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1.
NEJM Catalyst Innovations in Care Delivery ; 3(8), 2022.
Article in English | Scopus | ID: covidwho-2315789

ABSTRACT

Houston Methodist has endeavored to improve the resilience of its health care workforce by using an innovative two-pronged approach to fix the systemic barriers to wellness and well-being, as well as to support individual employees in their work. Programs that began in 2018 became essential during the Covid-19 pandemic, which exacerbated existing strain and created unprecedented challenges for both health care systems and health care workers. Houston Methodist identified three specific initiatives as part of an integrated plan to address resiliency: positive psychology, mindfulness, and intensive rounding for resiliency (referred to as Comfort Rounds). Further, each initiative was designed to address resiliency, primarily or secondarily, at either the individual level or the organizational level, which creates the opportunity to promote uptake, reinforce sustainability, and enhance impact. Data collected on these programs have shown that they reduce stress effectively and make clinicians feel more supported by the organization and their leaders. In addition to the innovative integration of the initiatives, the novel rounding model is focused solely on resilience issues and includes a mental health professional. © 2022 Massachusetts Medical Society. All rights reserved.

2.
Asian Journal of Legal Education ; 10(1):23-42, 2023.
Article in English | Scopus | ID: covidwho-2246390

ABSTRACT

One of the significant challenges in legal education during the coronavirus pandemic 2020–2022 was effectively conducting remote practical advocacy courses. This article addresses that issue by reporting results of a study conducted of final-year undergraduate law students taking part in a civil trial advocacy course conducted over two semesters, as part of their regular studies in their degree course. Candidates were surveyed at the conclusion of their studies on issues including what technology students used to take part in the course, technological issues encountered as part of their studies, whether they perceived that remote training was inferior or superior to in-person training, and what were their attitudes to specific issues in the remote course on advocacy including witness cheating, making objections, team cooperation, sharing of workload and assessment of student participation and performance. The survey results have validated the author's hypothesis that in-person trial advocacy training provides better training than a remote course. However, none of the five supposed limitations of remote training were validated. In fact, for many students, specific aspects of the remote course were viewed as conducive to better student training or at least reducing the practical inconvenience of some aspects of in-person advocacy training. This provides some reassurance to educators that remote training provides an effective, if slightly less preferable, mode in which to teach practical advocacy. This is encouraging when it seems that remote advocacy in the legal profession appears likely to remain a feature of legal practice indefinitely. Based on the salutary information received from the study, it is recommended that legal educators periodically conduct such voluntary surveys for the remote teaching of skills-based courses. © 2022 The West Bengal National University of Juridical Sciences.

3.
A Fresh Look at Fraud: Theoretical and Applied Perspectives ; : 42-57, 2022.
Article in English | Scopus | ID: covidwho-2163975

ABSTRACT

In this chapter we examine some of the main approaches used by scammers and the possible consequences. We (the authors) were working on this book volume when the COVID-19 pandemic broke out and were witness to the pandemic of scams, cons, and fraud that came along with it. The Federal Trade Commission (FTC) received more than 18,000 coronavirus complaints between January 2020 and April 15, 2020 (Carrns, 2020), and Google reported an unprecedented number of scam emails, having to block over 18 million a day. In the UK, likewise, a wide range of scams have circulated trying to lure individuals via emails, false websites, phone calls, and many other techniques, leading most news outlets to raise alarm and inform the wider public. During periods of social isolation, feelings of loneliness increase and people are turning to social media and online platforms to fulfil their social needs (Le Couteur et al., 2020) as well as perform activities of daily life (e.g., banking, submission of medical forms etc.). These shifting behaviors—from face-to-face to online banking and shopping—, coupled with increased calls for donation and governmental provision of funds and tax rebates, have all created a fertile ground for scammers to take advantage of people and organizations. This was even further exacerbated by the increasing sense of confusion and uncertainty. Understanding how scammers work and lure potential victims is the first step to reducing the rate of scams and fraud under such conditions. The goal of this chapter is to play witness to this phenomenon, discuss tactics, psychological factors, and contextual factors that may be activated during times of extreme uncertainty that benefit scammers, document trends in scams that have been occurring during the COVID-19 pandemic, and also review the rapidly emerging literature produced during this time. © 2022 selection and editorial matter, Yaniv Hanoch and Stacey Wood;individual chapters, the contributors.

