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The COVID-19 pandemic has significantly augmented the urgency for service providers to identify and develop clinically urgent system alterations into healthcare systems to facilitate antibody testing and treatment interventions. However, it has been difficult to determine how users assess the value of an information system in terms of its functionality and features. Conversely, the system development process to address urgent user requirements, for example, developing new functionality for COVID antibody testing, has been beset by a myriad of difficulties as research to understand the value of specific aspects of clinical information systems has been elusive. This study addresses this knowledge gap by identifying specific aspects of a national clinical information system in Wales, UK. Through a series of semi-structured interviews, a quantitative study of 559 clinical users and a focus group, the study deconstructs system-related value into 14 unique attributes that have been found to vary according to different types of user roles and geographic location. Attribution theory is identified in this study as a novel and effective way to study this multifaceted concept of system value. The identification of component attributes of the value of a clinical information system provides insights for service users, system developers, and organization managers to prioritize and focus their system development activity by using an importance ranking identified through this study. © 2021 Elsevier Ltd
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This paper explores the impact of policy changes and budget cuts on services and support faced by people with learning disabilities. Drawing upon collaborative research in England and Scotland and interviews with commissioners and support organisations, we show how landscapes of care and support are unstable and fragmented. We identify how pressures of time, resource and precaritisation in the workforce are creating ‘debilitating landscapes of care' that further erode the capacities of both the people that work in the sector and people with learning disabilities. Some challenges that people with learning disabilities face in this context include finding appropriate local support, narrowing access as a result of reductions in benefit entitlements and identifying quality providers amid a complex array of private and charitable provision. Capacity to cope with these challenges is contingent on access to quality advocacy, supportive family, friendships, productive occupational learning environments and peer support, but these are not always available. The impact of COVID-19 has only served to intensify some of the issues we identify and the urgent need for a response. Our analysis is inspired by Berlant's (2007) conception of ‘slow-death' and Puar's (2017) associated conceptualisation of ‘debility'. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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Due to coronavirus disease 2019 (COVID-19), diabetes services have been disrupted, causing difficulties for people with type 2 diabetes mellitus (T2DM), and understanding their experience could help improve diabetes care. Therefore, we used a qualitative interpretive description to explore the experience of self-care of adults with T2DM during the COVID-19 pandemic. Data were collected using semi-structured interviews and analyzed theoretically. The sample (N = 30) was composed of 7 females and 23 males, with a mean age of 69.9 years (60–77) and 19.4 mean years (3–40) of people living with T2DM. Our findings show reduced physical activity and increased smoking and alcohol consumption affected that self-care. Increased food consumption and stress eating, with greater stress and anxiety, caused worsening of glycemic values. Participants were able to contact healthcare professionals via eHealth or telephone. Others, even those with complications, were not able to receive care or advice. These results suggest that easier contact with health providers, continuous engagement, eHealth solutions, and formal peer support could help self-care in T2DM. Advanced nursing roles and services could solve many issues reported in this study during and after the pandemic.
