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2.
International Journal of Stroke ; 17(2 Supplement):35-36, 2022.
Article in English | EMBASE | ID: covidwho-2064673

ABSTRACT

Background: The $21.7 million NSW Telestroke Service was a 2019 NSW Government election commitment. Implementation of the service is a collaboration between South Eastern Sydney Local Health District, the NSW Agency for Clinical Innovation, eHealth NSW and the NSW Ministry of Health. Between March 2020 and June 2022, the telestroke service launched at 23 sites across regional and rural NSW, providing access to specialist stroke physicians for rapid assessment, diagnosis and treatment through virtual care. The service has treated over 2200 patients with a reperfusion rate for acute ischaemic stroke patients of 34%. Aim(s): To understand the factors driving the successful implementation of a major project led by multiple health organisations in a complex environment. Interrogating and documenting the success factors will help NSW Health agencies implement similar large-scale, complex projects. Method(s): The implementation team adopted a reflective approach to draw out key lessons during the implementation at each site. Lessons learnt discussions were held at a local and program-wide level, focusing on areas including resourcing, leadership, education and training, and sustainability. Result(s): Key elements of successful implementation highlighted by the reflective lessons learnt approach include: * Division of responsibility that reflected the strengths of each partner agency * Clear implementation roadmap including comprehensive implementation and training packages * Flexibility to adapt the implementation approach based on contextual factors and intervening events * Strong executive support at each partner agency * Upfront focus on sustainability to identify and mitigate issues early on The telestroke service was implemented by the target schedule, despite the significant impacts caused by the COVID-19 pandemic and natural disasters. The service was a finalist in the 2021 NSW Premier's Awards. Conclusion(s): The implementation of telestroke can offer insights for partner agencies into the key factors driving success of transformative projects to improve access to healthcare.

3.
International Journal of Stroke ; 17(1):22, 2022.
Article in English | EMBASE | ID: covidwho-2064667

ABSTRACT

Aim: The NSW Telestroke project implemented a virtual model of care to improve access to hyperacute stroke treatment across 23 hospitals. To understand and extrapolate the success factors involved in effective project implementation and sustainability. Objective: The successful implementation of large-scale service redesigns with demonstrated improvement in patient outcomes are limited. The implementation at scale to 23 hospitals with varying local contextual features including resourcing, culture, leadership and facility set up has provided insights into the key elements of successful implementation. Undertaking a systematic approach to implementation including formulating a well-developed and attainable proposal for change in practice with clear targets, assessing the performance and mapping potential barriers indicates markers for successful implementation. Lessons learned has provided a gauge of what future endeavours should consider to inform large scale system transformation. Results: The Telestroke project has been implemented across 18 hospitals to date, with a further five sites by June 30, 2022. This is within the expected timeframe despite COVID-19 outbreaks in NSW and subsequent restrictions limiting activity at crucial time periods. Discussion: Through reflective lesson learned discussions at a program, hospital and individual level key drivers for successful implementation and sustainability of the project were highlighted. They include: 1. A clear roadmap, detailing the implementation approach with matching resources and education packages, have allowed expedited delivery of the program at a site level 2. Skilled, dedicated and consistent staffing in program implementation lead roles has enabled stability in coordination and knowledge management. This supports key learnings being adapted and utilised for future go-lives. 3. Leveraging skill mix at each site to fill knowledge/experience gaps to support and embed Telestroke. 4. A supportive executive team and clearly identified key champions in each department to drive the change forward. 5. Adapting training to suit the local environment including resources and COVID-19 restrictions was crucial during implementation.

