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This chapter introduces a citizenship instruction program offered by the Teaching English to Speakers of Other Languages (TESOL) program at Oklahoma City University (OCU) in collaboration with two local libraries in the Oklahoma City metro area with a grant funded by the Institute of Museum and Library Services and the Oklahoma Department of Libraries. It specifically discusses the challenges that teachers and learners have encountered during the COVID-19 pandemic and the approaches utilized to address these challenges. Implications of this experience for instruction of civics/history and civics-based English, as well as the professionalization of ESL teachers, post-COVID-19 are discussed. © Springer Nature Switzerland AG 2021. All rights reserved.
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Introduction: The COVID-19 pandemic has negatively impacted clinical experience and case volumes. Surgical simulation is now an even more powerful training tool and, to maximize potential, we must ensure learner engagement. Our aim was to identify barriers to surgical simulation engagement and strategies to mitigate these. Method(s): Scoping search was performed with a trained librarian of PubMed, EMBASE and Web of Science. Title and screening were completed with inclusion criteria: articles describing barriers to engagement with surgical simulation. After full text screening, data was extracted from included articles: type of study, MERSQI score, type/number of participants, barriers to engagement and strategies to mitigate these. Result(s): Twenty-nine manuscripts were included with 951 faculty and 2,467 residents. The majority (86%) were in high income countries (HIC) and four in LMICs. Most were surveys (22/29), and five involved semi-structured interviews/focus groups. Mean adjusted MERSQI score was 8. Commonest barriers to HIC engagement were learner clinical duties (9/25), lack of learner time (13/25), lack of learner interest/motivation (9/25) and lack of faculty time or interest to participate (12/25). In LMIC, commonest barriers were lack of simulation lab/equipment (4/4), cost (3/4) and inadequate supervision (3/4). Strategies to improve HIC engagement were mandatory/protected resident simulation training (9/25) and, in LMIC, low cost simulators (4/4) and sharing resources (2/4). Conclusion(s): Identification of barriers to simulation engagement is crucial for successful learning. Given the increased importance of simulation education due to the COVID-19 pandemic, surgical educators should strategize to maximize engagement.
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Background It is a challenge for pharmacy courses worldwide to combine theoretical knowledge with practical skills to equip students for their future practice. Computer-based simulation offers a way of building a bridge between theory and practice. In recent years, digital simulation has expanded rapidly as a new technique of virtual learning. The digital platform ''Pharmacy Simulator'' proposes computer-based encounters with virtual patients to train clinical and communication skills in a community pharmacy setting. However, during the COVID-19 pandemic, while students were digitally resilient and endured the endless challenges of online lectures, many were dealing with Zoom and screen fatigue. Purpose To investigate pharmacy students' acceptance of Pharmacy Simulator before and during a pandemic situation. This focuses on students' self-assessment and confidence in counselling after playing the scenarios on Pharmacy Simulator. Method Two cohorts of Master of Pharmacy students at The University of Western Australia played two scenarios on Pharmacy Simulator in 2019 (anaphylaxis and salbutamol) and 2021 (anaphylaxis and vaccination). A mixed-method analysis was performed with data from (i) qualitative semi-structured interviews carried out in 2019 pertaining to participants' acceptance of Pharmacy Simulator and in 2021 (ii) a questionnaire with 25 items derived from the interviews. The interviews were transcribed verbatim into electronic format with the data management assistance MAXQDA and analyzed inductively using the Framework Method. Questionnaire responses were analyzed in Microsoft Excel using descriptive statistics. Openended questions were evaluated inductively. Findings Data were collected from 20 interviews and 31 answered questionnaires. In 2019, participants reported that Pharmacy Simulator was a fun, engaging, and straightforward learning tool and, therefore, user-friendly. They reported the feedback at the end of the session to be most valuable. The platform was perceived to fill the gap between the theory from lectures and community pharmacy practice. In 2021, participants ''agreed'' (median: 4, on a 5-point Likert scale) with seven statements about Pharmacy Simulator's usability, such as it being a helpful tool for acquiring new knowledge. Participants' confidence in counselling regarding the scenario topics improved. One participant stated, ''It taught me more through trial and error''. Conclusion Pharmacy students reported similar acceptance levels of Pharmacy Simulator before and during the COVID-19 pandemic. The use of simulation during virtual patient encounters seems to facilitate the transfer from theory to practice, independently of learning conditions that were predominantly screen-based.