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Summary: We aimed at comparing the incidence of hip fractures in older adults from Ecuador before and during the COVID-19 pandemic. There was a significant reduction in the number of hip fractures, with no change in the length of hospital stay, mortality, and case-fatality rate, during the period of social isolation. Introduction: The impact that the COVID-19 pandemic has had on fragility fractures is being recently evaluated in the literature. Despite this, data from Latin America in this regard is scarce. Purpose: This study aims to compare the incidence rate of hip fractures before and during the COVID-19 pandemic in older adults who received care in the public and private health system of Ecuador. Methods: This was a descriptive and retrospective study that analyzed data of individuals aged 60 years and older who had hip fractures before and during the COVID-19 pandemic. The information was obtained from the National Hospital Discharge Yearbook. We calculated the incidence, average length of hospital stay, mortality, and case-fatality rate associated with hip fractures. Results: There was a significant reduction in the incidence of hip fractures in adults 60 or older during the period of social isolation due to COVID-19. Between March and December 2019, there was an incidence of 152 hip fractures per 100,000 inhabitants, whereas during the same period but in 2020 in the incidence was 110 per 100,000 inhabitants (p < 0.0001). The main decrease was observed in women aged 80 or more. The average length of hospital stay did not show significant changes. Mortality displayed a non-significant decrease (p = 0.14), although this decrease was significant among women (p = 0.02). Case-fatality rate showed a non-significant increase for the whole group (p = 0.68) and for men (p = 0.09). Conclusion: Hip fracture rates decreased significantly in adults aged 60 and older in 2020 compared to 2019. This decrease of hip fracture incidence rates was mainly due to the reductions observed in older people and women. The average length of hospital stay, mortality, and case-fatality rate associated with hip fractures did not show significant changes during the pandemic. © 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
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Background: To compare the research hotspots of infections with the Delta and Omicron variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic and to identify future research trends. Methods: Studies about Delta and Omicron variant infections published over the last 3 years were retrieved from the Web of Science (WoS) database. A comparative bibliometric analysis was conducted through machine learning and visualization tools, including VOSviewer, Bibliographic Item Co-Occurrence Matrix Builder, and Graphical Clustering Toolkit. Research hotspots and trends in the field were analyzed, and the contributions and collaborations of countries, institutions, and authors were documented. A cross-sectional analysis of the relevant studies registered at ClinicalTrials.gov was also performed to clarify the direction of future research. Results: A total of 1,787 articles distributed in 107 countries and 374 publications from 77 countries focused on the Delta and Omicron variants were included in our bibliometric analysis. The top five productive countries in both variants were the USA, China, the UK, India, and Germany. In 5,999 and 1,107 keywords identified from articles on the Delta and Omicron, the top two frequent keywords were the same: "COVID-19” (occurrence: 713, total link strength: 1,525 in Delta;occurrence: 137, total link strength: 354 in Omicron), followed by "SARS-CoV-2” (occurrence: 553, total link strength: 1,478 in Delta;occurrences 132, total link strength: 395 in Omicron). Five theme clusters from articles on Delta variant were identified: transmission, molecular structure, activation mode, epidemiology, and co-infection. While other three theme clusters were recognized for the Omicron variant: vaccine, human immune response, and infection control. Meanwhile, 21 interventional studies had been registered up to April 2022, most of which aimed to evaluate the immunogenicity and safety of different kinds of vaccines in various populations. Conclusions: Publications and clinical trials related to COVID-19 increased annually. As the first comparative bibliometric analysis for Delta and Omicron variants, we noticed that the relevant research trends have shifted from vaccine development to infection control and management of complications. The ongoing clinical studies will verify the safety and efficacy of promising drugs. © Annals of Palliative Medicine. All rights reserved.
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Due to the COVID-19 pandemic, online teaching became a significant method at different levels of education across the globe. The transition from traditional offline to online educational environments brought new challenges for language teachers. Buoyancy plays a crucial role for teachers to bounce back from challenging situations. However, there is a scarcity of empirical research on language teacher buoyancy in online contexts from an ecological perspective which is conducive to unfolding the complex and dynamic nature of buoyancy. To fill this gap, the current study utilized a qualitative research method to investigate the factors influencing English teacher buoyancy in online teaching and how they shape and exercise buoyancy in their negotiation with different ecological systems in online teaching guided by Bronfenbrenner's ecological systems theory. The findings revealed that teachers experienced multiple challenges from different ecological systems, such as ineffective classroom interaction, work–life imbalance, heavy workload, and higher school requirements. Additionally, teacher buoyancy was shaped by the dynamic interaction between teachers and ecological systems and was not only viewed as the individual's ability but as a socio-ecological product. Based on the above findings, the paper provides some implications for developing and researching language teacher buoyancy in the future. © 2022 by the authors.
