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1.
Pediatr Res ; 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34099854

RESUMO

BACKGROUND: The COVID-19 pandemic has had a devastating impact on multiple aspects of healthcare, but has also triggered new ways of working, stimulated novel approaches in clinical research and reinforced the value of previous innovations. Conect4children (c4c, www.conect4children.org ) is a large collaborative European network to facilitate the development of new medicines for paediatric populations, and is made up of 35 academic and 10 industry partners from 20 European countries, more than 50 third parties, and around 500 affiliated partners. METHODS: We summarise aspects of clinical research in paediatrics stimulated and reinforced by COVID-19 that the Conect4children group recommends regulators, sponsors, and investigators retain for the future, to enhance the efficiency, reduce the cost and burden of medicines and non-interventional studies, and deliver research-equity. FINDINGS: We summarise aspects of clinical research in paediatrics stimulated and reinforced by COVID-19 that the Conect4children group recommends regulators, sponsors, and investigators retain for the future, to enhance the efficiency, reduce the cost and burden of medicines and non-interventional studies, and deliver research-equityWe provide examples of research innovation, and follow this with recommendations to improve the efficiency of future trials, drawing on industry perspectives, regulatory considerations, infrastructure requirements and parent-patient-public involvement. We end with a comment on progress made towards greater international harmonisation of paediatric research and how lessons learned from COVID-19 studies might assist in further improvements in this important area.

2.
Int Rev Educ ; : 1-17, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34075259

RESUMO

On 11 March 2020, the World Health Organization upgraded the outbreak of COVID-19 to pandemic status. On 15 March 2020, the South African president declared a national state of disaster under the Disaster Management Act of 2002. On 26 March 2020, national lockdown, which included measures stipulated in guidelines for education in emergencies, was implemented in South Africa. The presidential declaration and subsequent lockdown came at a time when some of the universities in South Africa were already struggling either to commence the academic year, or to make up for time lost due to persistent student protests relating to several student demands. However, disaster management now entailed that all schools and institutions of higher education were forced to close immediately for extended periods, necessitating alternative ways of ensuring access to education. The qualitative case study presented in this article sought to document the intervention strategies developed by two universities located in remote parts of Eastern Cape Province to deliver education during the COVID-19 restrictions. A second aim was an examination of the challenges experienced by the two institutions' largely rural student population. The authors collected data using a questionnaire completed by 15 educators and 30 students from the two universities. They also analysed official communications documents from the universities addressed to lecturers and students. The results indicate that access to online teaching and learning platforms and resources for students from poor rural communities in South Africa is challenging, and that there are gross inequalities in educational outcomes for learners from different socio-economic backgrounds. This affects the future plans of higher education institutions to provide teaching and learning through online-based platforms. The authors conclude their article by providing recommendations to support online learning in rural areas, which has the potential to expand higher education access post-COVID-19.

3.
Am J Public Health ; : e1-e6, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34111372

RESUMO

Both the 1918 influenza pandemic and the 2019‒2021 COVID-19 pandemic are among the most disastrous infectious disease emergences of modern times. In addition to similarities in their clinical, pathological, and epidemiological features, the two pandemics, separated by more than a century, were each met with essentially the same, or very similar, public health responses, and elicited research efforts to control them with vaccines, therapeutics, and other medical approaches. Both pandemics had lasting, if at times invisible, psychosocial effects related to loss and hardship. In considering these two deadly pandemics, we ask: what lessons have we learned over the span of a century, and how are we applying those lessons to the challenges of COVID-19? (Am J Public Health. Published online ahead of print June 10, 2021: e1-e8. https://doi.org/10.2105/AJPH.2021.306326).

4.
Support Care Cancer ; 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34114098

RESUMO

PURPOSE: Cancer-related biopsychosocial distress is highly prevalent across the cancer care continuum. The implementation of screening patients for biopsychosocial distress has become a standard of practice in cancer care. With the presence of COVID-19, clinical care has shifted from in-person care to virtual care in many instances. One of the realities of COVID-19 is the significant decrease in screening patients for biopsychosocial symptom burden. METHODS: Given that screening for distress has become an accreditation standard in many cancer programs, in the province of Alberta, Canada, all patients are screened for distress with every visit to the cancer centre. Given the presence of COVID-19, much of cancer care has shifted to being delivered virtually (through mediums such as Zoom). In this paper, we present pre- and post-COVID data on the frequency of distress screening and its impact on patient care. RESULTS: A review of pre- and post-COVID-19 screening for distress questionnaires revealed that patients who received virtual care were less satisfied in the areas of emotional support and received less resources and referrals to supportive care. CONCLUSION: The rapid integration of virtual care without the inclusion of a standardized distress screening tool was akin to a natural experiment, as two groups (virtual and in-person clinic patients) received different levels of care and interventions. Without the inclusion of distress screening, the clinical conversation around symptoms is less likely to occur and results in fewer referrals to best practices in supportive care services. Lessons learned about virtual cancer care without distress screening in the time of COVID-19 demonstrates significantly fewer patients being screened for distress and subsequently has resulted in less supportive care referrals. Going forward, we must find ways to ensure that virtual cancer care continues to support distress screening and best patient-centric care.

