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1.
Cityscape ; 24(2):269-280, 2022.
Article in English | ProQuest Central | ID: covidwho-2027152

ABSTRACT

The information used in developing this survey was obtained through an exhaustive review of each state's relevant statute and court rules, as well as a thorough review of appellate court opinions interpreting a relevant statute or providing guidance in the absence of statutory directive. In most instances, tenants are provided the lease on a take-it-or-leave-it basis with no opportunity to negotiate any of its terms, including provisions related to late fees.1 States that impose late fee maximums vary greatly on the amount and form of the limitation. In most of these states, the reasonableness requirement is established by courts rather than through legislation. * Arizona: For residential tenancies, it is implied within its eviction statutes that late fees must be reasonable. * California: Must be reasonably related to costs the landlord faces as a result of rent being late. * Connecticut: Fees must bear a reasonable relationship to the actual damage that the landlord sustains, and the court may void if excessive. * Illinois: Must be a reasonable forecast of damage caused by the breach. * Kentucky: Must be reasonable;$20 or 20 percent of the rental fee for each month is deemed reasonable. * Ohio: Must be reasonable in proportion to the rental rate and have a rational basis supporting the imposition of the charge. * Oklahoma: Must be reasonably related to actual costs incurred. * Pennsylvania: Late fees must be reasonable. * Texas: Must be reasonable;presumed reasonable if not more than 12 percent of the amount of rent for a dwelling located in a structure that contains no more than four units or 10 percent for a structure that contains more than four units. * Vermont: Late fee allowed if reasonably related to costs incurred. * Washington: Presumably must be reasonable. * West Virginia: Presumably must be reasonable. Most of these moratoriums were expired as of the date of the initial publication of this survey. * California: Renters who have submitted a declaration of COVID-19-related financial distress cannot be charged a late fee for the late payment of rental payments (no expiration date). * Colorado: Executive order prohibited landlords and lenders from charging late fees for any rent incurred between May 1, 2020, and April 27, 2021, due to the pandemic (expired). * Connecticut: Executive order 7X granted tenants an automatic 60-day grace period for April 2020 rent and made a 60-day grace period for May 2020 rent available upon request.

2.
Revista de Estudios Latinoamericanos sobre Reduccion del Riesgo de Desastres ; 6(2):72-87, 2022.
Article in Spanish | Scopus | ID: covidwho-2026900

ABSTRACT

This paper explores economic vulnerability in an industrial sector of Baja California, Mexico, during the first wave of COVID-19. In this regard, the Pressure and Release (PAR) model is used to analyze the information obtained from a panel of business representatives in the industrial sector. The results reveal several processes and factors that explain the fragility (vulnerability) of the industrial sector against hazardous events such as the COVID-19 pandemic. © 2022, Corporation for the Management and Reduction of Disaster Risk in Chile (GRID-Chile). All rights reserved.

3.
International Journal of Environmental Research and Public Health ; 19(16):10347, 2022.
Article in English | ProQuest Central | ID: covidwho-2023671

ABSTRACT

Suicide is a major public-health problem that exists in virtually every part of the world. Hundreds of thousands of people commit suicide every year. The early detection of suicidal ideation is critical for suicide prevention. However, there are challenges associated with conventional suicide-risk screening methods. At the same time, individuals contemplating suicide are increasingly turning to social media and online forums, such as Reddit, to express their feelings and share their struggles with suicidal thoughts. This prompted research that applies machine learning and natural language processing techniques to detect suicidality among social media and forum users. The objective of this paper is to investigate methods employed to detect suicidal ideations on the Reddit forum. To achieve this objective, we conducted a literature review of the recent articles detailing machine learning and natural language processing techniques applied to Reddit data to detect the presence of suicidal ideations. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we selected 26 recent studies, published between 2018 and 2022. The findings of the review outline the prevalent methods of data collection, data annotation, data preprocessing, feature engineering, model development, and evaluation. Furthermore, we present several Reddit-based datasets utilized to construct suicidal ideation detection models. Finally, we conclude by discussing the current limitations and future directions in the research of suicidal ideation detection.

