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1.
Some Problems of the Education System in Ukraine: Analytics ; : 1-160, 2021.
Article in English | Scopus | ID: covidwho-2081117

ABSTRACT

The monograph, based on the analysis of statistical data, establishes the wave-like nature of changes in the demographic situation and its periodization in Ukraine. The dependence of the birth rate on changes in GDP is formalized. An assessment of the volume of the educational market and forecasting changes in the contingent of applicants for secondary and higher education are evaluated. A quantitative analysis of the labor market in terms of groups of specialties and educational programs, and a quantitative assessment of the compliance of the popularity of entrants in specialties and educational programs to the demands of the labor market are conducted. It is conducted a quantitative analysis of employers' requirements for candidates for a job, the availability of higher education and work experience. The demand of employers for soft skills job seekers and professional competencies in terms of specialty groups are estimated. The impact of the COVID-19 pandemic on the structure of the labor market is studied. The clustering of specialties and educational programs by the criterion of similarity of demand for personal and professional competencies is conducted. The achievements and shortcomings of the functioning of the system of external independent evaluation (EIE) of learning outcomes in Ukraine are formulated. The possibilities of using the psychological characteristics of entrants, the scores of their EIE certificates to assess future learning outcomes and to assess career prospects after graduation are researched. A quantitative analysis of the system of financing higher education in Ukraine, including the current system of distribution of budget funds between of higher education institutions is conducted. The shortcomings of the current system and ways to eliminate them are substantiated. © 2021 V. Ponomarenko.

2.
Infect Dis (Lond) ; : 1-9, 2022 Oct 20.
Article in English | MEDLINE | ID: covidwho-2077533

ABSTRACT

BACKGROUND: Cryptosporidiosis is gastroenteritis caused by Cryptosporidium. Since 2017, reporting of cryptosporidiosis has increased in Finland. METHODS: We describe demographics of cryptosporidiosis cases notified to Finnish Infectious Disease Register (FIDR) during a 21-year surveillance period, 1995-2020, and a retrospective investigation of increased cryptosporidiosis in Ostrobothnian hospital districts in summer 2018. RESULTS: Incidence of cryptosporidiosis during the period 2017-2020 represented 20-fold increase from the period 1995-2016, with the highest incidence detected in Ostrobothnia. In 2018, cryptosporidiosis in Ostrobothnia was associated with living on or visiting a farm where the production animals had diarrhoea, noticing more flies than usual, gardening or handling manure and having a family member with gastroenteritis. Four gp60 subtypes were identified in patient samples: IIaA18G1R1, IIaA15G2R1, IIaA13G2R1 and IIaA15G1R1. CONCLUSIONS: In Finland, Cryptosporidium has been included in gastrointestinal PCR diagnostic panels in most clinical laboratories since 2016. Since then, the number of reported cases has subsequently increased, indicating improved diagnostics and awareness of the illness. In 2018, several C. parvum subtypes were identified in patients suggesting that the increase was not caused by a single source. Cryptosporidiosis increased in Finland in 2020 despite hand washing recommendations and travel restrictions imposed during the COVID-19 pandemic, indicating that domestic cases are more frequent than previously considered. To monitor cause and origin of cryptosporidiosis and the effect of control measures, Cryptosporidium should be identified at subspecies level, and travel history should be included in FIDR notification. Those working with cattle and calves require precise instructions on how to prevent C. parvum infection.

3.
Sci Afr ; 16: e01257, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2076693

ABSTRACT

Despite the significant and rising human and economic costs of the novel coronavirus disease (COVID-19), our knowledge on its epidemiology remains limited necessitating expedited research to aid public policy. This study contributes to the knowledge gap by focusing on exploring the effects of potential covariates (economic, institutional, and climatic conditions) on COVID-19 in tropical countries. Using an Ordinary Least Square (OLS) regression, our results showed a non-linear relationship between temperature and infection-to-test ratio. Specifically, temperatures warmer than 18 °C can favor the spread of the disease. In addition, strikingly, countries with better democratic principles registered more positive cases than their counterparts at high levels of corruption.