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Objectives: Evidence demonstrates that when hospitals focus on the discharge process patient safety improves and overall costs decline. Hospital discharge requires care coordination of multiple disciplines, often leading to fragmented care, and adverse outcomes after discharge include emergency department visits and hospital readmissions. The Re-Engineered Discharge (RED) process was developed as an evidence-based strategy to improve the hospital discharge. We evaluated perspectives and priorities of physicians, health care workers, and patients involved in the vascular discharge process using RED as a framework. Method(s): A single-center qualitative analysis using a semi-structured focus groups and an interview guide based on the RED process. Focus groups were Zoom platform recorded, transcribed into text files, independently coded, and analyzed with Dedoose qualitative software using a directed content analysis approach. Thematic concepts were created, and comparisons between groups were analyzed by coding frequency. Researchers independently thematically coded each transcript;prior to analysis, all redundancy of codes was resolved;and all team members agreed on text categorization and coding frequency. Result(s): Eight focus groups with 38 participants were performed. Participants included: physicians (n = 13), nursing and ancillary staff (n = 19), and patients/caregivers (n = 6). Transcript analyses revealed facilitators and barriers to discharge. Overarching themes identified from the qualitative analysis frequencies are displayed by stakeholder role (Fig 1). Themes identified with the greatest coding frequencies included helpfulness of discharge instructions, patient health literacy, patient medical complexity, poor interdisciplinary team communication, time constraints during discharge, technology literacy of patients, barriers to obtaining medications for patients, barriers to organizing outpatient services for health care workers, barriers for patients to obtain help after discharge, and the impact of COVID-19. Conclusion(s): These findings identify the need to strengthen efforts to overcome stakeholder barriers to improve patient safety at the interface of the hospital to create a well-organized discharge. Physicians were most concerned with low patient health literacy, patient understanding of discharge instructions, organizing outpatient services, and overall patient medical complexity hindering a smooth discharge. Health care staff identified time constraints, obtaining medications and, and inter-team communication as their greatest obstacles to an organized discharge. Patients found the complexity and amount of discharge instructions, the impact of COVID-19 on support systems, and technology utilization after discharge most challenging. Modifications to address individual stakeholder barriers within the discharge process are needed to develop a national standardized discharge specific for vascular surgery patients to improve patient safety and satisfaction. [Formula presented]Copyright © 2023
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Aims: The DisCOVery study sought to better understand the experiences of young people with complex emerging mental health problems over the longer-term social restrictions related to the COVID-19 pandemic. A key focus investigated young people's attitudes and experiences of social connection, and how they perceived this to be related to their mental health and future recovery needs. Method(s): Semi-structured interviews were completed with 16 young people (aged 20 to 25) with pre-existing and complex mental health and social problems, between January to December 2021. N = 6 completed follow up interviews approximately 6 months after their initial interview. Interviews were analysed using thematic analysis. Results and Conclusion(s): Four themes were identified. These centred around a preference for balancing solitude and quality relationships within small social worlds, the complex role of in-person versus online connection and interaction, how the COVID-19 lockdowns were a facilitator of both social connection and disconnection, and the importance of relationships, talking and being listened to for well-being. The findings suggest that in-person, and to some extent online connection, is a key component of well-being, and is an active recovery goal that socially withdrawn young people with complex pre-existing mental health problems would like to work on.
