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1.
Revitalising ASEAN Economies in a Post-COVID-19 World: Socioeconomic Issues in the New Normal ; : 145-167, 2022.
Article in English | Scopus | ID: covidwho-2193996

ABSTRACT

This study extends the existing literature on the use of financial stress index (FSI) to assess the financial condition of Singapore during the COVID-19 crisis. Specifically, a high-frequency FSI is constructed to provide timely analysis which is imperative given the pandemic is still lingering across the globe. There are two main uses of the FSI. First, we use FSI to detect episodes of financial stress and investigate whether Singapore's financial system is facing frailty during the pandemic. Second, we use a vector autoregression (VAR) model to analyse the comovement between FSI, COVID-19 indicators, and global financial factors, which shed light on the main drivers underlying Singapore's financial stress since the COVID-19 outbreak. Our findings suggest that (1) excessive stresses were detected during 9 March-21 April 2020, a period that corresponded to the evolution of COVID-19 into a global pandemic as well as the beginning of Singapore's Circuit Breaker period;and (2) the dynamics of Singapore's FSI is more due to the global financial factors than it is to the severity of the domestic COVID-19 condition. © 2022 by World Scientific Publishing Co. Pte. Ltd.

2.
2022 IEEE Frontiers in Education Conference, FIE 2022 ; 2022-October, 2022.
Article in English | Scopus | ID: covidwho-2191731

ABSTRACT

This Innovative Practice Full Paper presents experiences in designing a student-led virtual freshmen orientation program that uses a Minecraft environment. We describe the planning process, roles of the organizing committee members, and how the game was constructed for participants to learn and interact with one another. The student organizers not only created a virtual environment that scales the college map where more than a hundred freshmen (participants) could have an immersive experience of the campus, but also ensured the branding and marketing, logistics, and safety/well-being aspects of the event. In this paper, we present students' experience of this program from both the designers' as well as the participants' perspectives. We conducted surveys with the organizing committee members and interviewed the participants to gain insights on their perception of this event. Our analysis showed that student organizers had the autonomy to brainstorm, suggest creative ideas, develop novel games, and procure materials. They also felt that they developed authentic programming and leadership skills. On the other hand, participants felt engaged as the event was well-organized, had clear delivery of information, introduced them to new technology, made them more familiar with the campus, provided a conducive environment to hone their soft skills such as communication and teamwork even before they officially enrolled as undergraduate students in an engineering program, and helped them establish social networks to support them throughout their undergraduate education journey. © 2022 IEEE.

3.
Nat Med ; 2023.
Article in English | PubMed | ID: covidwho-2185960

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infections in vaccinated individuals and reinfections in previously infected individuals have become increasingly common. Such infections highlight a broader need to understand the contribution of vaccination, including booster doses, and natural immunity to the infectiousness of individuals with SARS-CoV-2 infections, especially in high-risk populations with intense transmission, such as in prisons. Here we show that both vaccine-derived and naturally acquired immunity independently reduce the infectiousness of persons with Omicron variant SARS-CoV-2 infections in a prison setting. Analyzing SARS-CoV-2 surveillance data from December 2021 to May 2022 across 35 California state prisons with a predominately male population, we estimate that unvaccinated Omicron cases had a 36% (95% confidence interval (CI): 31-42%) risk of transmitting infection to close contacts, as compared to a 28% (25-31%) risk among vaccinated cases. In adjusted analyses, we estimated that any vaccination, prior infection alone and both vaccination and prior infection reduced an index case's risk of transmitting infection by 22% (6-36%), 23% (3-39%) and 40% (20-55%), respectively. Receipt of booster doses and more recent vaccination further reduced infectiousness among vaccinated cases. These findings suggest that, although vaccinated and/or previously infected individuals remain highly infectious upon SARS-CoV-2 infection in this prison setting, their infectiousness is reduced compared to individuals without any history of vaccination or infection. This study underscores benefit of vaccination to reduce, but not eliminate, transmission.

