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1.
Tech Innov Gastrointest Endosc ; 23(3): 234-243, 2021.
Article in English | MEDLINE | ID: covidwho-1984124

ABSTRACT

BACKGROUND: Patients' perception regarding the risks of COVID-19 infection with gastrointestinal (GI) and the preventive measures taken in GI endoscopy units to mitigate infection risk remains unclear. We aimed to assess patients' perception regarding risks of COVID-19 with GI endoscopy and the changes in the endoscopy unit as a result of the ongoing pandemic. METHODS: Outpatients undergoing GI endoscopy at our institution were categorized into those scheduled to undergo GI endoscopy (preprocedure) and those who had recently undergone GI endoscopy during the pandemic (postprocedure). Two separate but similar survey instruments were designed. Patients were asked to respond on a 5-point Likert scale. Responses were stratified as "low," "neutral," and "high" for analysis. RESULTS: A total of 150 and 355 respondents completed the preprocedure and postprocedure surveys, with a combined response rate of 82.5%. Non-white ethnicity was associated with reporting a "high" level of concern for endoscopy related COVID-19 exposure in both the preprocedure (OR 4.09, 95% CI 1.54-10.82) and postprocedure cohorts (OR 2.11, 95% CI 1.04-4.29). 42% of patients in the preprocedure cohort and 11.8% in the postprocedure cohort reported their level of concern for COVID exposure as "high." Among the postprocedure cohort, 88% of the patients were likely to undergo repeat endoscopy during the pandemic if recommended. CONCLUSION: Patients are willing to undergo GI endoscopy during the COVID-19 pandemic. Non-white and older patients, and those undergoing screening examinations were more concerned with the GI endoscopy related COVID-19 transmission risk.

2.
Endocr Metab Immune Disord Drug Targets ; 21(12): 2119-2130, 2021.
Article in English | MEDLINE | ID: covidwho-1714872

ABSTRACT

Presently the world is witnessing the most devastating pandemic in the history of mankind caused by Severe Acute Respiratory Syndrome or SARS-CoV-2. This dreaded pandemic is responsible for escalated mortality rates across the globe and this is the worst catastrophe in the history of mankind. Since its outbreak, substantial scientific explorations focusing on the formulation of novel therapeutical and/or adjunct intervention against the disease are continuously in the pipeline. However, till date, no effective therapy has been approved and hence the present alarming situation urges the necessity of exploring novel, safe and efficient interventional strategies. Functionally, terpenoids are a class of secondary plant metabolites having multi facet chemical structures and are categorically documented to be the largest reservoir of bioactive constituents, predominant in nature. Intriguingly, very little is scientifically explored or reviewed in regards to the anti-CoV-2 attributes of terpenoids. The present article thus aims to revisit the antiviral efficacy of terpenoids by reviewing the current scientific literature and thereby provide an opinion on the plausibility of exploring them as potential therapeutical intervention to deal with ongoing CoV-2 pandemic.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , SARS-CoV-2/drug effects , Terpenes/therapeutic use , Animals , Antiviral Agents/adverse effects , COVID-19/physiopathology , COVID-19/virology , Host-Pathogen Interactions , Humans , SARS-CoV-2/pathogenicity , Terpenes/adverse effects
3.
Transbound Emerg Dis ; 68(6): 3643-3657, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1526427