4.
Electronics ; 11(16):2613, 2022.
Article in English | ProQuest Central | ID: covidwho-2023303

ABSTRACT

The present work is focused on the development of a Virtual Environment as a test system for new advanced control algorithms for an Unmanned Aerial Vehicles. The virtualized environment allows us to visualize the behavior of the UAV by including the mathematical model of it. The mathematical structure of the kinematic and dynamic models is represented in a matrix form in order to be used in different control algorithms proposals. For the dynamic model, the constants are obtained experimentally, using a DJI Matrice 600 Pro UAV. All of this is conducted with the purpose of using the virtualized environment in educational processes in which, due to the excessive cost of the materials, it is not possible to acquire physical equipment;moreover, is it desired to avoid damaging them. Finally, the stability and robustness of the proposed controllers are determined to ensure analytically the compliance with the control criteria and its correct operation.

5.
Diagnostics ; 12(8):1995, 2022.
Article in English | ProQuest Central | ID: covidwho-2023268

ABSTRACT

The complex and lengthy protocol of current viral nucleic acid extraction processes limits their use outside laboratory settings. Here, we describe a rapid and reliable method for extracting nucleic acids from viral samples using a rotating blade and magnetic beads. The viral membrane can be instantly lysed using a high-speed rotating blade, and nucleic acids can be immediately isolated using a silica magnetic surface. The process was completed within 60 s by this method. Routine washing and eluting processes were subsequently conducted within 5 min. The results achieved by this method were comparable to those of a commercially available method. When the blade-based lysis and magnetic bead adsorption processes were performed separately, the RNA recovery rate was very low, and the Ct value was delayed compared to simultaneous lysis and RNA adsorption. Overall, this method not only dramatically shortens the conventional extraction time but also allows for its convenient use outside the laboratory, such as at remote field sites and for point-of-care testing.

6.
PLoS One ; 17(9), 2022.
Article in English | ProQuest Central | ID: covidwho-2021964

ABSTRACT

Objective To develop a machine learning algorithm utilizing heart rate variability (HRV) and salivary cortisol to detect the presence of acute stress among pregnant women that may be applied to future clinical research. Methods ECG signals and salivary cortisol were analyzed from 29 pregnant women as part of a crossover study involving a standardized acute psychological stress exposure and a control non-stress condition. A filter-based features selection method was used to identify the importance of different features [heart rate (HR), time- and frequency-domain HRV parameters and salivary cortisol] for stress assessment and reduce the computational complexity. Five machine learning algorithms were implemented to assess the presence of stress with and without salivary cortisol values. Results On graphical visualization, an obvious difference in heart rate (HR), HRV parameters and cortisol were evident among 17 participants between the two visits, which helped the stress assessment model to distinguish between stress and non-stress exposures with greater accuracy. Eight participants did not display a clear difference in HR and HRV parameters but displayed a large increase in cortisol following stress compared to the non-stress conditions. The remaining four participants did not demonstrate an obvious difference in any feature. Six out of nine features emerged from the feature selection method: cortisol, three time-domain HRV parameters, and two frequency-domain parameters. Cortisol was the strongest contributing feature, increasing the assessment accuracy by 10.3% on average across all five classifiers. The highest assessment accuracy achieved was 92.3%, and the highest average assessment accuracy was 76.5%. Conclusion Salivary cortisol contributed a significant increase in accuracy of the assessment model compared to using a range of HRV parameters alone. Our machine learning model demonstrates acceptable accuracy in detection of acute stress among pregnant women when combining salivary cortisol with HR and HRV parameters.

