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1.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617063

ABSTRACT

Background: Whilst the Irish Health Service Executive (HSE) currently recommends COVID-19 screening for all adult hospital admissions, current guidelines state that the screening of asymptomatic paediatric admissions is not necessarily required. However, clinically determining who requires testing can be difficult and subject to inter-carer variability. We sought to audit our acute admissions and swab results to determine rates of testing, characteristics of those being tested, and rates of positivity in a busy Irish tertiary paediatric unit. Methods: We reviewed the charts of 122 patients admitted acutely to our unit over the course of July 2021 to determine whether or not they had undergone COVID-19 screening using a nasopharyngeal PCR test and the clinical indication for testing. The clinical presentation of these admissions was analysed to try to determine positive predictive factors for COVID-19 screening and better streamline surveillance criteria. Results: A total of 122 admissions were analysed, with 74 (60.7%) having had a COVID-19 PCR test performed at the point of admission. Of these, 1 patient was found to be COVID-19 positive, giving an overall positivity rate of 0.8% amongst admissions analysed and 1.4% for admissions screened. The patient who returned a positive result was febrile at presentation but did not have any respiratory symptoms. Respiratory symptoms were documented for 45 of the 122 admissions (36.9%), and 42 of these underwent COVID-19 screening (93.3%). All swabs were negative. A total of 59 out of 122 were febrile at presentation, 55 (93.2%) of whom underwent screening. As above, 1 case tested positive. Of the afebrile patients, 19 out of 64 underwent COVID-19 screening. COVID-19 screening was performed in 12 patients who did not have a fever or respiratory symptoms at the time of presentation. In terms of non-respiratory presentations, screening was performed in 12 out of 14 (85.7%) presenting with gastritis/gastroenteritis, and 9 out of 12 (75%) presenting with a history and examination consistent with a UTI/pyelonephritis. Of 18 patients who were admitted with primarily psychiatric presentations, none had either a fever or respiratory symptoms at presentation, and none underwent COVID-19 screening. Conclusion: Our results reflect the existing data that COVID-19 appears to be less pathogenic in paediatric populations than in adult ones. Our low positivity rate compared to a high swab rate has repercussions in terms of bed allocation and isolation status. There is variation in terms of clinical criteria being viewed as sufficient to justify screening. Further study is required to determine consensus guidelines for COVID-19 surveillance in acute paediatric hospital admissions.

2.
Gastroenterology ; 160(6):S-389, 2021.
Article in English | EMBASE | ID: covidwho-1596227

ABSTRACT

Introduction: Colorectal cancer screening and surveillance colonoscopy declined drastically during the initial surge of coronavirus infectious disease (COVID-19) cases in the United States. In August 2020, the state of Georgia (GA) had the highest per-capita circulating infection rate in the nation, with an average of more than 25 cases per 100,000 people and was the "most likely" state where someone may be exposed to COVID-19. Our ambulatory endoscopy unit at Emory Healthcare, which is a large, tertiary referral care center in GA had a precipitous drop in show rate for screening and surveillance colonoscopy even after elective procedures resumed. Patients cited fear of acquiring COVID-19 as the primary reason for previously cancelling their procedure. Therefore, we implemented a quality improvement project aimed at improving show rates for screening and surveillance colonoscopy by providing patients structured education via a telephone call regarding the safety of inperson colonoscopy and addressing concerns regarding COVID-19. Methods: We contacted patients between the ages of 40-75 who were due for screening or polyp surveillance colonoscopy in August via a telephone call. Patients were provided a comprehensive overview of public health guidelines regarding COVID-19, and safety precautions at Emory Healthcare to minimize risk of transmission of COVID-19 including pre-procedural testing for COVID-19, social distancing, enforcing a universal masking policy, limited visitor/escort policy, and vigorous surface disinfection. Patients who completed their procedures were asked to complete a survey to provide feedback about the impact of the study phone call using a dichotomous response of agree/disagree. Results: 161 patients were contacted, of which 49% were Caucasian, 48.4% were African-American and 1.9% were Asian. 95% of the patients who were contacted completed their colonoscopies. 91.8% agreed that they received information about COVID-19 that they were previously unaware of;81.4% agreed that they are now more likely to follow public health guidelines of social distancing, hand washing, and wearing a mask. 91.1% felt safer about procedures after the study phone call, and 90.9% agreed that they felt less anxious about the risk of acquiring COVID-19 while in our facility. 70.3% agreed that they may not have come in for their procedures if they did not receive the study phone call. 94.4% agreed that they were satisfied with the procedural protocol at our facility and would come back for another procedure if needed. Conclusions: Our study suggests that specific communication of pandemic related issues are key to reducing peri-procedural concerns about COVID-19. Failure of timely colorectal cancer screening and colonoscopy will lead to a large burden of missed polyps and colorectal cancers leading to increased morbidity and mortality from CRC.

