BEYOND RESPONSE: REIMAGINING THE LEGAL ACADEMY'S ROLE IN DISASTER RECOVERY AND PREPAREDNESS

This Article proposes expanding the legal academy's role in responding to disasters and emergencies, specifically through creating disaster clinics that take a communitybased lawyering approach. The Article is one of the first to identify the need for community-based disaster legal clinical education that goes beyond the immediate response phase. It also proposes creating a disaster legal pipeline from the clinic through post-graduation employment. The Article furthers the literature's discussion of the need for sustained disaster legal education. As the global pandemic caused by COVID-19 coronavirus continues to impact vulnerable populations and the frequency of natural disasters continues to increase, this Article provides a blueprint to law school faculty and administrators on the process of starting a new clinic or redesigning an existing clinic into a long-term disaster-related clinic. Additionally, the Article provides a timeline of disaster legislation that has evolved to provide a robust background for seminar courses. The Article draws from the author's expertise in creating two disaster clinics and multiple disaster and environmental justice courses. © 2023,Cleveland State Law Review. All Rights Reserved.

Evaluation of the bactericidal effect of UV-LED light on alginate impressions.

The oral cavity houses a large number of microorganisms that are potential pathogens, such as cytome-galovirus, hepatitis B virus (HBV), hepatitis C virus, herpes simplex virus types 1 and 2, human immuno-deficiency virus, mycobacterium tuberculosis and currently with the appearance of the SARS COV-2 that causes covid-19, the dental community must take stricter measures in its protection protocols against diseases. To evaluate its germicidal efficacy, ultraviolet light was applied with different exposure times on the alginate dental impressions, immediately after having taken the impression, which when it came into contact with the oral cavity of the patient is contaminated. As a result, a decrease in size and quantity of the bacterial colonies was observed in most of the samples in which the UV LED light was applied at 10 and 15 minutes of exposure. Some samples showed less bacterial growth even after 5 minutes of exposure. All this confirms its germicidal capacity thanks to its 245 nm ultraviolet spectrum that affects the DNA and RNA chain of microorganisms since it is the wavelength of maximum absorption of its molecule, eliminating its reproductive and survival capacity. The advantages it offers such as its small size, easy to handle and install, that it does not require constant maintenance, low acquisition cost;its constant high intensity light that does not generate any increase in temperature, makes it an excellent disinfectant auxiliary that can be incorporated into dental clinics.Copyright © 2023, Ediciones Avances S.L.. All rights reserved.

ID: 212302 Prevalence of False Negative Results for Morphine in Oral Fluid Toxicology Compared With Urine Toxicology

Introduction: Urine drug testing has been the standard for monitoring opioid compliance in chronic pain patients. The COVID-19 pandemic created a dilemma for opioid monitoring by severely limiting in-person testing due to safety concerns. Oral fluid toxicology emerged as a feasible, alternative test due to its ability for remote sample collection under virtual supervision while minimizing infringements on patient privacy. However, the efficacy of these two tests for reliably detecting opioids should be explored prior to transitioning to testing only with oral fluids. Method(s): In this study, we compared morphine levels in oral fluid and urine toxicology studies from 5 randomly selected patients from a Chronic Pain Center who were regularly taking high doses (>=90 mEq) of extended-release morphine. Charts from the start of the COVID-19 pandemic until July 2022 were reviewed for urine and oral fluid testing results and medication regimens. All oral fluid and urine test results and collection methods were validated by a nationally recognized toxicology lab. Prescription Monitoring Program (PMP) reports were reviewed for each patient to observe pre-testing prescription trends. Result(s): We found that the overwhelming majority of patients had at least 1 false negative oral fluid test result. The remainder of the oral fluid results were below threshold (10 ng/mL) or ranged from 11.3 to 54 ng/mL of morphine. 80% of patients (n = 5) had at least one negative or positive-but-below-threshold (10 ng/mL) result in their oral fluid sample analyses. In contrast, none of the urine studies had negative results. Urine studies for all patients were positive for morphine and well-above primary cutoff values (100 ng/mL) with levels >6000 ng/mL. PMP reports did not reveal any aberrant drug taking behavior in any of the patients. No unprescribed medications or illicit substances were detected in any of the oral or urine samples. Conclusion(s): The prevalence of false negative results for the detection of morphine metabolites in oral fluid toxicology may be higher than clinicians are currently aware of. Physicians and other providers monitoring opioid compliance in chronic pain patients should keep this possibility in mind when selecting toxicology tests and making conclusions about aberrant drug-taking behavior. Larger scale studies are needed to compare oral fluid and urine levels of morphine with extension to other commonly prescribed opioids. Disclosure: Evan Chung, MD: None, Joseph Valenza, MD: NoneCopyright © 2023