4.
Chest ; 162(4):A1821, 2022.
Article in English | EMBASE | ID: covidwho-2060870

ABSTRACT

SESSION TITLE: Outcomes Across COVID-19 SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Coronavirus disease 2019 (COVID-19) and influenza infections are associated with systemic inflammatory reactions that predispose to Takotsubo cardiomyopathy (TTS). Studies have investigated the epidemiology and clinical features of TTS in COVID-19 and influenza infection, however, there are limited data comparing TTS between patients with COVID-19 and influenza. METHODS: We searched PubMed/Medline, Web of Science, SCOPUS, EMBASE, and Google Scholar until November 1st, 2021, for case reports, case series, and observational cohort studies using these keywords: takotsubo syndrome/takotsubo cardiomyopathy, stress-induced cardiomyopathy, and broken heart syndrome combined with the terms COVID-19 and/or SARS-CoV-2, flu and/or influenza. All the published case reports included in the final analysis were in English and were categorized into patients with ‘COVID-19 + TTS’ and ‘Flu + TTS’. RESULTS: We identified 37 studies describing 64 patients with COVID-19+TTS and 10 case reports describing 10 patients with Flu + TTS. The mean age of patients in the COVID-19 + TTS was similar to the influenza group (69 years). Although women were more disproportionately affected by TTS in both groups, COVID-19 + TTS patients had a higher proportion of men than the Flu + TTS group (44% vs 30%) and previously reported incidence of TTS in men in the general population. Compared to patients with Flu + TTS, COVID-19 + TTS had a longer mean time from testing positive to developing TTS (7.3 days vs. 3.1 days), higher incidence rates of acute respiratory distress syndrome (77% vs. 40%), hypoxemic respiratory failure (86% vs. 60%), more likely to require invasive mechanical ventilation (63% vs. 40%) and higher in-hospital mortality rates (36%, n=23 vs 10%, n=1) CONCLUSIONS: Our systematic review highlights some important differences in the presentation and outcomes of TTS in patients with COVID-19 compared to seasonal influenza. Patients with COVID-19 + TTS had higher rates of respiratory complications and excess all-cause mortality compared to Flu + TTS. In contrast to the general population and patients infected with influenza, TTS tends to affect more men with COVID-19 infection. CLINICAL IMPLICATIONS: Hospitalized patients with COVID-19 who develop TTS appear to have a more severe disease course and poorer outcome compared to hospitalized patients with Flu+TTS. The study findings provide additional knowledge comparing complications between COVID-19 and influenza infections and may contribute to the continued efforts to manage the COVID-19 pandemic. DISCLOSURES: no disclosure on file for Temidayo Abe;No relevant relationships by Thomas Allingham No relevant relationships by Omovefe Edika No relevant relationships by Hammad Khalid No relevant relationships by Ifeoma Ogbuka No relevant relationships by Titilope Olanipekun No relevant relationships by Richard Snyder No relevant relationships by Abhinav Vedire No relevant relationships by Nicholas Wilson

5.
New Zealand Medical Journal ; 135(1560):89-98, 2022.
Article in English | EMBASE | ID: covidwho-2057603

ABSTRACT

The 2021 Global Health Security (GHS) Index Report was published on 8 December 2021. With an average country score of 38.9 out of a possible 100 points, global scores are essentially unchanged from 2019. Despite experience with the COVID-19 pandemic, no country is adequately prepared for future biological threats. No country scored above 75.9 and the scores of the bottom 11 States have all fallen since 2019. Aotearoa New Zealand, however, has substantially improved its country score, rising to 13th in the world at 62.5/100. This gain is partly driven by consolidation of capabilities developed and deployed in response to COVID-19. This is promising progress, but a lot more can be done to ensure legacy benefits from the pandemic response, notably through the proposed restructuring of the health system (Pae Ora (Healthy Futures) Bill). In this viewpoint article, we discuss this recent further development of the GHS Index, highlight the global results for 2021, delve into New Zealand's progress, and discuss what more is needed. Copyright © 2022 New Zealand Medical Association. All rights reserved.

