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1.
Challenges in Science Education: Global Perspectives for the Future ; : 59-81, 2023.
Article in English | Scopus | ID: covidwho-20243668

ABSTRACT

The development of vaccines against a range of deadly or debilitating diseases represents one of the major medical advances of our time, saving many millions of lives. The COVID-19 pandemic has led to extensive media coverage on vaccination. As a consequence, vaccination views and varied sides of the debate have become a common topic of social conversation and argument worldwide. Despite the undoubted benefits vaccines have provided, there is still skepticism about their safety amongst some sections of society. Anti-vaccine messages are being amplified and disseminated widely by social media, sometimes invoking either pseudo-science or anti-scientific justification. The prevalence and apparent influence of the current anti-vaccine movement suggest that the goals of science education including scientific literacy, critical thinking and argumentation based on reliable evidence, and sound reasoning are not being met for a substantial proportion of the population. This chapter will examine some of the non-scientific arguments currently being communicated about mass vaccination on social media platforms and the implications for science education in engaging with this problematic socio-scientific issue. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

2.
Strategic Human Resource Management in the Hospitality Industry: A Digitalized Economic Paradigm ; : 15-56, 2023.
Article in English | Scopus | ID: covidwho-2326095

ABSTRACT

The tourism industry in South Africa is viewed as the most significant potential engine of economic growth and employment creation among all industrial groupings. The introduction of the coronavirus had a terrible effect on the travel and tourism industry both internationally and in South Africa. The study's primary goals were to introduce design thinking to the tourism industry, comprehend its special ability to address difficulties unique to the industry, and eventually identify design thinking as a key strategic tool for advancing tourism in KwaZulu-Natal, South Africa. This study employed a qualitative research methodology with purposive sampling. The key findings indicated that participants in the study expressed a desire for design thinking to be adopted in this industry and offered a variety of activities to help achieve this goal. It is recommended that the tourism industry collaborates with key stakeholders and the design thinking model developed from this study be applied with various customized strategies in human resource design thinking competency. © 2023, IGI Global.

3.
Review of Religious Research ; 64(4):1001-1003, 2022.
Article in English | Web of Science | ID: covidwho-2311261

ABSTRACT

Background Organizations in changing contexts face uncertain futures. Anecdotal evidence suggests that the COVID-19 pandemic is changing the shape of the church. Such changes have implications for theological education and ministerial resourcing. Purpose In 2021, Whitley College and the Baptist Union of Victoria (BUV) commissioned research to clarify how a theological seminary might serve stakeholders. A posture of listening sought to understand how local ministry leaders envisioned the church and were responding to change. Methods A mixed-methods approach was utilized. Denominational literature, along with recent ecclesial literature, was examined. A mix of randomized and purposive selection resulted in fourteen individual interviews and eight focus groups (n = 47). Participants came from BUV churches of all sizes, with 15 females and 32 males, 15 LOTE (Language Other Than English) and 32 native English speakers, and 8 who identified as lay. All interactions happened under the denominational Code of Ethics. A range of questions explored perceptions of the future church and experiences of leading in change. The interviews, ranging in length from between 60 to 105 min, were recorded. Participants confirmed a de-identified summary for thematic analysis. Results Every denominational participant was unanimous that the future church would be different from today's church. These local ministry leaders were seeking different types of relationships with organizations. Seminaries would be valued as they participated with the local church in learning relationships. Participation included academic research, which was appreciated as an essential resource, notably if it undertook contextual social research and empirical research into generational and multi-cultural realities, church vitality, and best practice in leadership. Those interviewed requested equipping in innovation, leading change, mission as neighborhood placemaking, and faith formation across generations. A feature of the focus groups included the articulation of aspects of God seen as essential in the leading of change. One participant named God as patient, while several described God as creative in the midst of change. Another participant drew on a quote by British author and speaker Adrian Plass, "God is nice and he likes me" (2005: 10). These named attributes of God indicate that local church leaders are working with grassroots theologies in their leading of change. A distinctive theology of mission was present among LOTE participants. This theology focused on nurturing a second generation who, in time, might contribute across cultures in neighborhood witness. Conclusions and Implications A changing world presents significant opportunities for theological colleges and seminaries to re-invent themselves. Providers of theological formation have a significant role in resourcing the future church, particularly as they attend to collaborative and relational partnerships. Theological ethicist, Samuel Wells (2018) argues for the priority and value of "being with";imitating Jesus who spent thirty years "being with" humanity as a child and carpenter. This research revealed multiple grassroots invitations for colleges and seminaries to position themselves as "being with" local churches. Research partnerships in local ecclesial sites have the potential to deepen conversations between theory and practice. Cultivating teaching partnerships would allow grassroots leadership theologies to inform theories of leading change and enhance the diversity of voices in the learning context. Together, these changes point colleges and seminaries toward a renewed focus on local contextual theologies, empirical research, and grassroots partnerships. Such participation requires accompanying the local church, not as a problem to be fixed or a base for recruitment, but in a shared human quest to learn in change.