12.
Clin Imaging ; 79: 179-182, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34090113

RESUMO

The COVID-19 pandemic has brought enormous hardships to our country and healthcare system. We present our experience navigating through this pandemic with emphasis on reactivating our practice while keeping patients and staff safe. It is hoped that the methods and thought processes provided in this manuscript will help those who are in various stages of managing their practice or provide lessons learned as our country eventually moves beyond this pandemic. Lastly, we aspire to provide a guide for those who are in a position to prepare for the next pandemic.

13.
J Palliat Med ; 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34096800

RESUMO

COVID-19 strained our nation's hospitals and exposed gaps in care. As COVID-19 surged in Boston in March 2020, we worked to rapidly create a Palliative Care Compassion Unit (PCCU) to care for those dying of COVID-19 or non-COVID-19-related illnesses. The PCCU provided interdisciplinary end-of-life care, supported families, and enabled surge teams to focus on patients needing life-sustaining treatments. In this study, we describe the creation of the PCCU, including opportunities and challenges, in hopes of lending insight to other palliative care teams who may need to rapidly craft new care models during a crisis.

14.
Curr Pharm Teach Learn ; 13(7): 881-884, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34074522

RESUMO

PURPOSE: The purpose of this reflection or wisdom of experience article is to describe and reflect on the impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on experiential education (EE) leadership and teams. Additionally, this reflection will shift the focus from the spring 2020 environment of SARS-CoV-2 to what EE teams and college administration can learn from those experiences. Moving forward, EE teams and administrators can be better equipped to proactively plan for future emergencies. DESCRIPTION: Using the "What? So What? Now What?" model of reflection, this manuscript will broadly describe the experiences of three EE administrators and their teams during the SARS-CoV-2 pandemic. Proposed lessons learned as well as future planning strategies will be presented. ANALYSIS/INTERPRETATION: The world of education was unprepared for the SARS-CoV-2 pandemic, and most sectors were left scrambling to adjust to new models very quickly with no planning or preparation. In the realm of pharmacy education, SARS-CoV-2 caused complete disruption for pharmacy students on rotations, clinical sites, preceptors, and EE teams. In reflecting on spring 2020, much can be gained and applied to future planning efforts so that institutions can be better prepared for future crises. CONCLUSIONS/IMPLICATIONS: While still in the pandemic, schools must plan for the coming year. EE teams can work together to prepare for emergencies, craft contingency plans, and build additional capacity into their teams and available rotation offerings.


Assuntos
Educação em Farmácia/métodos , Preceptoria/métodos , Aprendizagem Baseada em Problemas/métodos , Estudantes de Farmácia/psicologia , COVID-19 , Humanos , Pandemias , SARS-CoV-2
15.
Ann Intern Med ; 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34125574

RESUMO

The development of the National Institutes of Health (NIH) COVID-19 Treatment Guidelines began in March 2020 in response to a request from the White House Coronavirus Task Force. Within 4 days of the request, the NIH COVID-19 Treatment Guidelines Panel was established and the first meeting took place (virtually-as did subsequent meetings). The Panel comprises 57 individuals representing 6 governmental agencies, 11 professional societies, and 33 medical centers, plus 2 community members, who have worked together to create and frequently update the guidelines on the basis of evidence from the most recent clinical studies available. The initial version of the guidelines was completed within 2 weeks and posted online on 21 April 2020. Initially, sparse evidence was available to guide COVID-19 treatment recommendations. However, treatment data rapidly accrued based on results from clinical studies that used various study designs and evaluated different therapeutic agents and approaches. Data have continued to evolve at a rapid pace, leading to 24 revisions and updates of the guidelines in the first year. This process has provided important lessons for responding to an unprecedented public health emergency: Providers and stakeholders are eager to access credible, current treatment guidelines; governmental agencies, professional societies, and health care leaders can work together effectively and expeditiously; panelists from various disciplines, including biostatistics, are important for quickly developing well-informed recommendations; well-powered randomized clinical trials continue to provide the most compelling evidence to guide treatment recommendations; treatment recommendations need to be developed in a confidential setting free from external pressures; development of a user-friendly, web-based format for communicating with health care providers requires substantial administrative support; and frequent updates are necessary as clinical evidence rapidly emerges.

