RESUMEN
Aims: This study examined the impact of the COVID-19 pandemic on mothers or childbearing parents using ongoing, systematic screening of a representative Ontario sample. Method(s): An interrupted time series analysis was conducted on data captured in the Healthy Babies Healthy Children (HBHC) screening tool to determine effects of the pandemic on relationships, support, mental health, and related clinical outcomes at the time of postpartum discharge from hospital. The ability to parent or care for the baby/child and other psychosocial and behavioural outcomes were assessed. Result(s): The co-primary outcomes of inability to parent or care for the baby/child were infrequently observed in both the pre -pandemic (March 9, 2019-March 15, 2020) and initial pandemic periods (March 16, 2020-March 23, 2021) ((parent 209/63,006 (0.33%) to 177/56,117 (0.32%), care 537/62,955 (0.85%) to 324/56,086 (0.58%)). Changes following pandemic onset were not observed for either outcome although a significant (beta = 1.013, 95% CI 1.002-1.025, p = 0.02) increase in slope was observed for inability to parent (with questionable clinical significance). For secondary outcomes, worsening was only seen for complications during labour/delivery. Significant improvements were observed in the likelihood of being unable to identify a support person to assist with care, need of newcomer support, and concerns about money over time. Conclusion(s): Despite more complications during labour/delivery, there were no substantive changes in concerns about ability to parent or care for children. Adverse impacts of the pandemic may have been mitigated by accommodations for remote work and social safety net policies.Copyright © 2023
RESUMEN
BACKGROUND: People with intellectual disabilities (ID) are at high risk of developing respiratory health issues. The COVID-19 pandemic has compounded this, with serious consequences, and for some, death. Despite home-based oxygen saturation monitoring being recommended for people with ID, there is a stark lack of evidence in the literature on its feasibility. METHOD: We conducted 3-day baseline home-based oxygen saturation monitoring, using pulse oximeters, with eight parents of nine adults with ID in Scotland. Two eligible parents also completed a further 2 weeks of monitoring, and returned an evaluation questionnaire on its feasibility. RESULTS: Baseline mean readings for eight adults with ID were within the normal range (%Sp02 ≥ 95), and for another one 94%. Fluctuations over the 3-day assessment period were experienced by six of these individuals. However, these variations were within limits which are not dangerous (lowest reading 92%), implying that parental home-based pulse oximetry monitoring is likely to be safe for adults with ID. The two parents who completed the evaluation found home-based pulse oximetry monitoring to be easy/very easy to do, and effective/very effective. CONCLUSIONS: This is the first research study, albeit with a very small sample, to report on the potential feasibility of parental home-based pulse oximetry monitoring for adults with ID. Home-based pulse oximetry monitoring appears to be safe in adults with ID at risk of developing serious respiratory problems, and not difficult for their parents to do. There is an urgent need to replicate this work, using a larger sample, to promote home-based respiratory health monitoring more widely for people with ID.
Asunto(s)
COVID-19 , Discapacidad Intelectual , Humanos , Adulto , Discapacidad Intelectual/diagnóstico , Pandemias , Oximetría , OxígenoRESUMEN
The demand for higher education has been increasing in Jamaica as in many other Caribbean countries. Those who respond to such demands, pursuing further studies in higher education, will need to navigate many obligations and challenges. Additionally, some individuals may be First Generation (FG) adult learners and may lack the tacit knowledge and emotional sustenance to help them succeed. Consequently, adult learners pursuing postgraduate studies will need support in understanding themselves as learners and how to succeed. This study reports findings on challenges that non-traditional adult learners in a Jamaican higher education context face in pursuing postgraduate studies. Using the photovoice research method, qualitative data were collected from 10 adult learners through photographed representations of prompts, photovoice focus group discussions, and participants' reflections. The main findings revealed that the adult learners experienced multiple conflicting emotions as they engaged in their postgraduate programmes of study;experienced challenges balancing their multiple roles and responsibilities, some of which were linked to their status as FG adult learners;and characterised the COVID-19 pandemic as having a dualistic nature, one that exacerbated challenges whilst also offering them opportunities to focus on their studies as well as themselves. The article makes recommendations for supporting these adult learners at the institutional and personal levels as they pursue their studies.