4.
Critical Care Medicine ; 51(1):585-585, 2023.
Article in English | Web of Science | ID: covidwho-2307973
5.
Sustainability ; 15(6), 2023.
Article in English | Web of Science | ID: covidwho-2307844

ABSTRACT

The price of food has been affected in recent months in response to events such as the war in Ukraine, energy costs, inflation, the COVID-19 pandemic, and climate change. Indeed, supply problems, as well as the repercussions of global issues, have had an impact on grocery bills. Just between September and October 2022, the price of food increased by 11.4% and 11% year-to-year. In addition, with the pandemic, buying locally has become a key factor for some in choosing which products to consume. This second edition of the report aims to answer the question Does eating local in Quebec cost more? More precisely, our objective was to identify if local products in the food sector, especially in Quebec, were competitive in their price points compared to foods coming from other regions of the world. To answer this, we used AI and machine learning to harvest data from 99 local products and 335 comparable nonlocal products, totaling 198,990 data points and 3745 prices across six data collection dates. The results showed that a total of 25 categories displayed an advantage for the local product or a neutrality, out of a total of 45 categories identified. Our results demonstrated that 55.6% of the categories that contained the local foods analyzed were price competitive with comparable products or less expensive than them.

7.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 84(5-B):No Pagination Specified, 2023.
Article in English | APA PsycInfo | ID: covidwho-2293542

ABSTRACT

In Csikszentmihalyi's 1990 theory of flow, individuals can become immersed in creative activities as well as other positive activities including exercise and meditation. Research found that individuals engaged in flow could persevere regardless of feeling boredom or fatigue. However, the flow state is more difficult to achieve in the face of stress (Csikszentmihalyi, 1990). The current research study utilized an archival database collected during a COVID-19 lockdown to examine the impact of flow-like activities (creative work, meditation, and inside exercise) on psychological well-being (boredom, fatigue, anxiety, and depression). Correlation analyses were conducted followed by hierarchical regression to determine the relative variance in boredom, fatigue, depression, and anxiety that was explained by creative work, exercise, and meditation ratings. Further, creative work was positively associated with meditating, indicating that participants who reported more frequent creative work also reported meditating more often. Additionally, creative work, inside exercise, and meditation were associated with psychological outcomes including feeling boredom and fatigue. However, only inside exercise was associated with decreased anxiety and depression symptoms. These findings should inform interventions to improve psychological well-being during difficult times such as the COVID-19 lockdown. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

8.
2022 Winter Simulation Conference, WSC 2022 ; 2022-December:1223-1234, 2022.
Article in English | Scopus | ID: covidwho-2249506

ABSTRACT

Pandemics have huge impact on all aspect of people's lives. As we have experienced during the Coronavirus pandemic, healthcare, education and the economy have been put under extreme strain. It is important therefore to be able to respond to such events fast in order to limit the damage to the society. Decision-makers typically are advised by experts in order to inform their response strategies. One of the tools that is widely used to support evidence-based decisions is modeling and simulation. In this paper, we present a hybrid agent-based and discrete-event simulation for the Coronavirus pandemic management at regional level. Our model considers disease dynamics, population interactions and dynamic ICU bed capacity management and predicts the impact of various public health preventive measures on the population and the healthcare service. © 2022 IEEE.