6.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009618

ABSTRACT

Background: Cancer and systemic anti-cancer treatment (SACT) have been identified as possible risk factors for infection and related severe illness associated with SARS-CoV-2 virus as a consequence of immune suppression. The Scottish COVID CAncer iMmunity Prevalence (SCCAMP) study aimed to characterise the incidence and outcomes of SARS-Cov-2 infection in patients undergoing active anticancer treatment during the COVID-19 pandemic and their antibody response following vaccination. Methods: Eligible patients were those attending secondary care for active anti-cancer treatment for a solid tumour. Blood samples were taken for total SARS-CoV-2 antibody assay (Siemens) at baseline and after 1.5, 3, 6 and 12 months. Data on COVID-19 infection, vaccination, cancer type, treatment and outcome (patient death) was obtained from routine electronic health records. Results: The study recruited 766 eligible participants between 28th May 2020 and 31st October 2021. During the study period there were 174 deaths (22%). The median age was 63 years, and 67% were female. Most received cytotoxic chemotherapy (79%), with the remaining 14% receiving immunotherapy and 7% receiving another form of anti-cancer therapy (radiotherapy, other systemic anti-cancer treatment). 48 (6.3%) tested positive for SARS-CoV-2 by PCR during the study period. The overall infection rate matched that of the local adult general population until May 2021, after which population levels appeared higher than the study population. Antibody testing detected additional evidence of infection prior to vaccination, taking the total number to 58 (7.6%). There was no significant difference in SARS-CoV-2 PCR positive test rates based on type of anti-cancer treatment. Mortality rates were similar between those who died within 90 days of a positive SARS-CoV-2 PCR and those with no positive PCR (10.4% vs 10.6%). Death from all causes was lowest among vaccinated patients, and of the patients who had a positive SARS-CoV-2 PCR at any time, all of those who died during the study period were unvaccinated. Multivariate analysis correcting for age, gender, socioeconomic status, Charlson co-morbidity score and number of previous medications revealed that vaccination was associated with a significantly lower infection rate regardless of treatment with chemotherapy or immunotherapy with hazard ratios of 0.307 (95% CI 0.144-0.6548) or 0.314 (95% CI 0.041-2.367) in vaccinated patients respectively. Where antibody data was available, 96.3% of patients successfully raised SARSCoV-2 antibodies at a time point after vaccination. This was unaffected by treatment type. Conclusions: SCCAMP provides real-world evidence that patients with cancer undergoing SACT have a high antibody response and protection from SARS-CoV-2 infection following COVID-19 vaccination.

7.
Rheumatology (United Kingdom) ; 61(SUPPL 1):i137-i138, 2022.
Article in English | EMBASE | ID: covidwho-1868420

ABSTRACT

Background/Aims Psychological distress is prevalent in people with inflammatory arthritis. In populations with axial spondyloarthritis (SpA), the risk of developing mental ill-health is high - for depression more than twice that of control populations. Positive emotions are protective against psychological distress and emotional wellbeing is favourably associated with physical illness prognosis. However, the emotional experiences of people who live with axial SpA are not well understood. This study aimed to explore and synthesise qualitative data about the emotional experience of living with axial SpA and identify barriers and facilitators to emotional wellbeing. Methods First, a systematic review and thematic synthesis was conducted. Nine databases were searched from inception to December 2019. Qualitative and mixed methods studies were included if they reported qualitative participant level data about the lived emotional experiences of people with axial SpA and were published in English or German. The search was updated in March 2021. Study quality was assessed using a modified version of the CASP (Critical Appraisal Skills Programme) qualitative tool. Grey literature was appraised using the Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist. Data were extracted, coded and categorised. Synthesis involved translation of concepts from one study into another and development of descriptive themes. Second, four axial SpA online forums were searched from inception to June 2020 for posts from UK-based individuals with axial SpA containing data about their emotional experiences of axial SpA. Thematic analysis was undertaken. Results Of 10,824 database records screened, 27 studies, published between 1995 and 2020, went forward for synthesis. Study populations included people diagnosed with Ankylosing Spondylitis (n=1143), axial SpA (n=53) and non-radiographic axial SpA (n=18). Two studies with mixed populations (n=37) did not specify numbers diagnosed with axial SpA. Most participants were male and had established disease. No studies specifically focused on the psychological experiences of living with axial SpA. 537 posts were identified from online fora, 278 (52%) of which were from men. Seven descriptive themes were generated from the qualitative synthesis: delayed diagnosis: a barrier to emotional wellbeing;disruptive symptoms: a source of mood swings;work disability: a loss of self-esteem;obstacles in interpersonal relationships: a trigger of distress;taking up exercise: 'personal pride' or 'unwelcomed reminders';anti-TNF therapy: hope reignited despite concerns;journey of acceptance: worry mixed with hope. The findings from our review of online fora supported and validated these themes. One additional theme - COVID-19: uncertainty and anxiety during the pandemic - was developed from constructs identified from online posts. Conclusion Our findings highlight substantial negative and mixed emotions experienced by people with axial SpA. However, data about the emotional experiences of women, people diagnosed with non-radiographic axial SpA, and those in the early stages of diagnosis, are limited.