The E-Nurture Project: A Hybrid Virtual Neonatal Follow Up Model for 2021.

Neonatal follow-up has long focused on a model of surveillance and identification of short-term outcomes. This model has long become outdated, with evidence documenting the need for longer follow-up with known school-based challenges and significant gaps in knowledge by educators. This article reviews the history of neonatal follow-up and demonstrates a novel approach to neonatal follow-up, built largely with a hybrid virtual platform, which then became essential with the declaration of the pandemic in 2020.

The environmental impact of surgical telemedicine: life cycle assessment of virtual vs. in-person preoperative evaluations for benign foregut disease.

BACKGROUND: Health care accounts for almost 10% of the United States' greenhouse gas emissions, accounting for a loss of 470,000 disability-adjusted life years based on the health effects of climate change. Telemedicine has the potential to decrease health care's carbon footprint by reducing patient travel and clinic-related emissions. At our institution, telemedicine visits for evaluation of benign foregut disease were implemented for patient care during the COVID-19 pandemic. We aimed to estimate the environmental impact of telemedicine usage for these clinic encounters. METHODS: We used life cycle assessment (LCA) to compare greenhouse gas (GHG) emissions for an in-person and a telemedicine visit. For in-person visits, travel distances to clinic were retrospectively assessed from 2020 visits as a representative sample, and prospective data were gathered on materials and processes related to in-person clinic visits. Prospective data on the length of telemedicine encounters were collected and environmental impact was calculated for equipment and internet usage. Upper and lower bounds scenarios for emissions were generated for each type of visit. RESULTS: For in-person visits, 145 patient travel distances were recorded with a median [IQR] distance travel distance of 29.5 [13.7, 85.1] miles resulting in 38.22-39.61 carbon dioxide equivalents (kgCO2-eq) emitted. For telemedicine visits, the mean (SD) visit time was 40.6 (17.1) min. Telemedicine GHG emissions ranged from 2.26 to 2.99 kgCO2-eq depending on the device used. An in-person visit resulted in 25 times more GHG emissions compared to a telemedicine visit (p < 0.001). CONCLUSION: Telemedicine has the potential to decrease health care's carbon footprint. Policy changes to facilitate telemedicine use are needed, as well as increased awareness of potential disparities of and barriers to telemedicine use. Moving toward telemedicine preoperative evaluations in appropriate surgical populations is a purposeful step toward actively addressing our role in health care's large carbon footprint.

Manifestation of Headache Affecting Quality of Life in Long COVID Patients.

