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1.
BMJ Supportive and Palliative Care ; 11:A38-A39, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-2032476

RESUMO

Background In response to the COVID-19 pandemic, the hospice moved to digital approaches. Whilst tele-rehabilitation has shown benefits for various chronic health conditions (Bhatt, Patel, Anderson, et al., 2019;Zanaboni, Hoaas, Lien, et al., 2017;Hwang, Bruning, Morris, et al., 2017), there is a gap in the literature on telehealth interventions for palliative rehabilitation. Aim To evaluate digital delivery of a palliative rehabilitation programme and obtain perceptions of users and staff. Methods All members of the Fatigue and Breathlessness (FAB) follow-on group (n=19) were invited to complete a questionnaire on the experience of transitioning to Zoom sessions. Descriptive statistics were produced using the statistical software package, Stata (Version 15;StataCorp, 2017). Qualitative data were analysed using an inductive thematic analysis framework (Braun & Clarke, 2006). Three members of the rehabilitation team were interviewed about encountered benefits and challenges. Results Thirteen members completed the questionnaire (68%) and all were positive about the transformed sessions. Eight respondents (62%) felt that the Zoom sessions were 'no different' or 'better' than in-person sessions. No adverse events were reported. Themes from open-ended comments included patient-level effects such as maintained exercise and social contact when in isolation and removed travel requirements. At the service level, there was improved access but technological challenges. Most respondents (9, 69%) suggested keeping the option of Zoom for flexibility and 46% (6) wanted both staff-led and self-led elements. The rehabilitation team felt their rapid response and team working enabled efficient transition to Zoom. This included risk assessments, particularly for those living alone. With help, users quickly learned and the virtual delivery provided opportunities to try new activities. At times, staff found the 'silent audience' challenging. The rehabilitation team felt the approach may only work with groups with existing rapport. Conclusions The hospice rehabilitation team now provide concurrent sessions at home via Zoom and in the hospice. These access options provide choice, appear to be acceptable and offer flexibility around changing condition status and personal factors.

2.
JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM ; 27:S101-S101, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-1965454
4.
Embase;
Preprint em Inglês | EMBASE | ID: ppcovidwho-326946

RESUMO

Rationale: High galectin-3 levels predict poor outcomes in patients with COVID-19. Galectin-3 activates monocytes and macrophages which are directly implicated in COVID-19 immunopathology and the cytokine storm. GB0139 is a potent thiodigalactoside galectin-3 inhibitor and may reduce the severe effects of the disease. We report safety and pharmacokinetics and pharmacodynamics of the inhaled galectin-3 inhibitor, GB0139, and assess clinical outcomes and key systemic inflammatory biomarkers in hospitalised patients with COVID-19 (ClinicalTrials.gov/EudraCT identifier: NCT04473053/2020-002230-32). Methods: Adults with COVID-19 requiring oxygen, and with pneumonitis on x-ray, were randomised to receive standard of care (SOC;including dexamethasone;n=21) or SOC plus 10 mg GB0139 twice daily for 48 hours, then once daily for ≤14 days (n=20). Results: Patients aged 27–87 years were enrolled from July 2020;the final patient completed the 90-day follow-up in April 2021. GB0139+SOC was well tolerated with no treatment-related serious adverse events reported. Incidences of adverse events were similar between treatment arms (40 with GB0139+SOC vs 35 with SOC). Plasma GB0139 was measurable in all patients after inhaled exposure, with moderate interpatient variability, and demonstrated target engagement with decreased circulating galectin (overall treatment effect post-hoc over days 2–7: p=0·0099 vs SOC). Rate of decline in fraction of inspired oxygen (%) requirement was significantly greater in the GB0139+SOC arm with a posterior mean difference of −1·51 (95% highest posterior density: −2·90, −0·189) versus SOC. Plasma levels of biomarkers associated with inflammation, coagulopathy, major organ function and fibrosis showed a downward trend versus SOC. Conclusions: GB0139+SOC was well tolerated and achieved clinically relevant plasma concentrations and target engagement. This, and the reduction in markers associated with inflammatory, coagulation, fibrosis, and reduction in inspired oxygen (%) over SOC alone, indicates the therapeutic potential for inhaled GB0139 in hospitalised patients with COVID-19.

6.
Int. Conf. Inf. Syst., ICIS - Mak. Digit. Incl.: Blending Local Glob. ; 2020.
Artigo em Inglês | Scopus | ID: covidwho-1172224
7.
American Journal of Obstetrics and Gynecology ; 224(2):S95-S96, 2021.
Artigo em Inglês | Web of Science | ID: covidwho-1140978
8.
J Intensive Care Soc ; 23(2): 162-169, 2022 May.
Artigo em Inglês | MEDLINE | ID: covidwho-1024343

RESUMO

The COVID-19 pandemic of 2020 imposed significant strain on critical care services worldwide. The South London region experienced the largest numbers of critical care admissions in the United Kingdom with King's College Hospital one of the busiest centres. This article outlines, using a descriptive narrative, the significant changes that occurred within King's Critical Care as a result of the pandemic and the decisions that were taken to provide effective co-ordination and control to the expanded service, in part drawing on the military experience of two of the authors. The wider context of crisis and major incident leadership and management is also discussed contrasting different approaches used in civilian and military settings.

9.
MEDLINE; 2020.
Preprint em Inglês | MEDLINE | ID: ppcovidwho-3198

RESUMO

While rapid and accessible diagnosis is paramount to monitoring and reducing the spread of disease, COVID-19 testing capabilities across the U.S. remain constrained. For many individuals, urgent care centers (UCCs) may offer the most accessible avenue to be tested. Through a phone survey, we describe the COVID-19 testing capabilities at UCCs and provide a snapshot highlighting the limited COVID-19 testing capabilities at UCCs in states with the greatest disease burden.

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