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1.
Asia-Pacific Journal of Clinical Oncology ; 18(Supplement 3):178, 2022.
Article in English | EMBASE | ID: covidwho-2136601

ABSTRACT

Introduction: The Sydney Cancer Survivorship Centre (SCSC) runs a face-to-face multi-disciplinary team (MDT) visit for each new patient. This enables patients to be assessed by each member of the MDT. In March 2020 the clinic rapidly transitioned to telehealth delivery in response to the COVID-19 pandemic. Aim(s): To explore the experiences of delivering survivorship care via telehealth. Method(s): Using an interpretive descriptive qualitative methodology, we conducted focus groups (FG) and individual interviews with MDT members from SCSC. One FG was conducted in person, all others via the zoom platform. Discussions were audio-recorded and transcribed for analysis. Result(s): Thirteen people participated in three FG or two individual interviews. Four key themes were identified: What is lost;Relationships;Logistical issues;and, Telehealth skills. Within 'Relationships' there were impacts on team relationships which became more fragmented without in person contact. With patients, telehealth was easier where relationships had already been established. Establishing rapport with new patients was more difficult. 'What is lost' identified the limited ability to garner visual cues, vital signs, and conduct physical examinations. While patient reported outcome measures assisted in overcoming some issues, without visual cues, assessment was more challenging. 'Logistical issues' were both positive and negative, with positive outcomes for patients: reduced travel time, time off work, parking, and costs. Whereas, time required to prepare patients for the clinic was greater, engaging with interpreters challenging, and technical issues commonly compromised interactions. Participants noted telehealth requires specific skills from both staff and patients. Determining patients able to manage telehealth was challenging. Staff noted developing skills in telehealth, particularly how to detect more subtle cues or communicate effectively. Conclusion(s): The SCSC clinic transitioned successfully to telehealth. However, there is a need to improve telehealth platforms, skills of staff to communicate and assess patients, and management of patient flow through the clinic.

2.
Asia-Pacific Journal of Clinical Oncology ; 18(Supplement 3):71, 2022.
Article in English | EMBASE | ID: covidwho-2136596

ABSTRACT

Background: Surgery is the standard treatment for early-stage colorectal and upper gastrointestinal (UGI) cancers. Prehabilitation aims to improve preoperative functional reserves through physical, nutritional, and/or psychological interventions. We aimed to evaluate the implementation of a multimodal prehabilitation program in gastrointestinal cancer surgery patients. Method(s): Single-arm implementation trial using a pre-post study design. Colorectal or UGI cancer patients scheduled for curative intent surgery at Concord Hospital, with >=14 days pre-surgery were recruited. Intervention delivered face-toface or by telehealth (COVID adaptations): 2-4-week program consisting of: i) supervised exercise (minimum 1/week);ii) dietary education session and daily high protein supplement;iii) weekly nursing support. Assessments: baseline, pre-surgery, and 30-days post-surgery. Primary Outcome: implementation using RE-AIM (Reach/Efficacy/Adoption/Implementation/ Maintenance) framework. Secondary outcomes included functional capacity, nutritional and psychological status changes. Result(s): Total 198 were screened over 16 months;100 (51%) were eligible. Reach/representativeness: 77/100 recruited (64 colorectal, 13 UGI). Mean (SD) age 67 (12.4) years;46 (60%) males. Median intervention duration 16 days (IQR:8). Adoption: 91% (70/77) referrals directly from surgeons. Implementation: 72/77 completed the intervention (34% of assessments and intervention sessions delivered by telehealth). Five withdrew: psychological stress (n = 2), medical (n = 1), disease progression (n = 1), noncompliance COVID precautions (n = 1). Adherence to all modalities was 34% (64% exercise, 81% nutrition, 63% nursing). Adherence rate for 31/35 patients was affected by staff unavailability. Efficacy: Functional capacity (mean 6-minute walk test) change from baseline to pre-surgery 464.4-471.7m(p=.775);and baseline to after surgery 464.4 to 482m(p = .052). No significant changes were seen in nutritional and psychological outcomes. Patient satisfaction:96%strongly recommended prehabilitation. Clinician satisfaction was high. Conclusion(s): Our results show a brief prehabilitation intervention (exercise, nutrition, psychological support) can be successfully implemented in a real-world setting;with a trend to improvement in functional capacity. Prehabilitation is an opportunity to optimize patients' function before gastrointestinal cancer surgery.

