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1.
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.

2.
Research Journal of Pharmacy and Technology ; 15(8):3717-3724, 2022.
Article in English | EMBASE | ID: covidwho-2067732

ABSTRACT

Background: Health care workers (HCWs), being in the front line dealing with COVID-19 patients, are facing various challenges. Therefore, being aware about COVID-19 is of high importance. The overall aim of this study is to evaluate the HCWs' knowledge and attitude about COVID-19. The objectives of the study are assessment of HCWs' knowledge and attitude about COVID-19 and determining the significant factors that influence their knowledge. Methods and Materials: a descriptive cross-sectional study was carried out among convenient sample (n=353) of HCWs in the UAE by using an online self-administrated questionnaire. The data was analyzed using the SPSS version 26. Mann Whitney u test and Kruskal Wallis test were used to test the differences in quantitative variables across groups. Multivariate logistic regression analysis was used to investigate the association between the knowledge about COVID-19 and significant factors. A p value <0.05 was chosen as the criteria to make decisions regarding statistical significance. Result(s): A total of (353) HCWs participated in the study and completed the whole questionnaire. The average knowledge score was 76.3% with a 95% confidence interval (CI) [75.2%, 77.5%]. Of the total participants, 122 (34.6%) have poor knowledge, 81 (22.9%) have acceptable knowledge and 150(42.5%) have good knowledge. In the present study, significantly higher knowledge scores were observed in Western participants (OR 2.83;95% CI 1.51 - 5.29), General practitioners (OR 1.319;95% CI 1.03 - 1.69), participants working in Dubai (OR 1.47;95 % CI 1.28- 1.69) and participants who had been in contact with suspected or confirmed COVID-19 cases (OR 1.235;95% CI 1.11- 1.37). On the other hand, significantly lower knowledge scores were observed in participants aged 30-39 years (OR 0.760;95% CI 0.647- 0.893), Arabian participants (OR 0.76;95 % CI 0.58- 0.98) and participants with less than 1year experience (OR 0.729;95% CI 0.601- 0.883). Conclusion(s): This study revealed that HCWs working in the UAE have a good level of general knowledge about COVID-19 symptoms, transmission, progression, and prevention. Questions about deeper knowledge revealed a lower level of knowledge. Therefore, tailored awareness campaigns may be required in order to meet HCWs' needs and enhance their levels of deep knowledge. Copyright © RJPT All right reserved.

3.
NeuroQuantology ; 20(11):3306-3318, 2022.
Article in English | EMBASE | ID: covidwho-2067339

ABSTRACT

Online learning is the solution chosen to avoid crowds, which are feared to lead to the new cluster of the Covid-19 pandemic. It's just that online learning is often followed by a different process of teacher interaction in online learning.This study is intended to describe teacher interactions in online learning during the pandemic between teacher and student perspectives.The research approach is quantitative with the type of comparative research, through random sampling, namely on respondents who are in teacher and student social media forums, from January to March in 2021.The results of data collection obtained 789 teachers and 910 student respondents. The data collection instrument used a closed questionnaire.The results showed interaction of teachers providing online learning during the pandemic at all levels of education is significantly different andthere is a significant difference between a teacher and student learning interactions, at the level of achievement of teacher and student respondents at certain times/times both have had online learning interactions during the pandemic. For teachers the average value is 2.55 with a percentage of 56.1%, for students, the average value is 2.55 with a percentage of 63.9%. The researcher recommends that it is necessary to reflect and evaluate teacher interactions in online learning. Copyright © 2022, Anka Publishers. All rights reserved.

4.
NeuroQuantology ; 20(11):2126-2139, 2022.
Article in English | EMBASE | ID: covidwho-2067335

ABSTRACT

Online learning is the solution chosen to avoid crowds, which are feared to lead to the new cluster of the Covid-19 pandemic. It's just that online learning is often followed by a different process of teacher interaction in online learning.This study is intended to describe teacher interactions in online learning during the pandemic between teacher and student perspectives.The research approach is quantitative with the type of comparative research, through random sampling, namely on respondents who are in teacher and student social media forums, from January to March in 2021.The results of data collection obtained 789 teachers and 910 student respondents. The data collection instrument used a closed questionnaire.The results showed interaction of teachers providing online learning during the pandemic at all levels of education is significantly different andthere is a significant difference between a teacher and student learning interactions, at the level of achievement of teacher and student respondents at certain times/times both have had online learning interactions during the pandemic. For teachers the average value is 2.55 with a percentage of 56.1%, for students, the average value is 2.55 with a percentage of 63.9%. The researcher recommends that it is necessary to reflect and evaluate teacher interactions in online learning.

