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1.
eClinicalMedicine ; 56:101785, 2023.
Article in English | ScienceDirect | ID: covidwho-2165232

ABSTRACT

Summary Background The SAVE-MORE trial demonstrated that anakinra treatment in COVID-19 pneumonia with plasma soluble urokinase plasminogen activator (suPAR) levels of 6 ng/mL or more was associated with 0.36 odds for a worse outcome compared to placebo when expressed by the WHO-Clinical Progression Scale (CPS) at day 28. Herein, we report the results of subgroup analyses and long-term outcomes. Methods This prospective, double-blind, randomised clinical trial, recruited patients with a confirmed SARS-CoV-2 infection, in need of hospitalisation, lower respiratory tract infection and plasma suPAR ≥6 ng/mL from 37 academic and community hospitals in Greece and Italy. Patients were 1:2 randomised to subcutaneous treatment with placebo or anakinra (100 mg) once daily for 10 days. Pre-defined subgroups of Charlson's comorbidity index (CCI), sex, age, level of suPAR, and time from symptom onset were analysed for the primary endpoint (overall comparison of distribution of frequencies of the scores from the WHO-CPS between treatments on day 28), by multivariable ordinal regression analysis in the intention to treat (ITT) population. This trial is registered with the EU Clinical Trials Register (2020-005828-11) and ClinicalTrials.gov (NCT04680949). Findings Patients were enrolled between 23 December 2020 and 31 March 2021;189 patients in the placebo arm and 405 patients in the anakinra arm were the ITT population. Multivariable analysis showed that anakinra treatment was accompanied by significantly lower odds for worse outcome compared to placebo at day 28 for all studied subgroups (CCI ≥ 2, OR: 0.34, 95% confidence intervals [CI] 0.22–0.50;CCI < 2, OR: 0.38, 95% CI 0.21–0.68;suPAR > 9 ng/mL, OR: 0.35, 95% CI 0.19–0.66;suPAR 6–9 ng/mL, OR: 0.35, 95% CI 0.24–0.52;patients ≥65 years, OR: 0.41, 95% CI 0.25–0.66;and patients <65 years, OR: 0.29, 95% CI 0.19–0.45). The benefit was uniform, irrespective of the time from start of symptoms until the start of the study drug. At days 60 and 90, anakinra treatment had odds of 0.40 (95% CI 0.28–0.57) and 0.46 (95% CI 0.32–0.67) respectively, for a worse outcome compared to placebo. The costs of general ward stay, ICU stay, and drugs were lower with anakinra treatment. Interpretation Anakinra represents an important therapeutic tool in the management of COVID-19 that may be administered in all subgroups of patients;benefits are maintained until day 90. Funding Hellenic Institute for the Study of Sepsis;Swedish Orphan Biovitrum AB.

2.
Technology in Society ; 72:102195, 2023.
Article in English | ScienceDirect | ID: covidwho-2165896

ABSTRACT

We examine how individual characteristics of employees such as digital self-efficacy, workforce agility, innovativeness, and commitment to change influence technological readiness in different stages of a crisis, i.e., before a crisis and during a crisis. We carried out a fuzzy set qualitative comparative analysis (fsQCA) on data from 2892 employees representing companies across several sectors and countries. Our results show that specific characteristics of employees can be beneficial for reaching technological readiness in organisations before a crisis and during a crisis. Our results, e.g., show that digital self-efficacy has a differential impact on technological readiness prior to a crisis and during a crisis while workforce agility is essential for both phases.

3.
Teaching and Teacher Education ; : 104015, 2023.
Article in English | ScienceDirect | ID: covidwho-2165888

ABSTRACT

This study collected monthly data between September 2020 and August 2021 to document the consequences of the COVID-19 pandemic for German preschool teachers during different pandemic phases. This longitudinal study investigated how subjective stress experiences and self-efficacy beliefs of preschool teachers (N = 279) change over time and explored associations on the inter- and intraindividual level. We observed phase-specific changes in subjective stress experiences and interindividual differences in change rates, but no systematic increase across the entire study period. Results also highlight self-efficacy beliefs as a resource for preschool teachers, which should be strengthened to better face stress experiences.