3.
Western Pacific Surveillance and Response ; 13(4), 2022.
Article in English | Web of Science | ID: covidwho-2124040

ABSTRACT

Objective: This retrospective, cross-sectional, observational study assessed the duration of coronavirus disease 2019 (COVID-19) symptoms during the second wave in Brunei Darussalam. Methods: Data from COVID-19 cases admitted to the National Isolation Centre during 7-30 August 2021 were included in the study. Symptom onset and daily symptom assessments were entered into a database during hospitalization and disease was categorized by severity. The time between symptom onset and hospital admission, the duration of symptoms and length of hospitalization were assessed separately by age group, disease severity and vaccination status using one-way analysis of variance with Bonferroni post hoc corrections. Results: Data from 548 cases were included in the study: 55.7% (305) of cases were male, and cases had a mean age of 33.7 years. Overall, 81.3% (446) reported symptoms at admission (mean number of symptoms and standard deviation: 2.8 +/- 1.6), with cough (59.1%;324), fever (38.9%;213) and sore throat (18.4%;101) being the most common. Being older, having more severe disease and being unvaccinated were significantly associated with the time between symptom onset and hospital admission, symptom duration and length of hospitalization. Discussion: Knowing which factors predict the duration of COVID-19 symptoms can help in planning management strategies, such as the duration of isolation, predict the length of hospitalization and treatment, and provide more accurate counselling to patients regarding their illness.

5.
IAF Symposium on Integrated Applications 2021 at the 72nd International Astronautical Congress, IAC 2021 ; B5, 2021.
Article in English | Scopus | ID: covidwho-1787346

ABSTRACT

With sudden changes in demand for certain goods, strict border control, and movement restrictions, pandemics can cause an immense disruption of the supply chain especially as it pertains to sustenance goods and job security. The most important recommendations on how this disruption can be mitigated by applying Remote Sensing have been outlined. Earth Observation (EO) and ground data can be used to mitigate the effects of pandemics on the interconnected global and local supply chain;with the COVID-19 pandemic as a case study. The scope of effects by COVID-19 includes issues in the supply chain, operational logistics, and goods production. EO data can be used to track goods like foods, medical kits, hand sanitizers, etc. which in turn aids the reallocation of high-demand goods to areas with limited supply. Satellite-based communication channels will be useful for more remote areas. The supply chain deals with adequate production, the food security issues faced by a significant part of the world's population, can be tackled with an integrated approach. An integrated application of Remote Sensing, (IoT), and Machine Learning is proposed for food security. EO can be used for agricultural monitoring using GNSS coupled with available tools to assess and predict produce status. This is useful in disaster management during restrictions of pandemics;machine learning models can be deployed in conjunction with IoT systems to help with farm monitoring watering of crops using weather data, environment monitoring and fertilizer requirement reminders, and triggering of risk management protocols during disasters. Copyright © 2021 by the International Astronautical Federation (IAF). All rights reserved.

6.
Asia-Pacific Journal of Clinical Oncology ; 17(SUPPL 9):96-97, 2021.
Article in English | EMBASE | ID: covidwho-1598556

ABSTRACT

Background: Sydney Cancer Survivorship Clinic (SCSC) aims to help survivors recover from their cancer and treatment, and to manage lasting effects (1). Clinicians use the Patient Reported Outcome Measures (PROMs) as an integral part of their consultation. Here, we report patient completion rate of PROMs for the clinic as a surrogate of patient acceptability. Method: Pre-COVID, SCSC attendees were mailed paper PROMs and asked to bring completed forms to clinic. PROMs assess symptoms, quality of life (QOL), distress, exercise levels, food intake, and self-rated performance status. Since March 2020, clinic consults were mostly conducted via telehealth, and paper PROMs were transitioned to electronic version (ePROMs) in September 2020. Descriptive statistics were used to report proportions of completed PROMs in these two periods. Results : Between 2013 to 2019, 656 new survivors attended SCSC with 622 consenting to data being included in the analysis. Demographics: 69% (n = 428) female;main tumour types: breast cancer 42%, colorectal 31%, haematological 17%, and other 10%. The highest completion rate was for food questionnaire (92%);91% for distress thermometer, symptom, and exercise-related PROMS;85% for QOL, 77% for self-rated performance status and the lowest for the 3-day food diary (55.5%). Between September 2020 to February 2021, 166 patients attended SCSC clinics;132 (79.5%) ePROMs were emailed out and completion rate was 79%. Conclusion: Comprehensive PROMS can be incorporated into clinical practice with excellent adherence, despite some language difficulties. Data provided in PROMS enabled clinicians to tailor their consults and provide an individualised care plan. PROMs that take longer to complete are more likely to have missing data but may still provide important information for clinicians. ePROMs are feasible and practical. Educating attendees' regarding the importance and relevance of the PROMS likely helps adherence;while streamlined administrative processes helps reduce avoidable missing data.