4.
Revista De Ciencias Sociales-Costa Rica ; - (174):143-165, 2022.
Article in Spanish | Web of Science | ID: covidwho-2067942

ABSTRACT

Identify the determinants of the change in the risk of hospitalization with and without and with intubation with respect to outpatient care in indigenous and non-indigenous patients according to conditions of indigenism with COVID-19 at the beginning of the pandemic. With information from the Ministry of Health of Mexico on May 20, 2020, multinomial logistic models are developed for both groups of patients, adjusting for socioeconomic variables, health conditions and place of residence that show common conditions such as pneumonia and others, as well as residence in large cities for indigenous people due to their migration.

5.
Drustvena Istrazivanja ; 31(3):405-427, 2022.
Article in English | ProQuest Central | ID: covidwho-2067058

ABSTRACT

Prethodna istraživanja uglavnom su zanemarivala mišljenja hotelskih zaposlenika o zdravlju (na radnom mjestu), uključujući njegovu povezanost s pandemijama (kao što je COVID-19). Ovo istraživanje ispituje ta mišljenja usmjerujući se na slučaj slovenske hotelske industrije. Anonimni web-upitnik, kao jedina praktična mogućnost, poslan je tijekom pandemije potencijalnim ispitanicima u hotelima diljem zemlje. U analizi primijenjeni su sljedeći pristupi: univarijatna analiza, provjera intervala pouzdanosti za srednju vrijednost, analiza glavnih komponenti s Varimax-rotacijom te Spearmanov i Pearsonov koeficijent korelacije ranga. Većina ispitanika promijenila je svoj stav prema zdravlju tijekom pandemije (x2 = 2,66). Analizom glavnih komponenti (PCA) uvedena je redukcija dimenzionalnosti skupa podataka i izdvojeno je pet komponenti koje čine 60,3 % ukupne varijance. Zbog niskog rs i rp, sve su komponente zanemarivo povezane s demografskim karakteristikama, kao i s promjenom zabrinutosti za zdravlje ispitanika zbog pandemije COVID-19.Alternate :Previous research has mostly overlooked the hotel employee-related perspectives on (occupational) health, including its relation to pandemics (such as COVID-19). This research examines this perspective focusing on the case of the Slovenian hotel industry. An anonymous web questionnaire, as the only practical option, was sent during the lockdown to potential respondents from hotels throughout the country. For the analysis, the following approaches were employed: univariate analysis, the check of reliability and confidence intervals for the means, principal component analysis with Varimax rotation, and Spearman's and Pearson's rank-order correlations. The majority of respondents changed their attitude towards health during the pandemic (x2 = 2.66). Using PCA, dimensionality-reduction of the dataset was implemented. A five-component solution, in which components account for 60.3% of the total variance, was identified. Due to low rs and rp, all components are negligibly correlated to demographic characteristics as well as to the respondents' changing health concerns due to COVID-19.

6.
Open Access Macedonian Journal of Medical Sciences ; 10(E):1420-1425, 2022.
Article in English | EMBASE | ID: covidwho-2066706

ABSTRACT

BACKGROUND: Indonesia’s lowest COVID-19 vaccine coverage of 6.5% is found in Teluk Makmur Village, Dumai City, Riau province. The success of the COVID-19 vaccination program is determined by vaccine hesitancy, which comprises numerous and presumably complex factors that vary over time and between countries or between regions of one given country. AIM: The aim of the study was to determine COVID-19 vaccine hesitancy prevalence and influencing factors in the community. MATERIALS AND METHODS: A cross-sectional study was conducted from September to November 2021 at Teluk Makmur Village, Dumai City, Riau Province, Indonesia, involving 149 respondents aged 25–93 years and using a questionnaire on respondents’ sociodemographic characteristics and their opinions on possible COVID-19 vaccines. COVID-19 vaccine hesitancy factors were analyzed by multivariable logistic regression (p ˂ 0.05). RESULTS: COVID-19 vaccine hesitancy was present in 51.7% of respondents. Multivariable logistic regression findings: Comorbidities, fear of dying from COVID-19, feelings of shame/stigmatization if known to be infected with COVID-19 were not significantly associated with vaccine hesitancy. Education and distrust of government COVID-19 related policy were significantly associated with vaccine hesitancy. CONCLUSION: Half of respondents were hesitant about COVID-19 vaccines. COVID-19 vaccine hesitancy factors consisted of education and distrust of government policy.