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Background: Family meals are an opportune context for initiating healthy eating habits in young children. However, using screens at family mealtimes may negate some of the associated nutritional and social benefits. In High Income countries, frequent mealtime screen use is common, particularly in families of low socioeconomic position (SEP). This study aimed to explore experiences and acceptability of mealtime screen use in families of low SEP with young children. Methods: Qualitative interviews with 25 mothers of low SEP were conducted via telephone or Zoom™ using Photo Interviewing and a semi-structured interview script. Transcripts were analysed thematically using a Constructivist paradigm. Results: Many parents reported an eagerness for reducing family mealtime screen use. Three major themes were identified in explaining the reasons behind levels of engagement in family mealtime screen use. These included parental self-efficacy, such as parental confidence in saying no to screens at mealtimes, physical resources such as having enough space in the home for a functioning dining table without view of a television, and temporal priorities such as prioritising screen use for managing children's difficult behaviour at mealtimes over long-term health considerations. Conclusions: This study highlights that although family mealtime screen use is likely linked with a range of child behaviours and parenting practices that may negatively influence children's dietary intake and social engagement, parents often considered screens acceptable at mealtimes. Nonetheless, parents' desire to reduce family mealtime screen use provides an important opportunity to determine how best to support parents to achieve this. © 2022 Elsevier Ltd
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COVID-19 showed the importance of trustworthy and accessible health information. News organisations increasingly introduced podcasting to keep their audiences informed. Podcasting's documented capacity for listener engagement makes it a pertinent medium to study another global public health threat – superbugs – through the lens of constructive journalism. Both constructive journalism and podcasting feature lived experiences of sources, in constructive journalism focused on empowering audiences to act. This practice-led research study is the first to explore how solutions-oriented journalism intersects with narrative podcasts. It demonstrates through the production of a podcast series about antimicrobial resistance (AMR), an affordance to tell complex and often scary health stories. It finds that podcasting can position individuals affected by AMR as sources of empowering information, rather than as victims. The study contributes new knowledge to constructive podcast journalism as an impactful approach in public health journalism, leveraging its potential to provide solutions to listeners and promote change. © The Author(s) 2023.
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Residential segregation (RS) is a global phenomenon that has become an enduring and important topic in international academic research. In this review, using RS as the search term, 2520 articles from the period 1928–2022 were retrieved from the Scopus database and were visually analyzed using CiteSpace software. The results revealed the following: (1) The United States and its institutions have made outstanding contributions to RS research, while various scholars (e.g., Johnston, Massey, Forrest, Poulsen, and Iceland) have laid the foundation for RS research. (2) Mainstream RS research originates from three fields—psychology, education, and social sciences—while the trend of multidisciplinary integration is constantly increasing. (3) The research hotspots of RS include racial difference, sociospatial behavior, income inequality, mixed income communities, guest worker minorities, typical district segregation, occupational segregation, health inequalities, metropolitan ghetto, and migrant–native differential mobility. Furthermore, (4) gentrification, spatial analysis, school segregation, health disparity, immigrant, and COVID-19 have become new themes and directions of RS research. Future research should pay more attention to the impact of multi-spatial scale changes on RS as well as propose theoretical explanations rooted in local contexts by integrating multidisciplinary theoretical knowledge. © 2022 by the authors.