4.
Journal of the American College of Surgeons ; 235(5 Supplement 1):S20, 2022.
Article in English | EMBASE | ID: covidwho-2114275

ABSTRACT

INTRODUCTION: Telehealth visits became a staple in surgical practice in the setting of COVID-19. The objective of this study is to assess benign foregut patient satisfaction and perceived cost savings with use of telehealth visits. METHOD(S): This is a single academic center prospective study of benign foregut patients evaluated for routine postoperative care by a telehealth visit over a 1-year period. Patients who agreed to participate completed a survey assessing their experience with telehealth. RESULT(S): There were 19 patients (13 phone, 6 virtual) ages 21 to 74 years (male:female 5:14) included. A total of 84% underwent hiatal hernia repair, and others underwent operation for achalasia, feeding access, gastric pacemaker, and choledocholithiasis (average length-ofstay 3.5 days, range 0 to 13). The majority (84.2%) reported a high overall satisfaction score (>4/5, range 3 to 5). Of these patients, 94.7% agreed/strongly agreed that their provider was able to adequately assess their problem, that their concerns were addressed, and that they would participate in future telehealth visits. The average time to drive to a hypothetical in-person appointment was 180 minutes (range 20 to 480 minutes). When comparing telehealth with hypothetical in-person visits, no patients had to take time off work for telehealth vs 15.8% would for in-person visits. A total of 21% would need a family member to take time off for in-person visit;of those, 75% would have suffered wage loss;36.8% and 42.1% would require overnight accommodation and meal costs for hypothetical in-person visits, respectively (travel time range 180 to 480 minutes). CONCLUSION(S): Postoperative benign foregut patients were very satisfied with telehealth care with time and cost-saving benefits reported for those traveling long distances for in-person visits.

5.
Asian Journal of Legal Education ; 2022.
Article in English | Scopus | ID: covidwho-2108694

ABSTRACT

One of the significant challenges in legal education during the coronavirus pandemic 2020–2022 was effectively conducting remote practical advocacy courses. This article addresses that issue by reporting results of a study conducted of final-year undergraduate law students taking part in a civil trial advocacy course conducted over two semesters, as part of their regular studies in their degree course. Candidates were surveyed at the conclusion of their studies on issues including what technology students used to take part in the course, technological issues encountered as part of their studies, whether they perceived that remote training was inferior or superior to in-person training, and what were their attitudes to specific issues in the remote course on advocacy including witness cheating, making objections, team cooperation, sharing of workload and assessment of student participation and performance. The survey results have validated the author’s hypothesis that in-person trial advocacy training provides better training than a remote course. However, none of the five supposed limitations of remote training were validated. In fact, for many students, specific aspects of the remote course were viewed as conducive to better student training or at least reducing the practical inconvenience of some aspects of in-person advocacy training. This provides some reassurance to educators that remote training provides an effective, if slightly less preferable, mode in which to teach practical advocacy. This is encouraging when it seems that remote advocacy in the legal profession appears likely to remain a feature of legal practice indefinitely. Based on the salutary information received from the study, it is recommended that legal educators periodically conduct such voluntary surveys for the remote teaching of skills-based courses © 2022 The West Bengal National University of Juridical Sciences.

6.
Earths Future ; 10(10), 2022.
Article in English | Web of Science | ID: covidwho-2069862

ABSTRACT

Despite the increased salience of infectious disease risk due to the COVID-19 pandemic, two recent surveys of the business and scientific communities have found a continued belief in the prominence of environmental risks. In particular, failure to take action on climate change was seen as a highly likely risk whose impacts would become locked-in barring an immediate global response. These expert opinions are consistent with a growing body of evidence and give us insight into the priorities of global thought leaders who study and respond to risk. Given this alignment in priorities, we argue for the importance of integrating climate and environmental action into responses to emerging threats.

