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2.
Infect Control Hosp Epidemiol ; 41(9): 1003-1010, 2020 09.
Article in English | MEDLINE | ID: covidwho-2096313

ABSTRACT

BACKGROUND: SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country. OBJECTIVE: With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients. DESIGN: Cross-sectional survey focused on various elements of respiratory disease preparedness. SETTING: Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho. METHODS: The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho. RESULTS: Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents-specifically COVID-19-as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases. CONCLUSIONS: Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Resources/supply & distribution , Hospitals/statistics & numerical data , Infection Control/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , COVID-19 , Cross-Sectional Studies , Health Care Surveys , Humans , Idaho , Infection Control/instrumentation , Infection Control/methods , Personal Protective Equipment/supply & distribution , Quarantine/methods , Quarantine/statistics & numerical data , SARS-CoV-2
3.
J Health Care Poor Underserved ; 33(3): 1715-1718, 2022.
Article in English | MEDLINE | ID: covidwho-2021446
4.
Health Expect ; 25(4): 1619-1632, 2022 08.
Article in English | MEDLINE | ID: covidwho-1961577

ABSTRACT

INTRODUCTION: British Pakistani women have exceptionally high rates of obesity and yet are seldom heard in a research priority setting concerning weight management. The objectives of this study were (i) to ascertain what multisectoral professionals perceive to be the most pressing unmet obesity needs or topic areas that need more research in relation to Pakistani women living in deprived areas of Bradford and (ii) to determine the top 10 obesity health priorities for this group to develop an obesity research agenda. METHODS: A two-step process was adopted using the following: (i) a survey of a wide range of multisectoral professional stakeholders (n = 159) and (ii) a ranking exercise involving Pakistani women living in deprived areas of Bradford (n = 32) to select and prioritize their top 10 obesity health concerns and unmet needs from a list of 31 statements identified in the survey and previous research. Survey data were analysed using inductive content analysis and themes were identified. Themes were translated into statements to be ranked by Pakistani women. The ranking exercise was conducted by telephone either via voice or video call. Data were analysed using a reverse scoring system. RESULTS: Survey responses were grouped into statements reflecting the following three categories: education needs; healthy behaviour barriers and mental well-being. The highest rankings were given by Pakistani women to statements on mental health and the need for education. The top 10 prioritized statements were developed with members of the public into an obesity research agenda that reflected the target population. CONCLUSION: Actively engaging British Pakistani women in setting research priorities provided a unique opportunity to understand the key areas they think are important for future research. The culminating research agenda can be used by researchers to advance the field of obesity research in Pakistani communities, thus producing research outputs that are relevant to and have impact in this population. PATIENT OR PUBLIC CONTRIBUTION: Participants in the ranking exercise collected data. Public contributors were involved in developing the prioritized statements into a research agenda.


Subject(s)
Health Priorities , Health Services Needs and Demand , Health Services Research , Obesity , Poverty Areas , Social Determinants of Health , Biomedical Research/methods , Biomedical Research/organization & administration , Female , Health Care Surveys , Health Priorities/organization & administration , Health Services Research/methods , Health Services Research/organization & administration , Humans , Intersectoral Collaboration , Obesity/epidemiology , Obesity/therapy , Pakistan/ethnology , Social Determinants of Health/statistics & numerical data , Stakeholder Participation , United Kingdom/epidemiology
6.
BMJ ; 378: o1764, 2022 07 15.
Article in English | MEDLINE | ID: covidwho-1950088
8.
BMJ Open ; 12(6): e057588, 2022 06 16.
Article in English | MEDLINE | ID: covidwho-1901998