9.
Cureus ; 15(1): e34083, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2256410

ABSTRACT

Introduction The objective of this study was to identify barriers that affect adherence to the management of diabetic retinopathy (DR) in an urban ophthalmology clinic. Patient beliefs regarding diabetic eye care, transportation to the eye clinic, the COVID-19 pandemic, and treatment with panretinal photocoagulation (PRP) or anti-vascular endothelial growth factor (anti-VEGF) injections were investigated. Materials and methods The original Compliance with Annual Diabetic Eye Exams Survey (CADEES) included 44 statements designed with a 5-point Likert scale to assess patients' beliefs and understanding of their eye health and the importance of diabetic eye examinations. This survey was modified to include additional statements regarding the COVID-19 pandemic and free-response questions about transportation barriers and patients' subjective experiences with PRP or anti-VEGF injections. A total of 365 patients with a diagnosis of any stage of DR from SLUCare Ophthalmology were identified as potential participants to complete the telephone survey. Patients were classified as non-adherent if they did not have a dilated eye examination within the past year, missed a scheduled follow-up appointment for DR care within the past year, or missed an appointment for anti-VEGF injections or PRP. The mean Likert scores for each CADEES statement were compared between the adherent and non-adherent groups using independent samples t-tests. Demographics and clinical indicators were also reported and compared between the two groups. Results Out of 365 patients, 68 completed the modified CADEES. Twenty-nine patients were adherent, and 39 patients were non-adherent. Results from six of the 54 CADEES statements were significantly different between the adherent and non-adherent groups. These statements addressed patients' perception of their eye health, self-confidence in making an eye appointment, knowing someone with diabetic eye complications, self-confidence in controlling blood sugar, ability to use public transportation during the COVID-19 pandemic, and prioritizing eye health during the pandemic. There were no significant differences in clinical indicators or demographics between the adherent and non-adherent groups. Of the participants, 39.7% offered reasons for why transportation to the eye clinic was difficult. Patients suggested three novel reasons for missing eye appointments that were not specifically addressed in the CADEES. Fourteen unique barriers were reported for non-adherence with PRP or anti-VEGF injections. Conclusions The CADEES is a thorough tool for evaluating social barriers impacting adherence with DR appointments in an urban ophthalmology clinic. The survey did not identify any clinical or demographic risk factors for non-adherence in this patient population. Decreased patient self-efficacy may lead to non-adherence with the management of DR. The COVID-19 pandemic impacted the adherence of a small percentage of patients.

10.
BMC Med Educ ; 23(1): 174, 2023 Mar 20.
Article in English | MEDLINE | ID: covidwho-2281434

ABSTRACT

BACKGROUND: The Covid-19 crisis sparked service reconfigurations in healthcare systems worldwide. With postgraduate medical education sitting within these systems, service reconfigurations substantially impact trainees and their training environment. This study aims to provide an in-depth qualitative understanding of the impact of service reconfiguration on doctors' training during the pandemic, identifying opportunities for the future as well as factors that pose risks to education and training and how these might be mitigated. METHODS: Qualitative parallel multi-centre case studies examined three Trusts/Health Boards in two countries in the United Kingdom. Data were collected from online focus groups and interviews with trainees and supervisors using semi-structured interview guides (September to December 2020). A socio-cultural model of workplace learning, the expansive-restrictive continuum, informed data gathering, analysis of focus groups and coding. RESULTS: Sixty-six doctors participated, representing 25 specialties/subspecialties. Thirty-four participants were male, 26 were supervisors, 17 were specialty trainees and 23 were foundation doctors. Four themes described the impact of pandemic-related service reconfigurations on training: (1) Development of skills and job design, (2) Supervision and assessments, (3) Teamwork and communication, and (4) Workload and wellbeing. Service changes were found to both facilitate and hinder education and training, varying across sites, specialties, and trainees' grades. Trainees' jobs were redesigned extensively, and many trainees were redeployed to specialties requiring extra workforce during the pandemic. CONCLUSIONS: The rapid and unplanned service reconfigurations during the pandemic caused unique challenges and opportunities to doctors' training. This impaired trainees' development in their specialty of interest, but also presented new opportunities such as cross-boundary working and networking.