4.
European Geriatric Medicine ; 13(Supplement 1):S143-S144, 2022.
Article in English | EMBASE | ID: covidwho-2175549

ABSTRACT

Introduction: The COVID-19 pandemic may have a disproportionate impact on people with dementia/mild cognitive impairment (MCI) due to isolation and loss of services. The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on neuropsychiatric symptoms (NPS) in people living with dementia/ MCI. Method(s): Two authors searched major electronic databases from inception to June 2021 for observational studies investigating COVID-19 and NPS in people with dementia/MCI. Summary estimates of mean differences in NPS scores pre- versus post-COVID-19 were calculated using a random-effects model, weighting cases using inverse variance. Study quality and risk of bias were assessed by the Newcastle-Ottawa Scale. Result(s): From 2730 citations, 21 studies including 7139 patients (60.0% female, mean age 75.6 +/- 7.9 years, 4.0% MCI) with dementia were evaluated in the review. Five studies found no changes in NPS, but in all other studies, an increase in at least one NPS or the pre-pandemic Neuropsychiatric Inventory (NPI) score was found. The most common aggravated NPS were depression, anxiety, agitation, irritability, and apathy during lockdown, but 66.7% of the studies had a high bias. Seven studies including 420 patients (22.1% MCI) yielded enough data to be included in the meta-analysis. The mean follow-up time was 5.9 +/- 1.5 weeks. The pooled increase in NPI score before compared to during COVID-19 was 3.85 (95% CI: 0.43-7.27;P = 0.03;I2 = 82.4%). All studies had high risk of bias. These results were characterized by high heterogeneity, but there was no presence of publication bias. Key conclusions: There is an increase in the worsening of NPS in people living with dementia/MCI during lockdown in the COVID pandemic. Future comparative studies are needed to elucidate whether a similar deterioration might occur in people without dementia/MCI.

7.
Malaysian Journal of Medical Sciences ; 29(6):164-169, 2022.
Article in English | EMBASE | ID: covidwho-2204909

ABSTRACT

This study aims to compare the feeding practices adopted by stay-at-home mothers and work-from-home mothers during the COVID-19 lockdown. Feeding practices were assessed using a 39-item validated Comprehensive Feeding Practices Questionnaire (CFPQ). The Multivariate Analysis of Covariance (MANCOVA) was used to determine the mean difference in feeding practices by maternal employment status after adjusting for the mother's age and educational attainment and the child's age and gender. The current study revealed that a noticeable proportion of mothers adopted feeding practices that encourage balance and variety (4.45 +/- 0.62), promote a healthy environment (4.34 +/- 0.81) and impose dietary restrictions for health (4.32 +/- 1.04) during the COVID-19 pandemic. There was no significant difference (P > 0.05) in the mean scores of feeding practices across maternal employment status, except for the emotion regulation and modelling subscales. Work-from-home mothers had a significantly higher mean score in the emotion regulation subscale than stay-at-home mothers (F = 14.892, P < 0.001). In comparison to work-from-home mothers, stay-at-home mothers had a significantly higher mean score in the modelling subscale during the COVID-19 pandemic (F = 4.163, P = 0.044). In conclusion, there was just a modest variation in the feeding practices adopted by stay-at-home mothers and work-from-home mothers in this unprecedented pandemic. Copyright © 2022, Penerbit Universiti Sains Malaysia. All rights reserved.

8.
Journal of Virology ; : e0124522, 2022.
Article in English | MEDLINE | ID: covidwho-2152892

ABSTRACT

The global spread of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the continuously emerging new variants underscore an urgent need for effective therapeutics for the treatment of coronavirus disease 2019 (COVID-19). Here, we screened several FDA-approved amphiphilic drugs and determined that sertraline (SRT) exhibits potent antiviral activity against infection of SARS-CoV-2 pseudovirus (PsV) and authentic virus in vitro. It effectively inhibits SARS-CoV-2 spike (S)-mediated cell-cell fusion. SRT targets the early stage of viral entry. It can bind to the S1 subunit of the S protein, especially the receptor binding domain (RBD), thus blocking S-hACE2 interaction and interfering with the proteolysis process of S protein. SRT is also effective against infection with SARS-CoV-2 PsV variants, including the newly emerging Omicron. The combination of SRT and other antivirals exhibits a strong synergistic effect against infection of SARS-CoV-2 PsV. The antiviral activity of SRT is independent of serotonin transporter expression. Moreover, SRT effectively inhibits infection of SARS-CoV-2 PsV and alleviates the inflammation process and lung pathological alterations in transduced mice in vivo. Therefore, SRT shows promise as a treatment option for COVID-19. IMPORTANCE The study shows SRT is an effective entry inhibitor against infection of SARS-CoV-2, which is currently prevalent globally. SRT targets the S protein of SARS-CoV-2 and is effective against a panel of SARS-CoV-2 variants. It also could be used in combination to prevent SARS-CoV-2 infection. More importantly, with long history of clinical use and proven safety, SRT might be particularly suitable to treat infection of SARS-CoV-2 in the central nervous system and optimized for treatment in older people, pregnant women, and COVID-19 patients with heart complications, which are associated with severity and mortality of COVID-19.