7.
Open Access Macedonian Journal of Medical Sciences ; 10(E):1397-1401, 2022.
Article in English | EMBASE | ID: covidwho-2066673

ABSTRACT

BACKGROUND: Many studies have found that assessing COVID-19 preventive behaviors using the health belief model (HBM) to understand both motives and fears is critical to better controlling the disease. AIM: The aim of the study was to assess the perceptions of social distancing as a preventive measure during the COVID-19 pandemic using the HBM among a sample of the Egyptian population. METHODS: An exploratory cross-sectional study was conducted using an online survey distributed through one of Egypt’s most popular social media platforms. Four hundred and seventy people responded to the survey. The survey constructed of two sections;the first section for sociodemographic data and Section 2 was for HBM constructs of self-efficacy, perceived susceptibility, and severity to COVID-19 prevention benefits and barriers. RESULTS: More than half of the participants (59.8%) were in the age range of 20–29, with an average age of 29.0 ± 6.4 years. Two hundred ninety-seven participants (63.2%) were females;60.2% lived in the canal region;57.9% were single;and 70% had university degrees. There were statistically significant differences regarding gender;females’ perceived higher scores in almost all model constructs (benefits, susceptibility, severity, self-efficacy, and total score). Many statistically significant differences were observed;those who were older than 30 years had higher scores in barriers, benefits, self-efficacy, and total score than younger ones. Similarly, married participants reported higher scores in barriers, benefits, self-efficacy, and total score than younger ones. Postgraduate education perceived higher scores than university in benefits, susceptibility, self-efficacy, and total score. CONCLUSION: In the present study, the majority of respondents had relatively high perceived benefits, severity, and self-efficacy, with the lower perceived self-COVID-19 susceptibility but higher for family members. Females perceived higher scores in almost all model constructs (benefits, susceptibility, severity, self-efficacy, and total score).

8.
New Armenian Medical Journal ; 16(2):25-32, 2022.
Article in English | EMBASE | ID: covidwho-2067787

ABSTRACT

Objectives: to assess the effect-related inflammatory and coagulation biomarkers in pregnancy and their connection with the coronavirus disease of 2019 (COVID-19). Method(s): A prospective case-control study was carried out among normal third-trimester pregnant women admitted to the labor room of Dr. Soetomo General Academic Hospital between January until June 2021. Two classified groups of patients were established in accordance with the result of the RT-PCR test. Demographic, clinical and laboratory results data of the two groups were collected and compared. Result(s): Platelet-to-lymphocyte ratio (PLR) was shown to be the only significant biomarkers found in the expectant with COVID-19, which was 35.8% higher compared to the ones free of COVID-19 [212.25 (157.57-269.37) vs 156.29 (128.55-195.3), p=0.048]. Logistic regression analysis of PLR between groups showed that the level of PLR was an independent factor in pregnant women with COVID-19 (OR 4.483, 95%CI 1.262-15.926). The ROC analysis showed that the PLR cut-off among the expectant was 171.335, with both sensitivity and specificity were 66.7% (p=0.021). The result shows no significant differences in leukocyte count, absolute neutrophils - lymphocyte count and percentage, neutrophil-to-lymphocyte ratio (NLR) and D-Dimer level between pregnant women infected with COVID-19 and free of the virus (p>0.05). Conclusion(s): Intriguingly, physiological adaptation during the course of the third trimester of pregnancy found no difference in most inflammation and coagulation markers, both in the condition of infected COVID-19 or not. The evidence from this single-centre study supports the viewpoint that elevated PLR was associated with independent biomarkers and thereby might be helpful to detect expectant with COVID-19. Copyright © 2022, Yerevan State Medical University. All rights reserved.

