-those hospitalized with COVID-19 and those who lived with the disease in the community-were at risk of developing debilitating sequelae that would impact their quality of life. Patients with long COVID asked for rehabilitation. Many of them, including previously healthy and fit clinicians, tried to fight postviral fatigue with exercise-based rehabilitation. We observed a growing number of patients with long COVID who experienced adverse effects from exercise therapy and symptoms strikingly similar to those of myalgic encephalomyelitis (ME). Community-based physical therapists, including those in private practice, unaware of safety issues, are preparing to help an influx of patients with long COVID. In this editorial, we expose growing concerns about long COVID and ME. We issue safety recommendations for rehabilitation and share resources to improve care for those with postviral illnesses. J Orthop Sports Phys Ther 2021;51(5):197-200. doi:10.2519/jospt.2021.0106.


Subject(s)
COVID-19/complications , Fatigue Syndrome, Chronic/etiology , Fatigue Syndrome, Chronic/therapy , Fatigue/etiology , Fatigue/therapy , Exercise Therapy/adverse effects , Humans , Quality of Life , Rest
6.
Psychosomatics: Journal of Consultation and Liaison Psychiatry ; : No Pagination Specified, 2020.
Article in English | APA PsycInfo | ID: covidwho-1208696

ABSTRACT

BACKGROUND: The coronavirus pandemic has changed health care rapidly and dramatically. OBJECTIVE: To provide a critical synthesis of the scientific literature on the pandemic's implications for psychiatric practice. METHODS: A rapid literature review was undertaken to identify scientific literature linking psychiatric outcomes and practice changes due to coronavirus and the disease it causes (COVID-19). A structured quality assessment was used to assess those articles reporting quantitative data. RESULTS: Fifty articles were identified for inclusion, but only 12 contained original data. Eleven of those twelve were rated as of weak quality. The literature described psychiatric sequelae of the coronavirus and related public health interventions through cross-sectional surveys among different populations;no studies include diagnostic or functional impairment data. Populations at risk include COVID-19 survivors, health care workers, the elderly, and those with preexisting psychiatric disease. Impacts on psychiatric practice were described, again without data on changes to quality or access of care. CONCLUSIONS: There is a quickly accumulating body of evidence on the psychiatric implications of coronavirus including psychological effects on the general public and at-risk subgroups. Similarly, psychiatric practice has witnessed substantial adaptation to the pandemic. However, there remain significant gaps in scientific knowledge. We suggest opportunities for consultation-liaison psychiatry to improve the understanding of the relationship between coronavirus and psychiatric care. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

7.
Radiol Cardiothorac Imaging ; 2(2): e200152, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-1155981

ABSTRACT

Routine screening CT for the identification of coronavirus disease 19 (COVID-19) pneumonia is currently not recommended by most radiology societies. However, the number of CT examinations performed in persons under investigation for COVID-19 has increased. We also anticipate that some patients will have incidentally detected findings that could be attributable to COVID-19 pneumonia, requiring radiologists to decide whether or not to mention COVID-19 specifically as a differential diagnostic possibility. We aim to provide guidance to radiologists in reporting CT findings potentially attributable to COVID-19 pneumonia, including standardized language to reduce reporting variability when addressing the possibility of COVID-19. When typical or indeterminate features of COVID-19 pneumonia are present in endemic areas as an incidental finding, we recommend contacting the referring providers to discuss the likelihood of viral infection. These incidental findings do not necessarily need to be reported as COVID-19 pneumonia. In this setting, using the term viral pneumonia can be a reasonable and inclusive alternative. However, if one opts to use the term COVID-19 in the incidental setting, consider the provided standardized reporting language. In addition, practice patterns may vary, and this document is meant to serve as a guide. Consultation with clinical colleagues at each institution is suggested to establish a consensus reporting approach. The goal of this expert consensus is to help radiologists recognize findings of COVID-19 pneumonia and aid their communication with other health care providers, assisting management of patients during this pandemic. Published under a CC BY 4.0 license.

8.
Radiology ; 299(1): E204-E213, 2021 04.
Article in English | MEDLINE | ID: covidwho-1147215

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is a global health care emergency. Although reverse-transcription polymerase chain reaction testing is the reference standard method to identify patients with COVID-19 infection, chest radiography and CT play a vital role in the detection and management of these patients. Prediction models for COVID-19 imaging are rapidly being developed to support medical decision making. However, inadequate availability of a diverse annotated data set has limited the performance and generalizability of existing models. To address this unmet need, the RSNA and Society of Thoracic Radiology collaborated to develop the RSNA International COVID-19 Open Radiology Database (RICORD). This database is the first multi-institutional, multinational, expert-annotated COVID-19 imaging data set. It is made freely available to the machine learning community as a research and educational resource for COVID-19 chest imaging. Pixel-level volumetric segmentation with clinical annotations was performed by thoracic radiology subspecialists for all COVID-19-positive thoracic CT scans. The labeling schema was coordinated with other international consensus panels and COVID-19 data annotation efforts, the European Society of Medical Imaging Informatics, the American College of Radiology, and the American Association of Physicists in Medicine. Study-level COVID-19 classification labels for chest radiographs were annotated by three radiologists, with majority vote adjudication by board-certified radiologists. RICORD consists of 240 thoracic CT scans and 1000 chest radiographs contributed from four international sites. It is anticipated that RICORD will ideally lead to prediction models that can demonstrate sustained performance across populations and health care systems.