7.
British Journal of Sports Medicine ; 56(17):970-974, 2022.
Article in English | ProQuest Central | ID: covidwho-2019957

ABSTRACT

ObjectivesHeadgear use is a controversial issue in girls’ lacrosse. We compared concussion rates among high school lacrosse players in an American state with a headgear mandate (HM) to states without an HM.MethodsParticipants included high schools with girls’ lacrosse programmes in the USA. Certified athletic trainers reported athlete exposure (AE) and injury data via the National Athletic Treatment, Injury and Outcomes Network during the 2019–2021 seasons. The HM cohort was inclusive of high schools from the state of Florida, which mandates the use of ASTM standard F3137 headgear, while the non-HM (NHM) cohort was inclusive of high schools in 31 states without a state-wide HM. Incidence rate ratios (IRRs) and 95% CIs were calculated.Results141 concussions (HM: 25;NHM: 116) and 357 225 AEs were reported (HM: 91 074 AEs;NHM: 266 151 AEs) across all games and practices for 289 total school seasons (HM: 96;NHM: 193). Overall, the concussion injury rate per 1000 AEs was higher in the NHM cohort (0.44) than the HM cohort (0.27) (IRR=1.59, 95% CI: 1.03 to 2.45). The IRR was higher for the NHM cohort during games (1.74, 95% CI: 1.00 to 3.02) but not for practices (1.42, 95% CI: 0.71 to 2.83).ConclusionsThese findings suggest a statewide HM for high school girls’ lacrosse is associated with a lower concussion rate than playing in a state without an HM. Statewide mandates requiring ASTM standard F3137 headgear should be considered to reduce the risk of concussion.

8.
Nature ; 609(7925):205-207, 2022.
Article in English | ProQuest Central | ID: covidwho-2016630

ABSTRACT

Online and digital harassment has had a significant impact on scientists working on issues such as climate change, gun control, vaccines and even challenging health conditions such as myalgic encephalomyelitis/ chronic fatigue syndrome. "If it impacts your quality of life, I think that's when you should get help." Another abusive tactic is doxxing, the public sharing of personal information such as address and contact details, sometimes with a threat that the harasser or others will contact the target in person. [...]Jack Heinemann, a geneticist at the University of Canterbury in Christchurch, New Zealand, who has a strong interest in academic freedom, says those policies are often more concerned with limiting what academics can say than with empowering them to feel safe when they're communicating opinions - even contentious ones.

9.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 83(10-B):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-2012796

ABSTRACT

A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied;however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The 2020 California Health Interview Survey is a public use database with 22,160 surveyed participants. Bronfenbrenner's social ecological model was used in this study to explain how healthcare access, delays of needed care, and usual source of care likely influenced asthma management for adults between the ages of 35 and 65. The information was used to understand the relationship between asthma status, healthcare access, usual source of health care, asthma management, and need to delay care using descriptive statistics, chi-square test of association, and logistics regression. This study focused on the healthcare influence during COVID-19 and asthma prevalence among individuals between the ages of 35 and 65. Thus, it led to the identification of another subset of the population that is likely to be at increased risk for developing chronic obstructive pulmonary disorder. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

10.
Gastro Hep Adv ; 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-2015303

ABSTRACT

BACKGROUN AND AIMS: Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multi-center cohort study, we evaluated variations in gastrointestinal (GI) and hepatic manifestations of COVID-19 throughout the United States (US). METHODS: Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at seven US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors. RESULTS: Among 2,031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to non-ICU patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (AST) (58.1% vs. 37.3%; p<0.01), alanine aminotransferase (ALT) (37.5% vs. 29.3%; p=0.01), and total bilirubin (12.7% vs. 9.0%; p<0.01). ICU patients also had a higher mortality rate (22.7% vs. 4.7%; p<0.01). Chronic liver disease was associated with the development of GI symptoms. Abnormal AST or ALT were associated with an increased risk of ICU admission. CONCLUSION: We present the largest multi-center cohort of patients with COVID-19 across the US. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the US.