9.
Neurology Asia ; 27(3):725-735, 2022.
Article in English | EMBASE | ID: covidwho-2067764

ABSTRACT

Background & Objective: Tension-type headache (TTH) is the most common primary headache. TTH worsens quality of life and is related to various psychosocial factors. We aimed to examine the severity of headache (intensity, frequency, and duration), analgesic use, quality of life (QoL), and the impact of COVID pandemic-induced stress in TTH patients. Method(s): TTH cases seen at neurology outpatient clinics in 15 centers in Turkey were included in the study. A questionnaire incorporating sociodemographic and medical information, headache features, sleep quality, general quality of life, and impact of the pandemic event was administered to the subjects. Result(s): A total of 975 TTH patients were evaluated. Headache severity was higher in women as well as in patients with a history of COVID-19 contact. Women, those with chronic diseases, and cases with a COVID-19 contact history had worse perceptions of quality of life and were affected to a greater extent by the pandemic. The factors affecting the impact of the pandemic were female gender and difficulty in access to health services for headache. Co-existing chronic diseases and lost productive time due to headaches were negative determinants for both QoL and the impact of the pandemic. Conclusion(s): Our results show that the COVID pandemic severely worsened the headache burden, quality of life and mental health of TTH patients. These findings can guide us in the clinical approach to TTH cases. Copyright © 2022, ASEAN Neurological Association. All rights reserved.

10.
Pakistan Journal of Medical and Health Sciences ; 16(7):438-440, 2022.
Article in English | EMBASE | ID: covidwho-2067742

ABSTRACT

Introduction: Pandemics affect people in a defeatist manner and become stressful for people with relatives which need specific forms of care and attention. The study was conducted to find out if anxiety prevails among caretakers during the Covid-19 Pandemic as according to the literature review caregivers experience burden and fears related to their care-recipients and telerehabilitation. Material and Methods: The study used cross sectional survey and quantitative research.50 care-givers participated in the research where they filled online questionnaires inspired and derived from care-giver burden scale and beck anxiety inventory. Anxiety was clearly evident as most of the care-givers agreed to have feelings of nervousness 19 (38%), feeling anxious 18 (36%), feeling distressed 22 (44%), complaints about emotional burden 23 (43%) and 23 (46%) constant immersion in duties towards care-recipients. Results: SPSS tables depict the analyzed results and their interpretation. The results show 36%of the care-givers agreed that they face anxiety when a situation gets out of control, 44% were distressed about not getting enough help from healthcare team and other family and friends, 55% are apprehensive about their present condition and 46% are emotionally challenged and constantly immersed in duties owing to their family members. Conclusions: Anxiety and depression as a result of caregiving burden is common among care-givers and needs to be addressed as soon as possible. This makes it essential that health professionals pay heed and attention to develop interventions for care-givers and provide them with pertinent knowledge.

11.
Jordan Journal of Pharmaceutical Sciences ; 15(3):365-377, 2022.
Article in English | EMBASE | ID: covidwho-2067669

ABSTRACT

Background: The pandemic COVID-19 requires collaborative teamwork by all healthcare professionals including Pharmacists who could help in combating epidemic diseases by providing several pharmaceutical services. Nevertheless, public perception of pharmacist's role in providing health service is controversial Methods: A cross-sectional web-based design validated survey of 25 items was used to explore patients' opinion about pharmacist's ability to provide different health services during COVID-19 pandemic. Exploratory factor analysis (EFA) was conducted to evaluate the best model for the questionnaire. The association between different demographic variables and awareness about pharmacist's role was evaluated using Pearson correlation, Mann-Whitney u test and Kruskal-Wallis one-way analysis of variance. Result(s): A total of 668 persons participated in the study. The mean (SD) of the respondent questionnaire scores was 97.1 (12.6) and the possible maximum score was 115 (12.9). Higher awareness score was associated with increased age, female gender, lower educational level, living out of Amman the capital, being college or university student or being employed in medical field. Conclusion(s): The positive public perception toward pharmacist role shown in the present study enlighten the need to expand pharmacist role to be more engaged in providing different health services during the disaster or normal conditions. Copyright © 2022 DSR Publishers/The University of Jordan. All Rights Reserved.

