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Item Advancing Public Health Surveillance in Child Care Centers: Stakeholder-Informed Redesign and User Satisfaction Evaluation of the MCRISP Network(JMIR, 2024-09-24) Gribbin, William; Dejonge, Peter; Rodseth, Jakob; Hashikawa, Andrew; Medicine, School of MedicineLeveraging user feedback, we redesigned a novel disease monitoring utility to allow for bidirectional data flow and in this letter offer insights into that process as well as lessons learned.Item An Accountable Care Organization Maintains Access for Appendicitis During the COVID-19 Pandemic(Elsevier, 2023) Menchaca, Alicia D.; Style, Candace C.; Wang, Ling; Cooper, Jennifer N.; Minneci, Peter C.; Olutoye, Oluyinka O.; Surgery, School of MedicineIntroduction: It has been reported that pediatric patients experienced a delay in treatment for acute appendicitis during the pandemic, resulting in increased rates of complicated appendicitis. We investigated the association of the COVID-19 pandemic and the incidence and severity of acute appendicitis among pediatric Medicaid patients using a population-based approach. Methods: The claims database of Partners For Kids, a pediatric Medicaid accountable care organization (ACO) in Ohio, was queried for cases of acute appendicitis from April to August 2017-2020. The monthly rate of acute appendicitis/100,000 covered lives was calculated each year and compared over time. Rates of complicated appendicitis were also compared. Diagnosis code validation for classification as complicated or uncomplicated appendicitis was performed for patients treated at our hospital. Results: During the study period, 465 unique cases of acute appendicitis were identified. Forty percent (186/465) were coded as complicated. No significant difference in the incidence of acute appendicitis cases was observed across the 4 y, either in an overall comparison or in pairwise comparisons (P > 0.15 for all). The proportion of acute appendicitis cases that were coded as complicated did vary significantly over the 4-year study period (P = 0.005); this was due to this proportion being significantly higher in 2018 than in either 2019 (P = 0.005 versus 2018) or 2020 (P = 0.03 versus 2018). Conclusions: The COVID-19 pandemic was not associated with reduced access to treatment for acute appendicitis among patients in a pediatric Medicaid ACO. This suggests that an ACO may promote continued healthcare access for their covered population during an unexpected crisis.Item Attitudes toward Adolescent HPV Vaccination after the COVID-19 Pandemic: A National Survey of Mothers(MDPI, 2024-08-28) Glauberman, Gary; Liebermann, Erica; Kornides, Melanie L.; Matsunaga, Masako; Lim, Eunjung; Zimet, Gregory; Fontenot, Holly B.; Pediatrics, School of MedicineIn the United States, vaccination rates for many routinely recommended vaccines have recovered to pre-pandemic levels, yet human papillomavirus (HPV) vaccination rates still lag pre-pandemic levels. This study sought to uncover the potential effects of the pandemic on attitudes about the HPV vaccine, and factors associated with changes in attitudes. We conducted a national survey (n = 3968) of U.S. mothers with children aged 9-17 years. Outcome variables measured changes in attitude toward the HPV vaccine following the pandemic. Two logistic regression models identified predictors of (1) those who did not have attitude changes (always negative vs. always positive), and (2) those who reported attitude changes (change to negative vs. change to positive). Attitudes toward the HPV vaccine remained unchanged in 78.9% of participants (58.1% positive, 20.8% negative). Of the 21.1% reporting changed attitudes, 9.6% changed to positive and 11.5% to negative. Those reporting changing to a negative attitude had a greater odds of reporting conservative political views, and being unsure/undecided about vaccinating their child against HPV compared to those who reported changing to a positive attitude. Targeted strategies are needed to address erosion in confidence in the HPV vaccine and other vaccines resulting from mis- and disinformation associated with the COVID-19 pandemic and future pandemics.Item Bariatric Surgery is Safe for Patients After Recovery from COVID-19(Elsevier, 2021-11) Vosburg, R. Wesley; Pratt, Janey