ABSTRACT

The coronavirus disease 2019 (COVID-19) is an emerging and rapidly evolving profound pandemic, which causes severe acute respiratory syndrome and results in significant case fatality around the world including Bangladesh. We conducted this study to assess how COVID-19 cases clustered across districts in Bangladesh and whether the pattern and duration of clusters changed following the country's containment strategy using Geographic information system (GIS) software. We calculated the epidemiological measures including incidence, case fatality rate (CFR) and spatiotemporal pattern of COVID-19. We used inverse distance weighting (IDW), Geographically weighted regression (GWR), Moran's I and Getis-Ord Gi* statistics for prediction, spatial autocorrelation and hotspot identification. We used retrospective space-time scan statistic to analyse clusters of COVID-19 cases. COVID-19 has a CFR of 1.4%. Over 50% of cases were reported among young adults (21-40 years age). The incidence varies from 0.03 - 0.95 at the end of March to 15.59-308.62 per 100,000, at the end of July. Global Moran's Index indicates a robust spatial autocorrelation of COVID-19 cases. Local Moran's I analysis stated a distinct High-High (HH) clustering of COVID-19 cases among Dhaka, Gazipur and Narayanganj districts. Twelve statistically significant high rated clusters were identified by space-time scan statistics using a discrete Poisson model. IDW predicted the cases at the undetermined area, and GWR showed a strong relationship between population density and case frequency, which was further established with Moran's I (0.734; p ≤ 0.01). Dhaka and its surrounding six districts were identified as the significant hotspot whereas Chattogram was an extended infected area, indicating the gradual spread of the virus to peripheral districts. This study provides novel insights into the geostatistical analysis of COVID-19 clusters and hotspots that might assist the policy planner to predict the spatiotemporal transmission dynamics and formulate imperative control strategies of SARS-CoV-2 in Bangladesh. The geospatial modeling tools can be used to prevent and control future epidemics and pandemics.


Subject(s)
COVID-19 , Animals , Bangladesh/epidemiology , COVID-19/veterinary , Pandemics , Retrospective Studies , SARS-CoV-2 , Spatial Analysis
4.
Acta Neurol Scand ; 143(2): 206-209, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1388169

ABSTRACT

BACKGROUND: Lockdown due to the SARS-CoV-2 pandemic became a challenge to maintain care for patients with epilepsy; we aimed to find out how the pandemic affected them. METHODS: We sent an online 22-item questionnaire to patients from our outpatient clinic, a reference centre in Spain for drug-resistant epilepsy, inquiring about the effects of lockdown, from March to May 2020. RESULTS: We sent the survey to 627 patients; 312 (58% women) sent a complete response and were included. Of all respondents, 57% took >2 antiseizure medications. One-third of respondents (29%) declared an associated cognitive or motor disability. A minority had confirmed infection with SARS-CoV-2 (1.92%). Seizure frequency remained like usual in 56% of patients, while 31.2% reported an increase. Less than 10% needed emergent assistance. Almost half reported anxiety or depression, and 25% increased behavioural disorders. Mood (F: 5.40; p: 0.002) and sleep disorders (F = 2.67; p: 0.05) were associated with increase in seizure frequency. Patients were able to contact their physicians when needed and were open to a future telematic approach to follow-up visits. CONCLUSIONS: Seizure frequency and severity remained unchanged in most patients during the lockdown. Mood and sleep disorders were common and associated with seizure worsening. Patients were open to telematic care in the future.


Subject(s)
COVID-19 , Epilepsy/therapy , Pandemics , Quarantine/statistics & numerical data , Adult , Anticonvulsants/therapeutic use , Anxiety/complications , COVID-19/complications , COVID-19/epidemiology , Cognition Disorders/complications , Communicable Disease Control , Depression/complications , Disabled Persons , Epilepsy/complications , Female , Humans , Male , Mental Disorders/complications , Mental Disorders/epidemiology , Middle Aged , Motor Disorders/complications , Outpatients , Seizures/epidemiology , Sleep Wake Disorders/classification , Sleep Wake Disorders/epidemiology , Spain/epidemiology , Surveys and Questionnaires , Telemedicine
5.
J Nurs Manag ; 29(7): 1893-1905, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1297804

ABSTRACT

AIM: To appraise and synthesize studies examining resilience, coping behaviours and social support among health care workers during the coronavirus pandemic. BACKGROUND: A wide range of evidence has shown that health care workers, currently on the frontlines in the fight against COVID-19, are not spared from the psychological and mental health-related consequences of the pandemic. Studies synthesizing the role of coping behaviours, resilience and social support in safeguarding the mental health of health care workers during the pandemic are largely unknown. EVALUATION: This is a systematic review with a narrative synthesis. A total of 31 articles were included in the review. KEY ISSUES: Health care workers utilized both problem-centred and emotion-centred coping to manage the stress associated with the coronavirus pandemic. Coping behaviours, resilience and social support were associated with positive mental and psychological health outcomes. CONCLUSION: Substantial evidence supports the effectiveness of coping behaviours, resilience and social support to preserve psychological and mental health among health care workers during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: In order to safeguard the mental health of health care workers during the pandemic, hospital and nursing administrators should implement proactive measures to sustain resilience in HCWs, build coping skills and implement creative ways to foster social support in health care workers through theory-based interventions, supportive leadership and fostering a resilient work environment.