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Background: Coronavirus disease-2019 (COVID-19) poses expectant mothers to a higher risk of serious complications and mortality. Following a risk-benefit review, a number of governmental and professional bodies from across the globe recently approved the COVID-19 vaccination during pregnancy. Aim(s): This study aimed to investigate knowledge, actual acceptance, and concerns about the COVID-19 vaccine among the obstetric population. Material(s) and Method(s): Participants were selected from among the expecting women who came for antenatal checkup during the study period (October 1, 2021-November 30, 2021). About 150 pregnant women who met the inclusion criteria and consented were recruited into the study. Data related to socio-demographic and clinical characteristics as well as knowledge, actual acceptance, and concerns about COVID-19 vaccine were collected through in-person interviews using a prestructured questionnaire. The SPSS version 23 was used to analyze data. The association between the attitude (acceptance and hesitance) of participants toward the COVID-19 vaccine and their sociodemographic and clinical profile was found by Fisher's exact test. Result(s): The actual acceptance of the COVID-19 vaccine among expecting women was 52.0%. The primary motive for accepting COVID-19 immunization was to protect the fetus, followed by the protection of one's own health. A significant association was found between COVID-19 vaccine acceptance and the level of education, socio-economic status, and presence of comorbidities. The leading causes for vaccine reluctance were concerns about the efficacy and safety of the vaccines and lack of awareness about their usage during pregnancy. Conclusion(s): Multifaceted activities are required to promote the effectiveness and safety profile of the COVID-19 vaccine as well as disseminate knowledge about its usage during pregnancy. Clinical significance: Unlike numerous other studies that have investigated the accepting attitude only, the present one has investigated the actual COVID-19 vaccine uptake among the obstetric population.Copyright © The Author(s).
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Aims: Youth are increasingly seeking health information through online platforms, such as websites, social media, and online forums. TikTok emerged as a popular platform for disseminating and consuming health information during the COVID-19 pandemic. As such, this study aimed to explore how youth used TikTok to access information about mental health and mental health services during the pandemic. Method(s): Twenty-one interviews were conducted over Zoom with youth (ages 12-24) who lived in British Columbia, Canada and had accessed TikTok for mental health information during the pandemic. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using an inductive approach. Result(s): Youth described TikTok as a safe place to talk about mental health and share personal experiences. This helped youth feel less alone with their struggles and facilitated conversations about mental health with friends, family, and service providers. Participants also described how mental health content on TikTok helped them be more mindful of their own mental health and the different resources and coping strategies available and encouraged them to seek services. For those hesitant or unable to access services, TikTok provided immediate support. Youth appreciated the ease of accessing this information, given the platform's engaging and digestible format (i.e., short videos) and predictive nature of its algorithm. However, participants expressed concerns with the spread of misinformation and the lack of verifiable information on the platform. Conclusion(s): TikTok is as a practical platform to disseminate mental health information to youth. However, efforts to establish strategies for preventing and reporting misinformation are warranted.
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Background/Objectives: Li-Fraumeni Syndrome (LFS) is a rare hereditary cancer predisposition syndrome characterized by high lifetime risks for multiple primary malignancies. Although most individuals with LFS inherit a pathogenic TP53 variant from a parent, approximately 20% have de novo variants with no suggestive family cancer history. This may result in an LFS experience distinct from individuals with affected relatives. This multi-case study report examines the unique psychosocial experiences of three young adults with de novo TP53 variants. Method(s): The National Cancer Institute's LFS study (NCT01443468) recruited adolescents and young adults (AYAs;aged 15-39 years) with LFS for qualitative interviews. Three participants had a de novo TP53 variant and a personal cancer history. An interprofessional team analyzed interview data using extended case study and narrative methods. Result(s): De novo participants lacked familiarity with LFS to situate a cancer diagnosis, interpret genetic test results, or adjust to chronic cancer risk. Communicating with and receiving support from family was challenged by their lack of common experience. De novo participants experienced socioemotional isolation, which was amplified during the COVID-19 pandemic. To cope, they sought support in online rare disease communities or through mental health providers. Conclusion(s): Individuals with de novo variants may lack familial guides and familiar providers to address disease management and uncertainty. Specialty health and mental health providers may support de novo patients across hereditary cancer syndromes by validating their uncertainties and connecting them with diseasespecific patient advocacy groups that support adjustment to chronic cancer risk.