Objectives: The present study aimed to elucidate the characteristics of long COVID patients with headaches. Methods: A single-center retrospective observational study was performed for long COVID outpatients who visited our hospital from 12 February 2021 to 30 November 2022. Results: A total of 482 long COVID patients, after excluding 6, were divided into two groups: the Headache group of patients with complaints of headache (113 patients: 23.4%) and the remaining Headache-free group. Patients in the Headache group were younger (median age: 37 years) than patients in the Headache-free group (42 years), while the ratio of females (56%) in the Headache group was nearly the same as that in the Headache-free group (54%). The proportion of patients in the Headache group who were infected in the Omicron-dominant phase (61%) was larger than the proportions of patients infected in the Delta (24%) and preceding (15%) phases, and that trend was significantly different from the trend in the Headache-free group. The duration before the first visit for long COVID was shorter in the Headache group (71 days) than in the Headache-free group (84 days). The proportions of patients in the Headache group with comorbid symptoms, including general fatigue (76.1%), insomnia (36.3%), dizziness (16.8%), fever (9.7%), and chest pain (5.3%) were larger than the proportions of patients in the Headache-free group, whereas blood biochemical data were not significantly different between the two groups. Interestingly, patients in the Headache group had significant deteriorations of scores indicating depression and scores for quality of life and general fatigue. In multivariate analysis, headache, insomnia, dizziness, lethargy, and numbness were shown to be involved in the quality of life (QOL) of long COVID patients. Conclusions: The manifestation of headaches related to long COVID was found to have a significant impact on social and psychological activities. Alleviation of headaches should be a priority for the effective treatment of long COVID.

The new normal: a UK fertility clinic experience of universal RT-PCR SARS-CoV-2 testing.

Following the temporary closure of fertility clinics in 2020 in many countries across the world, the SARS-CoV-2 pandemic has meant that the sector has had to rapidly adapt to novel ways of operating. The aim of this study was to investigate the efficacy and feasibility of universal real-time polymerase chain reaction testing at an IVF clinic within a UK tertiary referral centre. Between March and December 2020, we performed 2,401 SARS-CoV-2 RT-PCR tests on 1,215 individual patients, of which eight were positive (0.3%). Appropriate positive case identification allowed for delay in treatment initiation or cancellation as applicable. This has allowed our unit to continue to operate safely and efficiently.

Utilisation of tele-audiology practices in Australia during the COVID-19 pandemic: Perspectives of audiology clinic owners, managers and reception staff.

OBJECTIVE: To canvas the views of Australia-based hearing healthcare clinic owners/managers and reception staff regarding the utilisation, experiences and perspectives of providing tele-audiology services during the COVID-19 pandemic. DESIGN: A national prospective self-report survey was completed online. Data were analysed using descriptive statistics. STUDY SAMPLE: Twenty-one clinic owners/managers (Mage 54.43 years, 15 female) and 58 reception staff (Mage 42.88 years, 49 female) from Australia-based hearing clinics. RESULTS: Clinic owners/managers reported an increase in use of tele-audiology services as compared to pre-COVID-19. Reception staff reported providing more advice and support to clients over the phone. Both clinic owners/managers and reception staff indicated key barriers to providing tele-audiology services to include concerns about their clients' digital and technological literacy and the perception that in-the-clinic appointments deliver better client outcomes than tele-audiology appointments. CONCLUSIONS: The increased utilisation of tele-audiology services observed appears to be largely influenced by COVID-19 related factors (e.g. maintaining client and staff safety and increased funding). It is therefore possible that utilisation of tele-audiology service may drop once the threat of the pandemic has subsided. Perceived barriers relating to clients' digital literacy and the effectiveness of tele-audiology services require attention to safeguard the future of tele-audiology service delivery in Australia.

Paradigm shift in infection control practices in dental clinics in response to COVID-19 among dental professionals in Thailand.