4.
The Lancet Regional Health - Americas ; 18:100423, 2023.
Article in English | ScienceDirect | ID: covidwho-2165665

ABSTRACT

Summary Background SOBERANA-02 is a COVID-19 conjugate vaccine (recombinant RBD conjugated to tetanus toxoid). Phases 1/2 clinical trials demonstrated high immunogenicity, promoting neutralising IgG and specific T-cell response. A third heterologous dose of SOBERANA-Plus (RBD-dimer) further increased neutralising antibodies. The aim of this study is to evaluate the safety and efficacy of two immunisation regimes: two doses of SOBERANA-02 and a heterologous three-dose combination with SOBERANA-Plus added to it. Methods From March 8th to June 24th, 2021 we conducted in Havana, Cuba a multicentre randomised, double-blind, placebo-controlled, phase-3 trial evaluating a two doses SOBERANA-02 scheme and a heterologous scheme with one dose SOBERANA-Plus added to it (RPCEC00000354). Participants 19–80 years were randomly assigned to receiving 28 days apart either the two or three dose scheme or placebo. The main endpoint was vaccine efficacy in preventing the occurrence of RT-PCR confirmed symptomatic COVID-19 at least 14 days after the second or third dose in the per-protocol population. We also assessed efficacy against severe disease and, in all participants receiving at least one vaccine/placebo dose, safety for 28 days after each dose. Findings We included 44,031 participants (52.0% female, 48.0% male;median age 50 years, range 19–80 years;7.0% black, 24.0% mixed-race, 59.0% white) in a context of initial Beta VOC predominance, with this variant being partially replaced by Delta near the trial's end. Vaccine efficacy in the heterologous combination was 92.0% (95%CI 80.4–96.7) against symptomatic disease. There were no severe COVID-19 cases in the vaccine group against 6 in the placebo group. Two doses of SOBERANA-02 was 69.7% (95%CI 56.5–78.9) and 74.9% (95%CI 33.7–90.5) efficacious against symptomatic and severe COVID-19, respectively. The occurrence of serious and severe adverse events (AE) was very rare and equally distributed between placebo and vaccine groups. Solicited AEs were slightly more frequent in the vaccine group but predominantly local and mostly mild and transient. Interpretation Our results indicate that the straightforward to manufacture SOBERANA vaccines are efficacious in a context of Beta and Delta VOC circulation, have a favourable safety profile, and may represent an attractive option for use in COVID-19 vaccination programmes. Funding This study received funds from the National Fund for Science and Technology (FONCI-CITMA-Cuba, contract 2020–20) of the Ministry of Science, Technology and Environment of Cuba.

5.
International Immunopharmacology ; 115:109623, 2023.
Article in English | ScienceDirect | ID: covidwho-2165421

ABSTRACT

Background This study sought to evaluate and compare the effectiveness of plasmapheresis, Tocilizumab, and Tocilizumab with plasmapheresis treatment on the removal of inflammatory cytokines and improvement clinically of patients with severe COVID-19 in Intensive Care Units (ICU) due to the association between increased cytokine release and the severity of COVID-19. Methods This clinical trial study was conducted in three treatment arms in Iran. All patients received standard care and randomization into one of three treatment groups;Tocilizumab (TCZ) alone, plasmapheresis alone, or a combination of Tocilizumab and plasmapheresis. Demographics, clinical evaluation, oxygenation status, laboratory tests and imaging data were evaluated in the three groups and re-checked 48 h after the end of treatment trials. Primary outcomes were oxygenation status, the need for mechanical ventilation and the rate of death. Results Ninety-four patients were included in the trial after meeting the eligibility requirements. Twenty-eight patients received Tocilizumab alone, 33 had plasmapheresis alone, and 33 received both Tocilizumab and plasmapheresis. Baseline characteristics did not differ between three groups that included demographic, clinical and laboratory parameters. Following therapy, there was no difference between the three groups for CRP, ferritin, d-dimer, IL-6, pro-calcitonin and neutrophil to lymphocyte ratio (NLR) (P > 0.05). While a significant reduction was found in CRP levels within each group (32.04 ± 42.43 to 17.40 ± 38.11, 51.28 ± 40.96 to 26.36 ± 33.07 and 41.20 ± 34.27 to 21.56 ± 24.96 in the tocilizumab, plasmapheresis, and combined group, respectively) (p < 0.05), procalcitonin levels were elevated significantly in the Tocilizumab group (0.28 ± 0.09 to 0.37 ± 0.11) (p < 0.05). Clinically there was no difference between the three groups following treatment for O2 saturation levels with supplementary oxygen at discharge, endotracheal intubation rate, use of NIVPP, mortality, mean hospital and ICU length of stay (p > 0.05). Conclusion Study results showed that the reduction of serum inflammatory markers, the rate of intubation and therapeutic complications including death were no different between the three groups;however, CRP levels were significantly reduced in all three groups, indicating that the interventions reduced inflammation likely through a reduction in the cytokine storm, though clinical outcomes were unaffected.