Subject(s)
COVID-19 , Resilience, Psychological , Adaptation, Psychological , Health Personnel , Humans , Pandemics , SARS-CoV-2 , Social Support
7.
Internist (Berl) ; 62(7): 706-717, 2021 Jul.
Article in German | MEDLINE | ID: covidwho-1274798

ABSTRACT

Since the beginning of 2020 the coronavirus disease 2019 (COVID-19) pandemic has extensively impacted medical care in Germany and worldwide. Germany is currently facing the so-called third wave of the COVID-19 pandemic. This is exacerbated by emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants with increased virus transmission and severe courses of disease. Rising numbers of SARS-CoV­2 infections translate into an increasing number of severe COVID-19 cases requiring intensive care, which interacts with limited structural and personnel resources for COVID-19 and non-COVID-19 critically ill patients. Therefore, prioritization and triage for critically ill patients with allocation of intensive care capacities becomes necessary, as with all situations with higher strain on capacities. Both strategies are meaningful forms of organization and are not to be equated with a collapse of medical care. Cardiovascular comorbidities and cardiac involvement in COVID-19 are of particular importance for disease severity and the clinical course. In addition to the medical care of patients with SARS-CoV­2 infections due to the pandemic, other patients with acute sometimes life-threatening diseases must also continue to receive high-quality treatment. This article provides a current overview of proposed restructuring measures in German hospitals as well as the accompanying triage and prioritization algorithms. Moreover, it is necessary to adapt existing treatment algorithms to the pandemic situation. Due their special importance this is sketched using cardiovascular diseases as an example.


Subject(s)
COVID-19 , Cardiovascular Diseases , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/therapy , Germany , Humans , Pandemics , SARS-CoV-2 , Triage
8.
Health Secur ; 19(S1): S14-S26, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1254356

ABSTRACT

The long, fallacious history of attributing racial disparities in public health outcomes to biological inferiority or poor decision making persists in contemporary conversations about the COVID-19 pandemic. Given the disproportionate impacts of this pandemic on communities of color, it is essential for scholars, practitioners, and policymakers to focus on how structural racism drives these disparate outcomes. In May and June 2020, we conducted a 6-state online survey to examine racial/ethnic differences in exposure to COVID-19, risk mitigation behaviors, risk perceptions, and COVID-19 impacts. Results show that Black and Hispanic individuals were more likely than White respondents to experience factors associated with structural racism (eg, living in larger households, going to work in person, using public transportation) that, by their very nature, increase the likelihood of exposure to COVID-19. Controlling for other demographic and socioeconomic characteristics, non-White respondents were equally or more likely than White respondents to take protective actions against COVID-19, including keeping distance from others and wearing masks. Black and Hispanic respondents also perceived higher risks of dying of the disease and of running out of money due to the pandemic, and 40% of Black respondents reported knowing someone who had died of COVID-19 at a time when the US death toll had just surpassed 100,000 people. To manage the current pandemic and prepare to combat future health crises in an effective, equitable, and antiracist manner, it is imperative to understand the structural factors perpetuating racial inequalities in the COVID-19 experience.


Subject(s)
Attitude to Health/ethnology , COVID-19/psychology , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Racism/statistics & numerical data , Adult , African Americans/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , /statistics & numerical data , Humans , Male , Middle Aged , Social Isolation , Socioeconomic Factors , Surveys and Questionnaires , United States , Young Adult
9.
J Matern Fetal Neonatal Med ; : 1-5, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1246625