ABSTRACT

OBJECTIVE: Describe trends in opioid plus high-risk medication coprescribing in the USA. DESIGN: Analyses of serial, cross-sectional, nationally representative data of the National Ambulatory Medical Care Survey (NAMCS) over 2007-2016 and the National Hospital Ambulatory Medical Care Survey (NHAMCS) over 2007-2018. SETTING: US ambulatory (NAMCS) and emergency department (ED, NHAMCS) settings. PARTICIPANTS: Patient visits in which the patient was 18 years and older with an opioid prescription in the NAMCS or NHAMCS databases. PRIMARY AND SECONDARY OUTCOME MEASURES: Frequency of opioid plus high-risk medication coprescribing. RESULTS: From a combined sample of 700 499 visits over 2007-2018, there were 105 720 visits (15.1%) where opioids were prescribed. n=31 825 were from NAMCS and n=73 895 were from NHAMCS. The mean prevalence of coprescription of opioids and high-risk medications for the combined NAMCS and NHAMCS sample was 18.4% in 2007, peaked at 33.2% in 2014 and declined to 23.8% in 2016. Compared with adults receiving opioid prescriptions alone, those coprescribed opioids and high-risk medications were older, more likely female, white and using private or Medicare insurance (p<0.0001). CONCLUSIONS: Coprescribing is more common in ambulatory than ED settings and has been declining, yet one in four patient visits where opioids were prescribed resulted in coprescribed, high-risk medications in 2016. Efforts and research to help lower the rates of high-risk prescribing are needed.


Subject(s)
Analgesics, Opioid , Medicare , Adult , Aged , Ambulatory Care , Analgesics, Opioid/therapeutic use , Cross-Sectional Studies , Emergency Service, Hospital , Female , Health Care Surveys , Humans , Practice Patterns, Physicians' , United States
9.
N Z Med J ; 135(1550): 13-25, 2022 02 25.
Article in English | MEDLINE | ID: covidwho-1897652

ABSTRACT

AIM: The primary aim of this survey was to develop an understanding of current pulmonary rehabilitation practices in New Zealand. The onset of a COVID-19 lockdown in New Zealand in March 2020, shortly after completion of the initial survey, enabled a follow-up survey to determine how services had adapted in response to the global pandemic. METHODS: A cross-sectional observational design using two sequential purpose designed online surveys administered before (Survey 1) and after COVID-19 lockdowns (Survey 2) in New Zealand. RESULTS: Survey 1 was completed by 36 PR services across New Zealand and showed homogeneity in the content and structure of services provided. PR was primarily funded by district health boards, run by a multi-disciplinary team of health professionals and included participants with a range of chronic respiratory conditions. All programmes completed pre- and post-PR assessments, were a minimum of eight weeks in duration and included exercise and education. Survey 2 showed that, during level 4 and level 3 COVID-19 restrictions, 11 (40.7%) of services paused PR programmes, with 16 (59%) adapting the service to provide home-based rehabilitation via telephone or teleconference facilities. CONCLUSION: PR programmes in New Zealand report following Australian and New Zealand PR best practice guidelines and are homogenous in content and structure, but COVID-19 restrictions highlighted the need for services to provide more diverse options for service delivery. Future service development should focus on providing a range of delivery options allowing increased access to PR, tailoring therapy to meet individual needs and ensuring services are engaging for all participants to optimise participation.


Subject(s)
COVID-19 , Lung Diseases , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Cross-Sectional Studies , Health Care Surveys , Humans , Lung Diseases/rehabilitation , New Zealand/epidemiology
10.
Am J Infect Control ; 50(9): 975-980, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1894746

ABSTRACT

BACKGROUND: A 2014 study assessed infection prevention (IP) practices in Thai hospitals for catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). This study compares current IP practices to results obtained in 2014. METHODS: Between February 1, 2021 and August 31, 2021, we resurveyed Thai hospitals regarding practices to prevent CAUTI, CLABSI, and VAP. We also assessed COVID-19 impact and healthcare worker burnout and coping strategies. We distributed 100 surveys to a convenience sample of infection preventionists. RESULTS: Response rate: 100%. One-third (31%) of hospitals reported excellent leadership support for infection control (ie, responses of "good" or "excellent" to one survey question). Some prevention practices increased between 2014 vs 2021 (CAUTI: catheter reminder/stop-order/nurse-initiated discontinuation [50.0% vs 70.0%, P < .001]; condom catheters [36.3% vs 51.0%, P = .01]; ultrasound bladder scanner [4.7% vs 12.0%, P = .03]; CLABSI: chlorhexidine gluconate insertion site antisepsis [73.6% vs 85.0%, P = .03]; maximum sterile barrier precautions [63.2% vs 80.0%, P = .003]; VAP: selective digestive tract decontamination [26.9% vs 40.0%, P = .02]). Antimicrobial catheter use decreased since 2014 (10.4% vs 3.0%, P < .001). Many other practices remain suboptimal. COVID-19 challenges: staff shortages (71%), financial hardships (67%). Only 46% of infection preventionists felt safe working during COVID-19. CONCLUSIONS: More national strategic support is needed for IP programs to prevent CAUTI, CLABSI, VAP and healthcare worker well-being in Thailand during the COVID-19 pandemic.