11.
2022 Collaborative Network for Engineering and Computing Diversity, CoNECD 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2012584

ABSTRACT

In this paper we describe the Diversity, Equity, and Inclusion (DEI) Student Ambassadors program at Seattle University and the initiatives and activities that the ambassadors have been engaged in. This program drew inspiration from several Bias Busters groups created by industry and academia, especially the Bias Busters @ Carnegie Mellon University and the Bias Busters in the Electrical Engineering and Computer Science Department at University of California Berkeley. The student ambassadors were given broad objectives to improve the college community and educate the student population about diversity, equity, and inclusion. An initial planned project of the ambassadors was to organize a DEI Takeover Week during spring of 2020. This project had to be postponed due to the COVID-19 pandemic. The student ambassadors took this as an opportunity to instead develop programs focused on equity and inclusion issues that arose due to the pandemic and the transition to remote / virtual instruction. The DEI Student Ambassadors organized Zoom Town Halls that were open to all students, faculty, and staff in the college to engage in frank conversations about the challenges of the pandemic and how they connected to issues of diversity, equity, and inclusion. Additionally, the DEI Student Ambassadors developed theater-based workshops about microaggressions and bystander intervention. These workshops were administered in a number of classes, and highlighted real-world scenarios drawn from student surveys conducted in spring 2018 as well as the DEI Student Ambassadors' own experiences. Response to the DEI Student Ambassadors and the programs they have developed has been largely very positive. We conclude by discussing plans for how to continue, adapt, and expand this program. © 2022 American Society for Engineering Education.

12.
Medsurg Nursing ; 31(4):233-238, 2022.
Article in English | ProQuest Central | ID: covidwho-2011718

ABSTRACT

The increasing rate of homeless women veterans in the United States is presenting new challenges to society and civilian health services. Identifying women veterans at-risk or homeless, and gaining housing stability are critical steps in addressing the cause of homelessness.

13.
Dissertation Abstracts International Section A: Humanities and Social Sciences ; 83(11-A):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-2011591

ABSTRACT

Purpose: The purpose of this phenomenological study was to describe how exemplary K-5 principals in Southern California lead from the heart using Mark Crowley's (2011) 4 principles (building a highly engaged team, connecting on a personal level, maximizing employee potential and valuing and honoring achievements) to accomplish extraordinary results in their schools.Methodology: This study utilized a qualitative phenomenological methodology to study the behaviors of elementary principals. This study, due to current Covid restrictions, included virtual one-on-one interviews that were held via the Zoom online platform. The data collected included audio and video recordings, written transcripts, and artifacts from school and district websites, social media platforms, e-mails, newsletters, and meeting agendas. The population was narrowed for this study to include elementary principals in Southern California. The sample for this study, exemplary K-5 principals from three Southern California school districts, was chosen because participants met the specified criteria for exemplary school leadership.Findings: Exemplary elementary principals use the following heart-based strategies to achieve extraordinary results: develop collective values and goals, demonstrate transparency and vulnerability, engage in personal conversations with their staff, focus on continuous improvement for all employees, have intentional and hard conversations as needed, and publicly recognize their staff's accomplishments. Conclusions: The study supported the conclusions that exemplary principals pull together stakeholders with shared interests, passions, and commitments and solicit their input on collective goals for their work. They know that being transparent, open, and vulnerable helps them to connect personally with their staff, especially when joining a new community of professionals. Additionally, exemplary principals provide their staff ongoing opportunities for personal and professional improvement. Finally, this study revealed that exemplary principals will regularly honor their staff publicly through the use of newsletters, websites, social media postings, and verbal praise during meetings and assemblies.Recommendations: Post pandemic replication of this study is recommended after school districts and communities have recovered so that in-person interviews can be conducted, and in-person school site observations can be included in the data. School site observations will provide for more thorough and complete triangulation of the data. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