ABSTRACT

OBJECTIVE: Assess women's perceptions of the impact of COVID-19 on their health care and well-being, access to and satisfaction with medical care due to the changes in delivery of care triggered by the pandemic. METHODS: An online survey of women having health care appointments in the outpatient facilities across all divisions of a Department of Obstetrics and Gynecology at a tertiary care referral center in North Central Florida. Patients had outpatient appointments that were scheduled, canceled or rescheduled, in person or by telemedicine, between 11 March 2020 and 11 May 2020, a time during which a COVID-19 stay-at-home order was enacted across our state. A total of 6,697 visits were planned. Patients with multiple visits were unified, leaving 6,044 unique patients to whom the survey was emailed between 20 July 2020 and 31 July 2020. The survey was closed on 21 August 2020. Analyses were focused on simple descriptive statistics to assess frequency of responses. Analyses of variance and chi-square analyses were conducted to compare outcomes when all cells were ≥ 10, based on sub-specialty and insurance status; otherwise, frequencies were examined for the entire sample only. Missing data were excluded listwise. RESULTS: A total of 6044 patients were contacted. Completed surveys numbered 1,083 yielding a response rate of 17.9%. The most common sub-specialty visit was gynecology (56.7%) followed by obstetrics (31.5%,), pelvic floor disorders (4.8%), gynecological oncology (2.9%,), and reproductive endocrinology (0.5%). A substantial percentage of women had visits canceled (19.2%), rescheduled (32.8%) or changed (42.1%) to telemedicine. In our patient population, 32.6% were worried about visiting the clinic and 48.1% were worried about visiting the hospital. COVID-19 triggered changes were perceived to have a negative impact by 26.1% of respondents. Refusal of future telemedicine visits was by 17.2%, however, 75.2% would prefer to use both in-person and telemedicine visits. CONCLUSION: During the initial COVID-19 surge with lockdown, the majority of survey respondents were following public health precautions. However, there were significant concerns amongst women related to obstetric and gynecologic medical appointments scheduled during that period. During pandemics, natural disasters and similar extreme circumstances, digital communication and telemedicine have the potential to play a critical role in providing reassurance and care. Nevertheless, given the concerns expressed by survey respondents, communication and messaging tools are needed to increase comfort and ensure equity with the rapidly changing methods of care delivery.

10.
Med Clin (Barc) ; 157(8): 388-394, 2021 10 22.
Article in English, Spanish | MEDLINE | ID: covidwho-1244786

ABSTRACT

COVID-19 pandemic has impacted the world population, with a high rate of morbidity and mortality. While the evidence to date has attempted to describe clinical feature of acute illness, recent reports have also begun to describe persistent symptoms that extend beyond the initial period of illness. Adverse outcomes, in addition to respiratory, have been found to occur at different levels: cardiovascular, neurological, or immunological; skin, gastrointestinal or renal manifestations. The detrimental effect on mental health has also been described, not only in COVID-19 patients. The burden of disease secondary to this pandemic is likely to be enormous and not limited to acute disease alone, thus epidemiological studies are needed to further investigate the long-term impact of this disease. This review summarizes the current evidence on short-term effects and describes the possible long-term sequelae of COVID-19.


Subject(s)
COVID-19 , Pandemics , Humans , SARS-CoV-2
11.
Turk Gogus Kalp Damar Cerrahisi Derg ; 29(2): 252-258, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1239111

ABSTRACT

Novel coronavirus-2019 (COVID-19) pandemic has affected all over the world, leading to viral pneumonia-complicating severe acute respiratory distress syndrome and death. Although there is no proven definitive treatment yet, physicians use some assistive methods based on the previous epidemic viral acute respiratory distress syndrome experiences. Extracorporeal membrane oxygenation is one of them. In this report, we present one of the longest survived extracorporeal membrane oxygenation case (71 days) with COVID-19 infection and the pathology of the infected lung, with our veno-venous extracorporeal membrane oxygenation strategy.

12.
Sci Immunol ; 6(59)2021 05 18.
Article in English | MEDLINE | ID: covidwho-1234280

ABSTRACT

Coronaviruses are a family of RNA viruses that cause acute and chronic diseases of the upper and lower respiratory tract in humans and other animals. SARS-CoV-2 is a recently emerged coronavirus that has led to a global pandemic causing a severe respiratory disease known as COVID-19 with significant morbidity and mortality worldwide. The development of antiviral therapeutics are urgently needed while vaccine programs roll out worldwide. Here we describe a diamidobenzimidazole compound, diABZI-4, that activates STING and is highly effective in limiting SARS-CoV-2 replication in cells and animals. diABZI-4 inhibited SARS-CoV-2 replication in lung epithelial cells. Administration of diABZI-4 intranasally before or even after virus infection conferred complete protection from severe respiratory disease in K18-ACE2-transgenic mice infected with SARS-CoV-2. Intranasal delivery of diABZI-4 induced a rapid short-lived activation of STING, leading to transient proinflammatory cytokine production and lymphocyte activation in the lung associated with inhibition of viral replication. Our study supports the use of diABZI-4 as a host-directed therapy which mobilizes antiviral defenses for the treatment and prevention of COVID-19.