Subject(s)
COVID-19/diagnostic imaging , Databases, Factual/statistics & numerical data , Global Health/statistics & numerical data , Lung/diagnostic imaging , Tomography, X-Ray Computed/methods , Humans , Internationality , Radiography, Thoracic , Radiology , SARS-CoV-2 , Societies, Medical , Tomography, X-Ray Computed/statistics & numerical data
9.
Cureus ; 12(12): e12371, 2020 Dec 29.
Article in English | MEDLINE | ID: covidwho-1034466

ABSTRACT

The novel Coronavirus disease (COVID-19) pandemic has led to increases in anxiety and depression, and mental health-related emergency department visits remain frequent despite overall changes in ED utilization. Here, we present a case of COVID-related anxiety and demonstrate the utility of a brief, single-session therapy intervention delivered in the ED. The growing mental health burden of COVID-19 suggests that pediatric health care providers will treat patients with COVID-related anxiety during this pandemic. This case demonstrates a common presentation of somatization of anxiety and outlines a three-step, cognitive-behavioral intervention that can be particularly effective in treating COVID-related anxiety in the context of a single ED or medical visit.

11.
Ann Am Thorac Soc ; 17(11): 1358-1365, 2020 11.
Article in English | MEDLINE | ID: covidwho-908299

ABSTRACT

Coronavirus disease (COVID-19) is an illness caused by a novel coronavirus that has rapidly escalated into a global pandemic leading to an urgent medical effort to better characterize this disease biologically, clinically, and by imaging. In this review, we present the current approach to imaging of COVID-19 pneumonia. We focus on the appropriate use of thoracic imaging modalities to guide clinical management. We also describe radiologic findings that are considered typical, atypical, and generally not compatible with COVID-19. Furthermore, we review imaging examples of COVID-19 imaging mimics, such as organizing pneumonia, eosinophilic pneumonia, and other viral infections.


Subject(s)
Coronavirus Infections/diagnostic imaging , Diagnostic Imaging/methods , Pneumonia, Viral/diagnostic imaging , Betacoronavirus , COVID-19 , Diagnosis, Differential , Diagnostic Imaging/trends , Humans , Pandemics , Radiography, Thoracic , SARS-CoV-2 , Tomography, X-Ray Computed , Ultrasonography
12.
Ann Am Thorac Soc ; 2020 Oct 06.
Article in English | MEDLINE | ID: covidwho-835977

ABSTRACT

COVID-19 is an illness caused by a novel coronavirus that has rapidly escalated into a global pandemic leading to an urgent medical effort to better characterize this disease biologically, clinically and by imaging. In this review, we present the current approach to imaging of COVID-19 pneumonia. We focus on the appropriate utilization of thoracic imaging modalities to guide clinical management. We will also describe radiologic findings that are considered typical, atypical and generally not compatible with of COVID-19 infection. Further, we review imaging examples of COVID-19 imaging mimics, such as organizing pneumonia, eosinophilic pneumonia and other viral infections.

13.
J Thorac Imaging ; 35(4): 219-227, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-612519

ABSTRACT

Routine screening CT for the identification of COVID-19 pneumonia is currently not recommended by most radiology societies. However, the number of CTs performed in persons under investigation (PUI) for COVID-19 has increased. We also anticipate that some patients will have incidentally detected findings that could be attributable to COVID-19 pneumonia, requiring radiologists to decide whether or not to mention COVID-19 specifically as a differential diagnostic possibility. We aim to provide guidance to radiologists in reporting CT findings potentially attributable to COVID-19 pneumonia, including standardized language to reduce reporting variability when addressing the possibility of COVID-19. When typical or indeterminate features of COVID-19 pneumonia are present in endemic areas as an incidental finding, we recommend contacting the referring providers to discuss the likelihood of viral infection. These incidental findings do not necessarily need to be reported as COVID-19 pneumonia. In this setting, using the term "viral pneumonia" can be a reasonable and inclusive alternative. However, if one opts to use the term "COVID-19" in the incidental setting, consider the provided standardized reporting language. In addition, practice patterns may vary, and this document is meant to serve as a guide. Consultation with clinical colleagues at each institution is suggested to establish a consensus reporting approach. The goal of this expert consensus is to help radiologists recognize findings of COVID-19 pneumonia and aid their communication with other healthcare providers, assisting management of patients during this pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Tomography, X-Ray Computed/methods , COVID-19 , Consensus , Humans , North America , Pandemics , Radiography, Thoracic/methods , Radiologists , SARS-CoV-2 , Societies, Medical , United States
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