12.
Aging Medicine and Healthcare ; 13(3):139-146, 2022.
Article in English | EMBASE | ID: covidwho-2067647

ABSTRACT

Background/Purpose: As a result of the COVID-19 pandemic, changes in data collection methods have been introduced in research to ensure continuity despite physical distancing and lockdown restrictions. Our objective was to compare differences in physical and mental health of older adults participating in falls research using data collection methods pre-covid-19 pandemic (face-to-face) and during the pandemic (hybrid). Method(s): Individuals aged 60 years and over with at least one fall in the past 12 months, and controls with no history of falls in the past 12 months were recruited. Pre-pandemic, individuals were interviewed face-to-face exclusively, those interviews after the start of the pandemic were conducted virtually with physical assessments conducted face-to-face to minimize physical contact. Cognitive status, physical performance, psychological status, quality of life, physical activity, and social participation were measured. Result(s): Of the 145 participants of similar socio-demographic backgrounds, 69 were interviewed face-to-face, while 76 were assessed using a hybrid method. Differences were observed in presence of fall characteristics, with fewer fallers seeing a doctor and more fallers attending the emergency department after the start of the pandemic. After adjustment for baseline differences, participants interviewed using hybrid status had lower depression scores (OR (95%CI)=0.29(0.14-0.61)) and stress scores (OR(95%CI)=0.33(0.15-0.72)), but greater fear of falling (OR(95%CI)=2.16(1.04-4.48)) and reduced social participation (OR(95%CI)=2.64(1.20-5.79)). Conclusion(s): Alterations in data collection methods to overcome pandemic restrictions should take into consideration potential differences in individuals who agree to participate as well as the influence of major life events on the psychological status of participants. Copyright © 2022, Full Universe Integrated Marketing Limited. All rights reserved.

13.
Aging Medicine and Healthcare ; 13(3):132-138, 2022.
Article in English | EMBASE | ID: covidwho-2067646

ABSTRACT

Background/Purpose: Due to the pandemic of COVID-19 and the need to pay attention to the older adults as one of the most vulnerable groups, this study aimed to determine the effects of educational programs based on the Protection Motivation Theory (PMT) as non-pharmaceutical intervention in promoting protective behaviors against COVID-19 among the older adults in Hamadan. Method(s): The present study was a randomized controlled trial performed in 2021 on 80 older adults visiting retirement centers in Hamadan. Participants were randomly assigned to experimental (n=40) and control groups (n=40). The data collection tool was a researcher-made questionnaire including demographic variables and constructs of PMT which were completed before and two months after the intervention. The intervention consisted of four sessions implemented for the experimental group. The collected data was analyzed in SPSS-16 using Chi-square, Mann-Whitney, and Wilcoxon tests. Result(s): There was no significant difference between the two groups in terms of all demographic variables and theoretical constructs before the educational intervention. After the educational intervention, there was a significant difference in the constructs of perceived severity (P=0.012), perceived response efficiency (P=0.009), perceived self-efficacy (P=0.021), and perceived response cost (P <0.001) after the intervention. No significant changes were reported in the control group (P >0.05). Also, results showed that there was no significant difference in the mean of COVID-19 preventive behaviors between the two groups after the educational intervention (P >0.05). Conclusion(s): The results showed that the use of educational intervention as non-pharmaceutical intervention based on the PMT was an effective approach to perform preventive behaviors against infectious diseases such as COVID-19. Copyright © 2022, Full Universe Integrated Marketing Limited. All rights reserved.