Subject(s)
Antiviral Agents/pharmacology , Benzimidazoles/pharmacology , COVID-19/drug therapy , COVID-19/prevention & control , Membrane Proteins/agonists , SARS-CoV-2/drug effects , A549 Cells , Animals , CD8-Positive T-Lymphocytes/immunology , Cell Line , Chlorocebus aethiops , Enzyme Activation/drug effects , Epithelial Cells/virology , Female , Humans , Killer Cells, Natural/immunology , Lymphocyte Activation/drug effects , Male , Membrane Proteins/metabolism , Mice , Mice, Knockout , SARS-CoV-2/growth & development , Vero Cells , Virus Replication/drug effects
13.
Front Endocrinol (Lausanne) ; 12: 602735, 2021.
Article in English | MEDLINE | ID: covidwho-1231329

ABSTRACT

Coronavirus disease 2019 (COVID-19), which was named by the World Health Organization (WHO) in February 2020, has quickly spread to more than 200 countries around the world and was declared as a global pandemic in March 2020. The severity of the disease makes it more prone to severe symptoms and higher mortality rates in patients, especially those who are with comorbidities, including high blood pressure, cardiovascular disease, obesity, and diabetes, increases the concern over the consequences of this pandemic. However, initial reports do not clearly describe whether diabetes itself or associated comorbidities or treatment strategies contribute to the severe prognosis of COVID-19 infections. Various clinical trials are being conducted on glucose-lowering agents but to date, there is no standard treatment protocol approved for COVID-19 cases with pre-existing diabetes. This review is aimed to decipher the potential risk factors of COVID-19 involved from existing evidence. Identification of a novel therapeutic strategy could be beneficial for combating SARS-CoV-2, which might be dreadful to debilitating people who have diabetes.


Subject(s)
COVID-19/therapy , Diabetes Complications/therapy , Diabetes Mellitus/therapy , COVID-19/complications , Comorbidity , Humans , Risk Factors
14.
Front Pharmacol ; 12: 596855, 2021.
Article in English | MEDLINE | ID: covidwho-1226982

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is caused by an infectious novel strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which was earlier referred to as 2019-nCoV. The respiratory disease is the most consequential global public health crisis of the 21st century whose level of negative impact increasingly experienced globally has not been recorded since World War II. Up till now, there has been no specific globally authorized antiviral drug, vaccines, supplement or herbal remedy available for the treatment of this lethal disease except preventive measures, supportive care and non-specific treatment options adopted in different countries via divergent approaches to halt the pandemic. However, many of these interventions have been documented to show some level of success particularly the Traditional Chinese Medicine while there is paucity of well reported studies on the impact of the widely embraced Traditional African Medicines (TAM) adopted so far for the prevention, management and treatment of COVID-19. We carried out a detailed review of publicly available data, information and claims on the potentials of indigenous plants used in Sub-Saharan Africa as antiviral remedies with potentials for the prevention and management of COVID-19. In this review, we have provided a holistic report on evidence-based antiviral and promising anti-SARS-CoV-2 properties of African medicinal plants based on in silico evidence, in vitro assays and in vivo experiments alongside the available data on their mechanistic pharmacology. In addition, we have unveiled knowledge gaps, provided an update on the effort of African Scientific community toward demystifying the dreadful SARS-CoV-2 micro-enemy of man and have documented popular anti-COVID-19 herbal claims emanating from the continent for the management of COVID-19 while the risk potentials of herb-drug interaction of antiviral phytomedicines when used in combination with orthodox drugs have also been highlighted. This review exercise may lend enough credence to the potential value of African medicinal plants as possible leads in anti-COVID-19 drug discovery through research and development.

15.
Trends Ecol Evol ; 36(7): 580-590, 2021 07.
Article in English | MEDLINE | ID: covidwho-1221047

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic can cause reverse zoonoses (i.e., human-animal transmission of COVID-19). It is vital to utilize up-to-date methods to improve the control, management, and prevention of reverse zoonoses. Awareness of reverse zoonoses should be raised at both individual and regional/national levels for better protection of both humans and animals.