6.
Front Public Health ; 10: 917732, 2022.
Article in English | MEDLINE | ID: covidwho-2154833

ABSTRACT

Objective: This study aimed to determine the efficacy, effectiveness, and cost-effectiveness of inactivated COVID-19 vaccines (CoronaVac and BBIBP-CorV) in China using existing international clinical trials and real-world evidence. Methods: Through a search of PubMed, Embase, Web of Science, and CNKI, studies investigating the effectiveness of inactivated COVID-19 vaccines were identified, and a meta-analysis was undertaken to synthesize the vaccine efficacy and effectiveness data. Moreover, a decision-analytic model was developed to estimate the cost-effectiveness of inactivated vaccines for combating the COVID-19 pandemic in the Chinese context from a societal perspective. Results of the meta-analysis, along with cost data from official websites and works of literature were used to populate the model. Sensitivity analysis was performed to test the robustness of the model results. Results: A total of 24 studies were included in the meta-analysis. In comparison to no immunization, the effectiveness of inactivated vaccine against COVID-19 infection, hospitalization, ICU admission and death were 65.18% (95% CI 62.62, 67.75), 79.10% (95% CI 71.69, 86.51), 90.46% (95% CI 89.42, 91.50), and 86.69% (95% CI 85.68, 87.70); and the efficacy against COVID-19 infection and hospitalization were 70.56% (95% CI 57.87, 83.24) and 100% (95% CI 61.72, 100). Inactivated vaccine vaccination prevented more infections, hospitalizations, ICU admissions, and deaths with lower total costs, thus was cost-saving from a societal perspective in China. Base-case analysis results were robust in the one-way sensitivity analysis, and the percentage of ICU admission or death and direct medical cost ranked the top influential factors in our models. In the probabilistic sensitivity analysis, vaccination had a 100% probability of being cost-effective. Conclusion: Inactivated vaccine is effective in preventing COVID-19 infection, hospitalization, ICU admission and avoiding COVID-19 related death, and COVID-19 vaccination program is cost-saving from societal perspective in China.


Subject(s)
COVID-19 Vaccines , COVID-19 , Cost-Benefit Analysis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , China/epidemiology , Humans , Pandemics/prevention & control , Randomized Controlled Trials as Topic , Vaccines, Inactivated/therapeutic use
7.
Front Public Health ; 10: 904550, 2022.
Article in English | MEDLINE | ID: covidwho-2154831

ABSTRACT

Objective: After the unprecedented coronavirus disease 2019 (COVID-19) outbreak, the health status of the general population has suffered a huge threat, and the mental health of front-line healthcare providers has also encountered great challenges. Therefore, this study aims to: (1) investigate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among healthcare providers, and (2) verify the moderating role of self-efficacy in the influence of PTSD on mental health. Methods: A cross-sectional study was conducted using an online survey of 1993 participants. The presence of depression, anxiety, self-efficacy, and PTSD was evaluated using screening tests from March 1. Sociodemographic and COVID-19-related data were also collected. A data analysis was performed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regression. Results: The prevalence of PTSD among healthcare providers was 9.3%. PTSD was negatively correlated with self-efficacy (r = -0.265, P < 0.01), anxiety (r = -0.453, P < 0.01), and depression (r = 0.708, P < 0.01). Profession, daily working hours, maximum continuous working days, and daily sleep time were influencing factors of PTSD. A binary logistic regression analysis showed that physicians (OR = 2.254, 95% CI = 1.298, 3.914) and nurses (OR = 2.176, 95% CI = 1.337, 3.541) were more likely to experience PTSD than other healthcare providers. Conclusion: Self-efficacy has a moderating effect on the influence of PTSD on anxiety and depression. This suggests that health managers need to respond to the current psychological crisis of healthcare providers, implement appropriate psychological interventions, and minimize the psychological harm caused by COVID-19.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Health Personnel/psychology , Humans , Mental Health , Prevalence , Stress Disorders, Post-Traumatic/epidemiology
8.
Front Psychol ; 13: 967666, 2022.
Article in English | MEDLINE | ID: covidwho-2154810