7.
Public Health ; 213: 171-176, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2069606

ABSTRACT

OBJECTIVE: The COVID-19 pandemic disrupted sexual health services for young people, with potential consequences of decreasing preventive screening and increasing undiagnosed sexually transmitted infections (STIs). This study aimed to assess trends in asymptomatic screening among patients receiving STI testing and to estimate the number of STI cases that were missed during the early months of the pandemic. STUDY DESIGN: A cross-sectional study of electronic health records for chlamydia, gonorrhea, and trichomonas testing encounters from six pediatric primary care clinics in Philadelphia, July 2014 to November 2020. METHODS: A total of 35,548 testing encounters were analyzed, including 2958 during the pandemic. We assessed whether testing at each encounter was performed as asymptomatic screening, risk-based testing, or symptomatic testing. We evaluated screening trends over time and estimated the number of missed STI cases during the pandemic. RESULTS: The mean monthly testing encounters decreased from 479 per month prepandemic to 329 per month during the pandemic. The percent of tests performed as asymptomatic screening dropped from 72.5% prepandemic to a nadir of 54.5% in April 2020. We estimate that this decrease in asymptomatic screening would represent 159 missed cases (23.8% of expected cases) based on patient volume from the previous year. CONCLUSIONS: During the pandemic, the total volume of STI testing encounters and the proportion of tests performed as asymptomatic screening decreased, potentially resulting in missed diagnoses. Undiagnosed STIs can result in severe sequelae and contribute to community transmission of STIs. Efforts are needed to re-establish and sustain access to STI services for adolescents in response to disruptions caused by the pandemic.

8.
Aerosol Science & Technology ; : 1-12, 2022.
Article in English | Academic Search Complete | ID: covidwho-2050805

ABSTRACT

Numerous variants of SARS-CoV-2 with increased transmissibility have emerged over the course of the pandemic. Potential explanations for the increased transmissibility of these variants include increased shedding from infected individuals, increased environmental stability, and/or a lower infectious dose. Upon exhalation of a respiratory particle into the environment, water present in the particle is rapidly lost through evaporation, resulting in a decrease in particle size. The aim of the present study was to compare the losses of infectivity of different isolates of SARS-CoV-2 during the rapid evaporation of aerosol particles that occurs immediately post-generation to assess if there are differences suggestive of increased survival, and ultimately greater transmissibility, for more recent variants. Losses of infectivity of several isolates of SARS-CoV-2 suspended in viral culture media was assessed following aerosolization and evaporation in a flowing chamber. The results demonstrate that losses of infectivity measured post-evaporation were similar for three different isolates of SARS-CoV-2, including isolates from the more recent Delta and Omicron lineages. The average loss in infectivity across all three isolates was 61 ± 15% (-0.46 ± 0.17 log10 TCID50/L-air) at a relative humidity <30%. These results, together with those from several previous studies, suggest that it is unlikely that an increase in environmental stability contributes to the observed increases in transmissibility observed with more recent variants of SARS-CoV-2. [ FROM AUTHOR] Copyright of Aerosol Science & Technology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

9.
Innovation in Aging ; 5:766-766, 2021.
Article in English | Web of Science | ID: covidwho-2012166
11.
Journal of Adolescent Health ; 70(4):S50-S51, 2022.
Article in English | EMBASE | ID: covidwho-1936678

