Access to general practice during the COVID-19 pandemic - a cross-sectional view of the opinions of adults who use social media.

INTRODUCTION: The COVID-19 pandemic has had a significant impact on the health and wellbeing of people worldwide. General practices were forced to adapt to constantly changing circumstances, leading to predominance of virtual consultations. The aim of this study was to examine the impact the pandemic had on the ability of patients to access general practice. Other focuses included determining the nature of changes to appointment cancellations or delays and the level of disruption to long-term medication regimes during this period. METHODS: A 25-question online survey was administered using Qualtrics®. Adult patients of Irish general practices were recruited via social media between October 2020 and February 2021. The data were examined for associations between participant groupings and key findings using chi-squared tests. RESULTS: 670 persons participated. Half of all doctor-patient consultations during that time were completed virtually, predominantly via telephone. Overall, 497 (78%) participants accessed their healthcare teams as scheduled, and without disruption. 18% of participants (n=104) reported difficulty in accessing their long-term medications; those who were younger, and those who typically attend general practice on a quarterly or more basis, were associated most with this disruption (p<0.05; p<0.05). DISCUSSION: Despite the COVID-19 pandemic, Irish general practice has maintained its schedule for appointments in greater than three quarters of cases. There was a clear shift away from face-to-face consultations to telephone appointments. Maintaining the prescription of long-term medications for patients remains a challenge. Further work needs to be done to ensure the continuation of care and undisrupted medication schedules during any future pandemics.

Access to general practice during COVID-19: a cross-sectional view of the opinions of adults who use social media.

Background/Aim: Since the onset of the COVID-19 pandemic, virtual consultations have become commonplace, and access to healthcare more complex. The study was designed to examine the impact COVID-19 has had on access to general practice care in Ireland. Methods: A 25-question online survey was designed in Qualtrics®. Adult patients of Irish general practices were recruited via social media between October 2020 and February 2021 and volunteered their opinions. Results: 670 persons participated. Half of all doctor-patient consultations were now completed virtually-predominantly via telephone. Overall, 497 (78%) participants accessed their healthcare teams as scheduled, and without disruption. 18% of participants (n=104) reported difficulty in accessing their long-term medications; those who are younger, and those who typically attend general practice quarterly or more, were associated most with this disruption (p<0.05). Fifty-nine instances where a new health concern was subject to an appointment cancellation or rescheduling were reported. Conclusions: Despite the COVID-19 pandemic, Irish general practice has maintained its schedule for appointments in 78% of cases despite the challenges of the pandemic. Half of consultations were provided virtually; teleconsultation use was very infrequent. Maintaining the supply chain for long-term medications for patients remains a challenge during a pandemic. Authors accept that study participants were confined to those who use social media. A protocol may need to be designed by each practice to optimize the continuation of care and of medication schedules during any future pandemics.

Comparative analysis of the effects of packaging signal, transgene orientation, promoters, polyadenylation signals, and E3 region on growth properties of first-generation adenoviruses.

First-generation adenovectors have been developed for gene therapy and vaccine applications. The construction of these adenovectors has entailed the use of numerous types of expression cassettes. It has long been known that first-generation adenovectors can be rescued more easily and to higher titers with some transgenes than with others. This study has systematically shown that there can be marked differences in growth properties of recombinant adenovectors attributable to the use of promoters, the orientation of the transgene within the E1A/E1B-deleted region, and the inclusion of the E3 region. In addition, we had demonstrated the benefit of extending the packaging signal region to include elements V, VI, and VII. The effects of the complete packaging region were studied by plasmid competition studies between original and modified adenovectors. Similar competition studies between E3(+) and E3(-) adenovectors were performed and showed that the E3(+) vector had a growth advantage over its E3(-) counterpart. By making various changes, we have enhanced the growth capacity of our recombinant adenovector by more than 3-fold under serum-free and cell suspension growth conditions. Along with this enhanced growth, our adenovectors have maintained their genetic stability after 21 successive passages in cell culture. This increased robustness will be critical when adapting first-generation recombinant adenovectors to commercial production.