3.
Journal of the Association for Consumer Research ; 2021.
Article in English | Scopus | ID: covidwho-1550507

ABSTRACT

COVID-19 scams promise to alleviate the physical and financial risks associated with the ongoing coronavirus pandemic but in fact expose consumers to additional risk. The present research examines how one prominent and unequally distributed socioeconomic factor—resource availability during childhood—influences susceptibility to COVID-19 scams among US adults. One pilot and five preregistered studies (total N 5 1595) provide evidence that childhood adversity may often confer a protective advantage;when environmental threat is low, adults raised in scarcity are less susceptible to scams than those raised in abundance. However, heightened environmental threat—such as evidence of a worsening global pandemic—holds different consequences for those with different socioeconomic backgrounds: whereas adults raised in abundance become less susceptible to scams when the world seems more threatening, adults raised in scarcity become more susceptible to scams under these conditions. © 2021 Association for Consumer Research. All rights reserved.

4.
Perfect Beat ; 21(1):69-75, 2021.
Article in English | Scopus | ID: covidwho-1416934

ABSTRACT

In this article we explore a collaborative interdisciplinary Theatre and Music production as part of two undergraduate courses at the University of the Sunshine Coast, Australia, during COVID-19. Tertiary intuitions all over the world are currently being forced to adapt in radical response to the pandemic. The specific conditions of the authors’ experience prompted this collaboration where both teaching and learning occurred in an unstable, unpredictable and unprecedented environment. Experiences during the semester and the outcomes of the project were rich, multifaceted, and exceeded expectations. This included several weeks of intensive collaborative rehearsal and creative development, university-facing performances, and a public-facing performance at a NightQuarter event which had over 4,500 attendees. This article unpacks the ideas of Project-Based Learning (Bell 2010) and interdisciplinary collaboration, in order to understand the impact on teaching and learning and the potential of this model. © Equinox Publishing Ltd 2021

5.
British Journal of Dermatology ; 185:89-90, 2021.
Article in English | Web of Science | ID: covidwho-1396221
6.
Gastroenterology ; 161(1):E30-E30, 2021.
Article in English | Web of Science | ID: covidwho-1329499
7.
Sexually Transmitted Infections ; 97(Suppl 1):A130-A131, 2021.
Article in English | ProQuest Central | ID: covidwho-1301711