Infection control (IC) practice routines depend mainly on knowledge, perception, and awareness of a disease among dental professionals. However, there has been no report on the perception, awareness, and adaptability to the new practice guidelines of Thai dental professionals (dentists, dental nurses, dental assistants, and dental technicians) to the COVID-19 pandemic. This study aims to investigate how dental professionals in Thailand perceive and are aware of COVID-19, and how they have changed their IC practices in response to the pandemic. Online cross-sectional surveys using convenience sampling during September 2021 were sent to Thai dental professionals. The data were analyzed using descriptive statistics and the Chi-square test. Statistical analysis was performed using the Statistical Package for Social Sciences, version 22.0. The tests were two-tailed, with a significance level of p < 0.05 and 95% confidence intervals (CIs). The 1,177 dental professionals who completed the questionnaire were from the public and private sectors. Most respondents obtained their knowledge about COVID-19 from social media (91.8%). 86.7% had adapted to the new IC practice guidelines. The respondents reported that they had modified their work practices in several aspects; changes in administrative control, 1,039 (88.3%); enhancing local source control of dental aerosols, 1,031 (87.6%); heightening sterilization and disinfection procedures, 1,032 (87.7%); and improving the ventilation system, 994 (84.5%). As of October 2021, 1,162 (98.7%) respondents were vaccinated, and 47 (3.99%) had tested positive for COVID-19 compared with 2.30% in the general population. Among infected individuals, 10 (21.3%) were suspected of being infected while working in the dental setting. In conclusion, with an average worry score well over 4.10 out of 5, more than 96% of Thai dental professionals reported seeking updated knowledge and agreed that escalation of IC measures was needed. However, only 86.7% improved their COVID-19 infection prevention practices in 4 aspects and appropriate PPE use. The infection rate in dental professionals was 3.99%, with the highest infection rate in dental assistants. Despite statistical insignificance of infection rate between changed and unchanged group, it cannot be concluded that stricter IC measures are negligible as ones might contract disease from setting other than work.

The Reentry Health Care Hub: Creating a California-Based Referral System to Link Chronically Ill People Leaving Prison to Primary Care.

People released from prison experience high health needs and face barriers to health care in the community. During the COVID-19 pandemic, people released early from California state prisons to under-resourced communities. Historically, there has been minimal care coordination between prisons and community primary care. The Transitions Clinic Network (TCN), a community-based non-profit organization, supports a network of California primary care clinics in adopting an evidence-based model of care for returning community members. In 2020, TCN linked the California Department of Corrections and Rehabilitation (CDCR) and 21 TCN-affiliated clinics to create the Reentry Health Care Hub, supporting patient linkages to care post-release. From April 2020-August 2022, the Hub received 8420 referrals from CDCR to facilitate linkages to clinics offering medical, behavioral health, and substance use disorder services, as well as community health workers with histories of incarceration. This program description identifies care continuity components critical for reentry, including data sharing between carceral and community health systems, time and patient access for pre-release care planning, and investments in primary care resources. This collaboration is a model for other states, especially after the Medicaid Reentry Act and amid initiatives to improve care continuity for returning community members, like California's Medicaid waiver (CalAIM).

Simple Symptom-Based Prediction of COVID-19: A Single-Center Study of Outpatient Fever Clinic in Japan.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) symptoms are not fully understood in non-hospitalized individuals in Japan, and COVID-19 differentiation by symptoms alone remained challenging. Therefore, this study aimed to examine COVID-19 prediction from symptoms using real-world data in an outpatient fever clinic. METHODS: We compared the symptoms of COVID-19-positive and negative patients who visited the outpatient fever clinic at Imabari City Medical Association General Hospital and tested for COVID-19 from April 2021 to May 2022. This retrospective single-center study enrolled 2,693 consecutive patients. RESULTS: COVID-19-positive patients had a higher frequency of close contact with COVID-19-infected patients compared with COVID-19-negative patients. Moreover, patients with COVID-19 had high-grade fever at the clinic compared with patients without COVID-19. Additionally, the most common symptom in patients with COVID-19 was sore throat (67.3%), followed by cough (62.0%), which was approximately twice as common in patients without COVID-19. COVID-19 was more frequently identified in patients having a fever (≥37.5℃) with a sore throat, a cough, or both. The positive COVID-19 rate reached approximately half (45%) when three symptoms were present. CONCLUSION: These results suggested that COVID-19 prediction by combinations of simple symptoms and close contact with COVID-19-infected patients might be useful and lead to recommendations for testing of COVID-19 in symptomatic individuals.