ABSTRACT

During the COVID-19, the wanton spread of novel coronavirus had a huge negative effect on the emotions of college students, resulting in a serious impact on the daily learning behavior of many college students. In this context, college students' emotion management ability is particularly important. Therefore, based on the results of a questionnaire survey of 580 college students, the present study conducts an in-depth analysis of the relationship between current college students' emotion management ability and learning engagement, and explores the mediating role of psychological safety and self-efficacy in the relationship between emotion management ability and learning engagement. The results show that college students' emotion management ability is significantly positive related to learning engagement, psychological safety and self-efficacy; Psychological safety and self-efficacy can play a partial mediating role between emotion management ability and college students' learning engagement. The results reveal the importance of good emotion management ability of college students during the COVID-19, and enlighten colleges and universities to actively pacify students' emotions to promote their normal learning.

9.
Journal of Pharmaceutical Negative Results ; 13:2603-2606, 2022.
Article in English | EMBASE | ID: covidwho-2164819

ABSTRACT

Background: Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a widely known, prolonged, multifactorial limb movement disorder wherein patients have an insatiable desire to move their legs. This is frequently associated with abnormal, non-painful sensations that begin at rest and improve with activity and pain may be the distressing symptom in a few. Ropinirole, a dopamine agonist, is a proven drug for this disease. Method(s): In this study of thirty-two post covid restless leg syndrome, selected by well-established criteria, a course of ropinirole 2 mg in the night was given for three weeks. The drug compliance was maintained more than 95% by telephonic interview. The pain scores (VAS 0- 10), Likert scores of satisfactions, were observed after three weeks and three months. Result(s): The scores significantly decreased after three weeks which maintained the same and an insignificant decrease after three months. The median score decreased from 7 to 3 (three weeks) to 2 in three months. The Likert satisfaction scores improved to 1.81 from three (p value= 0.00). There was improvement in scores from three weeks to three months. There were no side effects. Conclusion(s): In this single centre, quasi experimental study on the efficacy of ropinirole on post covid restless syndrome, we found the drug dosage of 2 mg in the night for three weeks is effective in the control of symptoms. The drug gives better satisfaction which prolonged to three months even if the drug is stopped in three weeks. There were no clinically significant side effects. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

10.
Journal of Pharmaceutical Negative Results ; 13(3):502-506, 2022.
Article in English | EMBASE | ID: covidwho-2164807

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century, Forcing scientists to continue Research to discover a vaccine for this disease in in request to control and boundary the range Of the disease. This study was designed to hit upon out whether here are side effects on vaccinated people who received covid-19 vaccine or not by measuring the body's vitality by some of biochemical tests.Subjects:75 individuals between women and men aged (17-68 years)were enrolled in this study .Several biochemical tests were performed on them before taking the vaccine,a week to10 days after the first dose, and a week to 10 days after the second dose of covid-19 vaccine. RESULT(S): All subjects in this Study received the Pfizer-Bio N Tech vaccine and no systemic side effects were Observed in subjects vaccinated during the study period. Conclusion(s): From the Results of the current study, there were no abnormal biochemical markers, increased, or changes in basic body functions after receiving the Pfizer vaccine. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

11.
Professional Medical Journal ; 29(12):1760-1764, 2022.
Article in English | Academic Search Complete | ID: covidwho-2164611