Subject(s)
COVID-19 , Animals , Humans , Pandemics , SARS-CoV-2 , Zoonoses
16.
BMJ ; 373: n1157, 2021 May 05.
Article in English | MEDLINE | ID: covidwho-1218224
17.
Front Public Health ; 9: 640282, 2021.
Article in English | MEDLINE | ID: covidwho-1211883

ABSTRACT

The ongoing coronavirus disease 2019 (COVID-19) pandemic has disrupted every aspect of our life. The need to provide high-level care for an enormous number of patients with COVID-19 infection during this pandemic has impacted resourcing for and restricted the routine care of all non-COVID-19 conditions. Since the beginning of the pandemic, the people living with rare disorders, who represent a marginalized group of the population even in a normal world, have not received enough attention that they deserve. Due to the pandemic situation, they have experienced (and experiencing) an extreme inadequacy of regular clinical services, counseling, and therapies they need, which have made their life more vulnerable and feel more marginalized. Besides, the clinicians, researchers, and scientists working on rare genetic diseases face extra challenges due to the pandemic. Many ongoing research projects and clinical trials for rare and genetic diseases were stalled to avoid patients' and research staff's transmission to COVID-19. Still, with all the odds, telehealth and virtual consultations for rare disease patients have shown hope. The clinical, organizational, and economic challenges faced by institutions, patients, their families, and the caregivers during the pandemic indicate the importance of ensuring continuity of care in managing rare diseases, including adequate diagnostics and priority management strategies for emergencies. In this review, we endeavored to shed light on the issues the rare disease community faces during the pandemic and the adaptations that could help the rare disease community to better sustain in the coming days.


Subject(s)
COVID-19 , Telemedicine , Humans , Pandemics/prevention & control , Rare Diseases/epidemiology , SARS-CoV-2
18.
Radiography (Lond) ; 27(4): 1044-1051, 2021 11.
Article in English | MEDLINE | ID: covidwho-1211124

ABSTRACT

INTRODUCTION: The radiography profession is built upon strong educational foundations which help ensure graduate radiographers have the required knowledge, skills, and competence to practise safely and effectively. Changing clinical practices, service needs, technological developments, regulatory changes, together with our growing professional evidence-base, all contribute to the need for our curricula to responsive and continually reviewed and enhanced. This study aims to explore similarities and differences in training curricula and follows a 2012 global survey on radiography education and more recent surveys undertaken by the European Federation of Radiographer Societies (EFRS). METHODS: An online questionnaire, based on previous EFRS education and clinical education surveys, which comprised of open and closed questions and consisted of sections designed to ascertain data on: type, level and duration of education programmes leading to an initial or pre-registration qualification in radiography/medical radiation practice, pre-clinical skill development and clinical placement within programmes. The survey was distributed via social media channels and through an international network of professional societies. Descriptive statistics are reported for most analyses while open questions were analysed thematically. RESULTS: Responses were received from 79 individuals from 28 identified countries across four continents. This represented a total of 121 different pre-registration/entry level programmes offered across these institutions. While dedicated diagnostic radiography programmes were most common (42/121), almost one-third of programmes (40/121) offered two or more areas of specialisation within the curriculum. The average of total hours for clinical placement were 1397 h for diagnostic radiography programmes; 1300 h for radiation therapy programmes; 1025 h for nuclear medicine programmes; and 1134 h for combined specialisation programmes, respectively. Institutions provided a range of physical and virtual systems to support pre-clinical skills development. CONCLUSION: Around the world, radiography programmes vary considerably in terms of their level, duration, programme type, pre-clinical and clinical training, use of simulation, and also in terms of class sizes, student/staff ratios, and graduate employment prospects. The ability of graduates to work independently in areas covered within their programmes varied considerably. While some changes around simulation use were evident, given the impact of COVID-19 it would be beneficial for future research to investigate if pre-clinical and clinical education hours or use of simulation resources has changed due to the pandemic. IMPLICATIONS FOR PRACTICE: The heterogeneity that exists between radiography programmes presents a significant challenge in terms of the mutual recognition of qualifications and the international movement of the radiographer workforce.