Lean management technologies to optimize COVID-19 vaccination in adults

Introduction. Lean process improvements are needed to meet the increased adult demand for COVID-19 vaccinations. The purpose of the study is to develop interventions to improve adult vaccination against COVID-19 based on lean manufacturing strategies. Material and methods. We conducted 200 timings of the COVID-19 vaccination process and surveyed 200 vaccinated people. The time of the process, the time of creation of the value stream was calculated, production losses were analyzed. Results. After optimizing the COVID-19 vaccination process, the process time decreased by 2.3 times (from 5474.3 ± 127.3 to 2354.6 ± 22.5 sec;p < 0.01). The time for the prophylactic vaccination against COVID-19 in the vaccination room was reduced by 3 times (from 600.6 ± 23.3 to 181.3 ± 25.6 sec;p < 0.01). Production losses in the form of overproduction, excessive data processing, and unnecessary movements are excluded from the activities of the doctor and the nurse at the vaccination room. The time to value stream creation during vaccination increased from 68% to 97% (p < 0.01). Limitations. The research materials are limited to the results of scientific research of the North-Western State Medical University named after I.I. Mechnikov received over 2021. Conclusion. The use of lean manufacturing technologies made it possible to identify the nature of production losses and analyze the causes of their occurrence in the process of vaccination of the adult population against COVID-19. The organizational measures taken in the form of patient flow management, standardization of work processes, redistribution of functional responsibilities, elimination of production losses contributed to a significant increase in the throughput of the vaccination room in the context of the COVID-19 pandemic. © AUTHORS, 2023.

Clinical listening: Experience of a grieving mother in times of COVID-19

The aim of this article is to present the dynamics of a clinical situation with a mother bereaved by the death of her child victimized by COVID-19, through a theoretical-clinical study based on the phenomenological method. From the perspective and bases of the clinical phenomenological-existential, we will show a psychotherapeutic action in which grief is understood beyond the criteria positioned by the DSM-5. In phenomenological research on maternal mourning, mourning is understood as something of the order of the inescapable and the immeasurable. It is with this understanding of the affection of the bereaved that we will present the dynamics of a clinical performance of a 50-year-old woman attended by the Applied Psychology Service of a public university. We emphasize that the silence of the psychotherapist, during the care of the bereaved mother, favored that the mother felt understood in her pain. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Portuguese) O objetivo deste artigo e apresentar a dinamica de uma situacao clinica com uma mae enlutada pela morte de seu filho vitimado pelo COVID -19, por meio de um estudo teorico-clinico pautado no metodo fenomenologico. Em uma perspectiva clinica com bases fenomenologico-existenciais, mostraremos uma atuacao psicoterapeutica em que o luto e compreendido para alem dos criterios posicionados pelo DSM-5. Nas pesquisas fenomenologicas acerca do luto materno, o luto e compreendido como algo da ordem do incontornavel e do imensuravel. E com essa compreensao do afeto dos enlutados que apresentaremos a dinamica de uma atuacao clinica de uma mulher de 50 anos atendida pelo Servico de Psicologia Aplicada de uma universidade publica. Destacamos que o silencio do psicoterapeuta, durante o atendimento da mae enlutada, favoreceu que a mae se sentisse compreendida em sua dor. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Spanish) El objetivo de este articulo es presentar la dinamica de una situacion clinica con una madre afligida por la muerte de su hijo victima de COVID-19, a traves de un estudio teorico-clinico basado en el metodo fenomenologico. Desde una perspectiva clinica con bases fenomenologicas-existenciales, mostraremos una accion psicoterapeutica en la que el dolor se entiende mas alla de los criterios posicionados por el DSM-5. En la investigacion fenomenologica sobre el duelo materno, el luto se entiende como algo del orden de lo ineludible y lo inconmensurable. Es con esta comprension del afecto de los afligidos que presentaremos la dinamica de un desempeno clinico de una mujer de 50 anos a la que asistio el Servicio de Psicologia Aplicada de una universidad publica. Hacemos hincapie en que el silencio de la psicoterapeuta, durante el cuidado de la afligida madre, favorecio que la madre se sintiera comprendida en su dolor. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Ocular Oncology Practice During the COVID-19 Pandemic