Subject(s)
COVID-19 , Catheter-Related Infections , Cross Infection , Pneumonia, Ventilator-Associated , Urinary Tract Infections , COVID-19/prevention & control , Catheter-Related Infections/epidemiology , Catheter-Related Infections/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Health Care Surveys , Hospitals , Humans , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Ventilator-Associated/prevention & control , Thailand/epidemiology , Urinary Tract Infections/epidemiology
11.
Int J Med Inform ; 164: 104803, 2022 08.
Article in English | MEDLINE | ID: covidwho-1867251

ABSTRACT

BACKGROUND: Australia has seen a rapid uptake of virtual care since the start of the COVID-19 pandemic. We aimed to describe the willingness of consumers to use digital technology for health and to share their health information; and explore differences by educational attainment and area of remoteness. METHODS: We conducted an online survey on consumer preferences for virtual modes of healthcare delivery between June and September 2021. Participants were recruited through the study's partner organisations and an online market research company. Australian residents aged ≥18 years who provided study consent and completed the survey were included in the analysis. We reported the weighted percentages of participants who selected negative response to the questions to understand the size of the population that were unlikely to adopt virtual care. Age-adjusted Poisson regression models were used to estimate the prevalence ratios for selecting negative response associated with education and remoteness. RESULTS: Of the 1778 participants included, 29% were not aware of digital technologies for monitoring/supporting health, 22% did not have access to technologies to support their health, and 19% were not willing to use technologies for health. Over a fifth of participants (range: 21-34%) were not at all willing to use seven of the 15 proposed alternative methods of care. Between 21% and 36% of participants were not at all willing to share de-identified health information tracked in apps/devices with various not-for-profit organisations compared to 47% with private/for-profit health businesses. Higher proportions of participants selected negative response to the questions in the lower educational attainment groups than those with bachelor's degree or above. No difference was observed between area of remoteness. CONCLUSIONS: Improving the digital health literacy of people, especially those with lower educational attainment, will be required for virtual care to become an equitable part of normal healthcare delivery in Australia.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , Australia , COVID-19/epidemiology , Health Care Surveys , Humans , Technology
12.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1712-1719, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1826408

ABSTRACT

PURPOSE: The aim of the present study was to evaluate the impact of the coronavirus (COVID-19) pandemic on joint arthroplasty service in Europe by conducting an online survey of arthroplasty surgeons. METHODS: The survey was conducted in the European Hip Society (EHS) and the European Knee Associates (EKA). The survey consisted of 20 questions (single, multiple choice, ranked). Four topics were addressed: (1) origin and surgical experience of the participant (four questions); (2) potential disruption of arthroplasty surgeries (12 questions); (3) influence of the COVID-19 pandemic on the particular arthroplasty surgeon (four questions); (4) a matrix provided 14 different arthroplasty surgeries and the participant was asked to state whether dedicated surgery was stopped, delayed or cancelled. RESULTS: Two-hundred and seventy-two surgeons (217 EHS, 55 EKA) from 40 different countries participated. Of the respondents, 25.7% stated that all surgeries were cancelled in their departments, while 68.4% responded that elective inpatient procedures were no longer being performed. With regard to the specific surgical procedures, nearly all primary TJA were cancelled (92.6%) as well as aseptic revisions (94.7%). In most hospitals, periprosthetic fractures (87.2%), hip arthroplasty for femoral neck fractures and septic revisions for acute infections (75.8%) were still being performed. CONCLUSION: During the current 2020 COVID-19 pandemic, we are experiencing a near-total shutdown of TJA. A massive cutback was observed for primary TJA and revision TJA, even in massively failed TJA with collapse, dislocation, component failure or imminent dislocation. Only life-threatening pathologies like periprosthetic fractures and acute septic TJA are currently undergoing surgical treatment. LEVEL OF EVIDENCE: V.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Delivery of Health Care/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Orthopedic Procedures/statistics & numerical data , Pandemics , Pneumonia, Viral/epidemiology , COVID-19 , Europe/epidemiology , Health Care Surveys , Humans , Internet , Male , Prospective Studies , SARS-CoV-2
13.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1705-1711, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1826407