5.
NeuroQuantology ; 20(11):1858-1865, 2022.
Article in English | EMBASE | ID: covidwho-2067333

ABSTRACT

Background: Fighting the Covid-19 pandemic is one of the global priorities now, and the most important type of pandemic control is vaccination. Pfizer-Biotech is considered one of the most important vaccines currently because of its high effectiveness in stimulating the immune system, despite limited data regarding the duration of the response and its side effects. The goal of this study is to assess the response ofSARS CoV-2 S1-RBD IgG andInterleukin-15 after 30 and 120days fromthe 2nd dose ofPfizer-BioNTech vaccine which applied on themedical college students at Diyala university. Methodology: This study began after the obtainment of the Medical College of the University of Diyala, the Medical College of Al-IraqiaUniversity, and the Iraqi Ministry of Health approvals . It continued from October 2021 until March 2022.A total of45 male and femaleparticipants from the College of Medicine( DiyalaUniversity)students who took thetwo doses of Pfizer-BioNTech and were divided into two groups: 1 month (30 days) and 4 months (120 days) after the full vaccination (two doses).A 5 ml of their blood was taken two times (30 days and 120 days after the 2nd dose of thePfizer-BioNTech vaccine) in the postgraduate laboratories inside the Diyala Medical College. A serological analysis to quantify IL-15 and SARS CoV-2 S1-RBD IgG has been done using BT LAB/ Bioassay Technology Laboratory/ Human Interleukin 15 ELISA Kit from CHINA andDiasino/ SARS CoV-2 S1-RBD IgG ELISA Kit/ CHINA respectively. All the lab work happened in the postgraduate laboratories inside the Diyala Medical College. Demographic information (Age and Gender) has been collected from the participants. These participants were split into two groups depending on the time after the 2nd of Pfizer-BioNTech vaccine dose (1 month and 4 months, respectively). STATISTICA (version 12 )and SPSS (version 26 ) were used to input, review and data analysis. Essential approaches of percentages and frequencies were used for qualitative variables, while, average and standard deviation were used for quantitative variables. For both IL-15 and SARS CoV-2 S1-RBD IgG, less than 0.05 of a P-value was considered considerable. Result(s): The ratio, according to gender, was (17.8: 82.2) while the age Average was (20.9 years old). The serum data of IL-15 and SARS-CoV-2 S1-RBD IgG levels after 1 month (30 days) and 4 months (120 days) were statistically non-parametric. Mann-Whitney test (Independent two samples), showeda considerabledrop(P<0.05) of IL-15as well as SARS CoV-2 S1-RBD IgGserum levels in the 4th-monthsgroup compared to the 1-monthgroup. Conclusion(s): Interleukin-15 and SARS CoV-2 S1-RBD IgG serum levels significantly droped after 120days of the 2nd dose of Pfizer-BioNTech vaccine. Copyright © 2022, Anka Publishers. All rights reserved.

6.
NeuroQuantology ; 20(10):9443-9449, 2022.
Article in English | EMBASE | ID: covidwho-2067326

ABSTRACT

Oman has performed very well in the healthcare sector since 1970, it has achieved great heights in healthcare delivery. As per world bank data 2020, Oman has achieved 99% in providing basic sanitation services among its citizen and it has maintained this level since 2015.[1]. Centre of Studies Research-CSR-MOH has prepared a strategic plan “Health Vision 2050 for Health Research “to make Oman a regional leader in the Research & Development of Health Sector. As per this document, its mission is to provide a platform and conduct Research in the healthcare sector to address and prioritize healthcare services and reduce inequality in healthcare services among its citizen. This can be a major boost and contribute to socioeconomic development irrespective of the income among the Omani citizen. [2]. For any country to become prosperous needs a large pool of human capital, which can be achieved by providing good education and cheap health services to its citizen. Efficient human capitols lead to a good economy which further leads good GDP for any country. We can say the GDP of any country and its human capital complement each other. In this research paper, I have studied and analyzed the “Income & Expenditure” dataset from the data portal offal Al-Dakhliyah region of Oman, Health Vision document-2050, and Oman World Health Survey-2008. As per the report, Oman has scored very well ahead among the Gulf Cooperation Council (GCC) in economic stability, health, civil society, governance, and environment, in current-level Sustainable Economic Development Assessment (SEDA) scores, according to a report.[9]. In this research paper, we have reviewed and studied the impact of family income on sanitation, hygiene, and disease. Qualitative and quantitative methods like data collection using questionnaires, and world bank data and also reviewed various related research papers for our analysis. In this research paper, we have compared pre & post covid impacts on sanitation and hygiene practices among Omani citizens. A systematic review of published literature (2000-2019) evaluating the impact of family income on sanitation, hygiene, and disease. In low-and middle-income families [we used world bank data], we sought to examine the relationship between WASH provisions in healthcare facilities (HCF) and patient satisfaction/care-seeking behavior.[3].