S.A.; Kindel, Tammy; Rogers, Ann M.; Kudav, Siddharth; Banerjee, Ambar; Hernandez, Edward; Athanasiadis, Dimitrios; Fischer, Laura E.; Hayes, Kellen; Shin, Thomas H.; Aminian, Ali; Kim, Julie J.; Surgery, School of MedicineBACKGROUND: Studies of patients who have undergone surgery while infected with COVID-19 have shown increased risks for adverse outcomes in both pulmonary complications and mortality. It has become clear that the risk of complications from perioperative COVID-19 infection must be weighed against the risk from delayed surgical treatment. Studies have also shown that prior bariatric surgery conveys protection against mortality from COVID-19 and that obesity is the biggest risk factor for mortality from COVID-19 infection in adults under 45 years of age. Studies in patients who have fully recovered from COVID-19 and underwent elective surgery have not become widely available yet. OBJECTIVES: This multi-institutional case series is presented to highlight patients who developed COVID-19, fully recovered, and subsequently underwent elective bariatric surgery with 30-day outcomes available. SETTING: Nine bariatric surgery centers located across the United States. METHODS: This multicenter case series is a retrospective chart review of patients who developed COVID-19, recovered, and subsequently underwent bariatric surgery. Fifty-three patients are included, and 30-day morbidity and mortality were analyzed. RESULTS: Thirty-day complications included esophageal spasm, dehydration, and ileus. There were no cardiovascular, venous thromboembolism (VTE) or respiratory events reported. There were no 30- day mortalities. CONCLUSIONS: Bariatric surgery has been safely performed in patients who made a full recovery from COVID-19 without increased complications due to cardiovascular, pulmonary, venous thromboembolism, or increased mortality rates.Item Can Tele-Neuro-Ophthalmology Be Useful Beyond the Pandemic?(Springer Nature, 2023) Lai, Kevin E.; Ko, Melissa W.; Ophthalmology, School of MedicinePurpose of the review: Neuro-ophthalmologists rapidly adopted telehealth during the COVID-19 pandemic to minimize disruption to patient care. This article reviews recent research on tele-neuro-ophthalmology adoption, current limitations, and potential use beyond the pandemic. The review considers how digital transformation, including machine learning and augmented reality, may be applied to future iterations of tele-neuro-ophthalmology. Recent findings: Telehealth utilization has been sustained among neuro-ophthalmologists throughout the pandemic. Adoption of tele-neuro-ophthalmology may provide solutions to subspecialty workforce shortage, patient access, physician wellness, and trainee educational needs within the field of neuro-ophthalmology. Digital transformation technologies have the potential to augment tele-neuro-ophthalmology care delivery by providing automated workflow solutions, home-based visual testing and therapies, and trainee education via simulators. Tele-neuro-ophthalmology use has and will continue beyond the COVID-19 pandemic. Digital transformation technologies, when applied to telehealth, will drive and revolutionize the next phase of tele-neuro-ophthalmology adoption and use in the years to come.Item Clustering of Covid-19 infections among healthcare workers: Experience from a tertiary care center in Saudi Arabia(Elsevier, 2022) Saad, Mustafa M.; Molaeb, Bassel S.; Almoosa, Zainab A.; Mahmoud, Fadi; Sureendran, Bindu; Maranon, Carmela; El Gamal, El Shaymaa; Sanad, Ahmed; Mowafy, Basma; Al-Tawfiq, Jaffar A.; Medicine, School of MedicineIntroduction: Coronavirus infectious disease 2019 (COVID-19) had a significant impact on healthcare workers (HCWs) worldwide. Understanding the dynamics of infection transmission is important to develop strategies to prevent its spread. Methods: A retrospective study of a cohort of HCWs with COVID-19 from a single tertiary care hospital during the first wave of the pandemic. Epidemiological investigations and identification of clusters of infection were done prospectively. Results: A total of 326 HCWs had COVID-19 based on positive polymerase chain reaction tests for SARS-CoV-2. Ten clusters of infection were identified; nine clusters had HCWs as the index cases while one cluster had a patient as the index case. The largest cluster