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Coronaviruses (CoVs) are the largest positive-strand RNA viruses discovered, with high variability and high infectivity. There are seven kinds of CoVs that can infect humans so far. Among them, severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003, middle east respiratory syndrome coronavirus (MERS-CoV) in 2012 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 have caused global outbreaks, posing a serious threat to global public health security. Research on CoVs infection has never stopped, and the current treatment methods mainly focus on improving symptoms. Traditional Chinese medicine (TCM) has a long history and rich experience in preventing and treating various diseases. In terms of anti-CoVs, TCM has attracted much attention because of its multi-CoVs and multi-targets, significant antiviral effect and few side effect. TCM extracts or their compounds can exert anti-CoVs effects by directly or indirectly inhibiting the invasion, replication, assembly of CoVs, regulating immunity and inhibiting inflammation. This article systematically reviews the mechanism and clinical application of TCM in anti-CoVs and alleviating virus-induced symptoms, in order to provide theoretical reference for the research and development of anti-coronavirus drugs. © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Qualitative research methods had to quickly adapt to using online platforms due to the COVID-19 pandemic to limit in-person interactions. Online platforms have been used extensively for interviews and focus groups, but workshops with larger groups requiring more complex interactions have not been widely implemented. This paper presents a case study of a fully virtual social innovation lab on bioplastics packaging, which was adapted from a series of in-person workshops. A positive outcome of the online setting was diversifying the types of participants who could participate. Highly interactive activities such as icebreakers, networking, bricolage, and prototyping were particularly challenging to shift from in-person to online using traditional web conferencing platforms like Zoom. Creative use of online tools, such as Gather.Town and Kahoot!, helped unlock more innovative thinking by employing novel techniques such as gamification. However, challenges such as adapting facilitation for an online environment and exclusion of groups that do not have consistent access to internet and/or computers still need to be addressed. The reflections and lessons learned from this paper can help researchers adapt qualitative methods to virtual environments. © The Author(s) 2023.
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This article addresses the topic of 'openness' by interrogating established interior boundaries within the home through the speculative design of a 25 m(2) microhouse, as a direct response to a 'crises' in domestic architecture that has been abruptly placed in public discourse to an unprecedented extent by the COVID-19 global flu pandemic. During lockdown, our homes have had to accommodate a broader variety of activities with varying and sometimes conflicting requirements, which are often overlapping, both spatially and temporally. Over the course of the pandemic, this programmatic implosion of the home has starkly highlighted the failure of 'open-plan' spaces as individuals have struggled to establish personal territory, as well as the limitations of 'mono-functional' rooms. While the SARS-CoV-2 virus has tragically affected so many people globally, its associated social restrictions have provided an important catalyst for a much-needed spatial discourse on the domestic interior. The article posits the following question, amid a 'crisis' in domestic architecture that has been amplified by the Covid-19 flu pandemic and its associated lockdowns, how might the architect reconceptualize the spatial organisation of the contemporary dwelling interior to better accommodate the needs of its inhabitants through the speculative design of a 25m(2) microhouse? A 'Research by Design' method has resulted in 'Refugium', a microhome situated on the Danish Island of Bornholm. Through the design of 'Refugium', established domestic boundaries have been reimagined as liminal 'frontiers' of opportunity through spatial layering, a denser and less open 'atomised' plan arrangement & the articulation of deep inhabitable threshold places.
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Uncertainty tolerance, individuals' perceptions/responses to uncertain stimuli, is increasingly recognized as critical to effective healthcare practice. While the Covid-19 pandemic generated collective uncertainty, healthcare-related uncertainty is omnipresent. Correspondingly, there is increasing focus on uncertainty tolerance as a health professional graduate "competency,” and a concomitant interest in identifying pedagogy fostering learners' uncertainty tolerance. Despite these calls, practical guidelines for educators are lacking. There is some initial evidence that anatomy education can foster medical students' uncertainty tolerance (e.g., anatomical variation and dissection novelty), however, there remains a knowledge gap regarding robust curriculum-wide uncertainty tolerance teaching strategies. Drawing upon humanities, arts and social sciences (HASS) educators' established uncertainty tolerance pedagogies, this study sought to learn from HASS academics' experiences with, and teaching practices related to, uncertainty pedagogy using a qualitative, exploratory study design. Framework analysis was undertaken using an abductive approach, wherein researchers oscillate between inductive and deductive coding (comparing to the uncertainty tolerance conceptual model). During this analysis, the authors analyzed ~386 min of data from purposively sampled HASS academics' (n = 14) discussions to address the following research questions: (1) What teaching practices do HASS academics' perceive as impacting learners' uncertainty tolerance, and (2) How do HASS academics execute these teaching practices? The results extend current understanding of the moderating effects of education on uncertainty tolerance and supports prior findings that the anatomy learning environment is ripe for supporting learner uncertainty tolerance development. This study adds to growing literature on the powerful moderating effect education has on uncertainty tolerance and proposes translation of HASS uncertainty tolerance teaching practices to enhance anatomy education. © 2022 The Authors. Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.