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Qualitative methods are used to capture stakeholder perspectives within learning healthcare systems (LHS), but there is a need to specify methods that balance rigour and pragmatic approaches to inform quality improvement (QI). Utilizing examples from two QI projects within the OTNY LHS, we illustrate methods and strategies that build team capacity and flexibility to respond to an evolving LHS. Method(s): Qualitative methods were tailored to fit each project's timelines and goals, to inform both practice and research. Tools to facilitate rapid cycle feedback included interview/focus group summary templates, aggregate summaries that synthesize findings by stakeholder group, case matrix templates for rapid extraction and systematic categorization of data along topic areas, and dissemination materials adapted for stakeholder audience and project phases. Strategies to maintain rigour included processes for data reduction and interpretation, a multi-disciplinary approach for analysis, frequent consensus-based meetings, data triangulation, and member checks. Result(s): Rapid cycle approaches yielded interim results that reshaped research questions or identified critical gaps. Case summary analysis exploring the impact of COVID-19 revealed limited information on telehealth challenges amongst OTNY participants, necessitating a shift in recruitment and interview focus. For another project, analytic methods were sequenced to rapidly inventory suggestions from interview summaries on how to enhance OTNY practice to better address racism, while subsequent thematic analysis of transcripts captured participants' experiences of racism for context. Challenges included concurrent alignment of data collection and analysis, tailoring summary templates to maximize utility for rapid analysis, and maintaining flexibility to respond to evolving findings and LHS stakeholder input. Conclusion(s): The diverse methods and strategies illustrated by these projects offer guidance for balancing.
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Aims: to investigate if mental disorders and cognitive performance are associated with interpersonal behaviours and negative emotions among youth during the COVID-19 pandemic. Method(s): This work is part of the Brazilian High-Risk Cohort for Mental Conditions (BHRC), which included 6-12 years-old children at baseline (Year 2010) who participated in an online COVID-19 wave (N = 1.144). Outcomes were factor socres from specifc sections of the international Coronavirus Health and Impact Survey (relationship changes, stress, and concerns related to COVID-19). A structured interview (DAWBA, DSM-IV) assessed externalizing and internalizing disorders. Cognitive predictors were IQ and executive function assessed at baseline. We used Generalized Linear Models adjusting for sex and socioeconomic variables. First, higher IQ (B = 0.0032;t = 2.714;p = .006) and any internalizing disorder prior to the pandemic (B = 0.0902;t = 2.228;p = .026) were associated with higher perceived stress during the pandemic. Second, any externalizing disorder (B = -0.1449;t = -2.066;p = .039) was linked with lower levels of COVID-19-related worries, whilst higher performance in executive function tasks was associated with higher levels (B = 0.1803;t = 4.796;p = .001). Third, higher IQ was linked with negative changes in interpersonal relationships (B = -0.0007;t = -3.371;p = .0007). Conclusion(s): This study showed that lifetime externalizing and internalizing disorders, in addition to cognitive variables at lifetime externalizing and internalizing disorders, in addition to cognitive variables at an early age, were associated with distinct mental health outcomes during the COVID-19 pandemic.
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Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Aim and Objectives: 1. Knowledge of the COVID 19 vaccine among medical students in a tertiary care hospital. 2. Attitude towards the COVID 19 vaccine among medical students in a tertiary care hospital. Methodology: Study Location: Tertiary care hospital facility in Visakhapatnam. Study Period: From August to September 2022 will be the study period. Study Sample Size: 316. Statistics: Data are gathered using google forms, and the spread document is error-checked. Calculations are made for descriptive numbers like frequency and percentage. Result(s): Sociodemographic details about the participants-There were 316 competitors in total. Men make up about 34.5% (n=109) of the members. Approximately 65.5% of the members (n=207) are female. About 40.5% (n=128) of the participants are first-year students, 39.25% (n=124) are second-year students, 14.5% (n=46) are third-year students, and 5.7% (n=18) are fourth-year students. Conclusion(s): The majority of medical students' responses to this research show moderate knowledge of and a favorable outlook towards the COVID 19 vaccine. It also demonstrates that medical students are more knowledgeable and have more optimistic dispositions. Our findings can be applied to interventions that promote public health, particularly for medical students. To dispel the medical students' fears and misunderstandings regarding the COVID 19 vaccine, there should be seminars, lectures, and instructional videos that are specifically aimed at them.Copyright © 2023, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved.