ABSTRACT

Purpose: Offering contraceptives at pharmacies without a prescription is one solution to reduce the incidence of unintended pregnancies among adolescents and young adults (AYA) in the US by increasing convince, simplicity, and affordability of contraceptives. The purpose of this study was to develop a Telemedicine e-platform that simulates pharmacist prescribing contraceptives to AYA, and receive feedback from the target population via usability testing of the e-platform prototype. Methods: An existing telemedicine e-platform COVID symptom check-in tool used by a large pediatric hospital system was modified into a prototype to simulate pharmacist prescribing contraceptives to AYA. Usability testing participants enrolled in April 2021 were assigned female sex at birth, 15-21 years old, seeking contraceptive initiation services at a subspecialty academic adolescent medicine clinic, had a prior history or intention to have penile-vaginal intercourse in the next 12 months, owned a mobile device, and could read and speak English. During a one-hour study visit participants first completed brief surveys on their sociodemographic and sexual history. Next, in a video-recorded “think aloud” interview participants verbalized initial thoughts, technical issues, and feedback while they engaged with the e-platform prototype on their own mobile device. Following the interview, participants completed an online survey answering questions on a 5-point Likert scale to evaluate the usefulness, ease of use, effectiveness, reliability, and satisfaction with the prototype. Descriptive analysis was utilized for the analysis of quantitative survey data and thematic analysis was employed for the interview transcripts. Results: Usability testing was conducted with N=10 patients, with a mean age of 16.9 (SD 1.97) years old. Seven participants (70%) reported using birth control to prevent pregnancy and 4 (40%) reported taking a pregnancy test in the past. Overall participants agreed or strongly agreed that using an app to receive contraceptives would make it easier for teens to access (100%) and make contraceptive use less stigmatizing (100%). Also, participants agreed that receiving birth control prescriptions from a pharmacist without a doctor’s visit would be safe (80%), convenient (80%), acceptable (80%), and easy (80%). Additionally, three main issues with the prototype were identified during interviews. First, participants described difficulty comprehending medical history questions from CDC medical eligibility criteria, suggesting the need to better account for adolescent health literacy in re-design. Next, participants identified glitches with the prototype e-platform to address before moving to production. Lastly, participants shared e-platform design suggestions to improve engagement including, adding images and visually drawing attention to links to important resources or functions (i.e. link to bedside.org, button to call pharmacist directly). Conclusions: AYA found contraceptive prescription by pharmacist via an e-platform to be highly acceptable and provided critical feedback to improve usability prior to final design and pilot testing, including edits for health literacy, and to improve function and aesthetics of the e-platform. Sources of Support: CHOP Center for Pediatric Clinical Effectiveness;National Institutes of Health, K23 (NIH K23MH119976-01A, Wood).

12.
Industrial Relations Journal ; : 32, 2022.
Article in English | Web of Science | ID: covidwho-1927594

ABSTRACT

Concerns about work intensification within universities have been an issue over the past decade and the Covid-19 pandemic may have accelerated any trend toward excessive job demands associated with work-related stress. This paper reports a longitudinal study conducted in two English universities based on observations at 11 time points from March 2020 to February 2021, covering academic and nonacademic workers. The results show that four measures of job demands increased during the period and that blended learning has contributed to these increases. Various measures of well-being are negatively associated with work intensity, while work-nonwork conflict is positively related to it and mediates the demands-well-being relationship. The study also shows that the use of a variety of methods of accommodating the increased demands-increasing total hours, working at weekends, extending the work day and forsaking breaks, normal holidays and exercise-are associated with increased work intensity. The policy implications of the study are that interventions aimed at employee well-being should be focused on the causes of stress and, particularly, job demands, rather than coping with stress and that future decisions about homeworking should take account of these causes and not simply the satisfaction or performance levels of homeworkers.

13.
Topics in Antiviral Medicine ; 30(1 SUPPL):350, 2022.
Article in English | EMBASE | ID: covidwho-1880027

ABSTRACT

Background: Sexually transmitted infection (STI) diagnosis serves as an important linkage to HIV testing and pre-exposure prophylaxis (PrEP) for adolescents. The COVID-19 pandemic disrupted sexual health services for young people, with a potential consequence of increasing undiagnosed STIs. This study aimed to describe STI testing changes and estimate undiagnosed STI cases during the pandemic. Methods: We analyzed electronic medical records for chlamydia, gonorrhea, and trichomonas testing encounters from six pediatric primary care clinics in Philadelphia, July 2014-November 2020. We assessed whether testing was asymptomatic screening, risk-based testing, or symptomatic testing, and whether any result was positive. We evaluated STI trends over time, comparing pre-pandemic (before March 1st, 2020) and pandemic periods (after March 1st, 2020). Missed STI cases during the pandemic were estimated using decreases in patient volume and asymptomatic screening as compared to the previous year. Generalized linear mixed-effects models estimated the effects of patient-level and neighborhood-level characteristics on STI outcomes. Results: 35,548 STI testing encounters were analyzed, including 2,958 during the pandemic period. The median patient age was 17.5 years, 57% of patients were female, and 84% were Black/African American. Mean monthly STI testing encounters decreased from 479/month pre-pandemic to 329/month during the pandemic. Test positivity increased from 12.5% pre-pandemic to a peak of 27.5% in April 2020. The percent of STI tests performed as asymptomatic screening dropped from 72.5% pre-pandemic to a nadir of 54.5% in April 2020 (Figure). We estimate that the decrease in asymptomatic screening in the pandemic period would be associated with 159 missed cases (23.8% of expected cases) based on patient volume from the previous year. In multivariate models controlling for testing type (asymptomatic screening, risk-based testing, or symptomatic testing), the odds of test positivity were 50% higher during the pandemic (OR: 1.50, p<0.001). Conclusion: STI test positivity increased during the pandemic while asymptomatic screening decreased. Test positivity was higher for asymptomatic patients, suggesting increased STI prevalence. These changes likely resulted in a substantial number of undiagnosed STIs, representing missed opportunities for PrEP linkage. Efforts are needed to re-establish and sustain access to STI services for adolescents in response to disruptions caused by the pandemic.