7.
NeuroQuantology ; 20(10):7053-7068, 2022.
Article in English | EMBASE | ID: covidwho-2067311

ABSTRACT

The study is aimed to create a valid and appropriate instrument to measure the awareness level of Indonesians on the COVID-19 pandemic by using the ORID (Objective, Reflective, Interpretational and Decisional) instrument and to analyze the strategies to develop the knowledge needed to raise the awareness level. This study employed a descriptive approach by combining quantitative and qualitative methods. To determine the level of ORID awareness of respondents in Indonesia, descriptive statistics and inferential testing were used using Confirmatory Factor Analysis (CFA). The results of the study concluded that increasing awareness of ORID in Indonesian society is unidimensional. That is, all aspects of the formation of ORID have a positive and significant contribution in increasing ORID awareness, although each aspect has a different contribution. Inequality of knowledge is one of the problems that cause differences in the level of public awareness in understanding the COVID-19 pandemic and thus making it difficult for the authorities to deal with the pandemic effectively. Overall, holistic approach needs to be applied by the government and communicated to the people so that government policies adopted in overcoming the COVID-19 pandemic by strengthening social capital can be carried out more effectively. Meanwhile, the social capital could increase people's knowledge and the effectiveness of health protocols and other protective behaviors. Nevertheless, the ORID instrument could play as a vital role in disaster mitigation during the COVID-19 pandemic.

8.
NeuroQuantology ; 20(9):4727-4732, 2022.
Article in English | EMBASE | ID: covidwho-2067294

ABSTRACT

During the period of pandemic, education officials have been forced to cancel classes and close the doors to campuses across the world in response to the growing coronavirus outbreak. In addition, all over country’s’ academic institutions have switched classes to online learning, cancelled spring break trips and students studying abroad in China, Italy and South Korea have been encouraged to return home to complete their studies. Besides, the most effective tool in keeping student retention and maintaining access to learning has been online courses. Universities across the country have adjusted their programs in response to the spread of the coronavirus While the majority of colleges and universities around the world integrate some form of online education into their coursework, moving all programs online may prove challenging. Therefore, this paper evaluates and quantifies the impact of the coronavirus disease of 2020 to 2021(COVID-19) on stock market performance of selected four educational sector by using daily stock market data spanning from Jan 2021 to July 2021. Hence, this research employed a basic statistical analysis to estimate the relative effects of the COVID-19 pandemic on stock market performance in those educational sector stocks. The analysis of the study found that there is a strong relationship among the stock price of educational sector and its financial performance indicators.

9.
Journal of Clinical and Diagnostic Research ; 16(9):DC12-DC17, 2022.
Article in English | EMBASE | ID: covidwho-2067199

ABSTRACT

Introduction: Bharat Biotech International Ltd in partnership with National Institute of Virology (NIV), has developed an indigenous whole virion inactivated Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) viral vaccine BBV-152 (Covaxin), formulated with Toll Like Receptors 7/8 agonist Imidazoquinoline (IMDG) molecule adsorbed to alum (Algel). Variety of factors other than environmental ones can affect vaccines efficiency outside the strict setting of clinical trials, like how the vaccine is stored or transported, and even how patients are vaccinated. In addition, the intrinsic capacity of the recipient to respond to a vaccine which is determined by sex, genetic factors, age, psychological stress, nutrition and other diseases are also likely to have an impact. Aim(s): To determine the safety, reactogenicity and immunogenicity of the inactivated whole virus vaccine (Covaxin) amongst hospital-based population groups. Material(s) and Method(s): The prospective analytical study was conducted in the Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India, from January 2021 to March 2021.The study primarily included Healthcare Workers (HCWs) employed at SMS Medical college and attached hospitals. In-vitro quantitative IgG antibodies against SARS-CoV-2 spike Receptor Binding Domain (RBD) were measured using Chemiluminescence Immunoassay (CLIA) based Advia centaur SARS-CoV-2 IgG, manufactured by Siemens Pvt Ltd, Munich, Germany, as per manufacture's instructions. Result(s): Out of total 223 individuals, 61.88 % (138/223) showed neutralising antibody titre of >1 index value by CLIA, rest 38.12% (85/223) were non reactive i.e., titre <1 index value, after four weeks of receiving first dose of Covaxin. After 2 to 4 weeks of receiving second dose 84.30% (188/223) showed neutralising antibody titre of >1 index value by CLIA, rest 15.70% (35/223) were non reactive i.e., titre <1 index value. After receiving first dose, 100% (223/223) of the participants developed localised pain and bodyache 33.63% (75/223). None of the participants showed any anaphylactic reaction or any emergency condition just after vaccination. Conclusion(s): Covaxin is a well-tolerated vaccine, and induces good humoral response against SARS-CoV-2 with a significant rise in the neutralising antibody titres. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