Subject(s)
COVID-19 , Curriculum , Humans , Internationality , Radiography , SARS-CoV-2
19.
Front Neurol ; 12: 647995, 2021.
Article in English | MEDLINE | ID: covidwho-1210489

ABSTRACT

Introduction: OnabotulinumtoxinA (BT-A) is a preventive treatment for chronic migraine (CM), which needs to be administered regularly by a trained clinician every 3 months. The spread of the severe acute respiratory syndrome coronavirus-2 pandemic has forced many patients to momentarily stop the scheduled BT-A injections. The goal of this study was to explore whether those patients experienced a worsening of their CM and, if any, the clinical predictors of migraine worsening after BT-A withdrawal. Methods: This was a retrospective, multicenter study. Patients' clinical data were obtained from their clinical documentation stored at each center. In particular, the following variables were collected: the mean number of headache days in the last month (NHD), the average number of painkillers taken in the last month (AC), the average number of days in which patients took, at least, one painkiller in the last month (NDM), the average intensity of migraine using the numeric rating scale (NRS) score in the last month, and the average score obtained at the six-item Headache Impact Test. The variables mentioned earlier were compared before and after BT-A withdrawal. Results: After BT-A suspension, there was a significant increase in the NHD (P = 0.0313, Kruskal-Wallis rank test), AC (P = 0.0421, Kruskal-Wallis rank test), NDM (P = 0.0394, paired t-test), NRS score (P = 0.0069, Kruskal-Wallis rank test), and six-item Headache Impact Test score (P = 0.0372, Kruskal-Wallis rank test). Patients who were not assuming other preventive treatments other than BT-A displayed similar results. Patients who experienced a >30% worsening in NHD after BT-A was withdrawn displayed a longer CM history (P = 0.001, Kruskal-Wallis rank test), a longer MOH duration (P = 0.0017, Kruskal-Wallis rank test), a higher AC value at the baseline (P = 0.0149, Kruskal-Wallis rank test), a higher NDM (P = 0.0024, t-test), and a higher average value of the NRS score (P = 0.0073, Kruskal-Wallis rank test). Conclusion: BT-A withdrawn during severe acute respiratory syndrome coronavirus-2 pandemic was associated with a general worsening in patients suffering from CM, hence the need to continue BT-A injection to avoid patients' worsening.

20.
Indian J Ophthalmol ; 69(5): 1264-1270, 2021 May.
Article in English | MEDLINE | ID: covidwho-1207844

ABSTRACT

PURPOSE: COVID-19 pandemic has affected the healthcare system worldwide hindering the continuum of treatment of chronic disease patients. The objective of the study is to analyze the barriers encountered by the glaucoma patients for the follow-up visit and medication adherence during the pandemic. METHODS: This cross-sectional study included glaucoma patients who did not attend the scheduled appointment from April 1, 2020 to July 31, 2020 in a tertiary eye care center (88.21%). Eligible patients of age >18 years and advised antiglaucoma medication in Madurai Zone were interviewed with validated questionnaire through telephonic call. RESULTS: 363 patients answered the questionnaire through telephonic interview. 57.3% of the patients were found to be non-adherent to medication. The main barriers for glaucoma follow-up visit during the pandemic were lockdown restriction, transport problem, and financial difficulties. The top barriers for medication adherence were non availability of medication (54.81%), financial difficulties (30.29%), did not feel much improvement with eye drops (20.19%). On multiple regression analysis, longer distance to hospital, low socioeconomic status, more than one antiglaucoma medication use, lack of awareness of glaucoma, non-complaint before COVID-19 and stress due to the pandemic were found to be significant factors for medication non adherence. CONCLUSION: COVID-19 pandemic has emphasized the need for reformation in health care system for accessibility of medical care to patients in rural areas. Decentralization of health system to primary care level and utilization of teleophthalmology should be considered by health care planners in future.


Subject(s)
COVID-19 , Glaucoma , Ophthalmology , Telemedicine , Adolescent , Communicable Disease Control , Cross-Sectional Studies , Follow-Up Studies , Glaucoma/drug therapy , Glaucoma/epidemiology , Humans , India/epidemiology , Medication Adherence , Pandemics , SARS-CoV-2
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