Subject(s)
COVID-19 , Physicians , Humans , Male , Female , COVID-19/epidemiology , United Kingdom , Focus Groups , Learning , Qualitative Research
11.
Translational Issues in Psychological Science ; 8(3):295-299, 2022.
Article in English | Scopus | ID: covidwho-2283709

ABSTRACT

Pandemics such as the coronavirus 2019 (COVID-19) outbreak are global epidemics of emerging or reemerging infectious diseases. Pandemics and other outbreaks will likely become more prevalent over the coming decades for a variety of reasons, including growing population density, increasing mobility (e.g., ease of international travel), and climate change (e.g., warmer, wetting winters favoring the proliferation of disease-carrying organisms such as mosquitoes). Accordingly, pandemic concerns need to be addressed now and in the future. Psychology plays a vital role in pandemics and their management. Psychological factors influence (a) adherence to pandemic mitigation methods (e.g., adherence to social distancing), (b) pandemic-related social disruption (e.g., panic buying, racism, lockdown protests), and (c) pandemic-related distress and related problems (e.g., anxiety, depression, substance abuse;Taylor, 2019, Taylor et al., 2022b). Many of the psychosocial phenomena, such as panic buying and lockdown protests observed during COVID-19, were observed in past pandemics and other outbreaks of infectious disease, such as influenza, plague, and cholera (Taylor, 2019, 2022a, 2022b). This suggests that research into the psychology of COVID-19 may help us to better understand and prepare for future pandemics. © 2022 American Psychological Association

12.
Haemophilia ; 29(Supplement 1):193, 2023.
Article in English | EMBASE | ID: covidwho-2283708

ABSTRACT

Introduction:With improved medical management the message to be physical active (PA) has changed for those with haemophilia. Being PA has many benefits, both physically and mentally however those with haemophilia have often had difficulties accessing PA and confidence to try being more active Methods: Prior to COVID a balance/core exercise class were set up. Patients with all severities of haemophilia were invited to attend and baseline outcomes collected. The class lasted 60 minutes and taken by a physiotherapist, comprising of warmup, balance/core exercises, use of the gym equipment and stretches. During COVID these face to face (F2F)classes were stopped and taken online in the form of real-time telerehabilitation. Exercises were like the F2F classes, except the gym equipment was not accessible. A questionnaire evaluation was completed during COVID to review the online classes Results: 1 patient did not attend the online classes due to lack of room at home n=8 completed the questionnaire. Online connection was reported as good (80%), patients used a variety of devices. 100% reported the demonstration of exercises were clear with a variety of difficulty levels and class frequency was suitable. When asked what aspects of the class patients enjoyed, they reported feeling supported and motivated by their peers. Especially during COVID where many felt isolated. They felt stronger and more confident to move. They reported improved balance and liked having a link to a HCP to answer questions which helped keep them motivated to be active. When asked which class delivery patients preferred, there was a mixture of responses. Many reported they preferred F2F for the in person social interaction however the virtual classes were more convenient for time and cost of travel. They were still motivated by each other on screen and enjoyed hearing what others were managing to try Discussion/Conclusion: Patients reported satisfaction with both the F2F and virtual classes. The ease of access for the virtual classes was appreciated due to the large travel times. However, patients enjoyed the social interaction both online and F2F and improved self-efficacy from meeting and exercising with others of similar ability. Virtual classes work well in aiding PWH to be more active and provide support from peers to aid self-efficacy however hybrid models of care delivery may provide the best of both approaches.

13.
American journal of obstetrics and gynecology ; 224(2):S685-S685, 2021.
Article in English | EuropePMC | ID: covidwho-2281731
14.
J Clin Med ; 12(4)2023 Feb 18.
Article in English | MEDLINE | ID: covidwho-2238923