RESUMEN
This paper describes the changes made to the administration of assessments in the second design trial of the Maths Intensive course at a comprehensive university in South Africa because of Covid-19. The course was designed in direct response to poor attainment in the Primary Teacher Education project's mathematics test. Building on positive findings of improved attainment evident in the first design cycle, the Maths Intensive course was further refined for a second cohort of students, and shifts in attainment were once again analysed. The Covid-19 lockdown meant that student could not write the post-test on campus. As a result, the post-test data were not used to measure impact but, instead, were used to establish what the student teachers knew and were able to do at the end of the course. The Maths Intensive test framework mapped the test items to the learning outcomes for the course. Facility scores revealed areas where students were capable and areas where they still required support. The assumption that students would use calculators in un-invigilated circumstances was challenged, and requires further research. These findings may be of interest to lecturers and teachers seeking to develop assessment reports that provide useable information to improve their instructional design and teaching practice. They may also be of interest to academics and training providers designing mathematics education programmes for initial teacher education or for ongoing professional development courses for teachers in primary schools.
RESUMEN
Background: Potential moral hazards from COVID-19 for patient-facing oncology staff include rationalizing treatment, but prior research into staff distress has not included ancillary/administrative staff or compared geographic settings. We sought to document measures of distress and perceived preparedness from diverse oncology staff during the COVID-19 pandemic response, and correlate these with unfolding events. Methods:We utilized a mixed-methods approach comprising weekly diarising of executive communications and eventsby investigators, and prospective self-administered online surveys-by staff. Survey domains included perceived institutional preparedness, personal wellbeing, and perceived stress using a distress thermometer (0-10, no-extreme distress). Responses were Likert-scaled or free-text. Quantitative responses were aggregated by role/site and analysed using R. These were correlated with emergent qualitative themes using the Framework Method. The study was conducted at a metropolitan and a regional hospital in Queensland, Australia. Results: 12 surveys across 18 weeks commencing April 3, 2020 (encompassing 1st lockdown, lockdown easing, and 2nd lockdown) had 993 individual responses. 40% respondents were located regionally. Role categories included: nursing (50%), allied health (18%), medical (16%), administrative (15%), ancillary (e.g. cleaner, food service) (1%). Emergent themes were: Strategies for protectionat work and home. Up to 27% respondents reported being able to attend to critical personal needs only sometimes or less, although patients were perceived to be well supported most/all of the time (>90% responses). Navigating rules and keeping up-high levels of perceived institutional preparedness in >75% responders coexisted alongside fluctuating levels of self-reported distress, from median 5 (IQR 3-7) at 1st lockdown outset to 1 (IQR 1-4) after lockdown restriction easing. Tempered optimism-pride in one's place was reported both as reflecting healthcare worker identity and as Australians in the context of low local infection rates. No significant differences in distress or preparedness perceptions were evident comparing geographic sites. Framing the new normal-although respondents longitudinally reported increasing familiarity with pandemic directives, distress levels increased concurrently with the announcement of 2nd lockdown. Conclusions: In the context of low local COVID-19 infection rates, oncology staff regardless of role and geographic setting reported high perceptions of institutional preparedness. Distress levels increased concurrently with lockdown phases and reports of distress and psychosocial workload fatigue were made by various workers including administrative and ancillary. These should be considered frontline staff for the purpose of workplace psychosocial support in pandemic responses.