The COVID-19 pandemic created a worldwide shift in how physician deliver optimal medical care. Ocular oncology practices have had to adapt to new challenges including how the delivery of service is performed in order to minimize SARS-CoV-2 exposure without sacrificing quality. Understanding the individual characteristics of every practice will maximize the efforts to adapt to this new reality. Telemedicine, virtual waiting rooms, and personal protective equipment have become the new standard during these unprecedented times. During clinic and operating room, our practices have had to strive for a new level of synchrony between patient and physician availability to minimize wasted time and exposure risk. Overall, medical care should not be delayed or deferred in patients with malignant ocular tumors during the COVID-19 pandemic;however, implementing safety measures for patients and healthcare workers is crucial to successfully continue to practice ocular oncology. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Clinical manifestations and emotional disorders in patients with new coronavirus infection (COVID-19)

The Novel Coronavirus Disease (COVID-19) is characterized by a variety of clinical manifestations, including a predominant lesion of the respiratory system with the possible development of distress syndrome, the development of multiple organ failure. COVID-19 can cause depression, anxiety, and other emotional disorders, which may interfere with subsequent physical recovery. The aim - clinical analysis of emotional disorders in patients with the Novel Coronavirus Infection (COVID-19). Material and methods. A retrospective analysis of electronic medical records of 124 patients admitted to the infectious diseases department of Chelyabinsk City Clinical Hospital No. 8 in 2020-2021 was carried out. The methods of clinical and psychological research (including clinical conversation, observation and testing using the "Hospital Scale of Anxiety and Depression" HADS and the "Symptom Check List" SCL-90-R) were used to identify the features of the emotional states of patients with COVID-19. Statistical analysis was performed using the statistical package <<Statistica 6.0>>. The Spearman rank correlation coefficient was used. Results. Typical complaints upon admission to the hospital are fever, cough, general weakness, loss of smell and taste, runny nose. The majority of patients showed elevated levels of C-reactive protein and protein of the acute phase of inflammation - ferritin, an increase in the D-dimer by more than 2.5 times compared with the average standard values, a decrease in the value of the prothrombin index (mean value 88.7+/-6.4%) indicate coagulopathy as a manifestation of hyperinflammation that develops in COVID-19. More than half of patients (52.08+/-9.42%) experienced psychological distress of moderate and high severity: an increased level of distress was recorded in 42.78+/-9.33% of the examined patients, a high level of distress was found in 9.30+/-5.48% of patients. Direct correlations of varying degrees of strength between general somatic distress and indicators of anxiety, depression, psychopathological manifestations (obsessive-compulsiveness and interpersonal sensitivity) and mental distress were identified. Revealed negative emotional experiences in patients with COVID-19 can cause adverse effects on the course and prognosis of the disease, reduce adherence to treatment, negatively affect the social functioning and quality of life of patients.Copyright © Infectious Diseases: News, Opinions, Training 2022.

Clinical and laboratory characteristics of new coronaviral infection (COVID-19) in children

Another rise in the incidence of a new coronavirus infection (COVID-19), due to the penetration of the SARS-CoV-2 delta strain into Russia in the second half of April 2021, is characterized by rapid spread, severe course in adults and an increase in cases of the disease among children. The aim of the work is to assess the clinical and laboratory parameters of a new coronavirus infection (COVID-19) in children. Material and methods. The results of clinical and laboratory examination and complex therapy of 95 children with moderate and severe forms of COVID-19, hospitalized in the Republican Clinical Infectious Diseases Hospital in Ufa from May to September 2021, are presented. Results. The anamnesis of the disease and life, epidemiological, clinical and laboratory, instrumental data obtained during the examination of children with COVID-19 in the course of the disease were studied. Among the clinical manifestations in children, symptoms of acute respiratory infection (37.9+/-4.98%), pneumonia without respiratory failure (26.3+/-4.52%), pneumonia with acute respiratory failure (33.7+/-4.85%). In 2 patients of the first months of life (2.1+/-1.47%), against the background of a aggravated premorbid background, immunodeficiency, COVID-19 proceeded in an extremely severe form with a fatal outcome. Conclusion. The clinical manifestations of COVID-19 are similar in children and adults, but differ in the frequency of respiratory symptoms. A severe course with a fatal outcome was registered in children in the first months of life with a burdened premorbid background.Copyright © Infectious Diseases: News, Opinions, Training 2022.