10.
Journal of Clinical and Diagnostic Research ; 16(9):EC41-EC46, 2022.
Article in English | EMBASE | ID: covidwho-2067190

ABSTRACT

Introduction: Coronavirus Disease 2019 (COVID-19) is an extremely transmissible infectious disease. Detection of coronavirus by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) requires expert skills and moreover, it is not widely available in all the laboratories. Aim: To evaluate Red Blood Cell (RBC), platelet histogram and White Blood Cell (WBC) scattergram graphic patterns and interpretation of corresponding parameters along with peripheral smear in 500 COVID-19 RT-PCR positive study cases (COVID-19) and to compare them with normal study controls (non COVID-19). Materials and Methods: This was a laboratory-based observational study, conducted at a fully accredited National Accreditation Board for testing and calibration Laboratories’s (NABL) Central Diagnostic Research Laboratory, RL Jalapa Hospital Tamaka, Kolar, Karnataka, India from September 2020 to April 2021. RBC, platelet histogram, WBC scattergram graphic patterns with corresponding parameters were noted in RT-PCR COVID-19 positive patients and compared with controls using (Automated Haematology Analyser XN11500). Cases were further subcategorised into moderate and severe categories. For statistical analysis, Chi-square test or Fisher’s exact test, Independent t test was used for assessing qualitative and quantitative data respectively. Mean and standard deviation were depicted in box plots. Receiver Operating Characteristic (ROC) curve was used for predicting severity. A p-value <0.05 was considered statistically significant. results: Among 500 subjects, males were 359 and females 141 with the mean age 50.5 years. Present study showed a characteristic finding of “sandglass” effect in WBC scattergram which is described as discontinuous cluster of plasmacytoid lymphocytes. RBC histogram and parameters did not show any significant changes. In severe COVID-19 cases among WBC parameters most common finding was neutrophilia. Platelet Lymphocyte Ratio (PLR), Platelet Monocyte Ratio (PMR), Platelet Neutrophil Ratio (PNR) were statistically significant in severe COVID-19 cases (p-value <0.001) corresponding ROC curve for WBC and platelet showed WBC count and PLR as the significant parameter in severe COVID-19 positive cases. conclusion: Current study reported a specific and unique sandglass effect in WBC scattergram in severe COVID-19 subjects which can help the physicians for predicting the severity of disease and to prevent further pro ression of disease

11.
Open Access Macedonian Journal of Medical Sciences ; 10(E):1463-1471, 2022.
Article in English | EMBASE | ID: covidwho-2066697

ABSTRACT

BACKGROUND: Clinical laboratory (CL) services are at the forefront to support health-care services, particularly during the pandemic of COVID-19. The increasing number of private clinical laboratories at present days indicates the increase in patient needs, causing the health-care service provider to face challenges as people have more options. Therefore, fostering patient loyalty (PL) is a crucial success factor for the business growth of clinical laboratories as health-care providers. AIM: The purpose of this study is to analyze antecedents of patient satisfaction (PS) in clinical laboratories towards PL with the switching cost and location as moderating factors. METHODS: This study was done as a quantitative survey, and data were obtained by a cross-sectional approach with partial least squares structural equation modeling for the data analysis method. There are 266 respondents eligible as samples, who undergo the phlebotomy process (PP) in a private laboratory located within a specific area. RESULTS: This study demonstrated that all the nine hypotheses supported with α: 0.05 and p < 0.05, include six independent variables named administrative process, information availability (IA), the environment in the phlebotomy room, PP, waiting time, and result notification that influence PS. PS has been shown to have a direct effect on PL and also mediate the antecedents. Furthermore, SC and LO have demonstrated a significant effect to moderate this relationship. CONCLUSIONS: PS has been confirmed as the main construct to predict PL whereas the AP is the most important independent variable followed by IA. CL management should pay more attention to these antecedents to ensure PS and retain the clinic’s patients. The cost from the patient’s perspective should be taken into account since this helps the CL keep the patient loyal.