ABSTRACT

Objective: The aim of this study was to compare the outcome of dexamethasone and methylprednisolone among patients suffering with COVID-19 pneumonia. Study Design: Quantitative Retrospective Comparative study. Setting: Department of Medicine, Allied Hospital, Faisalabad. Period: February to September 2021. Material & Methods: Data included archival record of 120 diagnosed cases of COVID-19 pneumonia during July 2020 to December 2020. Data was retrospectively collected by researchers using a predesigned study proforma and analyzed through SPSS software 25.0. Results: Out of 120 reported cases of COVID-19 pneumonia, 76 (63.3%) were males, and 44(36.7%) were females (p= 0.097). There were 67 patients (55.8%) prescribed with dexamethasone treatment (Group A) and 53 patients (44.2%) with methylprednisolone treatment (Group B). Mean duration of hospital stay was 3.48 + 3.0 days in Group A and 3.45 + 3.0 days in Group B. Six patients were lost for follow-up Out of 114 patients, 63 patients (55.26%) had mortality within 30 days of study while 51 patients (44.74%) survived. Conclusion: There is no statistical difference in the outcomes of COVID-19 pneumonia when treated with dexamethasone as compared to methylprednisolone in terms of outcome related to duration of hospitalization, need for ICU admission and reported mortality within 30 days. More studies are warranted with larger sample size. [ FROM AUTHOR]

12.
Journal of Head Trauma Rehabilitation ; 37(6):E518, 2022.
Article in English | EMBASE | ID: covidwho-2161228

ABSTRACT

Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea, and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2016 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is then recommended and has been proven effective. Recently, the COVID-19 pandemic has led tele-consultations to seek healthcare professionals in primary care. The benefit of such a telerehabilitation approach compared with in-clinic rehabilitation program should therefore be further investigated. Objective The objective of this study was to compare the effects of an in-clinic cervicovestibular rehabilitation program combined with a symptom-limited aerobic exercise (SLAE) program with the same program in a telerehabilitation format in adults with persistent symptoms following mTBI on severity of symptoms and other indicators of clinical recovery. Methods In this parallel-group nonrandomized clinical trial, 40 adults with persistent symptoms following mTBI were assigned to (1) an in-clinic 6-week cervicovestibular rehabilitation program combined with SLAE program (n =30) OR (2) the same program performed in a telerehabilitation format (n =10). All participants took part in 4 evaluation sessions (baseline, weeks 6, 12, and 26) performed by a blinded evaluator. The primary outcome was the Post-Concussion Symptoms Scale (PCSS). The secondary outcomes were Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI), Headache Disability Inventory (HDI), Dizziness Handicap Inventory (DHI), and time-to-return to function. Nonparametric analysis for longitudinal data was used to evaluate the effect of interventions on outcomes. Results For the PCSS total score, and PCSS number of symptoms, there were group-by-time interactions at 6-month follow-up (P < .05);clinically significant time effects were observed for both groups (P < .05). There were group-by-time interactions at all time point follow-up for the global rating of change (P < .05) and the NPRS neck pain (P < .01) in favor of the in-clinic rehabilitation program. There were no group-by-time interactions for other outcome measures. Conclusion The study indicates that an in-clinic cervicovestibular rehabilitation combined with SLAE program was superior to the same telerehabilitation program in terms of symptoms improvement and global rating of change inmTBI with persistent symptoms. However, other outcome measures were equally improved after either the in-clinic or the telerehabilitation program. These results must be interpreted with caution, given the limited number of participants in the telerehabilitation group and the nonrandomized group allocation.

13.
Current Research in Ecological and Social Psychology ; : 100082, 2022.
Article in English | ScienceDirect | ID: covidwho-2158708

ABSTRACT

The global SARS-CoV-2 (COVID-19) pandemic presents a pressing health challenge for all countries, including Aotearoa New Zealand (NZ). As of early 2022, NZ public health measures have reduced impacts of the pandemic, but ongoing efforts to limit illness and fatalities will be significantly aided by widescale uptake of available vaccines including COVID-19 booster doses. Decades of research have established a broad range of demographic, social, cognitive, and behavioural factors which influence peoples' uptake of vaccinations, including a large amount of research in the last two years focused on COVID-19 vaccination in particular. In this study, we surveyed people in New Zealand (N = 660) in May and June of 2021, at which point the vaccine had been made available to high-risk groups. We explored individual versus collective motivations, finding that people who were hesitant about COVID-19 vaccination scored lower on independent self-construals (how people define themselves) but higher on community identity, weaker but still positive perceived social norms, lower general risk of COVID-19 to New Zealanders and higher vaccine risk for both themselves and others, and lower response-efficacy both for personal and collective benefits. Overall, the findings suggest some benefit of collective over individual appeals, but that generally messaging to encourage vaccination should focus on conveying social norms, risk from COVID-19 broadly, and vaccine safety and efficacy.