ABSTRACT

PURPOSE: Due to the lack of evidence, it was the aim of the study to investigate current possible cutbacks in orthopaedic healthcare due to the coronavirus disease 2019 pandemic (COVID-19). METHODS: An online survey was performed of orthopaedic surgeons in the German-speaking Arthroscopy Society (Gesellschaft für Arthroskopie und Gelenkchirurgie, AGA). The survey consisted of 20 questions concerning four topics: four questions addressed the origin and surgical experience of the participant, 12 questions dealt with potential cutbacks in orthopaedic healthcare and 4 questions addressed the influence of the pandemic on the particular surgeon. RESULTS: Of 4234 contacted orthopaedic surgeons, 1399 responded. Regarding arthroscopic procedures between 10 and 30% of the participants stated that these were still being performed-with actual percentages depending on the specific joint and procedure. Only 6.2% of the participants stated that elective total joint arthroplasty was still being performed at their centre. In addition, physical rehabilitation and surgeons' postoperative follow-ups were severely affected. CONCLUSION: Orthopaedic healthcare services in Austria, Germany, and Switzerland are suffering a drastic cutback due to COVID-19. A drastic reduction in arthroscopic procedures like rotator cuff repair and cruciate ligament reconstruction and an almost total shutdown of elective total joint arthroplasty were reported. Long-term consequences cannot be predicted yet. The described disruption in orthopaedic healthcare services has to be viewed as historic. LEVEL OF EVIDENCE: V.


Subject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Orthopedic Procedures/statistics & numerical data , Orthopedics/statistics & numerical data , Pneumonia, Viral/epidemiology , Aftercare/statistics & numerical data , Arthroplasty/statistics & numerical data , Arthroscopy/statistics & numerical data , Austria/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/virology , Germany/epidemiology , Health Care Surveys , Humans , Internet , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/virology , Rehabilitation/statistics & numerical data , SARS-CoV-2 , Switzerland/epidemiology
14.
Swiss Med Wkly ; 152: w30165, 2022 04 11.
Article in English | MEDLINE | ID: covidwho-1822537

ABSTRACT

BACKGROUND: Mask wearing contributes to the reduction of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In Switzerland, compulsory use of masks was introduced in indoor public spaces and later in schools. This study explored perceptions of the usefulness of masks in school and public in a cohort of children and adolescents in the canton of Zurich, Switzerland, in January to May 2021. METHODS: School children aged 10 to 17 years enrolled in Ciao Corona, a prospective school-based cohort study, responded to nested online surveys between 12 January and 24 March 2021 (Q1) and 10 March and 16 May 2021 (Q2). Secondary school children were surveyed at Q1 and Q2, and primary school children at Q2 only. Surveys for parents and their children included questions on the children's perception of the usefulness of masks and mask wearing behaviour by applying a non-validated questionnaire. Associations between perceived usefulness of masks and child's school level and gender, and parents' educational attainment were analysed with Pearson's and McNemar's chi-square tests. Free-text comments provided by children were classified into categories of expressed attitude towards mask wearing. RESULTS: A total of 595 (54% girls) and 1118 (52% girls) school children with predominantly Swiss nationality and a high socioeconomic status responded to online questionnaires at Q1 and Q2, respectively. More than half of the school children perceived masks to be useful at school (Q1: 60% and Q2: 57%) and in public (Q1: 69% and Q2 :60%). Girls perceived masks as useful more often than boys (at Q2 at school: 61% versus 53%, in public: 64% versus 57%), and children of parents with high educational attainment more often than those of parents with lower educational attainment (at Q2 at school: 61% versus 49%, in public: 63% versus 54%). At Q1 and Q2 each, about 20% of children provided individual statements about masks, of which 36% at Q1 and 16% at Q2 reported side effects and discomfort such as skin irritations, headache or difficulties breathing during physical education. CONCLUSIONS: Approximately 60% of school children perceived masks at school and in public places as useful. A small but non-negligible proportion of children reported discomfort and side effects that should be considered to ensure high adherence to mask wearing among school children. A validation of the questionnaire is needed.