12.
Open Access Macedonian Journal of Medical Sciences ; 10:1-4, 2022.
Article in English | EMBASE | ID: covidwho-2066687

ABSTRACT

BACKGROUND: In 2020, humankind is faced with a pandemic problem. If preventive efforts have been made and the COVID-19 virus still infected humans, the last step that can be done against the virus is human immunity. Hence, efforts to increase immunity need to be done, especially during the pandemic. Immunity is related to optimum nutrition. However, optimal nutrition will not be achieved if the related factors are not achieved as well. Therefore, researchers were interested in conducting research to see the knowledge profile of balanced nutrition and stress level as one of the factors in achieving best nutrition during the pandemic. AIM: The aim of this study was to determine the knowledge profile of balanced nutrition and stress levels with a sample of health science students at Unsika (Singaperbangsa Karawang University) during the pandemic. METHODS: This analysis design was a combination of quantitative and qualitative exploration. It was determined purposively and conducted in November–December 2020. RESULTS: From the results of the inquiry, it is known that the profile picture of balanced nutrition knowledge during the pandemic of Unsika students;35% of respondents had less intelligence, 61% of the survey participants had moderate insight, and only 4% had a good one. Based on this experiment, it is also known that students got a lot of information from the internet (websites/ articles/popular social media). An overview of the stress level of Unsika students was 35% of respondents at normal stress level, 14% of the samples had mid stress stage, 27% considered as moderate stress phase, 20% included in severe stress class, and 4% got very heavy stress one. CONCLUSION: The causes of the stress during the pandemic included a slumping economic situation, due to task deadlines and lack of understanding of learning materials, loneliness, boredom, fear of infection of the virus, and other personal reasons.

13.
Open Access Macedonian Journal of Medical Sciences ; 10:217-221, 2022.
Article in English | EMBASE | ID: covidwho-2066680

ABSTRACT

INTRODUCTION: The first data for COVID-19 in pregnancy showed mild-to-moderate forms of the disease while the current data speak of severe forms in these subjects. Here, we present a case of a severe form of COVID-19 in a gemelar pregnant woman complicated with pneumomediastinum and pneumothorax, during her hospital stay, in a late stage of disease. CASE PRESENTATION: A 38-year-old multiparous woman was referred to university hospital at 25 weeks of gemelar pregnancy. On admission, the patient presented with signs of moderate respiratory insufficiency, which after 12 h progressed further to severe ARDS. She tested positive for SARS-CoV-2 on quantitative real-time polymerase chain reaction. Under these conditions, it was decided that the patient undergoes a cesarean section for termination of pregnancy. Remdesivir 200 mg/day and tocilizumab 8 mg/kg were administered, based on national guidelines. The patient’s fever subsided, but her SpO2 remained at 94%, even with a 15 L/min oxygen mask. After 12 days, the patient complains of a severe back pain and her respiratory condition rapidly worsened and reduced saturations up to 80% being under O2 therapy with facial mask with 15 l/min. Chest CT findings confirmed pneumomediastinum and pneumothorax, which deteriorated the patient’s status. Thereafter, tube thoracostomy was performed. There was a clinical and ABG analysis parameter’s improvement. The patient was discharged 34 days after cesarean delivery with a proper general health. CONCLUSION: Our case highlights even more convincingly the fact that, in pregnancy, can be severe to life-threating forms of COVID-19. Pneumothorax and pneumomediastinum are complications that can be encountered even in the late stages of severe forms cases with COVID-19 in pregnancy. Early diagnosis of these complications is essential in adequate management and treatment to avoid fatal outcome.

14.
Open Access Macedonian Journal of Medical Sciences ; 10:1698-1705, 2022.
Article in English | EMBASE | ID: covidwho-2066674

ABSTRACT

BACKGROUND: The rapid worldwide spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 pandemic from its epicenter;Wuhan was first reported in December 2019. Egypt reported its first COVID-19 case on February 14, 2020. Thereafter, Egypt scaled-up preventive measures, with a partial lockdown starting on March 25. Several therapeutic agents along with convalescent plasma transfusion (CPT) are under investigation and data from CPTs have been receiving a lot of attention, after Emergency approvals from the Food and Drug Administration suggesting that it may provide a clinical effect in the treatment of SARS-COV-2. IMPORTANCE: Early and effective treatment of COVID-19 is vital for control of SARS-CoV-2 infection. METHODS: Designs: An interventional, single-arm, and non-randomized clinical trial conducted in Egypt from April 15 to July 21, 2020. Settings: This was a multi-center study conducted in three hospitals in Egypt. Participants: A total of 94 COVID-19 laboratory-confirmed patients using quantitative real-time polymerase chain reaction were enrolled in the study. Intervention: All patients were administered with two plasma units (each unit is 200 cc). The volume of donated plasma was 800 cc. Main Outcome and measures: Primary measure was the degree of clinical improvement among the COVID-19 patients who received CPT within 7 days. RESULTS: A total of 94 patients were enrolled who received CPT either within 7 days or after 7 days of hospitalization. 82 were severely ill and 12 were critically ill. The average age remained 58 years (±standard deviation 15.1 years). Male were 69% and 49% patients got cured while 51% died with case fatality rate 51%. Seventy-five percent deaths were above 45 years of age. The symptoms were dyspnea (55%), fever (52%), cough (46%), and loss of taste and smell (21%), and cyanosis (15%). The most common co-morbidities among the <40 years remained diabetes mellitus (21%) and asthma (14%). Among 40–60 years hypertension (56%), diabetes mellitus (39%) and among >60 years age group hypertension (57%), and chronic heart disease (24%) were reported. CPT within 7 days remained significant as compared with the CPT after 7 days with the number of days to cure (p=0.007) and ICU stay (p = 0.008) among severely ill cured cases. CONCLUSIONS: Among patients with COVID-19 and severe or critical illness, the use of CPT along with routine standard therapy resulted in a statistically significant improvement when administered within seven days of hospital admission. However, plasma transfusion, irrespective of days to transfusion may not help treat critically ill patients. The overall mean time to cure in severely ill patients was 15 days if CPT provided within 7 days with 65% cure rate. TRIAL REGISTRATION: Clinical Intervention identifier: MOHP_COVID-19_Ver1.1 registered April 2020.