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Objectives: This study aimed to estimate the direct medical costs of patients with post COVID-19 condition in a Colombian insurance company with more than 2.5 million affiliates. Method(s): We conducted a bottom-up cost-of-illness study of adults with persistent symptoms after at least three months of hospital discharge due to COVID-19. We surveyed patients that were hospitalized between March 2020 and August 2021. We asked about healthcare resource utilization (HCRU), which included laboratories and images, medications, consults, rehospitalizations, and others, associated with post COVID-19 condition. The answers were verified using the company's outpatient and inpatient service authorization records. Costs were estimated from the third payer perspective and expressed in American dollars using an exchange rate of 1USD$=3,743COP. Result(s): We included 202 participants, 51.5% were male, mean age of 55.6 years old, 49% had a comorbidity (41.9% hypertension), and 46 patients (22.8%) required an intensive care unit. A total of 159 (78.7%) patients reported at least one symptom after discharge. Of these, 132 (65.3%) persisted with at least one symptom during the telephone survey. Seventy-five (47.2%) of the 159 patients with persistent symptoms reported HCRU. Of these, 93.3% consulted a physician (mean consultations: 2.1 SD 1.1;mean consultations with specialists: 2.4 SD 2.0), and 9.3% were re-hospitalized. The average direct medical costs of post COVID-19 condition were US$824 (95%CI 195-1,454). Costs in outpatient were US$373 (95%CI 158-588), and in inpatient, US$3,285 (95%CI -167-6,738). Conclusion(s): It is crucial to follow up and identify patients discharged from the hospital who persist with symptoms after three months since we observed a greater HCRU, including prolonged recovery therapiesCopyright © 2023
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Introduction: Cancer patients have a high risk of severe COVID-19 and complications from it. Although the COVID-19 pandemic has led to an increase in the conduction of clinical trials (CTs), there is a scarcity of data on CT participation among cancer patients. We aimed to describe the level of participation in a COVID-19 CT, willingness to participate, as well as trust in sources of information for CTs among persons with and without a previous cancer diagnosis in Puerto Rico. Method(s): Data collected from November 2021 to March 2022 from two cross-sectional studies were merged and used for analysis. Informed consent, telephone, face-to-face, and online interviews were conducted among participants >=18 years old living in Puerto Rico (n=987). Descriptive statistics and bivariate analysis (Fisher's exact text and chi-squared test) was done to describe the outcomes of interest, overall and by cancer status. Result(s): Mean age of participants was 41+/-15.5 years. Most participants were women (71.3%), with an educational level greater than high school (89.5%) and with an annual family income below $20,000 (75.1%). Overall, 4.4% of participants (n=43) reported history of cancer diagnosis. Only 1.8% of the population reported to have participated in a COVID-19 CT to receive either a treatment or vaccine;stratifying by cancer, none of the cancer patients had participated in a COVID-19 CT, and only 1.9% of non-cancer patients participated. While 37.0% of the participants indicated being very willing to sign up for a CT assessing COVID-19 treatment, willingness was higher in cancer patients (55.8%) than among participants without cancer (36.1%). Regarding trust in sources of information for CTs, the level of trust ("a great deal/a fair amount") was higher for their physicians (87.6%), researchers (87.0%), the National Institute of Health (86.7%), their local clinics (82.9%), and a university hospital (82.7%), while it was lower for a pharmaceutical company (64.0%), and for friend, relative, or community leader (37.6%);no differences were observed by cancer status. Conclusion(s): While participation in COVID-19 CTs was extremely low in the study population, the willingness to participate was higher among cancer patients. Education on CTs and their availability are necessary to increase participation in this understudied group. Such efforts will enhance the representation of Hispanic and vulnerable populations, such as cancer patients, on COVID-19 CTs, and thus proper generalizability of study findings in the future.