Subject(s)
COVID-19 , Masks , Pandemics , Adolescent , COVID-19/prevention & control , COVID-19/psychology , Child , Female , Health Care Surveys , Humans , Internet , Longitudinal Studies , Male , Pandemics/prevention & control , Perception , Prospective Studies , SARS-CoV-2 , Switzerland
15.
Cien Saude Colet ; 25(suppl 1): 2447-2456, 2020 Jun.
Article in Spanish | MEDLINE | ID: covidwho-1725047

ABSTRACT

The scope of this work is to explore the feelings and expectations that COVID-19 has generated in Argentina during the first stage of the pandemic. A survey of the World Health Organization adapted to the local context was applied. Open-ended questions were included to study people's feelings about COVID-19, and content analysis was subsequently conducted. In terms of results, it is revealed that the population surveyed feels uncertainty, fear and anguish, albeit a feeling of responsibility and care in the face of COVID-19 also emerges. Moreover, positive feelings regarding society stand out as an achievement of social interdependence. The results obtained show that the impact on mental health differs in accordance with gender, educational level, and perceived comfort in the home. The study concludes that the emotional and bonding dimensions of people are central to confronting the COVID-19 pandemic in Argentina. It is recommended that these dimensions, as well as their subjective and differential social impact among the different population groups, should be considered in the planning of policies to address the COVID-19 pandemic.


El objetivo de este trabajo es explorar los sentimientos y expectativas que genera el COVID-19 en Argentina durante la primera etapa de la pandemia. Se aplicó una encuesta de la Organización Mundial de la Salud adaptada al contexto local. Se incluyeron preguntas abiertas para indagar sentimientos de las personas frente al COVID-19, y se realizó un análisis de contenido. Como resultados se advierte que la población encuestada siente incertidumbre, miedo y angustia, pero también emerge un sentimiento de responsabilidad y cuidado frente al COVID-19. Así mismo se destacan sentimientos positivos para la sociedad como una valoración de la interdependencia social. Los resultados arribados señalan que el impacto en la salud mental es desigual según el género, el nivel educativo alcanzado y el confort percibido en el hogar. El estudio permite concluir que las dimensiones emocionales y vinculares de las personas resultan aspectos centrales ante la pandemia del COVID-19 en Argentina. Es recomendable que estas dimensiones, así como y su impacto subjetivo y social diferencial entre los diversos grupos poblacionales, sean consideradas en la planificación de políticas para afrontar el COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Emotions , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Adult , Age Factors , Aged , Anxiety/epidemiology , Argentina/epidemiology , COVID-19 , Coronavirus Infections/prevention & control , Cross-Sectional Studies , Educational Status , Fear , Female , Health Care Surveys/statistics & numerical data , Health Impact Assessment/statistics & numerical data , Humans , Male , Mental Health , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Uncertainty , Vulnerable Populations/psychology
16.
J Pediatr Gastroenterol Nutr ; 70(6): 727-733, 2020 06.
Article in English | MEDLINE | ID: covidwho-1722710