9.
Journal of Health and Translational Medicine ; 25(2):93-96, 2022.
Article in English | Scopus | ID: covidwho-2146067

ABSTRACT

Background: To date, the Malaysian government has implemented three nationwide lockdowns (Movement Control Order, MCO) to mitigate the spread of COVID-19 transmission. It is predicted that children’s eating behaviour could be different due to the sudden change in daily routine and school closure during the pandemic. Therefore, this study aims to compare the children’s eating behaviour during the implementation of MCO 1.0 and MCO 2.0. Methods: Children’s eating behaviour during the lockdowns was assessed with a 35-item validated Children’s Eating Behaviour Questionnaire (CEBQ). Results: Children in Malaysia attained significantly higher mean scores (p<0.05) in food responsiveness, enjoyment of food, and desire to drink subscales in MCO 2.0 than that of MCO 1.0. Conversely, significantly lower mean scores (p<0.05) were observed in satiety responsiveness and slowness in eating subscales during the MCO 2.0 compared to MCO 1.0. Conclusion: Children residing in Malaysia had higher food responsiveness, food enjoyment, desire to drink, and eating speed during the MCO 2.0 than MCO 1.0. The findings of this study may be useful for the policymakers in formulating healthy eating intervention strategies in the post-COVID-19 era. © 2022, Faculty of Medicine, University of Malaya. All rights reserved.

10.
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.

11.
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.

12.
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.

13.
Thorax ; 77(Suppl 1):A168, 2022.
Article in English | ProQuest Central | ID: covidwho-2118860

ABSTRACT

Hospitals throughout the country have utilised different strategies in the management of COVID pneumonitis. Our hospital established a Respiratory High Care Unit (RHCU) to provide CPAP to patients deteriorating despite Standard Oxygen Therapy (SOT). Patients were considered to be either for full escalation (intubation and mechanical ventilation) or to have CPAP as a ceiling of care.Our aim was to assess CPAP success in those not eligible for mechanical ventilation.We retrospectively analysed patients admitted to RHCU who had a CPAP ceiling of care. Between 1stJune 2020 and 31st March 2021, 156 patients were admitted, with 144 notes available for analysis. Patients were transferred to RHCU following review by respiratory consultant and met Trust criteria for CPAP. 75 patients (52%) had a ceiling of care of CPAP. 8 patients were excluded.Average age was 75.1 years. Mean Clinical Frailty Score (CFS) was 3.6. 70% were male. 97% were admitted with FiO2 ≥40%. Mortality in patients with CPAP as ceiling of care was 79%.Patients that survived had a mean age was 74.6 years, a mean CFS of 3.1 and a pO2 on admission of 7.8kPa, as compared to a mean age of 75.2 years, a mean CFS of 3.7 and pO2 on admission of 7.7kPa in those that died. Demographics between the two cohorts of patients were similar, making it difficult to predict who would survive with CPAP therapy.21% of patients not suitable for mechanical ventilation survived with CPAP. In other centres, these patients may have only been eligible for SOT alone. The data suggests that offering CPAP may increase survival in patients that would not be suitable for mechanical ventilation.

14.
Thorax ; 77(Suppl 1):A121, 2022.
Article in English | ProQuest Central | ID: covidwho-2118580

ABSTRACT

During the pandemic, our hospital established a RHCU to provide level 2 care for patients with severe Covid-19. Mortality rate was 54% over the first year. We designed a questionnaire around Patient Health Questionnaire-9 to assess the emotional impact upon our workforce. We also evaluated burnout, using the Oldenburg Burnout Inventory.Staff retrospectively rated their pre-pandemic mental health (Feb 2020) and current mental health (Jan 2022). 60 questionnaires were circulated with 83% completed.Doctors encompassed 28% of respondents, nurses 38%, HCAs 18%, and 16% were other clinical and administrative staff. 62% had worked on RHCU for ≥12 months.72% felt their mental health had deteriorated. 94% reported their physical health had been negatively impacted.In Jan 2022, 51% reported feeling depressed, 71% anxious, 46% tearful and 69% irritable, half the time or more. All figures had increased ≥2 fold compared to pre-pandemic levels.The pandemic has affected personal life too, showing a 3.6 fold increase in strain on personal relationships compared to pre-pandemic. 70% reported difficulty with sleep pattern.Worryingly, 71% scored high/very high using the Oldenburg Burnout Inventory. Levels of burnout were notably increased in junior doctors (88%) and staff nurses (89%), demonstrating high/very high levels of burnout. 75% of junior doctors and 56% of staff nurses were unsure or would not continue in their current role. These figures are incredibly concerning, considering that junior doctors and staff nurses make up one third of RHCU staff.Our results highlight the need for urgent intervention for RHCU staff to prevent further burnout and improve mental health.