ABSTRACT

Chronic lymphocytic leukemia (CLL) caregivers play a central role in disease management-a role that has been heightened during the COVID-19 pandemic given the healthcare system's reliance on frontline family caregivers and CLL patients' increased risk of infection and mortality. Using a mixed-method design, we investigated the impact of the pandemic on CLL caregivers (Aim 1) and their perceived resource needs (Aim 2): 575 CLL caregivers responded to an online survey; 12 spousal CLL caregivers were interviewed. Two open-ended survey items were thematically analyzed and compared with interview findings. Aim 1 results showed that two years into the pandemic, CLL caregivers continue to struggle with coping with distress, living in isolation, and losing in-person care opportunities. Caregivers described experiencing increasing caregiving burden, realizing the vaccine may not work or didn't work for their loved one with CLL, feeling cautiously hopeful about EVUSHELD, and dealing with unsupportive/skeptical individuals. Aim 2 results indicate that CLL caregivers needed reliable, ongoing information about COVID-19 risk, information about and access to vaccination, safety/precautionary measures, and monoclonal infusions. Findings illustrate ongoing challenges facing CLL caregivers and provide an agenda to better support the caregivers of this vulnerable population during the COVID-19 pandemic.

15.
CJEM ; 25(3): 193-199, 2023 03.
Article in English | MEDLINE | ID: covidwho-2235944

ABSTRACT

PURPOSE: Pressures related to the COVID-19 pandemic have created the need to develop innovative ways to deliver mental health care, especially for urgent needs. After the launch of a pediatric Emergency Department (ED) Virtual Care service, we aimed to evaluate pediatric ED physicians' experiences with the use of ED virtual care for mental health assessments. METHODS: This mixed-methods study was conducted at a pediatric academic health center in Ontario, Canada. Pediatric ED physicians who conducted ED virtual mental health assessments from May to December 2020 were eligible. Participants completed a 22-question novel survey and were invited to participate in a focus group. Descriptive and thematic analyses were used to analyze the data. RESULTS: Twenty-nine physicians provided mental health services through the ED virtual care platform. Twenty-five physicians (86% response rate) completed the survey and 3 (10%) participated in a focus group. While many agreed that virtual care benefits patients (67%), key barriers identified included time constraints, lack of mental health clinician support, and uncertainty around the pediatric ED physicians' role in these types of assessments. Despite these barriers, physicians recognized the potential benefit of the ED virtual care service for mental health assessments and were largely amenable to improving this process should mental health support be available. CONCLUSIONS: While many physicians agreed that there is a potential benefit of the ED virtual care platform for urgent mental health assessments, time constraints and lack of confidence in providing satisfactory virtual mental health care with minimal mental health support limited its acceptability. These findings can inform the future implementation of mental health services using an innovative virtual ED platform.


RéSUMé: OBJECTIF: Les pressions liées à la pandémie de COVID-19 ont créé le besoin de développer des moyens innovants pour fournir des soins de santé mentale, en particulier pour les besoins urgents. Après le lancement d'un service de soins virtuels aux urgences pédiatriques, nous avons cherché à évaluer les expériences des médecins des urgences pédiatriques avec l'utilisation des soins virtuels aux urgences pour les évaluations de la santé mentale. MéTHODOLOGIE: Cette étude à méthodes mixtes a été menée dans un centre universitaire de santé pédiatrique en Ontario, au Canada. Les médecins pédiatriques qui ont effectué des évaluations virtuelles de la santé mentale aux urgences de mai à décembre 2020 étaient admissibles. Les participants ont rempli une enquête inédite de 22 questions et ont été invités à participer à un groupe de discussion. Des analyses descriptives et thématiques ont été utilisées pour analyser les données. RéSULTATS: Vingt-neuf médecins ont fourni des services de santé mentale par le biais de la plateforme de soins virtuels des urgences. Vingt-cinq médecins (taux de réponse de 86 %) ont répondu au sondage et trois (10 %) ont participé à un groupe de discussion. Si beaucoup s'accordent à dire que les soins virtuels sont bénéfiques pour les patients (67 %), les principaux obstacles identifiés sont les contraintes de temps, le manque de soutien des cliniciens en santé mentale et l'incertitude quant au rôle des urgentistes pédiatriques dans ces types d'évaluations. Malgré ces obstacles, les médecins ont reconnu l'avantage potentiel du service de soins virtuels de l'urgence pour les évaluations de la santé mentale et étaient largement disposés à améliorer ce processus si un soutien en santé mentale était disponible. CONCLUSIONS: Bien que de nombreux médecins s'accordent à dire que la plateforme de soins virtuels des urgences présente un avantage potentiel pour les évaluations urgentes de la santé mentale, les contraintes de temps et le manque de confiance dans la prestation de soins de santé mentale virtuels satisfaisants avec un soutien minimal en matière de santé mentale ont limité son acceptabilité. Ces résultats peuvent éclairer la mise en œuvre future des services de santé mentale à l'aide d'une plateforme virtuelle d'urgence innovante.