14.
AANA Journal ; 88(4):283-288, 2020.
Article in English | ProQuest Central | ID: covidwho-2011319

ABSTRACT

Cigarette smoking has negative health implications for surgical patients. Smoking cessation before surgery reduces complications;however, information on the risks of smoking and benefits of quitting on surgical outcomes are not regularly provided to patients. It is especially important for smokers to quit now because they are at increased risk of serious complications of coronavirus disease 2019 (COVID-19). The purpose of this project was to develop and implement a program for smoking cessation in a preanesthesia clinic associated with a southwestern medical center to increase motivation to quit smoking. The evidence-based program involved development of a provider toolkit, a referral process, provider education, and program evaluation. After provider education, the program commenced. Of the 134 current smokers encountered over a 16-week period, most were ready to quit within 30 days (n = 92, 68.66%). Of the smokers who were ready to quit, 50 (37.31%) accepted referral for smoking cessation counseling, treatment, or both. Only 13 (9.70%) of the 134 smokers were already receiving treatment. This program enabled providers to feel more comfortable discussing the implications of smoking, advising smokers to quit, providing education materials, and offering referral services at the appropriate stage of readiness for behavior change.

15.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009516

ABSTRACT

Background: Implementation of the Affordable Care Act (ACA) has resulted in improvements in cancer outcomes but the extent to which these apply to specific racial and ethnic populations is unknown. We examined changes in health insurance distributions pre- and post-ACA and assessed cancer-specific mortality rates by race and ethnicity. Methods: The population included 167,181 newly diagnosed breast (n = 117,738), colorectal (n = 38,334), and cervix cancer (n = 11,109) patients younger than 65 years and 141,026 patients 65 years or older in the California Cancer Registry. Hazard rate ratios (HRRs) and 95% confidence intervals (CIs) were calculated using multivariable Cox regression to estimate associations with risk of 5-year cancer-specific death for each cancer site pre- (2007-2010) and post-ACA (2014-2017), and by race and ethnicity (American Indian/Alaska Natives, AIAN;Asian Americans;Hispanics;Native Hawaiian/Pacific Islanders, NHPI;non-Hispanic Blacks, NHB;and non- Hispanic whites, NHW). Difference-in-difference analysis was conducted to compare changes over time between younger (< 65 years) and older (65 years and older) patients. Results: Cancer-specific mortality for patients age < 65 was significantly lower post- vs. pre-ACA for colorectal cancer among Hispanic (HRR = 0.83;95% CI: 0.74-0.93), NHB (HRR = 0.69;95% CI: 0.58-0.81), and NHW (HRR = 0.90 95% CI: 0.84-0.97) but not Asian American (HRR = 0.95;95% CI: 0.82-1.10) patients. The HRR for younger NHB colorectal cancer patients was significantly lower than that for patients 65 years of and older (HRR = 1.09;95% CI, 0.95-1.25, p-interaction < 0.0001). A significantly lower risk of dying from cervix cancer was observed in the post- vs. pre-ACA period among younger NHB women (HRR = 0.68;95% CI: 0.47-0.99), but this was not significantly different than that for older women (HRR = 0.41;95% CI, 0.16-1.01, p-interaction = 0.30). No significant differences in breast cancer-specific mortality were observed for any racial or ethnic group. Conclusions: Findings show decreases in cancer-specific mortality for colorectal and cervix cancers for some racial and ethnic groups following ACA implementation in California. These results shed light on ongoing discussions as additional states consider Medicaid expansion. Future studies should assess shifts between health insurance plans resulting from the economic impact of the 2019 novel coronavirus (COVID-19) pandemic.

16.
Journal of applied gerontology : the official journal of the Southern Gerontological Society ; : 7334648221120458, 2022.
Article in English | MEDLINE | ID: covidwho-2009275

ABSTRACT

This paper describes the evaluation of a longitudinal peer-support program developed to address loneliness and isolation among low-income, urban community-dwelling older adults in San Francisco. Our objective was to determine barriers, challenges, and successful strategies in implementation of the program. In-depth qualitative interviews with clients (n = 15) and peers (n = 6) were conducted and analyzed thematically by program component. We identified barriers and challenges to engagement and outlined strategies used to identify clients, match them with peers, and provide support to both peers and clients. We found that peers played a flexible, non-clinical role and were perceived as friends. Connections to community resources helped when clients needed additional support. We also documented creative strategies used to maintain inter-personal connections during the COVID-19 pandemic. This study fills a gap in understanding how a peer-support program can be designed to address loneliness and social isolation, particularly in low-income, urban settings.