15.
Sustainability ; 14(19):12879, 2022.
Article in English | ProQuest Central | ID: covidwho-2066476

ABSTRACT

Environmental, Social, and Governance (ESG) criteria are novel and exciting tools of corporate disclosure for decision making. Using quantitative and qualitative analyses, the present study examined the key characteristics and trends of ESG controversies in the European market. At the same time, it identified the controversies’ determinants. A bibliometric analysis was the qualitative method employed on the data derived from Scopus using Biblioshiny software, an R package. The quantitative analysis involved an international sample of 2278 companies headquartered in Europe from 2017–2019 being studied using a Generalized Linear Model. The findings of this research highlighted the role of the “S” and the “G” dimensions of the ESG controversies as the most crucial in affecting controversies. Women are under-represented in the business hierarchy, but their natural characteristics such as friendliness and peaceability lead to a low level of illegal business practices. However, independent of gender, executives have personal gains that they want to satisfy. Thus, executives may become involved in unethical practices and harm their colleagues and the business’s reputation. On the other hand, democracy emerged as one of the most disputed factors. Democracy gives people the voice to express themselves and publicly support their ideas without restrictions. Although, the regression results showed that democracy is not always operated as the “pipe of peace” and can affect, to some extent, controversies.

16.
Archives of Disease in Childhood ; 107(Supplement 2):A376-A377, 2022.
Article in English | EMBASE | ID: covidwho-2064050

ABSTRACT

Aims The Covid-19 pandemic has significantly impacted the education of doctors in training, with disruption to training events and teaching, as well as staff redeployment. During the initial wave of the pandemic, patient numbers in paediatrics were low and there was time for reflection, leadership and management opportunities. However, post lockdown there were significantly more paediatric attendances to A&E, resulting in surges of admissions never previously seen at that time of year, putting a substantial strain on the medical team. In our paediatric department, we found that our established hour-long weekly lunchtime teaching and education programme was no longer sustainable. We therefore developed a new format - a microteaching programme to ensure evidencebased, relevant teaching was maintained at a time of highly stretched resources. Methods In December 2020 the microteaching programme was launched;the concept was five-minute teaching sessions rostered between junior doctors following Thursday morning handover so more of the multidisciplinary team, including nurses and medical students, could attend. The teaching could take any format such as quizzes, powerpoints or games and focussed on common paediatric topics. Feedback was collected after each session. The programme was reinforced with the new intake of junior doctors in August 2021. To obtain feedback on the effectiveness of the new format, an online survey was sent to all grades from foundation doctors and trainee Advanced Nurse Practitioners to consultants, to capture quantitative alongside qualitative data in November 2021. Results There were eleven responses to the survey, with 81.8% having attended the microteaching programme. Those who had not attended were excluded from subsequent quantitative analysis. Reasons for non-attendance were thematically analysed and found to be based on working patterns, such as working less than full time. 88.8% of respondents felt microteaching content was relevant to their training and 100% agreed it was at an appropriate level. 100% felt they had learnt something from microteaching with two-thirds of respondents strongly agreeing with this statement. Barriers to regular teaching included unanticipated staff movement due to urgent clinical need, senior staff being unaware of the scheduled teaching programme or concern about ward pressures and workload. Respondents felt microteaching was a useful concept that ensures teaching takes place, helps keep knowledge up-to-date and prompts further reading. Conclusion Despite the Covid-19 pandemic significantly impacting trainees' teaching, the implementation of the microteaching programme locally, and subsequent survey, have demonstrated a positive way for learning opportunities to continue despite clinical pressures. The survey highlights the need for senior support to ensure the value of teaching is recognised and designated teaching time is kept. It emphasises the need for re-evaluation of the teaching rota to minimise disruption secondary to staff movement. Following feedback, to maximise the impact of each session at the start of the new teaching rota, we will summarise key points via email so trainees unable to attend can still benefit. Overall, the microteaching programme enables key concepts to be presented during morning handover and allows educational opportunities to continue without adversely impacting on clinical duties in the paediatric department.