Impact of the Coronavirus Disease 2019 Pandemic on Dental Visits in Japan.

PURPOSE: This study aimed to clarify the impact of the coronavirus disease 2019 (COVID-19) pandemic on individual dental-visit behaviour and examine the difference between elderly and other individuals regarding the impact on dental visits. MATERIALS AND METHODS: An interrupted time-series analysis was performed to examine the change in data from the national database before and after the first declaration of a state of emergency. RESULTS: The number of patients visiting a dental clinic (NPVDC), number of dental treatment days (NDTD) and dental expenses (DE) during the first declaration of a state of emergency decreased by 22.1%, 17.9%, and 12.5% in the group under 64 years of age and 26.1%, 26.3%, and 20.1% in the group over 65 years of age, respectively, compared with those in the same month of the previous year. Between March and June 2020, the monthly NPVDC and NDTD were significantly reduced (p < 0.001, p = 0.013) in those over 65 years of age. The DE did not change statistically significantly in either the under 64 group or the over 65 group. There was no statistically significant change in the slope of the regression line in the NPVDC, NDTD, and DE before and after the first state-of-emergency declaration. CONCLUSION: The first state of emergency greatly reduced the NPVDC, NDTD, and DE compared to those in the previous year. In people aged over 65 years, it might still be unresolved 2 years after the postponement of dental treatment owing to the first declaration of a state of emergency.

Basic needs of the first batch of medical staff in the fever clinic of Peking union medical college hospital during Coronavirus disease 2019 outbreak: A qualitative study.

Objective The objective of this study was to investigate the basic needs of medical staff during the coronavirus disease 2019 pandemic in a fever clinic, so as to provide a reference for the global epidemic medical teams. Methods A semi-structured qualitative interview outline was designed, including: (1) work level: Working hours, working intensity, and safety guarantee in a fever clinic;(2)life level: Diet, sleep, and physical comfort;(3)psychological level: Emotion, pressure, coping style, and interpersonal resources. The basic needs of the first batch of the fever clinic in Peking Union Medical College Hospital was studied by open telephone interviews. Results A total of 37 medical staff were interviewed, including 8 males (21.6%) and 29 females (78.4%). Among them, there were 16 doctors (43.2%), 19 nurses (51.4%), and 2 medical technicians (5.4%). In terms of work settings, the ideal continuous working time was 4-6 hours per shift. There should be pro re nata positions during extremely high workload, and sufficient personal protective equipment was the key to safety. In terms of living conditions, providing meals according to different shifts was important for dietary needs, and sleeping pills were temporarily needed for sleep. In terms of psychological reactions, nervousness and worrying were relatively common. Family and colleagues were important resources of support. Sport could help relieve physical and psychological stress, and psychological support from psychologists was helpful in reducing their negative emotions. Conclusions The basic needs of medical staff should be respected so as to keep the efficacy of their work. We suggest that medical staff can rest after each 4-6 h working shift. Personal protective equipment should be sufficient. Psychological support should be noted in all of them and provided when necessary.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

Development of a carpark cardiac implantable electronic device clinic to improve time efficiency and patient satisfaction in the context of restrictions imposed by the COVID-19 pandemic.

INTRODUCTION: We evaluated time efficiency and patient satisfaction of a "car park clinic" (CPC) compared to traditional face-to-face (F2F) during the COVID-19 pandemic. METHODS: Consecutive patients attending CPC between September 2020 and November 2021 were surveyed. CPC time was recorded by staff. F2F time was reported by patients and administrative data. RESULTS: A total of 591 patients attended the CPC. A total of 176 responses were collected for F2F clinic. Regarding satisfaction, 90% of CPC patients responded "happy" or "very happy." 96% reported feeling "safe" or "very safe." Patients spent significantly less time in CPC compared to F2F (17 ± 8 vs. 50 ± 24 min, p < .001). CONCLUSION: CPC had excellent patient satisfaction and superior time efficiency compared to F2F.