15.
Thorax ; 77(Suppl 1):A168, 2022.
Article in English | ProQuest Central | ID: covidwho-2118579

ABSTRACT

There has been much debate on how best to manage COVID pneumonitis. We established a Respiratory High Care Unit (RHCU) to provide CPAP for hypoxic patients as an intermediate between standard oxygen therapy (SOT) and mechanical ventilation (MV). In some centres, CPAP was not offered outside trial settings, meaning deteriorating patients went straight from SOT to MV.The RECOVERY-RS trial has found that CPAP reduces the need for MV in severe COVID. This study reported for every 12 people treated with CPAP, in comparison to SOT, 1 patient avoided MV.1Between 1/6/20 and 30/3/21, we admitted 156 patients to the RHCU. All patients met local Trust criteria for CPAP. Out of these, 69 patients (48%) were considered to be suitable for full escalation (intubation and mechanical ventilation on ITU). 1 patient died of non-COVID causes and was excluded. Of the remaining 68 patients, 72% improved with CPAP, with all patients surviving until discharge. 28% were transferred to intensive care for MV.Patients that avoided intubation had a mean age of 53.8 years, an average clinical frailty score (CFS) of 1.3 and a pO2 on admission to RHCU of 9.1kPa versus an age of 63.5 years, CFS of 1.5 and pO2 of 8.0kPa in those intubated.This analysis showed that CPAP was an effective modality of treatment, with 72% of patients avoiding going on to MV, which was the standard care provided in some other centres. For every 1.4 patients given CPAP, 1 MV was avoided. This data strongly supports emerging evidence on the benefit of CPAP in avoiding MV in COVID patients.Perkins G, Ji C, Connolly B, Couper K, Lall R, Baillie J et al. An adaptive randomized controlled trial of non-invasive respiratory strategies in acute respiratory failure patients with COVID-19. 2021.

16.
Eur Heart J ; 43(Suppl 2), 2022.
Article in English | PubMed Central | ID: covidwho-2107458

ABSTRACT

Background: SARS-CoV-2 infection affects the cardiovascular system and can result in vascular dysregulation and dysfunction. However, the hospitalization rates due to pre-existing cardiovascular disease and concomitant SARS-CoV-2 infection are not fully known. Purpose: To further elucidate the association between hospitalization and SARS-CoV-2 patients with pre-existing cardiovascular disease. We hypothesize that pre-existing cardiovascular disease is positively associated with hospitalization in patients who test positive for SARS-CoV-2. Methods: This is a retrospective study of patients 18 years and older who tested positive for SARS-CoV-2 between March 2020 and April 2021. Patients with cardiovascular co-morbidities, specifically hypertension, coronary artery disease (CAD), heart failure, were analyzed. The primary outcome was hospitalization. Secondary outcomes were all-cause mortality, myocardial infarction (MI), vasopressor use, hypotension, intubation, and acute kidney injury. Multivariate logistic regression analysis adjusted for demographics and comorbidities. Results: We identified 23,076 patients who tested positive for SARS-CoV-2;the hospitalization rate was 11.8% (2,721 patients). The incidence was 722 (26.5%) for CAD, 2068 (76%) for hypertension, 534 (91.3%) for heart failure, 188 (6.9%) for ESRD, 1484 (58.6%) for diabetes in patients who were hospitalized. The adjusted odds ratio (OR) of hospitalization was of 1.54 (95% Confidence Interval [CI]: 1.112–2.125;p<0.009) in patients with CAD, 5.730 (95% CI: 4.685–7.009;p<0.001) in patients with hypertension, 3.639 (95% CI: 2.308–5.737;p<0.001) in patients with heart failure. Use of angiotensin-converting enzyme inhibitor (ACEI) (p<0.001) was associated with reduced hospitalization, while the use of hydralazine (p<0.001), beta-blockers (p<0.001), and calcium channel blockers (p<0.001) were associated with increased hospitalization. Conclusion: SARS-CoV-2 positive patients with CAD, hypertension or heart failure were associated with increased hospitalization. Admitted patients were more likely to be taking calcium channel blockers, beta-blockers, and hydralazine. In contrast, these patients were also less likely to be taking ACEI. Funding Acknowledgement: Type of funding sources: None.