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Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis;treatment modalities such as radiotherapy and surgery;and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average 10-year survival for all European cancer patients by 2035. © 2023 Elsevier Ltd
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Many governments in the world reacted to the coronavirus disease 2019 pandemic by swiftly offering stimulus packages to their populations. While public unpreparedness was dramatic, it was not unexpected: many alarms had been sounded. Strategies by the federal and various provincial governments of Canada in core sectors predisposed the country to the current situation and weakened its capacity to respond adequately. This paper reviews the cumulative effects of these strategic orientations: a deficient investment strategy in fundamental science;disconnect between laboratory work and the country's capacity to produce vaccines and antiviral drugs;the priority of cost efficiency that led to overwhelming dependency on foreign production of medical supplies;and dramatic spending cuts in public health. We will discuss a Mission strategy to exit the crisis that takes a long-term perspective, in which public interest and public health, combined with a strong State leadership, stimulate innovation and collaboration between national and international actors. © 2022
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The main purpose of the present study was to determine the association of physical activity (PA) patterns prior to COVID-19 confinement with severe respiratory distress consistent with COVID-19 symptoms. Participants were recruited by sending a survey through various social network channels via the snowball method. A voluntary sample of 420 individuals consisting of 199 men and 221 women from the Spanish national territory participated in this study. Some factors, such as being overweight and obese were related to the presence of a greater number of symptoms associated with COVID-19. Interestingly, it was observed that not performing moderate or vigorous PA increased the risk of COVID-19 symptoms. Consequently, when the effect of the practise of PA was evaluated in terms of the number of practises per week and in minutes per practise per week, a protective effect was observed, where moderate PA >150 min per week reported an inverse association with hospitalization for respiratory symptoms (RR: 95%CI: 0.24, 0.05–1.04, P = 0.05). Likewise, overweight (RR: 16.3, 95%CI: 1.93–137.9, P = 0.01), obesity (RR: 19.1, 95%CI: 1.63–222.5, P = 0.019) and non-performance of moderate PA (RR: 4.12, 95%CI;0.95–17.76, P = 0.05) reported positive associations with hospitalization for respiratory symptoms. Thus, the practise of moderate PA (>150 min per week) is a protective factor against hospitalization for respiratory symptoms consistent with COVID-19 symptoms.
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Introduction: The level of post-traumatic stress symptoms (PTSS) associated with the early stages of the COVID-19 outbreak, stress, anxiety, and depressive symptoms was assessed. Risk factors for mental health in the Polish population have been identified. Material and methods: Nine hundred and twenty-six respondents completed a set of questionnaires consisting of questions concerning COVID-19, PTSS related to the COVID-19 outbreak (Impact of Event Scale-Revised, IES-R), and their mental health status (Depression, Anxiety and Stress Scale, DASS-21). Results: Most respondents reported severe PTSS related to the COVID-19 outbreak (44.06%), the normal intensity of depressive symptoms (52.38%), anxiety symptoms (56.05%), and stress (56.48%). Almost 20% of Polish respondents were characterized by a severe or extremely severe level of stress, anxiety, or depressive symptoms. Every seventh respondent reported an extremely severe level of depressive symptoms. Female gender, parental status, having a relationship, at least a two-person household were associated with higher PTSS or DASS-21 subscales. A few physical symptoms, a medical visit, quarantine, negative health evaluation, chronic diseases, knowledge about the increase in the number of infected people or deaths were associated with higher levels of PTSS. Some of the precautions and the need for additional information on COVID-19, the certainty of a high COVID-19 contracting probability or of a low survival rate, and concerns about the loved ones were associated with higher PTSS. Conclusions: The indicated risk factors can be used for developing psychological interventions to improve mental health. It is necessary to conduct qualitative research on the psychological reasons for the occurrence of mental symptoms during the pandemic.