involved 15 transmissions, and one cluster included a secondary transmission. Sharing accommodation and social gatherings were the commonest epidemiological links. The majority of infected HCWs had mild infections, 23 (6%) required hospital admission and 3 (1%) required intensive care; all fully recovered. Majority of infections (80%) were community-acquired. Living in shared accommodation was associated with COVID-19 (120/690 versus 206/1610, P value = .01) while working in COVID-19 designated wards/units was not associated with COVID-19 (52/297 vs 274/2003, P value = .13). Conclusions: Clustering of COVID-19 was common among HCWs and related to shared accommodation and social gatherings, infection was of mild severity, and was not associated with caring for COVID-19 patients.Item COVID-19 Pandemic Driven Knowledge, Attitude, Clinical Practice, Distress Reactions, and Post-Traumatic Growth of Dental Care Providers in Riyadh City, Saudi Arabia: A Cross-Sectional Study(2021) Labban, Nawaf; Alfouzan, Afnan F.; Al-Shibani, Nouf; Al-Otaibi, Hanan N.; Al Taweel, Sara Mohammad; Al Ghanem, Shahad Hamad; Schrader, Stuart M.; Biomedical Sciences and Comprehensive Care, School of DentistryObjective: The present study aimed to assess knowledge, attitude, clinical practices, distress reactions, and post-traumatic growth of dentists during the COVID-19 pandemic in Riyadh City. Methodology: An online questionnaire was developed to assess various dental professionals from both governmental and private sectors during the early COVID-19 outbreak in Riyadh City, Saudi Arabia. The questionnaire was framed to assess the demographic variables, knowledge, attitude, and clinical practices towards handling the COVID-19 pandemic. Furthermore, the general anxiety disorder-7 (GAD-7), worry questionnaire items, short form of post-traumatic growth inventory (PTGI-SF), and life satisfaction questionnaire items were developed to assess the anxiety, worries, post-traumatic growth, and life satisfaction of dental care providers following the traumatic events. Data were analysed using SPSS 22.0 and R environment ver.3.2.2. Continuous measurement results were presented as mean ± SD, and categorical measurements results were presented in number (%). Results: Our study's significant findings revealed that a majority of the dentists were in the age group of 21-30 and practiced general dentistry. The study participants in age groups 51–60 and 41–50 years old showed more liability in perceiving COVID-19 as an extremely dangerous disease than 31–40 and 21–30 age groups. The majority of respondents (63.4%) had an anxiety scale score of greater than 40, followed by 22.8% with scores 20-40 and 13.9% with scores less than 20, respectively. The mean scores for the GAD-7 and the worry items were 8.24 ± 3.21 and 13.92 ± 4.77, respectively. The data showed that most survey participants had adopted moderate post-traumatic changes during the pandemic, as evident by their mean score of 34.17 ± 3.40. The life satisfaction of the participants was neutral, as demonstrated by their mean score of 20.16 ± 4.03. Conclusion: This study’s findings delineated that the COVID-19 pandemic situation has influenced dentists' mental health, with a moderate level of anxiety, and worries among other psychological symptoms. Furthermore, there was adequate knowledge regarding the COVID-19 among dentists; however, the pandemic affected the financial conditions of the respondents. There was a moderate level of post-traumatic growth and neutral life satisfaction of the dental providers.Item Ethnoracial Disparities in Posttraumatic Stress Disorder Symptoms during the COVID-19 Pandemic: A Brief Report(Sage, 2023) Hong, Michin; Yi, Eun-Hye Grace; Kim, HaeJung; School of Social WorkDespite the well-identified vulnerability of older adults during the COVID-19 pandemic, it is unclear about their experiences with COVID-related posttraumatic stress disorder symptomology (COVID-PTSD). This study examined ethnoracial disparities in the level of, and factors associated with, COVID-PTSD using a national data set, including 1926 Whites and 488 ethnoracial minorities. Results showed that ethnoracial minorities reported a greater COVID-PTSD than Whites. COVID-related distress was the common risk factor of COVID-PTSD for the both groups. Being a