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Background: The COVID-19 pandemic, together with the cost-of- living crisis, have shone a light on health inequalities running through our society - not least in UK lung cancer. Lung cancer has the widest deprivation gap of all cancers. Despite published data about socio-economic factors, the amount of evidence available about other health inequalities is poor. Method(s): The Bridging the Gap report is the output from a Health Inequalities focus-group meeting of the UKLCC's Clinical Advisory Group in June 2022. These opinions were supplemented by views and information gathered from 15 interviews with leading lung cancer and health inequalities experts, from across the four UK nations in August/September 2022. Further desk research and literature reviews were carried out over the same period. Result(s): The report calls for a 'comprehensive' approach to data collection on health inequalities - to bridge gaps in current knowledge, improve outcomes and ensure people with lung cancer have equitable access to diagnosis, treatment, and care - wherever they live and from whatever background. Key recommendations include: * Extending the remit of the National Lung Cancer Audit (NLCA) to collect more data on ethnicity, LGBTQ+ and other health inequality factors - such as gender, religion and disability. * Establishing a single, coordinated data strategy, compiling evidence on health inequalities at local, regional and national levels. * Introducing a Personal Care and Access Card scheme, carried by the patient, combining their Holistic Needs Assessment information with their personal treatment and care plan to facilitate transfer of information between hospitals and specialists. * Disease awareness campaigns targeted to address local needs and communities. Conclusion(s): The UKLCC believes that - with the implementation of these recommendations and support from policy makers, commissioners and clinicians - we can successfully mitigate health inequalities in lung cancer and have further impact on lung cancer outcomes. Report accessible here: www.uklcc.org.uk/our-reports Disclosure: No significant relationships.Copyright © 2023 Elsevier B.V.
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Domestic violence against women is a major social problem in Bangladesh. This paper examines the determinants of domestic violence in Bangladesh during the COVID-19 pandemic. The project was carried out in selected areas of Khulna district of the country and followed survey research design. A total of 312 ever married female respondents who experienced domestic violence at any stage of their life were surveyed. The respondents were selected through simple random sampling as a semi-structured questionnaire/ interview schedules was used as the primary tool for data collection. The data were collected in two stages between the months of May-October, 2021 through face-to-face interviews. Results from the chi-square analysis show that, respondents' residence, educational status, age at first marriage, duration of marriage life, husband's income, husband's occupation, and a demand for dowry were all associated with domestic violence against women (p <.01). The study concludes that creation of awareness and empowerment of women through income generating activities particularly in the rural areas of Bangladesh is necessary to reduce the prevalence of domestic violence.Copyright © Nova Science Publishers, Inc.
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Aims: A proof-of- concept pilot investigating the profile of person who engaged with remote testing for their annual diabetes review, and service user (SU) and primary care practice acceptability for completing annual diabetes review tests remotely (blood pressure, finger-stick blood test and urine test). Method(s): A mixed methods evaluation based on SU surveys sent to all 144 pilot participants, semi-structured SU and staff interviews, and demographic and clinical data extraction from primary care electronic patient record system. Result(s): Profile: The pathway was considered suitable for people who were working, digitally capable, younger, had household support to complete the tests, had non-complex diabetes, or a combination of these attributes. It was deemed less suitable for the very elderly, the less digitally capable, those with complex health needs or socially isolated. SU Acceptability: Interviewees and survey respondents overall deemed the remote tests acceptable for use. Convenience and reduced exposure to Covid-19 were motivating factors for participation. Preference for face-to- face care or concerns around using digital technologies were key reasons for decline. Staff Acceptability: The pathway was deemed acceptable and was successfully implemented at both practices. Support from a designated pathway co-ordinator and project manager were key factors linked to acceptability and success. The remote pathway was seen as an opportunity to reduce primary care pressures on in-person care. Conclusion(s): It is possible to successfully conduct annual diabetes reviews remotely. Although not appropriate nor desirable to everyone, remote testing provides a viable alternative to in-person testing for certain individuals.