16.
Int J Health Serv ; : 207314211024900, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34125625

RESUMO

Hospitals play a critical role in providing essential care during emergencies; however, this essential care can overwhelm the functional capacity of health systems. In Italy, substantial cuts in funding have drastically reduced the resources of the National Health Service (NHS) and contributed to the expansion of the private health sector which, unlike the public health system, does not have the capacity to deal with a health emergency such as coronavirus disease 2019 (COVID-19). The purpose of this article is to show how the privatization of the NHS contributed to making Italy more vulnerable and unprepared to tackle the COVID-19 pandemic. The available capacity and resources in the public and private emergency services systems in Italy are compared, including a focus on the numbers of hospital staff, hospitals, and hospital beds. The reduced funding and subsequent shortfalls in services in the NHS are reasons why extreme measures were needed to increase these resources during the COVID-19 pandemic. A public NHS in Italy would be better prepared for future health emergencies. The lessons learned from the COVID-19 pandemic can help to inform future health systems strategies, to halt the current financial decline and performance loss of national health systems, and to enable better preparation for future health emergencies.

17.
Preprint | medRxiv | ID: ppmedrxiv-21255008

RESUMO

ObjectiveTo describe characteristics, clinical management, and patient outcomes during and after acute COVID-19 phase in a long-term acute care hospital in the Northeastern United States. MethodsA single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, was conducted to evaluate patient outcomes in response to the facilitys holistic treatment approach. Results118 admissions were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. ConclusionThe majority of patients treated at a long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

18.
Western Pac Surveill Response J ; 12(1): 61-68, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34094627

RESUMO

International borders to Vanuatu closed on 23 March 2020 due to the global COVID-19 pandemic. In May-July 2020, the Government of Vanuatu focused on the safe and timely return of citizens and residents while ensuring Vanuatu remained COVID-19 free. Under Phase 1 of repatriation, between 27 May and 23 June 2020, 1522 people arrived in the capital, Port Vila, and were placed in compulsory government-mandated 14-day quarantine in 15 hotels. Pre-arrival health operations included collection of repatriate information, quarantine facility assessments, training for personnel supporting the process, and tabletop and functional exercises with live scenario simulations. During quarantine, health monitoring, mental health assessments and psychosocial support were provided. All repatriates completed 14 days of quarantine. One person developed symptoms consistent with COVID-19 during quarantine but tested negative. Overall health operations were considered a success despite logistical and resource challenges. Lessons learnt were documented during a health sector after-action review held on 22 July 2020. Key recommendations for improvement were to obtain timely receipt of repatriate information before travel, limit the number of repatriates received and avoid the mixing of "travel cohorts," ensure sufficient human resources are available to support operations while maintaining other essential services, establish a command and control structure for health operations, develop training packages and deliver them to all personnel supporting operations, and coordinate better with other sectors to ensure health aspects are considered. These recommendations were applied to further improve health operations for subsequent repatriation and quarantine, with Phase 2 commencing on 1 August 2020.

19.
Liver Transpl ; 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34096188

RESUMO

Over the last year, novel coronavirus-19 (COVID-19) has continued to spread across the globe, causing significant morbidity and mortality among transplant candidates and recipients. Patients with end stage liver disease awaiting liver transplantation and patients with a history of liver transplantation represent vulnerable populations, especially given high rates of associated medical comorbidities in these groups and their immunosuppressed status. In addition, concerns surrounding COVID-19 risk in this patient population has affected rates of transplantation and general transplantation practices. Here, we explore what we have learned about the impact of COVID-19 on liver transplant candidates and recipients as well as the many key knowledge gaps that remain.

20.
Internist (Berl) ; 2021 Jun 03.
Artigo em Alemão | MEDLINE | ID: mdl-34081156

RESUMO

Resources for the rapid and comprehensive availability of reliable diagnostic tests were an important prerequisite for the detection and management of the pandemic triggered by the coronavirus disease 2019 (COVID-19). The capacity for the diagnostic tests had to be rapidly planned and established in early 2020 and had to be constantly expanded. The German healthcare system with dedicated and experienced specialists for laboratory medicine, clinical microbiology, virology and infection epidemiology was well prepared to meet these challenges, both professionally and organizationally. The experiences with the challenges in the first year of the pandemic are presented in this article.

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