Subject(s)
COVID-19 , Physicians , Humans , Child , Mental Health , Pandemics , COVID-19/epidemiology , Emergency Service, Hospital , Physicians/psychology , Ontario
16.
Pharmacy Education ; 20(2):272-275, 2020.
Article in English | EMBASE | ID: covidwho-2218250

ABSTRACT

Introduction: Student wellbeing is a key component of pharmacy programmes, with most events occurring in-person through co-curricular or extra-curricular activities. With the shift to online classes due to COVID-19, many wellness events were cancelled due to social distancing limitations. However, promotion of wellbeing was considered to be of utmost importance during this time due to rising levels of stress and social isolation among students. Description: The school's Instagram and Facebook accounts were managed by a group of the university's faculty for six weeks. Each week, different daily wellness themes were shared and participation by followers encouraged through quizzes, polls, or reposts. The Instagram stories and posting platforms were used routinely with select posts also shared via Facebook. A new hashtag was created and promoted to encourage additional posting and community building. Video stories were also shared of faculty expressing their mental/physical health challenges and subsequent coping mechanisms during COVID-19. Result(s): During the last six weeks of virtual learning, 280 stories and 23 posts were shared via Instagram. Shared stories included promotion of: cardiovascular exercise, weight training, yoga, music, media, gratitude, recognition, positive thinking, coping and games. Overall, 20 different faculty and staff were involved in sharing video stories to promote wellbeing. Of the 13 posts also shared to Facebook, a total of 10,429 people were reached. Conclusion(s): School social media platforms can be used to regularly connect virtually during times of crises. Promoting wellness activities can help engage students and faculty/staff to ensure they are focusing on their own wellbeing. With social distance regulations for the foreseeable future, pharmacy programs should consider using social media as a wellbeing tool for both student and faculty/staff engagement. Copyright © 2020, International Pharmaceutical Federation. All rights reserved.

17.
Critical Care Medicine ; 51(1 Supplement):600, 2023.
Article in English | EMBASE | ID: covidwho-2190681

ABSTRACT

INTRODUCTION: The COVID-19 pandemic disrupted access and delivery of routine continuing care for sepsis recovery, including provision of postacute services like skilled nursing facility (SNF) discharge, home healthcare (HH), and outpatient follow up. We hypothesized pandemic-related precautions and care disturbances would disparately impact postacute care for adults with sepsis due to COVID-19 vs non-COVID-19 pneumonia. METHOD(S): ENCOMPASS is an ongoing hybrid trial to test implementation of a multidisciplinary postsepsis transitional care program at 8 diverse hospitals (NCT04495946). In the current study, we analyzed community-dwelling trial participants (i.e., adults with clinically defined sepsis) enrolled July 2020-Nov 2021 with discharge diagnoses of COVID-19 (ICD10 U07.1) or non-COVID-19 pneumonia (ICD10 J13-18). Using EHR data, we examined discharge care setting (SNF or inpatient rehab, HH, or home with self care) and outpatient follow up within 14 days (in-person, virtual, or none) as primary and secondary outcomes. For each outcome, we fit multinomial regression models adjusted for patient (age, insurance), clinical (comorbidity burden, organ failure, length of stay) and community factors (rurality by zip code). RESULT(S): Among 410 participants with COVID-19 (n=151) or non-COVID-19 (n=259) pneumonia (median, at enrollment: age=70, CCI=5, SOFA score=4), 52 (13%) died in hospital and 18 (4%) discharged to hospice. of remaining patients, 134 (39%) were discharged to home with self care, 118 (35%) to HH, and 88 (26%) to SNF or inpatient rehab. Survivors with vs without COVID-19 had similar adjusted odds of discharge to HH (OR=1.17 95%CI=0.65-2.10) and SNF or inpatient rehab (OR=1.60 95%CI=0.81-3.14) compared to home. Outpatient visit completion was similar for COVID-19 and non-COVID-19 survivors (26% vs 30%, p=0.43), but patients with vs without COVID-19 had higher odds of virtual (OR=4.76 95%CI=2.11-10.75) compared to no completed follow-up. CONCLUSION(S): In an ongoing postsepsis care trial, COVID-19 and non-COVID-19 survivors had similar provision of postacute services. COVID-19 was associated with increased virtual outpatient follow up, highlighting the value of telehealth to reduce exposure risk while maintaining close follow up of patients recovering from serious illness during the pandemic.