17.
Archives of Disease in Childhood ; 107(Supplement 2):A346-A347, 2022.
Article in English | EMBASE | ID: covidwho-2064041

ABSTRACT

Aims Many paediatric emergency departments (PED) reported an unexpected increase in attendances during summer 2021;most of these children were stated to have minor illnesses and were discharged with reassurance. The primary objective of our questionnaire was to obtain parental perspective of how changes to local acute paediatric healthcare services in response to Covid-19 had impacted upon accessing care for their children. Additional objectives aimed to identify if parents were more worried about their child's health in view of the pandemic, understand parents' ideas of how children should be assessed when unwell, and explore how parents felt remote consultations could be improved. Methods A questionnaire comprised of Likert scale, multiple choice and free-text questions was developed to explore the study aiSeveral iterations of the questionnaire were test-run with parents prior to roll-out. The project was registered with the Trust's Quality Improvement team. A total of 88 families presenting to the paediatric emergency department and local urgent treatment centres completed the questionnaire between 26th October and 31st December 2021. Excluded were families for whom a translator was needed for their medical assessment. A thematic analysis was performed using NVivo, and quantitative analysis performed using PRISM statistical software. Results 68.2% of parents had sought medical advice outside of the PED prior to presentation, either in the community and/or online. 20.5% of respondents sought healthcare input from two or more sources prior to attending PED. Figure 1 outlines the responses to Likert-scale questions. Statistical analysis of the responses in relation to of age of child, number of children in the family and whether English was the family's first language was performed. Confidence of phone/video assessments and English/non-English as first language approached statistical significance (p=0.059). No other comparisons were statistically significant. Analysis of free-text responses identified key themes regarding the parental expectation of how children should be reviewed when unwell, and how parents thought remote consultations can be improved. An outline of the identified themes and a selection of responses are outlined in Figure 2. Conclusion The questionnaire identified that parents had still been able to access healthcare during the pandemic when they felt their child was unwell. Parents reported concerns of their children becoming sick with Covid-19, but still felt confident managing minor illnesses at home. The increasing volume of remote assessments in primary care was a necessary adjustment during the pandemic which is likely to be embraced as a more permanent model of service. Many parents recognised the benefit of remote consultations for non-urgent issues. However, a key theme from the questionnaire was the lack of parental confidence in remote (particularly phone) consultations;parents were more likely to still seek a face-to-face assessment in PED if they felt they couldn't communicate their child's signs and symptoms over the phone. As local networks embrace a more remote model of working to deliver some urgency and emergency care it is necessary to identify the cohorts of patients who may still attend PED, and plan how better to provide clinical reviews for them in the community.

18.
Archives of Disease in Childhood ; 107(Supplement 2):A267, 2022.
Article in English | EMBASE | ID: covidwho-2064032

ABSTRACT

Aims To review the glycaemic control of type 1 diabetic patients attending the paediatric and transition adolescent diabetes clinic within NHS Lanarkshire during the coronavirus pandemic. Methods A quantitative analysis of 348 patients attending the paediatric and transition adolescent diabetes clinics within NHS Lanarkshire was carried out. Data collected included age, sex, date of diagnosis and insulin delivery device. Comparing these measures to the Scottish Index of Multiple Deprivation (SIMD) of the patient. Patient data was anonymised within a single data collection sheet. Results 94% of patients across both clinics (n=298) attended a consultation during lockdown, before returning to school in August. Within the paediatric diabetes clinic, results from 199 patients were analysed. 30.65% (n=61) patients experienced a rise in their HbA1c over lockdown whilst 65.32% (n=130) of patients reduced their HbA1c. In this cohort, the mean HbA1c before lockdown compared to after lockdown was 3.77mmol/mol (95% CI 1.93, 5.61;P=0.000). 90 sets of patient data were analysed from the transition adolescent diabetes clinic. 27.78% (n=25) of patients had a rise in their HbA1c and whilst patients from this clinic gained tighter glycaemic control over lockdown. The mean HbA1c pre-lockdown compared to post-lockdown in this clinic reduced by 4.67mmol/mol (CI: +1.35, +7.99, P= 0.006). Patients residing in SIMD quintiles 3-5 had the greatest improvement in HbA1c over lockdown. Conclusion Glycaemic control of patients within the NHS Lanarkshire paediatric diabetes clinics improved over lockdown. There was a mean reduction in HbA1c over the lockdown period. Repeating this audit in a year would be beneficial to see how returning to school and further local lockdowns affected the glycaemic control of paediatric patients.

