Aspirin is associated with lower risks of severe covid-19 disease: a population-based study

IntroductionThe use of aspirin has been hypothesized to improve severe clinical outcomes in COVID-19 infection. The present study aims to evaluate the effect of both antecedent and inpatient aspirin use, individually and concomitant with other medications, on severe disease outcomes in COVID-19 positive patients treated with steroids/antiviral therapy.MethodsConsecutive patients who attended Hong Kong's public hospitals or outpatient clinics between 1st January and 8th December 2020 for COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) and received steroids/antiviral therapy were included. Propensity score matching (1:1) between aspirin users and non-users was performed. The primary endpoint was the composite outcome of the need for intubation and 30-day all-cause mortality.ResultsA total of 2664 RT-PCR positive and hospitalized COVID-19 patients receiving steroids/antiviral therapy were included (male= 50.7%, baseline age= 52.3 [35.2-64.6] years old). Over follow-up, 2.96% suffered from 30-day all-cause mortality. Univariable logistic regression showed that aspirin use was associated with lower odds of severe COVID-19 in the propensity score-matched cohort (odds ratio [OR]: 0.33, 95% confidence interval [CI]: [0.18, 0.6];P=0.0003). This association remained significant following adjustment for significant confounders (OR= 0.33, 95% CI= [0.18, 0.59], P= 0002).ConclusionAspirin use was associated with lower odds of severe outcomes in COVID-19.Conflict of InterestNone

Health visiting in the UK in light of the COVID-19 pandemic experience (RReHOPE): a realist review protocol.

INTRODUCTION: Health visiting services, providing support to under 5s and their families, are organised and delivered in very different ways in different parts of the UK. While there has been attention to the key components of health visiting practice and what works well and how, there is little research on how health visiting services are organised and delivered and how that affects their ability to meet their objectives. The COVID-19 pandemic rapidly disrupted service delivery from March 2020. This realist review aims to synthesise the evidence on changes during the pandemic to identify the potential for improving health visiting services and their delivery. METHODS AND ANALYSIS: This review will follow the RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) quality standards and Pawson's five iterative stages to locate existing theories, search for evidence, select literature, extract data, synthesise evidence and draw conclusions. It will be guided by stakeholder engagement with practitioners, commissioners, policymakers, policy advocates and people with lived experience. This approach will consider the emerging strategies and evolving contexts in which the services are delivered, and the varied outcomes for different groups. A realist logic of analysis will be used to make sense of what was happening to health visiting services during and following the pandemic response through the identification and testing of programme theories. Our refined programme theory will then be used to develop recommendations for improving the organisation, delivery and ongoing postpandemic recovery of health visiting services. ETHICS AND DISSEMINATION: General University Ethics Panel approval has been obtained from University of Stirling (reference 7662). Dissemination will build on links to policymakers, commissioners, providers, policy advocates and the public. A range of audiences will be targeted using outputs tailored to each. A final stakeholder event focused on knowledge mobilisation will aid development of recommendations. PROSPERO REGISTRATION NUMBER: CRD42022343117.

A Remote Music-Based Service-Learning Project to Support Isolated Older Adults in Long-Term Care

Growth of the aging population warrants a commitment to teaching students to work effectively with older adults. In an online university course focused on inclusive music practices, students engaged in an extensive service-learning project to enhance course learning objectives and increase sensitivity to disability, social justice, and inclusion issues across the lifespan. Based on community needs, one student aimed to reduce isolation among older adults living in a long-term care facility. The student selected this target and population because of the detrimental effects of isolation on psychosocial, cognitive, and physical well-being;and reduced access to interactive programs and services among older adults living in residential facilities during the COVID-19 pandemic. Components of the project included a service-learning proposal, an annotated bibliography, an interview with the community partner, three activity designs, and a reflective essay. Based on existing research regarding interventions used to reduce isolation among older adults, the three activities the student designed were music bingo, interactive singing, and stretches to music. Throughout the service-learning process, the student consulted the community partner to ensure relevance of the activities. Principles of Universal Design for Learning (UDL), such as providing multiple visual and auditory means to engage with materials, enhanced accessibility of the activities. In this presentation, the student and course instructor will reflect on this case experience and the value of service-learning to foster professional skill development, engaged citizenship in working effectively with older adults, and an appreciation of the need for justice, equity, and fairness for all community members.