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Background: The COVID-19 pandemic catalyzed major changes in how youth mental health (MH) services are delivered. Understanding youth's MH, awareness and use of services since the pandemic, and differences between youth with and without a MH diagnosis, can help us optimize MH services during the pandemic and beyond. Objective(s): We investigated youth's MH and service use one year into the pandemic and explored differences between those with and without a self-reported MH diagnosis. Method(s): In February 2021, we administered a web-based survey to youth, 12-25 years, in Ontario. Data from 1373 out of 1497 (91.72%) participants were analyzed. We assessed differences in MH and service use between those with (N=623, 45.38%) and without (N=750, 54.62%) a self-reported MH diagnosis. Logistic regressions were used to explore MH diagnosis as a predictor of service use while controlling for confounders. Result(s): 86.73% of participants reported worse MH since COVID-19, with no between-group differences. Participants with a MH diagnosis had higher rates of MH problems, service awareness and use, compared to those without a diagnosis. MH diagnosis was the strongest predictor of service use. Gender and affordability of basic needs also independently predicted use of distinct services. Conclusion(s): Various services are required to mitigate the negative effects of the pandemic on youth MH and meet their service needs. Whether youth have a MH diagnosis may be important to understanding what services they are aware of and use. Sustaining pandemic-related service changes require increasing youth's awareness of digital interventions and overcoming other barriers to care.Copyright © 2023, Canadian Academy of Child and Adolescent Psychiatry. All rights reserved.
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Introduction: With two cycles of virtual residency interviews, we evaluated applicants' perceptions and behavior. Method(s): All 2021 and 2022 general surgery interviewees at our institution were surveyed. Analyses were conducted using chi-square and t-tests. Result(s): Cumulatively, 134 of 238 interviewees responded (56.3%). Respondents were 50.3% male, 83% white, and 27.2 years old (SD 2.9). Candidates applied to more programs due to interviews being virtual (61%), but this effect decreased in 2022 (38%, p=0.2). Similarly, they endorsed accepting more interviews (54% in 2021 and 45% in 2022, p=0.6) with a median of 17 interviews in 2021 and 15 in 2022 (p=0.18). 27.6% reported expanding their geographic reach. The advantages were consistently saving money (96%), saving time (50%), and avoiding COVID-19 (44%). Top limitations were the inability to observe interpersonal interactions (61.2%), increased difficulty comparing programs (58.2%) and less exposure to current residents and faculty (57.4%). In the 2022 cycle, 84.7% of candidates felt the common supplemental application was not worth their time because it did not improve their application. 95% of respondents 'signaled' their top five programs, from which 20% received no interview offers and only 3% received offers from all. Conclusion(s): Virtual interviews led applicants to expand their geographic range and increase the number of programs to which they applied;however, 2022 saw a dampening of this effect. Perceived limitations did not improve in 2022, and the supplemental application was not valued by applicants. The benefits of virtual interviews must be balanced against the intangible ability to observe program culture.
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Background: The Early Youth Engagement (EYE) project co-developed the first engagement-focussed intervention derived from the perspectives of young people and their families in Early Intervention in Psychosis services. Patient and Public Involvement (PPI) in the EYE-2 study aimed to ensure that the voices of people experiencing first episode psychosis, and carers, were embedded in the refinement, delivery and evaluation of the Early Youth Engagement (EYE-2) approach across the UK. Method(s): The EYE-2 project used a multi-level PPI approach: Each of five sites had a PPI lead, trained and supported by senior PPI researchers. PPI leads convened local Lived Experience Advisory Panels (LEAPs), and co-delivered staff and researcher training. Practical challenges were identified and resolved. Results and Impacts: Tangible PPI impacts included: the co-produced revised booklets and EYE-2 website https://www.likemind.nhs.uk following workshops of over 40 people;the delivery of on average 52 peer-led intervention social groups at each site, allowing people to connect with peers with lived experience and build a sense of optimism, shared identity, interpersonal skills and problem-solving in a social environment, with activities driven by service users. Written outcomes included a PPI-led booklet on running peer-led social groups, a person-centred telephone interview for the HoNOS questionnaire for use during the Covid-19 pandemic, peer reviewed papers, blogs and video logs. Conclusion(s): PPI was integral to the delivery of the EYE-2 study;the multi-level approach facilitated a diversity of voices across different aspects of the study and ensured that people with lived experience shaped the intervention, research design and implementation.