ABSTRACT

INTRODUCTION: With the current coronavirus disease 2019 (COVID-19) pandemic, concerns have been raised about the risk to children with inflammatory bowel diseases (IBD). We aimed to collate global experience and provide provisional guidance for managing paediatric IBD (PIBD) in the era of COVID-19. METHODS: An electronic reporting system of children with IBD infected with SARS-CoV-2 has been circulated among 102 PIBD centres affiliated with the Porto and Interest-group of ESPGHAN. A survey has been completed by major PIBD centres in China and South-Korea to explore management during the pandemic. A third survey collected current practice of PIBD treatment. Finally, guidance points for practice have been formulated and voted upon by 37 PIBD authors and Porto group members. RESULTS: Eight PIBD children had COVID-19 globally, all with mild infection without needing hospitalization despite treatment with immunomodulators and/or biologics. No cases have been reported in China and South Korea but biologic treatment has been delayed in 79 children, of whom 17 (22%) had exacerbation of their IBD. Among the Porto group members, face-to-face appointments were often replaced by remote consultations but almost all did not change current IBD treatment. Ten guidance points for clinicians caring for PIBD patients in epidemic areas have been endorsed with consensus rate of 92% to 100%. CONCLUSIONS: Preliminary data for PIBD patients during COVID-19 outbreak are reassuring. Standard IBD treatments including biologics should continue at present through the pandemic, especially in children who generally have more severe IBD course on one hand, and milder SARS-CoV-2 infection on the other.


Subject(s)
Coronavirus Infections/therapy , Inflammatory Bowel Diseases/therapy , Pneumonia, Viral/therapy , Adolescent , Adult , Betacoronavirus , COVID-19 , Child , Consensus , Coronavirus Infections/chemically induced , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Health Care Surveys , Humans , Immunologic Factors/adverse effects , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/epidemiology , Pandemics , Pneumonia, Viral/chemically induced , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Severity of Illness Index
17.
Dermatol Online J ; 27(10)2021 Oct 15.
Article in English | MEDLINE | ID: covidwho-1643785

ABSTRACT

Teledermatology has been widely adopted during the COVID-19 pandemic as virtual patient care promotes social distancing and decreases viral exposure risk. As teledermatology has become more prominent during this period, it is essential to assess whether virtual visits allow for adequate patient care. To assess perceptions of advantages and disadvantages of teledermatology, a survey was sent to academic dermatologists through the Association of Professors of Dermatology (APD) listserv. Of the physicians surveyed, 94% reported their departments had implemented teledermatology during the COVID-19 pandemic. The majority (64%) described teledermatology as an effective tool for patient care because of improved access to care, decreased risk of COVID-19 exposure, and convenience. Frequently cited limitations of teledermatology were image quality, technical difficulties, and inability to perform a comprehensive skin examination. Thirty-seven percent of respondents reported teledermatology as a contributor to their professional burnout. Although teledermatology has become more prevalent as a result of the pandemic, its role moving forward is uncertain given its limitations.


Subject(s)
COVID-19/epidemiology , Dermatologists , Dermatology/methods , Pandemics , Telemedicine , Adult , Age Distribution , Aged , Burnout, Professional/etiology , COVID-19/prevention & control , Computer Terminals/standards , Dermatologists/psychology , Dermatologists/statistics & numerical data , Dermatology/trends , Female , Health Care Surveys , Health Services Accessibility , Humans , Male , Middle Aged , Physical Examination , Sex Distribution , Telemedicine/trends , Uncertainty
18.
Pancreas ; 50(9): 1305-1309, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1621704

ABSTRACT

OBJECTIVES: It is unknown to what extent coronavirus 2019 (COVID-19) may co-occur with acute pancreatitis (AP) in children and how their clinical course may differ from children with AP alone. METHODS: An online survey was sent to pediatric gastroenterologists to report on COVID-19 and AP cases from December 11, 2020, to February 26, 2021. RESULTS: From 72 respondents (20 countries, 5 continents), 22 cases of positive COVID-19 infection and AP were reported. Patients were predominantly White or Hispanic/Latinx (73%), female (68%), and adolescents (68%). For 86% of patients, this was their first episode of AP. Sixty-eight percent of positive COVID-19 tests were polymerase chain reaction based. There was significant morbidity; 60% required intensive care, 45% had multiorgan involvement, and 24% developed shock. Eleven percent had pancreatic necrosis. Abnormal clotting and systemic inflammatory laboratories were common (31%-92% and 93%, respectively). Median length of symptomatic pancreatitis recovery was 1.8× longer than AP without COVID-19. CONCLUSIONS: Coronavirus 2019 infection and AP co-occur primarily in children without a prior history of pancreatitis. Given the increased need for intensive care, multiorgan involvement, and potentially higher risk for pancreatic necrosis, pediatric providers should have a high level of suspicion for AP in children with COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Multiple Organ Failure/epidemiology , Pancreatitis/epidemiology , Adolescent , Age Factors , COVID-19/diagnosis , COVID-19/therapy , Child , Child, Preschool , Comorbidity , Female , Health Care Surveys , Humans , Infant , Infant, Newborn , Male , Multiple Organ Failure/diagnosis , Multiple Organ Failure/therapy , Pancreatitis/diagnosis , Pancreatitis/therapy , Prognosis , Risk Assessment , Risk Factors , Symptom Assessment , Young Adult
19.
J Arthroplasty ; 37(8): 1426-1430.e3, 2022 08.
Article in English | MEDLINE | ID: covidwho-1616375