14.
Asia-Pacific Journal of Oncology Nursing ; : 100179, 2022.
Article in English | ScienceDirect | ID: covidwho-2158440

ABSTRACT

Objective This study aims to understand the experiences of colorectal cancer (CRC) patients and their spousal caregivers during the COVID-19 pandemic, and to refine a self-efficacy (SE) intervention for these couples. Methods A descriptive phenomenological approach was used in this study. Data were collected from 11 CRC couples. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. Results Three themes and eight subthemes emerged: (a) Get and contribute support, (b) Life's challenges, and (c) The Journey of Reconstruction. The CRC couples encountered escalating challenges in coping with cancer during COVID-19. At the same time, they have received considerable support and developed confidence in rebuilding themselves in the process. Healthcare providers are advised to focus on giving appropriate support to CRC couples, so they can go further. Conclusions This study gave insights to healthcare providers on the experiences of CRC couples and the development of SE intervention programme to support these couples: (a) initially providing caregiving training for spousal caregivers and psychological support for patients, (b) encouraging self-care for CRC couples in the middle stage, (c) guiding them to view life positively in the later stage, and (d) assessing their situation in time to identify their needs and to provide support. Healthcare providers are recommended to increase flexibility in the SE intervention programme delivery format, to reduce the impact of COVID-19 on CRC couples.

15.
Universal Access in the Information Society ; 2022.
Article in English | Scopus | ID: covidwho-2158064

ABSTRACT

With the development of technology and demand for online courses, there have been considerable quantities of online, blended, or flipped courses designed and provided. However, in the technology-enhanced learning environments, which are also full of social networking websites, shopping websites, and free online games, it is challenging to focus students' attention and help them achieve satisfactory learning performance. In addition, the instruction of programming courses constantly challenges both teachers and students, particularly in online learning environments. To overcome and solve these problems and to facilitate students' learning, the researchers in this study integrated two teaching approaches, using meta-cognitive learning strategy (MCLS) and team regulation (TR), to develop students' regular learning habits and further contribute to their programming skills, academic motivation, and refusal self-efficacy of Internet use, in a cloud classroom. In this research, a quasi-experiment was conducted to investigate the effects of MCLS and TR adopting the experimental design of a 2 (MCLS vs. non-MCLS) × 2 (TR vs. non-TR) factorial pre-test/post-test. In this research, the participants consisted of four classes of university students from non-information or computer departments enrolled in programming design, a required course. The experimental groups comprised three of the classes, labelled as G1, G2, and G3. G1 concurrently received both the online MCLS and TR intervention, while G2 only received the online MCLS intervention, and G3 only received the online TR intervention. Serving as the control group, the fourth class (G4) received traditional teaching. This study investigated the effects of MCLS, TR, and their combination, on improving students' programming skills, academic motivation, and refusal self-efficacy of Internet use in an online computing course. According to the results, students who received online TR significantly enhanced their programming design skills and their refusal self-efficacy of Internet use a cloud classroom. However, the expected effects of MCLS on developing students' programming skills, academic motivation, and refusal self-efficacy of Internet use were not found in this study. The teaching strategy of integrating MCLS and TR in an online programming course in this study can serve as a reference for educators when conducting online, blended, or flipped courses during the COVID-19 pandemic. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

16.
Psychology in the Schools ; 2022.
Article in English | Web of Science | ID: covidwho-2157893

ABSTRACT

This study sought to understand education support professionals' (ESPs) experiences early in the COVID-19 pandemic, including how they were feeling about their roles in education, strategies they were using to cope with unprecedented times, barriers they encountered toward maintaining SE health at work, and opportunities they identified as critical for creating safe and supportive school environments. This study employed a convergent parallel (QUAN + QUAL) mixed methods research design to capture ESPs' affective experiences and use of social and emotional learning (SEL). Data were collected in partnership with the National Education Association across 4 weeks through a survey including open and closed-ended questions. A total of 175 participants responded to the quantitative portion of the survey and at least one qualitative survey question. Findings suggest ESPs were feeling frustrated and experiencing very little SEL support in their daily work. ESPs would benefit from increased communication, inclusion, recognition, and well-being promotion in their schools. This study offers new insight into how schools and districts can provide better SEL support to ESPs.