14.
Wellcome Open Research ; 6:220, 2021.
Article in English | MEDLINE | ID: covidwho-1863328

ABSTRACT

Background: We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity.

15.
24th ACM Conference on Computer-Supported Cooperative Work and Social Computing, CSCW 2021 ; : 179-182, 2021.
Article in English | Scopus | ID: covidwho-1515331

ABSTRACT

The COVID-19 pandemic and the resulting economic recession have negatively affected many people's physical, social, and psychological health. Parks and green-spaces may have ameliorated the negative effects of the pandemic by creating opportunities for outdoor recreation and nature exposure, while other public activities and gatherings were restricted due to risk of disease transmissions. Using park visitation estimates derived from 140K Instagram images shared in four US metropolitan areas, this study investigates trends in park use over the span of the COVID-19 pandemic. We find that while COVID-related stay-at-home orders are associated with shifts in park visitation, the cities that we analysed do not follow uniform trends. Our analyses suggest that future research may be able to explain variability in park visitation based on local factors such as park location and the socio-demographics of visitors. However, the research community does not currently have access to the volume and resolution of data that is necessary to study the issue. There is an urgent need for the CSCW community and social computing researchers to address this data gap if we are to understand the impacts of the pandemic, plan for urban resiliency, and ensure equitable access to parks and other shared resources. © 2021 ACM.

17.
J Bone Oncol ; 29: 100375, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1267729

ABSTRACT

Optimum management of patients with cancer during the COVID-19 pandemic has proved extremely challenging. Patients, clinicians and hospital authorities have had to balance the risks to patients of attending hospital, many of whom are especially vulnerable, with the risks of delaying or modifying cancer treatment. Those whose care has been significantly impacted include patients suffering from the effects of cancer on bone, where delivering the usual standard of care for bone support has often not been possible and clinicians have been forced to seek alternative options for adequate management. At a virtual meeting of the Cancer and Bone Society in July 2020, an expert group shared experiences and solutions to this challenge, following which a questionnaire was sent internationally to the symposium's participants, to explore the issues faced and solutions offered. 70 respondents, from 9 countries (majority USA, 39%, followed by UK, 19%) included 50 clinicians, spread across a diverse range of specialties (but with a high proportion, 64%, of medical oncologists) and 20 who classified themselves as non-clinical (solely lab-based). Spread of clinician specialty across tumour types was breast (65%), prostate (27%), followed by renal, myeloma and melanoma. Analysis showed that management of metastatic bone disease in all solid tumour types and myeloma, adjuvant bisphosphonate breast cancer therapy and cancer treatment induced bone loss, was substantially impacted. Respondents reported delays to routine CT scans (58%), standard bone scans (48%) and MRI scans (46%), though emergency scans were less affected. Delays in palliative radiotherapy for bone pain were reported by 31% of respondents with treatments often involving only a single dose without fractionation. Delays to, or cancellation of, prophylactic surgery for bone pain were reported by 35% of respondents. Access to treatments with intravenous bisphosphonates and subcutaneous denosumab was a major problem, mitigated by provision of drug administration at home or in a local clinic, reduced frequency of administration or switching to oral bisphosphonates taken at home. The questionnaire also revealed damaging delays or complete stopping of both clinical and laboratory research. In addition to an analysis of the questionnaire, this paper presents a rationale and recommendations for adaptation of the normal guidelines for protection of bone health during the pandemic.

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