RESUMEN
Introduction: The COVID-19 pandemic demanded reduced face-to-face (FTF) contact. Our department integrated virtual assessment into the incoming referral pathway to enable continuation of high-quality care. This study aimed to assess any potential efficiency benefit of this change in service whilst ensuring no compromise to clinical outcomes. Method: A prospective analysis was undertaken of all hand fractures referred virtually during a seven-week period starting at the initiation of national lockdown. Cost analysis using NHS reference costs, inflated to 2019/20 prices, was performed. Clinical performance was assessed using the British Society for Surgery for the Hand (BSSH) Standards for Open and Closed Hand Fractures. Results: Seventy-six hand fractures were referred;FTF attendance was avoided in 35 cases, with an estimated per-patient cost saving of £179.16. Of the 33 patients who attended FTF, 13 achieved same day non-operative treatment;20 underwent operative intervention with 95% compliance to BSSH standards. No complications occurred. Conclusions: Our pilot model demonstrates potentially significant cost savings of £6270 over a relatively short period, as well as clinical noninferiority. This supports sustained integration of virtual patient assessment in the 'new normal'. Further work across all disciplines is needed to define acceptable limits of telemedicine and new avenues for potential benefit.
RESUMEN
Nurses who work with respiratory patients, have been at the forefront of the pandemic response. Lessons need to be learnt from these nurses' experiences in order to support these nurses during the existing pandemic and retain and mobilise this skilled workforce for future pandemics. This study explores UK nurses' experiences of working in a respiratory environment during the COVID-19 pandemic. We distributed an e-survey via professional respiratory societies [Association of Respiratory Nurse Specialists (ARNS), British Thoracic Society (BTS) and the Primary Care Respiratory Society (PCRS)] and social media in May 2020. The survey included a resilience scale, the GAD7 (anxiety) and the PHQ9 (depression) tools. 255 complete responses were received, predominately women (89%), aged over 40 (71%). Over 95% of the respondents were white, with a very small sample of BAME 58% usually worked in an acute setting, 57% had changed their role due to the pandemic, and 49% were undertaking aerosol generating procedures. There were significant differences in anxiety and depression scores for those undertaking aerosol generating procedures (both p<0.001) and who worked in different clinical settings (depression only, p<0.05) Just over 50% experienced minimal symptoms of anxiety, 28.3% experienced mild symptoms and just over 20.9% experience moderate-to-severe symptoms. Nearly 52% experienced minimal depression symptoms, 30.9% experienced mild symptoms and 17.2% experienced moderate-to-severe symptoms. 45.8% had a moderate or moderately high resilience score. Regression analysis showed that being younger, having fewer years of nursing experience, and feeling unable to support your household were key predictors of increased symptoms of anxiety and depression. This is the first UK study to look at resilience in nurses working in respiratory clinical areas during the COVID-19 pandemic. The average resilience scores were moderate-indicating some resilience which needs strengthening. Age and experience were shown to be significant predictors of resilience. Anxiety and depression levels were low but a proportion of respondents had high levels of anxiety and depression. Our findings show that younger, BAME, less experienced nurses have higher levels of anxiety and depression. We need to develop interventions to support them and help staff to maintain and improve their levels of resilience.
RESUMEN
To reduce person-to-person transmission of COVID-19 Canada implemented restrictions at com-munity and hospital levels. At Kingston Health-Science-Centre most outpatient psychiatric services, including the Child and Adolescent Mental Health Urgent Consult Clinic (CAMHUCC), were transitioned from in-person to virtual clinics. The aim of this study is to examine changes in referrals to CAMHUCC and in management of youth referred for urgent psychiatric consult. Methods: This retrospective study compares all patients <18years assessed by the CAMHUCC after the switch to the virtual clinic model (March to May 2020;COVID group), with patients who were assessed for the same time period in 2019 (Pre-COVID group). Groups are compared by their demographic and clinical characteristics. Results: All patients agreed to the assessment through telepsychiatry. There are less referrals during the COVID than in the Pre-COVID period (63 vs. 84). Demographic and clinical characteristics between the two groups are without significant difference. In the COVID group there is a slightly higher number of indigenous children and patients diagnosed with adjustment disorder. There is no significant dif-ference in recommendations between the groups. However, implementation of recommendations differs in that those in the COVID group requiring behavior intervention and or psychoeducational assessment, could not be provided the service as these were not feasible via OTN. Conclusion: The pandemic-related restrictions and the switch to an online clinic model does not negatively impact urgent psychiatric assessment and management of youth but does affect available resources. Further research is warranted to evaluate the long-term effect of those changes.