18.
Critical Care Medicine ; 51(1 Supplement):585, 2023.
Article in English | EMBASE | ID: covidwho-2190677

ABSTRACT

INTRODUCTION: Prior data indicate that sepsis survivors face persistent health challenges and fail to receive adequate support after hospital discharge. Delivery of high-quality transition care may be exacerbated by the COVID-19 pandemic. We assessed patient reported satisfaction with transitional care and health outcome status for survivors of respiratory sepsis (due to COVID-19 and non-COVID-19 pneumonia) during the pandemic. METHOD(S): We enrolled patients (or surrogate caregivers) from both usual care and intervention arms of ENCOMPASS, an ongoing clinical trial evaluating the effectiveness of a multicomponent sepsis transition program. Individuals who consented to participate completed health related quality of life (HRQoL;EQ-5D-5L) and other outcomes measures (Mini-MOCA, IES-6, mMRC) 3 months after hospital discharge and responded to questions about post-discharge support. Interviews were conducted via telephone. Data were collected in REDCap (Research Electronic Data Capture) and analyzed with SAS. RESULT(S): Among 18 participants (14 patients, 4 caregivers [non-overlapping]), 56% were female, median patient age was 67 years, median Charlson index was 4, median SOFA was 4, and 2 patients were recovering from COVID-19. Most reported being satisfied/very satisfied with their transitional care (15, 83%) and were able to get all of the healthcare services needed during the pandemic (14, 78%). Many participants reported persistent problems at 3 months after discharge (mobility [17, 94%], self-care [17, 94%], usual activities [18, 100%], pain or discomfort [17, 94%], and anxiety or depression [15, 83%]), independent of coexisting chronic disease burden. The median EQ-5D visual analog scale was 65 (IQR=40-80). 12 (86%) patients reported persistent dyspnea, 2 (14%) had cognitive impairment by mini-MOCA, and 3 (21%) had symptoms of post-traumatic stress by IES-6. CONCLUSION(S): Sepsis survivors experience multidimensional HRQoL problems 3 months after discharge. Despite concerns about the provision of transitional support during the pandemic, most patients in this small study were satisfied with the transitional support received. Our findings reinforce the need for high-quality transitional support that addresses the new or worsening health problems experienced after sepsis.

20.
Asia Pacific Journal of Health Management ; 17(3), 2022.
Article in English | Web of Science | ID: covidwho-2205243

ABSTRACT

Telehealth has been used to care for patients at a distance in specific clinical and demographic situations, but the demand for physical isolation during the COVID-19 pandemic has expanded its application to the broader community. This systematic literature review, of very recent publications, elucidates the new ways telehealth has been implemented, confirms it's acceptability, accessibility and safety by collating reviews, trial and cohort studies from peer reviewed journals meeting defined risk of bias criteria.Five literature reviews, three qualitative studies and 22 quantitative studies were included, which confirmed that telehealth is a safe medium for delivery of surgical health care, is accessible and efficient for the majority of patients and clinicians across the age and socioeconomic spectrum. It is time and resource efficient for providers and recipients and improves the delivery of patient-centred care. Many providers have published innovative solutions to the difficulties of telehealth, such as conducting a physical examination or technological limitations at the remote site. Health care can now be delivered directly to the home or the workplace.Routine in-person postoperative review of patients should be replaced by patient-led telehealth unless there is a specific reason for face-to-face review. Assessment and management of new cases could be managed more efficiently if a carefully planned digital referral process is developed and adopted.

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