17.
Annals of the Rheumatic Diseases ; 81:573-574, 2022.
Article in English | EMBASE | ID: covidwho-2008993

ABSTRACT

Background: The novel coronavirus disease 2019 (COVID-19) pandemic has spurred global action. Beginning in March of 2020, the Southern California COVID-19 pandemic response to limit virus transmission was characterized by mandated lockdowns and quarantines, resulting in signifcant stressors for rheumatology patients and potentially threatening their disease. Objectives: To examine factors associated with changes in rheumatoid arthritis (RA) disease activity and fares in the COVID-19 pandemic. Methods: RA patients identifed by ICD-9/10 codes and active email addresses within a University of California, Los Angeles (UCLA) Rheumatology database were sent surveys via email in July and November of 2020. The survey was UCLA Institutional Review Board approved and included electronic consent and questions related to: perceptions of disease activity/remission via Routine Assessment of Patient Index Data 3 (RAPID3), fare frequency, RA fare questionnaire (RA-FQ), Perceived Stress Scale (PSS-4), and pandemic impact on stress (I.e. emotional state, apprehension, panic, helplessness, work, home, fnancial, and social distancing stress). Demographics were extracted from electronic medical records. Results were examined via descriptive analyses, Pearson correlations, and chi-square test for comparisons plus linear stepwise regressions where appropriate to evaluate the relationship between stress measures, RA disease activity, and fare frequency and severity. Results: Among 5037 patients surveyed, 361 in July and 4676 in Novem-ber,1128 (22.4%) responded. The study population demographics were: mean age of 57.5 ± 15.1 years, 79.4% female, racially diverse (69.6% Caucasian, 13.7 % LatinX, 9.5 % Asian, and 4.9% Black), and 62% seropositive (CCP and/or RF). Perceived disease activity and remission remained stable in most patients with 719 reporting no fares, and 409 in current fares at the time of the survey (Table 1). A minority reported perceived increases in disease activity which were associated with multiple aspects of perceived stress. At survey completion, 346 had not experienced fares, 290 had experienced one fare, and 492 had experienced multiple fares. Use of DMARDs was associated with lack of fare versus current fare (77.8% versus 71.6%, p = 0.02). The use of conventional synthetic, biologic, or targeted synthetic DMARDs were not associated with fare while current corticosteroid use was associated with fare (9.3% without fare and 20.8% with fare, p < 0.0001). Current fare was associated with increased PSS-4 scores (odds ratio (OR): 1.17 (95% confdence interval: 1.12-1.22, p < 0.0001). Figure 1 describes the odds ratio of experiencing aspects of stress with the presence of RA fare. Conclusion: In a large survey population of RA patients during the COVID-19 pandemic, multiple aspects of stress were found to correlate with RA disease activity and fare.

18.
Female Pelvic Medicine and Reconstructive Surgery ; 28(6):S111-S112, 2022.
Article in English | EMBASE | ID: covidwho-2008701