RESUMEN
Nurses who work with respiratory patients, have been at the forefront of the pandemic response. Lessons need to be learnt from these nurses’ experiences in order to support these nurses during the existing pandemic and retain and mobilise this skilled workforce for future pandemics.This study explores UK nurses’ experiences of working in a respiratory environment during the COVID-19 pandemic. We distributed an e-survey via professional respiratory societies [Association of Respiratory Nurse Specialists (ARNS), British Thoracic Society (BTS) and the Primary Care Respiratory Society (PCRS)] and social media in May 2020. The survey included a resilience scale, the GAD7 (anxiety) and the PHQ9 (depression) tools.255 complete responses were received, predominately women (89%), aged over 40 (71%). Over 95% of the respondents were white, with a very small sample of BAME. 58% usually worked in an acute setting, 57% had changed their role due to the pandemic, and 49% were undertaking aerosol generating procedures. There were significant differences in anxiety and depression scores for those undertaking aerosol generating procedures (both p<0.001) and who worked in different clinical settings (depression only, p<0.05) Just over 50% experienced minimal symptoms of anxiety, 28.3% experienced mild symptoms and just over 20.9% experience moderate-to-severe symptoms. Nearly 52% experienced minimal depression symptoms, 30.9% experienced mild symptoms and 17.2% experienced moderate-to-severe symptoms. 45.8% had a moderate or moderately high resilience score. Regression analysis showed that being younger, having fewer years of nursing experience, and feeling unable to support your household were key predictors of increased symptoms of anxiety and depression.This is the first UK study to look at resilience in nurses working in respiratory clinical areas during the COVID-19 pandemic. The average resilience scores were moderate – indicating some resilience which needs strengthening. Age and experience were shown to be significant predictors of resilience. Anxiety and depression levels were low but a proportion of respondents had high levels of anxiety and depression. Our findings show that younger, BAME, less experienced nurses have higher levels of anxiety and depression. We need to develop interventions to support them and help staff to maintain and improve their levels of resilience.
RESUMEN
BACKGROUND: The delivery of healthcare during the COVID pandemic has had a significant impact on front line staff. Nurses who work with respiratory patients have been at the forefront of the pandemic response. Lessons can be learnt from these nurses' experiences in order to support these nurses during the existing pandemic and retain and mobilise this skilled workforce for future pandemics. METHODS: This study explores UK nurses' experiences of working in a respiratory environment during the COVID-19 pandemic. An e-survey was distributed via professional respiratory societies; the survey included a resilience scale, the GAD7 (anxiety) and the PHQ9 (depression) tools. Demographic data was collected on age, gender, ethnicity, nursing experience and background, clinical role in the pandemic, and home-life and work balance. RESULTS: Two hundred and fifty-five responses were received for the survey, predominately women (89%, 226/255), aged over 35 (79%, 202/255). Nearly 21% (40/191) experiencing moderate to severe or severe symptoms of anxiety. Similar levels are seen for depression (17.2%, 31/181). 18.9% (34/180) had a low or very low resilience score. Regression analysis showed that for both depression and anxiety variables, age and years of qualification provided the best model fit. Younger nurses with less experience have higher levels of anxiety and depression and had lower resilience. CONCLUSION: This cohort experienced significant levels of anxiety and depression, with moderate to high levels of resilience. Support mechanisms and interventions need to be put in place to support all nurses during pandemic outbreaks, particularly younger or less experienced staff.