8.
New Zealand Medical Journal ; 134(1547):135, 2021.
Article in English | Scopus | ID: covidwho-1787052

ABSTRACT

On Tuesday 30 November and Monday 6 December (respectively), two corrections were applied to this manuscript: August 17 2001" was changed to "August 17 2021" (page 10) Figure 2 was updated (page 10). © 2021 New Zealand Medical Association. All rights reserved.

9.
Anaesthesia ; 77(5): 609-611, 2022 05.
Article in English | MEDLINE | ID: covidwho-1784581

Subject(s)
Air Pollutants , Aerosols , Humans
10.
11.
Online Learning Journal ; 26(1):203-220, 2022.
Article in English | Scopus | ID: covidwho-1743153

ABSTRACT

Even before COVID-19, literacy graduate coursework was increasingly offered online, replacing the traditional campus-based courses This study investigated how graduate literacy students perceive coursework in an online learning environment. This understanding is important because (a) student perceptions regarding online learning are critical to motivation and learning;and (b) faculty designing courses need to consider student voice in course development. This survey research queried literacy master’s degree candidates their perceptions prior to and after taking online classes, their confidence levels using technology, and about the technological tools that have impacted their learning. Results indicated initial perceptions of online learning changed positively after engagement in coursework, but course design influenced collaboration and engagement. Statistical significance was found in changes in initial perceptions of online learning to a more positive overall feelings toward online learning. The results of this study raise important considerations for implementing online coursework for literacy graduate students. © 2022, The Online Learning Consortium. All rights reserved.

13.
Rhinology ; 60(2): 155-158, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1675023

ABSTRACT

Infection with SARS-CoV-2 can cause severe respiratory disease and it is predicted that the COVID-19 pandemic will leave a substantial number of patients with long-term respiratory complications (1).


Subject(s)
COVID-19 , Ciliary Motility Disorders , Humans , Pandemics , SARS-CoV-2
15.
J Health Psychol ; 27(12): 2847-2859, 2022 10.
Article in English | MEDLINE | ID: covidwho-1613196

ABSTRACT

The current study examines predictors of social distancing behavior across populations (students and community members) and across time in the early months of the COVID-19 pandemic, focusing on two factors commonly associated with risk perception and prevention: knowledge and affect. Results showed that, despite similar levels of social distancing, student distancing was predicted only by feelings of threat about COVID-19, whereas community distancing was predicted by both feeling informed and threatened. Examining longitudinal effects, which were limited to students only, students became more informed about COVID-19 over time, and increases in being informed (but not feeling threatened) predicted more distancing.


Subject(s)
COVID-19 , Physical Distancing , COVID-19/prevention & control , Humans , Pandemics/prevention & control , SARS-CoV-2
16.
European Journal of Public Health ; 31:33-33, 2021.
Article in English | Web of Science | ID: covidwho-1610571
17.
International Journal of Pharmaceutical Sciences Review and Research ; 70(2):188-195, 2021.
Article in English | EMBASE | ID: covidwho-1579147

ABSTRACT

Coronavirus disease of 2019 (COVID-19) is a highly contagious infectious disease which lead to a global pandemic. This virus attacks the small blood vessels, endothelial linings and lead to impaired blood flow and vessel malfunctioning's in various organs. This explains the reason why the high vulnerability patient population is those with comorbidities like hypertension, diabetes, COPD, obesity and cardiovascular diseases. The objective of the study was to compare the rates of recovery in the comorbid Covid-19 patient population when compared to those without comorbidities by evaluating their CT Chest-Score, RT-PCR, duration of hospitalization and thereby assess if the quality of life was compromised. A Prospective Observational Study was conducted for a period of 4 months with over 400 laboratory-confirmed Covid-19 patients. Out of the 400 patients, considering the exclusion and inclusion criteria 191 moderately ill covid-19 patients with or without comorbidities were included in the study. The severity of the patients was assessed based on the CT-Chest Score and COVID-19 RT-PCR reports. Various other complications faced by comorbid patients when compared to patients with nil comorbidities were also investigated. In our study among the underlying comorbidities, the most common were DM (40.11%), HTN (35.32 %), CAD (7.78 %), COPD (6.58 %), CKD (5.38 %) and then hypothyroidism (4.79 %). Our study also concluded that the percentage of patients with a comorbid condition was higher (59.68%) than those without a comorbid condition (40.31%). The mean reduction in CT-Score in the comorbid and nil-comorbid was found to be 9.38 ± 2.85 and 7.08 ± 2.89. The mean reduction in hospital stay in the comorbid and nil comorbid group was found to be 9.50 ± 2.34 and 8.08 ± 1.71. The mean reduction in RT-PCR was 10.04 ± 2.95 and 7.44 ± 2.33 in the comorbid and nil comorbid group respectively. Therefore, the RT-PCT, duration of hospital stay and CT-Chest Score showed a statistical significance of p-value<0.0001. The study concludes that the comorbid patients when compared to those without comorbidities had a longer hospital stay and more time for recovery which led to a compromise in their health status.