14.
Iatreia ; 35(4):414-423, 2022.
Article in Spanish | EMBASE | ID: covidwho-2067412

ABSTRACT

Objective: To identify the clinical presentation and factors associated with anosmia and ageusia in patients with COVID-19 in a health center in a province of Peru for the period 2020-2021. Method(s): Cross-sectional analytical study through data from the COVID-19 program of the Essalud Po-lyclinic in Jauja, Peru. Sociodemographic characte-ristics, symptoms and comorbidities of the patients were detailed. A bivariate analysis identified the factors associated with anosmia and ageusia. Result(s): 356 patients were identified: 53.1 % were wo-men, mean age was 48.7 years (+/-17.8) and 261 (73.3%) with mild COVID-19. Of the total, 22.2% had anosmia and 19.9% ageusia;of which the majority were un-der 65 and female. Associated symptoms were found in 86.1% of patients with anosmia and 83.1% with ageusia. The main factors associated with anosmia were age younger than 65 years (p=0.027), cough (p<0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and fever (p<0.001);and ageusia: age younger than 65 years (p=0.006), cough (p=0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and diarrhea (p<0.001). Conclusion(s): Anosmia and ageusia are common symptoms of COVID-19. Most patients had these symptoms associated with common symptoms. Many of those who had anosmia had nasal congestion, so it is advisable to consider differentiating them when making the diagnosis. Copyright © 2022, Universidad de Antioquia. All rights reserved.

15.
Journal of Clinical and Diagnostic Research ; 16(9):FC15-FC19, 2022.
Article in English | EMBASE | ID: covidwho-2067197

ABSTRACT

Introduction: Long-term repercussions of Coronavirus Disease-2019 (COVID-19) on antimicrobial resistance have been raised as a grave concern due to the rampant use of antibiotics in the management of COVID-19. As per meta-analysis, the prevalence of antibiotic prescribing was 74.6% which was significantly higher than the estimated prevalence of bacterial co-infection. World Health Organisation (WHO) recommended that antibiotic therapy should not be used in patients with mild/moderate COVID-19 unless there is any bacterial suspicion. Also, the guidelines laid down by the Ministry of Health and Family Welfare, Government of India, does not recommend systematic empiric antibiotic therapy in patients hospitalised with COVID-19. Despite not being recommended, antimicrobials are still given in clinical practice. Aim(s): To analyse prescriptions for antimicrobials and to identify potential predictors for antibiotic prescription. Material(s) and Method(s): A retrospective observational study was conducted at a tertiary care teaching institute. Data (demographic profile, co-morbidities, disease category, prescribed antimicrobials, laboratory investigations, and duration of hospital stay) were collected from case files of patients with laboratory-confirmed Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection. These patients were admitted in the institute from January 2021 to May 2021. Logistic regression was used to analyse factors associated with the empirical use of antimicrobial agents. Result(s): A total of 184 case files were analysed. The mean age of patients was 55.84+/-15.72 years, with a male preponderance (70.10%). Among antimicrobials, antivirals were prescribed in 159 (86.41%) patients, and antibiotics in 152 patients (82.6%). Antivirals prescribed include Remdesivir [109(68.55%)] and Favipiravir [70(44.02%)]. Ceftriaxone was found to be the highest prescribed antibiotic, with a median duration of administration of six days. An association was found between disease severity and CRP level with antibiotic prescription. On multivariable analysis, the odds of receiving antibiotics were 6.7 times higher in patients with severe disease. Conclusion(s): More than 80% of COVID-19 patients received antibiotics. Duration of hospital stay was similar among patients whether they received antibiotics or not. Disease severity and raised CRP level were strong predictors for prescribing antibiotics for COVID-19. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

16.
Journal of Clinical and Diagnostic Research ; 16(9):ED01-ED03, 2022.
Article in English | EMBASE | ID: covidwho-2067193

ABSTRACT

Sickle Cell Disease (SCD) is an inherited disorder with variable clinical presentation and low immunity. Coronavirus Disease-2019 (COVID-19)is a pandemic disease with a high-risk in chronic disease patients and older adults. SCD is widely distributed in Sudan;many SCD patients are infected with COVID-19. Despite this, no published data is available. This case report demonstrated the haematological and clinical course of a Sudanese sickle cell anaemia patient with COVID-19. A 20-year-old male patient was admitted to a hospital for 15 days. Demographic and clinical data were obtained from his medical records. A blood sample was taken at the time of admission and during hospitalisation. Tests were performed during admission, including Complete Blood Count (CBC), liver function test, renal function test, coagulation studies, viral screening, and urine general. The patient was diagnosed with COVID-19 using the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test based on the nasopharyngeal swab and COVID-19 IgG and IgM using Enzyme Linked Immunosorbent Assay (ELISA) for the previous infection. The patient received intravenous fluids, antibiotics, analgesia, oxygen supplementation, and blood transfusion two times during hospitalisation, and there was no need for Intensive Care Unit (ICU) admission. The patient's prognosis was good;he was discharged on day 16 with no symptoms and a negative result of the COVID-19 PCR test. A severe illness was expected because he was infected twice by COVID-19, the patient showed mild clinical symptoms with a good prognosis, so further studies are required to understand COVID-19 among Sudanese SCD patients.