ABSTRACT

BACKGROUND: A survey was conducted at the 2021 Annual Meeting of the American Association of Hip and Knee Surgeons (AAHKS) to evaluate current practice management strategies among AAHKS members. METHODS: An application was used by AAHKS members to answer both multiple-choice and yes or no questions. Specific questions were asked regarding the impact of COVID-19 pandemic on practice patterns. RESULTS: There was a dramatic acceleration in same day total joint arthroplasty with 85% of AAHKS members performing same day total joint arthroplasty. More AAHKS members remain in private practice (46%) than other practice types, whereas fee for service (34%) and relative value units (26%) are the major form of compensation. At the present time, 93% of practices are experiencing staffing shortages, and these shortages are having an impact on surgical volume. CONCLUSION: This survey elucidates the current practice patterns of AAHKS members. The pandemic has had a significant impact on some aspects of practice activity. Future surveys need to monitor changes in practice patterns over time.


Subject(s)
Ambulatory Surgical Procedures , Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , COVID-19 , Health Workforce , Orthopedics , Practice Management , Ambulatory Surgical Procedures/statistics & numerical data , Arthroplasty, Replacement, Hip/economics , Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Hip/statistics & numerical data , Arthroplasty, Replacement, Knee/economics , Arthroplasty, Replacement, Knee/methods , Arthroplasty, Replacement, Knee/statistics & numerical data , COVID-19/epidemiology , Delivery of Health Care/statistics & numerical data , Health Care Surveys/statistics & numerical data , Health Workforce/statistics & numerical data , Humans , Orthopedics/economics , Orthopedics/organization & administration , Orthopedics/statistics & numerical data , Pandemics , Practice Management/economics , Practice Management/organization & administration , Practice Management/statistics & numerical data , Practice Patterns, Physicians'/economics , Practice Patterns, Physicians'/organization & administration , Practice Patterns, Physicians'/statistics & numerical data , Professional Practice/economics , Professional Practice/organization & administration , Professional Practice/statistics & numerical data , United States/epidemiology
20.
J Child Neurol ; 37(2): 127-132, 2022 02.
Article in English | MEDLINE | ID: covidwho-1602856

ABSTRACT

INTRODUCTION: This study was designed to assess current recommendations from child neurologists and epileptologists on masking for school-age children with epilepsy. METHODS: A 7-item survey was created and sent out to members of the Child Neurology Society and Pediatric Epilepsy Research Consortium in August of 2021 to assess current practice and provider recommendations on masking. RESULTS: One hundred four individuals participated with representation from all regions of the United States. Masking was recommended by 95.1%, with 63.4% (n = 66) noting exception of those with severe intellectual disability, autism, and behavioral problems. Of those who write exemption letters, 54% write these <5% of the time. Only 3% reported potential adverse events associated with masking. CONCLUSION: Nearly all respondents recommended masking for school-age children with epilepsy. Potential risks of masking and adverse events were low. Improved guidance on masking is needed to ensure academic success of our patients with epilepsy.


Subject(s)
COVID-19/prevention & control , Epilepsy/physiopathology , Health Care Surveys/statistics & numerical data , Masks/statistics & numerical data , Child , Consensus , Humans , Neurologists/statistics & numerical data , SARS Virus , United States
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