7.
Advanced Science ; : 14, 2021.
Article in English | Web of Science | ID: covidwho-1230189

ABSTRACT

The pandemic of coronavirus disease 2019 (COVID-19) is continually worsening. Clinical treatment for COVID-19 remains primarily supportive with no specific medicines or regimens. Here, the development of multifunctional alveolar macrophage (AM)-like nanoparticles (NPs) with photothermal inactivation capability for COVID-19 treatment is reported. The NPs, made by wrapping polymeric cores with AM membranes, display the same surface receptors as AMs, including the coronavirus receptor and multiple cytokine receptors. By acting as AM decoys, the NPs block coronavirus from host cell entry and absorb various proinflammatory cytokines, thus achieving combined antiviral and anti-inflammatory treatment. To enhance the antiviral efficiency, an efficient photothermal material based on aggregation-induced emission luminogens is doped into the NPs for virus photothermal disruption under near-infrared (NIR) irradiation. In a surrogate mouse model of COVID-19 caused by murine coronavirus, treatment with multifunctional AM-like NPs with NIR irradiation decreases virus burden and cytokine levels, reduces lung damage and inflammation, and confers a significant survival advantage to the infected mice. Crucially, this therapeutic strategy may be clinically applied for the treatment of COVID-19 at early stage through atomization inhalation of the NPs followed by NIR irradiation of the respiratory tract, thus alleviating infection progression and reducing transmission risk.

9.
Wuli Xuebao/Acta Physica Sinica ; 70(6), 2021.
Article in Chinese | Scopus | ID: covidwho-1168082
10.
Singapore Med J ; 2020.
Article in English | PubMed | ID: covidwho-953997

ABSTRACT

INTRODUCTION: Disease outbreaks such as the coronavirus disease 2019 (COVID-19) pandemic significantly heighten the psychological stress of healthcare workers (HCWs). The objective of this study was to understand the factors contributing to the perceived stress levels of HCWs in a public primary care setting during the COVID-19 pandemic, including their training, protection and support (TPS), job stress (JS), and perceived stigma and interpersonal avoidance. METHODS: This cross-sectional study using an electronic self-administered questionnaire was conducted at the National Healthcare Group Polyclinics in March 2020. Data was collected anonymously. Analysis was performed using regression modelling. RESULTS: The response rate was 69.7% (n = 1,040). The mean perceived stress level of HCWs in various departments ranged from 17.2 to 20.3. Respondents who reported higher perceived stress were those who made alternative living arrangements, were more affected by the current pandemic, reported higher JS and were Muslims. Respondents who reported lower perceived stress were those who had been through the severe acute respiratory syndrome epidemic in 2003 and H1N1 pandemic in 2009 as HCWs, and those who had higher confidence in the organisation's TPS. CONCLUSION: All HCWs, regardless of scope of work, were similarly stressed by the current pandemic compared to the general population. Improving the confidence of HCWs in their training, protection and the support of personal protective equipment, and retaining experienced HCWs who can provide advice and emotional support to younger colleagues are important. Adequate psychological support for HCWs in the pandemic can be transformed into reserves of psychological resilience for future disease outbreaks.

11.
Dianzi Keji Daxue Xuebao/Journal of the University of Electronic Science and Technology of China ; 49(5):788-794, 2020.
Article in Chinese | Scopus | ID: covidwho-891677

ABSTRACT

Close contacts with high-risk exposure to COVID-19 cases are more robust in statistics for inferring future development of COVID-19 epidemic. In Beijing, the proportion of close contact cases in newly confirmed cases had increased from about 50% at the end of January to nearly 100% in mid-February, indicating that contact tracing and quarantine measures are effective non-pharmaceutical interventions for containing the epidemic. In addition, we show at the national level that the cumulative number of close contacts was stabilized at about eight times as much as infected individuals, and the growth rate of daily close contacts was consistent with that of daily confirmed cases 5~6 days later. Consequently, tracking the daily change of close contacts is beneficial to predict the trend of the epidemic, based on which advanced medical supplies scheduling and effective epidemic prevention can be achieved. © 2020, Editorial Board of Journal of the University of Electronic Science and Technology of China. All right reserved.

12.
Singapore Med J ; 2020.
Article in English | PubMed | ID: covidwho-854647

ABSTRACT

INTRODUCTION: Chest radiographs (CXR) are widely used for the screening and management of the coronavirus disease 2019 (COVID-19). This paper determinates the radiographic features of COVID-19 based on an initial national cohort of patients. METHODS: This is a retrospective review of swab-positive COVID-19 patients admitted to four different hospitals in Singapore between 22 January and 9 March 2020. Initial and follow-up CXR were reviewed by three experienced radiologists to identify the predominant pattern and distribution of lung parenchymal abnormalities. RESULTS: In total, 347 CXR of 96 patients were reviewed. Initial CXR were abnormal in 41 out of 96 patients (42.7%). The mean time from onset of symptoms to CXR abnormality was 5.3 (range 1-21) days. The predominant pattern of lung abnormality was ground-glass opacity on initial CXR (51.2%) and consolidation on follow-up CXR (51.0%). Multifocal bilateral abnormalities in mixed central and peripheral distribution were seen in 63.4% and 59.2% of abnormal initial and follow-up CXR, respectively. The lower zones were involved in 90.2% of the initial CXR and 93.9% of the follow-up CXR. CONCLUSION: In a cohort of swab-positive patients, including those identified from contact tracing, we found the incidence of CXR abnormality to be lower than previously reported. The most common pattern was ground-glass opacity or consolidation, but mixed central and peripheral involvement was more common than peripheral involvement alone.

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