17.
International Journal of Stroke ; 17(2 Supplement):3, 2022.
Article in English | EMBASE | ID: covidwho-2064672

ABSTRACT

Background & Aims: Young stroke survivors (YSS) report unmet needs related to age and life stage that stroke services often overlook. Researchers, advisers with lived experience, and clinicians collaborated to develop the "Young Stroke Unmet Needs Screening Tool". Method(s): Mixed-method codesign project conducted in three phases: 1. Literature review conducted and workshop held with 12 advisers (8 YSS, 4 clinicians) to develop initial tool content. 2. Online survey conducted to examine YSS preferences for methods of meeting needs, and gain feedback on tool's usability and content. 3. A version was then developed for people with communication or cognitive impairment using Principles of Supported Conversation for Adults with Aphasia, and cognitive strategies. Semi-structured interviews and focus groups held to further develop and test both versions. Result(s): 171 online survey responses (68% female, mean age 45 years, IQR 36-51). Respondents' demographic and stroke-related characteristics influenced preferences for methods of meeting needs, including face-to-face contact with professionals, peer support and succinct tip sheets. Interviews and focus groups were held online due to COVID, with 20 YSS (age 24-53yrs, 60% reported cognitive impairments and 80% had mild to moderate-severe language limitation), and 10 family members. Recruitment of people with more severe language limitations required personal invitation rather than advertising via social media or stroke groups. The tools include six domains (Body and Mind, Emotions, Information, Daily Life, Relationships, Social) covering 53 potential needs. Also included is a distress thermometer. Use of the tool was strongly endorsed for both versions. Conclusion(s): These new unmet needs screening tools could be used to identify service needs for young stroke survivors, including those with cognitive and/or communication difficulties. The tools are now being used in a large study to identify care pathway requirements, to inform the development of a bespoke health service for young stroke survivors.

18.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P109, 2022.
Article in English | EMBASE | ID: covidwho-2064491

ABSTRACT

Introduction: Human papillomavirus (HPV) vaccination remains inadequate in the United States, and lack of provider-prompted initiation presents a critical barrier to broader coverage. This study aims to determine the efficacy of an electronic health record (EHR) intervention on primary and catch-up HPV vaccination. Method(s): A retrospective analysis was performed of 22,517 patients aged 9 to 26 years receiving HPV 9-valent or quadrivalent vaccines by primary care providers in a single health care system from 2016 to 2021. Vaccine administrations and sociodemographic characteristics were compared before and after the implementation of an EHR health maintenance reminder (HMR) prompting HPV vaccination in February 2020. Multivariate logistic regression modeling was used to ascertain independent variables associated with early (<18 years) vs late vaccination (>18 years) across the study period. Result(s): In the cohort, most were female (52.7%) and White (55.9%). Mean age was 15.4 and 16.3 years before and after HMR implementation, respectively (P<.001). There was a 48% increase in vaccinations given in those over 18 years in 2020 compared with the year prior. Of patients, 34.5% receiving the vaccine post-HMR were older than 18 years, compared with 26.2% pre-HMR (P<.001). On multivariate analysis, Black (odds ratio [OR]=1.27;95% CI, 1.18-1.36;P<.001) and Asian (OR=1.52;95% CI, 1.36-1.71;P<.001) patients were more likely to be greater than 18. Notably, outpatient visits decreased by about 18% in 2020 during the pandemic compared with the prior 3 years. Conclusion(s): EHR reminders are an effective provider-level intervention in improving catch-up HPV vaccination numbers, despite waning health care utilization during the COVID- 19 pandemic. This may be particularly important for patients who are more likely to have received the vaccine at a later age.