female and greater social support were associated with COVID-PTSD only for Whites, whereas higher education, greater IADL and fewer ADL limitations were associated with COVID-PTSD for ethnoracial minorities. The findings provided preliminary, but generalizable understanding of ethnoracial disparities in COVID-PTSD, among the Medicare beneficiaries aged ≥65.Item Impact of COVID-19 on Life Experiences of Essential Workers Attending a Dental Testing Facility(Sage, 2021) Fontana, M.; McCauley, L.; Fitzgerald, M.; Eckert, G. J.; Yanca, E.; Eber, R.; Biostatistics and Health Data Science, School of MedicineObjectives: 1) To compare the impact of COVID-19 on the life experiences of essential workers attending a COVID-19 antibody testing clinic at a dental school. 2) To compare responses of dental, non-dental health care, and non-health care essential workers. 3) To assess acceptability/satisfaction of testing done in a dental setting. Method: A total of 984 participants completed a self-administered online questionnaire. Results: Over 90% were healthy (i.e., not in a high-risk health-related group for COVID-19), did not have COVID-19 symptoms within 30 d, and always/frequently engaged in preventive measures. Fifty-eight percent thought that they had a 0% to 25% chance of having immunity/antibodies to COVID-19. Non-dental health care workers thought that their chance was significantly higher (P < 0.05) than others. Over 70% were sometimes, frequently, or always worried about their friends and loved ones getting COVID-19 and of resulting financial problems. Dental workers were significantly less afraid than non-dental health care and non-health care providers. For all groups, more than half of the respondents stated that the pandemic had a negative (somewhat worse or worse) impact on daily life (59%), interactions with others (65%), stress levels (66%), and enjoyment of life (56%). There were significant differences among all 3 groups regarding the percentage of individuals with a negative impact on job security (dental, 47%; non-dental health care, 34%; non-health care, 31%). However, more than half of the respondents stated that the pandemic had a positive impact (same, somewhat better, or much better) on caring about one another, self-care, and exercise. Knowing the results of an antibody test would decrease the level of stress and anxiety in 67% of respondents. Over 80% found a COVID-19 test received in a dental setting acceptable, were "definitely" satisfied, and would "definitely" recommend it to a friend, family, or coworker. Conclusions: These findings support that dental workers are as vulnerable as other essential workers to threats and psychological impacts of COVID-19. They also support the acceptability and satisfaction of testing for a pandemic done in a dental setting. Knowledge transfer statement: The results of this study highlight the impact that pandemics such as COVID-19 can have on life experiences of essential workers, including dentists. It also highlights a role that dentistry can play within the broader health care system, during and beyond the current pandemic, to help with surveillance efforts of community health. Testing may also help alleviate stress and anxiety associated with these pandemics.Item The Impact of the COVID-19 Pandemic on Behavioral Health in Indiana(The Center for Health Policy, 2021-06-01) Kooreman, Harold; Gutta, Jyotsna; Bandali, Elhaam; Greene, Marion S.As of January 2021, the Johns Hopkins Coronavirus Resource Center has confirmed more than 20 million SARS-CoV-2 cases and over 350,000 deaths in the United States alone and 100 million cases and more than 2 million deaths globally. As of December 31, 2020, over half a million Hoosiers had tested positive for COVID-19 and more than 8,000 had died as a result of complications from the disease. This report is a review on the impact the COVID-19 pandemic had (and has) on the mental and behavioral health of Hoosiers. Specifically, we reviewed pandemic-related stress on children, parents, and the elderly; substance use, misuse, and overdose deaths; mental health concerns; suicide; domestic violence; and child abuse and neglect. The current report is a summary of findings. It provides a snapshot in time. Data and conclusions were relevant and timely at the time the report was produced.