ABSTRACT

Introduction: The Covid 19 pandemic led to a rapid adoption of telehealth. But challenges include technology literacy1 and access to technology (i.e. smartphones) 2. Since our institution's implementation of the Epic Systems (Verona, WI) electronic health record, Epic MyChart (EPIC) is the patient-facing, mobile portal application. It is the primary mode for televideo visits (televisit) endorsed by the institution. However, the platform is in English, requires downloads and passwords, site navigation, and requires over 20 clicks to setup. In a non-English speaking (55%), and digital elderly (50 + yrs old)3 patient population, this may be difficult. Doximity (Doximity, Inc, San Francisco, CA) is a text message based application without passwords and takes 4 clicks to start a televisit. This population successfully utilized Doximity for 76% of the televisits prior to EPIC. Objective: This quality improvement project is to assess the type of application needed for a televisit. If an EPIC televisit does not connect, then a Doximity televisit text was sent to the patient's cell phone. If this is not successful, it is then converted to a phone visit. The secondary purpose is to assess for factors that would predict who would be successful utilizing EPIC for their televisit. Methods: All televisits scheduled from August 1-Dec 31, 2021 was deidentified to create the dataset. ed data include televisit application, age, language, the need for login help, and zip code. Statistical analysis is conducted using SAS Studio Software. Descriptive statistics are used to summarize patient and visit data. Logistic regression is utilized for binary outcomes. Chisquare, and Fischer's used for categorical variables. Results: See Table 1. 93% (n = 208) of the scheduled televisits (n = 224) were completed. No login help was needed for 27% of scheduled televisits via EPIC (average age(age): 50 years old (yo), 87% speaking English), with an additional 24% via Doximity (age: 60yo, 67% speaking English). Login help was needed for a smaller proportion of Doximity visits (29%;age 69yo, 41% speak English) compared to EPIC (35%;age: 68yo, 36% speak English). If Doximity was still unable to connect, a phone visits was initiated 17% of the time (age: 71 yo, 24% speaking English). Factors for independent televisits include EPIC (p = 55yo (OR 0.089, P < 0.0001) are associated with a decreased likelihood that a patient will access an EPIC televisit without help. Conclusions: In this non-English speaking and older patient population, only a minority of telehealth visits are accessible via EPIC. Despite selecting out younger and English speaking patients, due to the step-wise utilization of the televisit applications (EPIC, then Doximity), older (average 60 yo) and non-English speaking patients are able to independently login for a Doximity telehealth visit. These factors decrease access to care when only utilizing the EPIC application. To improve health equity and minimize barriers for care, a televisit application's ease of use, needs to be considered when deciding on which televisit application should be utilized by an institution. And a choice of televisit applications should be offered for access to care (Table Presented).

19.
Infection control and hospital epidemiology ; : 1-9, 2022.
Article in English | MEDLINE | ID: covidwho-2008228

ABSTRACT

BACKGROUND: Candida auris is an emerging fungal pathogen causing outbreaks in healthcare facilities. Five distinctive genomic clades exhibit clade-unique characteristics, highlighting the importance of real-time genomic surveillance and incorporating genotypic information to inform infection prevention practices and treatment algorithms. METHODS: Both active and passive surveillance were used to screen hospitalized patients. C. auris polymerase chain reaction (PCR) assay on inguinal-axillary swabs was performed on high-risk patients upon admission. All clinical yeast isolates were identified to the species level. C. auris isolates were characterized by both phenotypic antifungal susceptibility tests and whole-genome sequencing. RESULTS: From late 2019 to early 2022, we identified 45 patients with C. auris. Most had a tracheostomy or were from a facility with a known outbreak. Moreover, 7 patients (15%) were only identified through passive surveillance. Also, 8 (18%) of the patients had a history of severe COVID-19. The overall mortality was 18%. Invasive C. auris infections were identified in 13 patients (29%), 9 (69%) of whom had bloodstream infections. Patients with invasive infection were more likely to have a central line. All C. auris isolates were resistant to fluconazole but susceptible to echinocandins. Genomic analysis showed that 1 dominant clade-III lineage is circulating in Los Angeles, with very limited intrahost and interhost genetic diversity. CONCLUSIONS: We have demonstrated that a robust C. auris surveillance program can be established using both active and passive surveillance, with multidisciplinary efforts involving the microbiology laboratory and the hospital epidemiology team. In Los Angeles County, C. auris strains are highly related and echinocandins should be used for empiric therapy.

20.
Journal of the American College of Cardiology ; 80(11):1107-1109, 2022.
Article in English | EMBASE | ID: covidwho-2007792
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