19.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P20-P21, 2022.
Article in English | EMBASE | ID: covidwho-2064482

ABSTRACT

Introduction: While there is anecdotal evidence that a SARSCoV- 2 (COVID-19) reverse transcription polymerase chain reaction screening nasopharyngeal swab confers an elevated risk of epistaxis, no studies substantiate this. We aim to assess the association between epistaxis and exposure to a provideradministered COVID-19 swab. Method(s): A paired-exposure crossover cohort design was used among all patients who received a single COVID-19 swab between April 2020 and March 2021. Occurrence of epistaxis was compared during the hazard period, the 7 days following the index COVID-19 swab, to the control period, the 7 days preceding the index COVID-19 swab. McNemar test was used to compare rates of control- and hazard-period epistaxis. Conditional logistic regression was used to evaluate sociodemographic and clinical risk factors for epistaxis. Result(s): A total of 827,987 participants were included, with 1047 epistaxis encounters. The prevalence of epistaxis during the hazard and control periods were 0.08% and 0.04%, respectively. Swab exposure was associated with 1.92-fold odds of epistaxis in the hazard period (95% CI, 1.73, 2.12];P<.01). Older age (odds ratio [OR] 1.07;95% CI, 1.02, 1.75), Asian ancestry (OR 1.68;95% CI, 1.40, 2.02), men (OR 1.33;95% CI, 1.16, 1.54), anticoagulation/antiplatelet use (OR 2.88;95% CI, 2.11, 3.92), hypertension (OR 2.31;95% CI, 1.92, 2.78), and prior facial trauma (OR 1.63;95% CI, 1.21, 2.19) were associated with significantly increased odds of epistaxis during the hazard period (P<.01). Conclusion(s): COVID-19 nasal swabs are associated with increased risk of epistaxis. Physicians should provide additional counseling to patients, particularly those at highest risk, including those on anticoagulants/antiplatelets or with hypertension, prior to undergoing a COVID-19 nasal swab.

20.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P150, 2022.
Article in English | EMBASE | ID: covidwho-2064481

ABSTRACT

Introduction: The pandemic of COVID-19 in association with mucormycosis would be a deadly fungal infection with high level of mortality and morbidity. Our aim is to evaluate the surgical outcome of patients with rhino-orbito-cerebral mucormycosis to suggest better management strategies. Method(s): A total of 62 cases of COVID-19-associated rhino-orbito-cerebral mucormycosis were admitted to the ear, nose, throat department in Mashhad, Iran, from August 1 to October 15, 2021. All data were analyzed using SPSS version 27.0. Descriptive analysis was used for demographic and clinical characteristics. Result(s): Main predisposing conditions were diabetes mellitus (90%) followed by hypertension (41%). Main symptoms were headache (75%), periorbital or retro-orbital pain (61%), visual loss (45%), and facial numbness (41%). Mucosal and ocular findings showed necrosis (67%), blindness (n=35), ptosis (n=31), proptosis (n=27), ophthalmoplegia (n=25), and chemosis (n=20). Neurologic loss of consciousness (19%) and palsies of cranial nerves (53%) were observed. Endoscopy findings showed necrosis (70%), discharge (61%), and crusting (54%). Imaging enhancement revealed mucosal thickening (69%), opacification of sinus (69%), bony destruction of sinus (35%), and orbital involvement (25%). Debridement surgery was necessary in nearly all patients (96%), dominated by ethmoid sinus (90%), maxillary sinus (87%), middle turbinate (80%), and sphenoid sinus (79%). Based on our follow-up, 25 patients died (42%). Those who survived will suffer from no light perception (35%), cranial nerve palsy (12%), and cerebral vascular accident (1.6%). Conclusion(s): Mucormycosis is an aggressive fungal infection. Diabetes mellitus, COVID-19 complication, inappropriate use of corticosteroids, and delayed vaccination had significantly increased its incidence. As there is an urgent need to address this public health concern, we present our data set from Iran.

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