ABSTRACT

BackgroundWe aimed to examine the changes public sexual health services across Australia made during the national lockdown (March-May 2020) due to the COVID-19 pandemic.MethodsFrom July-August 2020, we emailed a link to an online survey to 21 sexual health clinic directors/managers who were part of the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood-borne Viruses (ACCESS) network.ResultsAll 20 participating clinics remained open but reported changes during the lockdown, including suspension of walk-in services in 8 clinics.Some clinics stopped offering asymptomatic screening for heterosexuals (n=11), men who have sex with men (MSM) (n=3), or transgender persons (n=2). Most clinics offered a mix of telehealth and face-to-face consultations for asymptomatic MSM (n=11), asymptomatic transgender persons (n=12), post-exposure prophylaxis (PEP) prescription (n=13) or to initiate pre-exposure prophylaxis (PrEP) (n=14). People who were symptomatic for STIs and contacts of STIs were offered face-to-face and telehealth consultations across all clinics. Seven clinics suspended STI test-of-cure consultations and four clinics suspended hepatitis vaccinations for people not living with HIV. Nineteen clinics reported delays in testing and 13 reported limitations in testing during lockdown. Most clinics changed to phone consultations for HIV medication refill (n=15) with faxed (n=14) or mailed (n=13) prescriptions. Fourteen clinics had staff redeployed to assist the COVID-19 response;14 clinics reported a reduction in total number of full-time equivalent (FTE) clinical nurses from 74.4 to 45.6 FTE collectively and three clinics reported reduction in FTE clinical doctors, from 20.1 to 17.1 FTE collectively.ConclusionAustralian public sexual health clinics rapidly pivoted service delivery to reduce the risk of COVID-19 transmission in their clinical settings, managed staffing reductions and delays in molecular testing, released staff to support the COVID-19 response, and maintained a focus on urgent and symptomatic STI presentations and those at higher risk of HIV/STI acquisition.

8.
Gastroenterology ; 160(6):S389-S389, 2021.
Article in English | Web of Science | ID: covidwho-1250513
9.
Pediatrics ; 147(3):956-957, 2021.
Article in English | EMBASE | ID: covidwho-1177797

ABSTRACT

Introduction: Gliomas are the most common primary CNS tumors making up 50-60% of brain tumors inchildren. Prognosis for gliomas depends on histologic grade and location of tumor. Impingement on normalbrain tissue or increase in intracranial pressure is caused by either obstruction of CSF flow or by direct masseffect. Symptoms can include lethargy, headache and vomiting. Signs of slow growing CNS tumors can includeirritability, poor school performance and loss of developing milestones. Most arise with no known underlyingrisk factor or disorder. Case Presentation: 7-year-old male with no significant past medical history presented with left sided weakness that began 8 weeks prior to admission. Initially mother noticed the patient to have anasymmetric smile. Patient was seen by PCP and was referred to ophthalmology and neurology at that time. 4weeks later, he was noted to have left arm weakness and difficulty writing with his left hand. A week later hebegan having weakness in his left leg and was noticed to have increased instability. Patient was reevaluated byPCP who instructed him to complete a 5-day course of steroids and follow-up with neurology. On the day of admission he was seen by an outpatient neurologist using telemedicine due to COVID outbreak. It was notedthe patient had left sided paralysis, a dilated left pupil, weakness of the left arm and leg with elevation. Afterseeing the physical exam findings through a webcam, the neurologist suggested for the patient to have urgentevaluation in the emergency department. CT brain with contrast revealed a heterogenous, complex mass inthe region of the right hypothalamus. MRI brain showed mass that involved the right and left cerebralhemisphere, with infiltration of the left optic tract. A brain biopsy was performed by neurosurgery andpathology was GFAP positive confirming astrocytoma in the brainstem. Discussion: About 25% ofastrocytomas are aggressive or high grade. Brainstem gliomas make up 10-20% of CNS tumors in children lessthan 15 years old. Diffuse midline gliomas are infiltrative tumors, usually with astrocytic morphology and arelocated in the pons, thalamus or spinal cord. Most cases have high grade features and are histologicallyconsistent with Grade 4. Treatment includes surgery, radiotherapy and chemotherapy. For high grade tumorssurgery can be performed as well as radiotherapy and chemotherapy. But without reasonable resectionchemotherapy is palliative. Brainstem gliomas cannot be removed, and therefore have a poor outcome.Conclusion: Despite lack of in person evaluation, this case highlights the importance of prompt recognitionand action when performing history and physical exams even in this new era of telemedicine. In the setting ofthe COVID-19 pandemic, the use of telemedicine proved to be prominent in the diagnosis of this patient.

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