17.
JACCP Journal of the American College of Clinical Pharmacy ; 2022.
Article in English | EMBASE | ID: covidwho-2157827

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a highly contagious, airborne viral infection that can infect anyone. Those with certain underlying conditions may be at higher risk for infection to develop into a severe disease requiring hospitalization. This report summarizes use of nirmatrelvir-ritonavir for the treatment of COVID-19 in high-risk patients at a single academic medical center through a pharmacist delegation protocol and demonstrates real-world efficacy and safety of treatment. Method(s): This retrospective, single-center, observational study analyzed all patients who received nirmatrelvir-ritonavir ordered by a clinical pharmacist for treatment of COVID-19 infection. The primary outcomes were safety and efficacy of nirmatrelvir-ritonavir. Safety was evaluated by analyzing drug interaction management and adverse events. Efficacy was evaluated through hospitalization and death within 28 days of nirmatrelvir-ritonavir use. Result(s): Sixty patients were eligible for inclusion. No patients were hospitalized or died within 28 days after initiation of nirmatrelvir-ritonavir. Pharmacists identified 101 drug interactions with 60% considered clinically significant, requiring modification of home medications. Adverse outcomes associated with the use of nirmatrelvir-ritonavir were reported in 13 patients (21.7%). Conclusion(s): A comprehensive program to mitigate drug interactions and prescribe nirmatrelvir-ritonavir ensured timely access to COVID-19 therapy, which may be associated with the prevention of hospitalization and death. Copyright © 2022 Pharmacotherapy Publications, Inc.

18.
Hepatology ; 76(Supplement 1):S1479, 2022.
Article in English | EMBASE | ID: covidwho-2157796

ABSTRACT

Background: Evolution toward remote lifestyles, including healthcare access, has accelerated due to the COVID-19 pandemic. Challenges related to participant recruitment and retention mean clinical trial design is also evolving toward a remote model where trials use digital health technologies and services to improve patient experience. A Decentralized Clinical Trial (DCT) is an emerging model where assessment of patients can occur outside of a traditional site, including at a patient's own home. Hybrid trials which incorporate some DCT components increase convenience and enhance accessibility to patients. Several professional organizations including the Clinical Trials Transformation Initiative and Decentralized Trials and Research Alliance advocate DCT design in clinical studies. Draft guidance on the use of digital health technology for remote data acquisition from participants in clinical trials has been recently issued by the FDA. They recognize that to improve participant recruitment and retention, and increase patient diversity, remote data collection can allow more frequent or even continuous data collection that may better represent real-world experience with the study drug. DCTs are particularly relevant for rare diseases such as PBC where patients may not be in close proximity to a specialist. In fact, 70% of patients with PBC surveyed indicated they would be more likely to participate in a clinical trial if remote options were available. Method(s): The Phase 3 GLISTEN trial (NCT04950127) is investigating the efficacy and safety of linerixibat for the treatment of cholestatic pruritus in patients with PBC. Several operating models are in place, including a fully decentralized option (Figure). DCT elements included in GLISTEN include digital recruitment of patients via social media/patient groups, remote completion of informed consent, telemedicine, electronic clinical and patient-reported outcome (PRO) assessments, home health visits, and direct shipment of study drug/placebo to the patient's home. The primary endpoint in GLISTEN is a PRO, making it compatible with a DCT approach. Result(s): Patient recruitment is ongoing;the study is active at physical study sites worldwide and as a fully remote DCT in the USA. Conclusion(s): Incorporation of DCT design elements into GLISTEN is expected to address the issues of limited numbers and diversity of patients recruited, which is particularly important for a rare disease such as PBC.