17.
Asia Pacific Journal of Tourism Research ; 27(8):823-841, 2022.
Article in English | Web of Science | ID: covidwho-2097098

ABSTRACT

COVID-19 have led companies and organizations to carefully decide overseas business travel after borders reopen. This study aims to develop a theory to guide a structural analysis of the situational factors that companies and organizations would consider in overseas business travel decisions and how to measure these factors. A qualitative research approach was adopted. Bunn's situational characteristics were used as the starting point to guide the study. The findings suggest that the decision results from a struggle between carry-on and hold-back forces, which were affected by two and six situational factors respectively. Their measuring dimensions and ten propositions are suggested.

18.
6th International Conference on E-Education, E-Business and E-Technology, ICEBT 2022 ; : 78-84, 2022.
Article in English | Scopus | ID: covidwho-2088931

ABSTRACT

This study examines the factors influencing continuous intention to use mobile commerce applications in Malaysia during the COVID-19 pandemic. Drawing on the Unified Theory of Use and Acceptance of Technology (UTAUT), Task-Technology Fit Model (TTF), and Expectancy Confirmation Model (ECM), the multiple regression analysis indicated that Performance Expectancy (PE), Social Influence (SI), Perceived Task-Technology Fit (TTF), and Hedonic Value (HV) positively affect continuous intention to use mobile commerce applications. Contrariwise, Effort Expectancy (EE), Trust (TR), Confirmation (COF), and Perceived Risk (PR) did not predict continuous intention to use mobile commerce applications. Theoretical and practical implications are discussed in this paper. © 2022 ACM.

19.
International Journal of Stroke ; 17(2 Supplement):8-9, 2022.
Article in English | EMBASE | ID: covidwho-2079342

ABSTRACT

Background: The COVID-19 pandemic has disrupted modern healthcare and delayed time to acute stroke treatment at some centres internationally. The effect of the pandemic on time metrics in patients with a large vessel occlusion (LVO) at Australian stroke centres is unknown. Aim(s): To evaluate time metrics for patients with an LVO transferred from a primary stroke centre (PSC) to a comprehensive stroke centre (CSC), during and before the coronavirus pandemic. Method(s): Retrospective analysis of consecutive patients with an LVO who were transferred from a single PSC to any of three CSCs were enrolled. The pandemic period was defined as the 24 months following the March 2020 state of emergency declaration in Melbourne, and prepandemic period the preceding 24 months. "Door-in" was the time triaged as a stroke, and "Door-out" was the time ambulance staff departed. Result(s): 159 patients were included, 82 in the pandemic group and 77 in the pre-pandemic group. There were no significant differences between groups in patient age, sex, modified Rankin scale score, or National Institute of Health Stroke Scale score. Door-in to Door-out (DIDO) times were reduced during the pandemic (median 52 vs 66 minutes, IQR 41-66 vs 52-95 minutes, p<0.001). There was no change in time from PSC Door-in to the first CSC DSA images (median 125 vs 125 minutes, p=0.79). Within the DIDO workflow, the only significantly different metric was time from CSC advising of patient acceptance to PSC door-out, which improved (median 8 vs 14 minutes, p=0.016). DIDO times out of hours when the stroke registrar was called in also improved (median 51 vs 87 minutes, p=0.003). Conclusion(s): The median DIDO times at our PSC improved during the pandemic. Further studies are required to determine if this is due to a continued quality improvement program at our centre, or due to other factors.

20.
International Conference on Transportation and Development 2022, ICTD 2022 ; 7:122-133, 2022.
Article in English | Scopus | ID: covidwho-2050655

ABSTRACT

A prime component of any effective public transportation system is equitable access for all riders within the community. Building transportation networks with equity in mind can boost ridership and transit network coverage. The problem of social equity in transportation is further exacerbated by historically auto-dependent cities and the pandemic restrictions from COVID-19. This paper aims to quantify transit equity using a disadvantage index. These results are then applied to different periods of a transit system throughout the COVID-19 pandemic to see how it affected social equity in public transportation as part of a case study in Riverside, California. Heat maps are overlaid on the transit network's lines and stops using geographic information systems (GIS) software to visualize the variables associated with transit equity calculations. Publicly released General Transit Feed Specification (GTFS) data is used to plot the state of the transit network at different points in time. The results show that route changes during the COVID-19 pandemic had a noticeable but minimal effect on social equity in transportation. © ASCE. All rights reserved.

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