19.
Archives of Disease in Childhood ; 107(Supplement 2):A21, 2022.
Article in English | EMBASE | ID: covidwho-2064011

ABSTRACT

Aims A recent RCPCH publication shared the struggles across Paediatric Emergency Departments (PEDs) with meeting the 'Facing the Future' standards for children and young people (CYP) with mental health (MH) concerns, with few units studied being able to adequately meet the needs of CYP in MH crisis (1). We work in a central London teaching hospital and major trauma centre: our aim was to understand the experience of CYP aged 13-17 presenting to the PED with MH concerns, as compared with those presenting with physical complaints. Methods Collection of quantitative data surrounding CYP in the ED with MH presentations (n=271), including time to be seen, time to see Child and Adolescent Mental Health Services (CAMHS), time to admission or discharge, and total time spent in ED (all as compared with physical health presentations n=7551). Use of independent samples t-tests to analyse differences between groups across outcomes. Two time periods (1 July-30 Oct 2019 and 1 July-30 Oct 2021, n= 3913 and 3909 respectively) were examined to encapsulate pre and post COVID. Qualitative inquiry with 22 CYP presenting to the ED to co-produce experience maps to visualise their healthcare journeys and identify opportunities to improve their care. Results CYP with MH presentations spent a mean time of 747.6 minutes in the ED, compared with physical health patients who spent 195.76 minutes (p=<0.001). Mean time to be seen by CAMHS was 225.0 minutes, whereas patients with physical health complaints who are referred to specialties waited 196.52 minutes to be seen (a difference that was not significant). More CYP with MH presentations than those with physical health presentations spent >4 hours but <12 hours in the ED (76.4% vs 18.4%, p<0.001) and almost 1/3 spent more than 12 hours in the ED (32.8% vs 1.0%, p<0.001). Experience mapping captured that CYP and families acknowledged the wait but would benefit from signposting of the physical environment (e.g. 'you are here' maps), the presence of age-appropriate entertainment, and the input of volunteers or staff to support basic needs (e.g. food, water, pillows): we are implementing each. Conclusion CYP with MH presentations have a worse experience of the ED than their counterparts with physical health complaints, spending longer in the department, being more likely to surpass 4 or 12 hours in the ED. CYP have indicated to us some simple changes to their environment and the management of their stay which could improve their experience. It is widely acknowledged that most areas need to grow our provision of CAMHS to meet the need, but we also need to further utilise other MH services available beyond hospital walls (e.g. crisis lines, wellbeing practitioners, school counselling, youth support services). (1) John Criddle, Virginia Davies, RCPCH Website https:// www.rcpch.ac.uk/news-events/news/time-raise-standard-childrenpresenting- emergency-departments-mental-health-crisis.

20.
American Journal of Transplantation ; 22(Supplement 3):651, 2022.
Article in English | EMBASE | ID: covidwho-2063521

ABSTRACT

Purpose: The OPTN's monitoring of equity in access to deceased donor kidney (KI) transplants (tx) among waitlisted candidates has consistently found service area (DSA) of listing as the factor most independently associated with access disparities. We extracted center-level from DSA-level effects to better characterize geographic disparities in the COVID-19 and KAS 250NM circle eras. Method(s): Poisson tx rate regression, with random DSA and center effects, was applied to 3 period-prevalent cohorts (KAS: 2018-2019;KAS COVID Onset: 1/2020-3/2021;KAS250: 4/2021-9/2021) of active KI waiting list registrations using OPTN data. Risk-adjusted, population-weighted, factor-specific disparities were quantified as the Winsorized standard deviation (SDw) of log(tx rate) among registrations, holding other factors constant. Geographic disparity was also quantified by median incidence rate ratios (MIRR), interpreted as the median increase in tx rate if a candidate switched to a random, higher tx rate center or DSA. The association between donor supply to demand ratios (S/D;# deceased kidney donors / # prevalent WL candidates) and residual (after removing center effects) DSA effects was assessed with Spearman's rho. Result(s): Pre-COVID, variation in tx rates was markedly higher for centers (MIRR 1.72) vs. DSAs (MIRR 1.32). Under COVID, center-level MIRR rose to 1.94 and has remained high. The DSA-level MIRR fell to 1.20 in the early KAS250 era (Fig 1). As measured by population-weighted SDw, tx center (0.62) is the factor most associated with unintended disparities in the KAS250 era, with residual DSA-level variation (0.25) ranked 4th (Fig 2). Residual DSA effects were positively correlated (rho=0.55, p<0.001) with local S/D. Conclusion(s): DSA-level variation declined under KAS250, but disparities remain and are associated with differential local S/D. Tx center-level variation is the top driver of access disparities and may have been exacerbated by COVID. Further reductions in geographic disparities may be possible through allocation policy changes, although other interventions - such as reducing center variation in offer acceptance decisions and maximizing the recovery of potential deceased donors - may have greater impacts.

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