19.
Hepatology ; 76(Supplement 1):S108-S109, 2022.
Article in English | EMBASE | ID: covidwho-2157785

ABSTRACT

Background: Hepatic encephalopathy (HE) in acute-on- chronic liver failure (ACLF) is associated with significant morbidity and mortality. There is paucity of data regarding HE management in patients with ACLF and most of the evidence is extrapolated from patients with cirrhosis. We conducted a prospective, randomized controlled clinical trial to study the efficacy of intravenous branched chain amino acids (IV-BCAA) with lactulose versus lactulose alone for improvement in HE scores at 24h, day 3 & day 7. Duration of ICU stay and survival at days 7 and 28 was compared. Method(s): CANONIC ACLF patients with HE grades >= 2 were assessed for eligibility and randomized into two groups -experimental arm (IV-BCAA -500mL/ day for 3 days + Lactulose;n=39) and comparator arm (Lactulose alone;n=37). Six patients developed COVID-19 after randomization & were excluded (4-experimental arm & 2-comparator arm). Grade of HE was assessed by West Haven Classification and Hepatic Encephalopathy Scoring Algorithm (HESA). ACLF severity was determined by CLIF-C ACLF and MELD scores. All patients received standard of care for HE and ACLF management. Result(s): Both groups were similar in baseline characteristics including grade of HE (2.85 +/- 0.75 vs 2.82 +/- 0.66;P = 0.864) and CLIF-C ACLF score (54.19 +/- 5.55 vs 54.79 +/- 5.74;P = 0.655). Overall survival was 40% at 28 days (48.5% vs 31.4%;P=0.143). Significant improvement in HESA score by >=1 grade at 24h was seen in 14 patients (40%) in BCAA arm and 6 patients (17.14%) in control group (P=0.034) which translated to a shorter ICU stay in the BCAA arm (Table 1). Median change in HESA score at 24h was significantly more in BCAA arm than control arm (P=0.006), however, this was not sustained at day 3 or 7. Ammonia levels did not correlate with the grade of HE (Spearman's correlation coefficient(rho) = -0.0843;P=0.295). Conclusion(s): Intravenous BCAA leads to early but ill-sustained improvement in grade of HE and reduced ICU stay in ACLF.

20.
Hepatology ; 76(Supplement 1):S1046, 2022.
Article in English | EMBASE | ID: covidwho-2157777

ABSTRACT

Background: The Grady Liver Clinic (GLC) is a primary care-based hepatitis C (HCV) clinic that provides comprehensive care for an urban, primarily African American, underserved patient population at Grady Health System. At the onset of the COVID-19 pandemic, GLC pivoted to using a telehealth model for HCV treatment. With telehealth, treatment visits were conducted via telephone or video and HCV medications could be couriered to patients' residences. We aim to compare outcomes of the HCV telehealth treatment model to traditional, in-person treatment. Method(s): We performed a retrospective chart review of all patients who initiated HCV treatment at GLC from 03/2019-02/ 2020 (Pre-Pandemic) and 03/2020-02/ 2021 (Pandemic). The latter cohort was stratified into three types of visits: in-person only, telehealth only, and hybrid (mixture of in-person and telehealth). We compared demographic data and HCV treatment outcomes between groups. Result(s): Patients in pre-pandemic and pandemic cohorts were similar genders, ages, ethnicities, and used similar payor sources. The average number of days from referral to treatment initiation differed between cohorts (52 days vs 92 days) as did the treatment duration (84 vs 56 days). The rate of sustained virologic response (SVR12) was similar between cohorts, with SVR12 obtained in 59% of the pre-pandemic cohort that started treatment (96% of those who completed testing for SVR12) vs 61% of the pandemic cohort that started treatment (95% of those who completed testing for SVR12). A substantial proportion of patients in both groups did not follow-up for SVR12 testing. Importantly, there were similar rates of SVR12 in the pandemic in-person, telehealth, and hybrid subgroups (Figure 1, attached). Conclusion(s): Our results show that virtual delivery of healthcare is as effective as traditional in-person clinic visits for HCV treatment. Our data supports continued use of telehealth to improve access to HCV treatment for a vulnerable patient population who face chronic barriers to healthcare access. (Figure Presented).

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