18.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514535

ABSTRACT

The European Public Health Association (EUPHA), in conjunction with the Mental Health Foundation UK, conducted a purposely designed online survey of public and mental health professionals from across Europe, exploring public mental health responses to the pandemic in different regions, nations and localities. Participants were recruited from EUPHAs mental health division and through snowballing. Four broad areas were explored, namely;(1) perceived changes in available mental health supports during the pandemic;(2) whether or not a public mental health response plan had been developed;(3) if any demographic groups or priority areas had been given particularly consideration in this response and (4) how the response had been developed (i.e. whether intersectoral approaches had been adopted and the perceived degree to which service users and carers had been included in its development). Forty-four survey responses from twenty different European nations were collected and grouped according to whether respondents were practising in countries with low, medium or high COVID-19 incidence rates. The majority of responses were from public health professionals with over 20 years of experience. Results indicated wide variations in policy responses to the crisis and in the way mental health services have adapted to date. However, in the majority of countries surveyed, while an increase in online mental health supports during the pandemic was reported, no change in long term funding for mental health supports was observed. In addition, in the majority of countries, several vulnerable groups were rarely given specific attention in policy responses, namely low-income families, people with long-term health conditions or disabilities and ethnic minorities. In this workshop we will discuss the findings from this survey and explore what insights might be learned from experiences across Europe to date.

19.
New Zealand Medical Journal ; 134(1542):109-118, 2021.
Article in English | MEDLINE | ID: covidwho-1414286

ABSTRACT

The Climate Change Commission's draft report and recommendations provide a pathway towards achieving the New Zealand Government's commitment to net zero emissions by 2050. However, the Commission has not adequately considered the health co-benefits of climate change mitigation. In this viewpoint, we assess how the Commission has considered health co-benefits in the key response domains. Extrapolating UK evidence to the New Zealand context suggests climate change mitigation strategies that reduce air pollution, transition the population towards plant-based diets and increase physical activity via active transport could prevent thousands of deaths per year in coming decades. Substantial health co-benefits would also arise from improved housing, cleaner water, noise reductions, afforestation and more compact cities. The Commission's draft report only briefly mentions many of these health co-benefits, and some are completely absent. We recommend the Commission's final report: (i) use health co-benefits as an explicit frame;(ii) ensure the government's Treaty of Waitangi obligations are met in all the domains covered to maximise benefits for Maori health and wellbeing;(iii) build on the successful COVID-19 response that demonstrated rapid, science-informed and vigorous government action can address major global health threats;(iv) include both public health expertise and Maori health expertise among its commissioners;(v) explain how health co-benefits are likely to generate major cost-savings to the health system.

20.
Applied Economic Perspectives and Policy ; 43(1):58-72, 2020.
Article in English | CAB Abstracts | ID: covidwho-1308947

ABSTRACT

The COVID-19 pandemic has altered conceptions of "normal" globally, including food purchasing and acquisition decisions. In this paper, we surveyed a panel of 1,370 U.S. households four times during the COVID-19 pandemic from mid-March to late April 2020. With this unique panel, we observe changes in food expenditures, shopping behaviors, and food values as the pandemic evolved. Our results reveal reductions in food-away-from-home expenditures and increases in online grocery shopping. Food values appear to be fairly stable in the early stages of the pandemic;however, decreases in the importance of price and nutrition reveal tradeoffs households make during the pandemic.

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