The show must go on: Dermatologic procedural education in the era of COVID-19.
Ontology highlight
ABSTRACT:
SUBMITTER: Pollock SE
PROVIDER: S-EPMC7694554 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ContextThe COVID-19 pandemic led to shutting of education faculties, including clinical clerkships for medical students.ObjectiveTo review a selective for a course in diagnostic pathology geared toward undergraduate medical students, including its design, technical implementation, instructor and student evaluations, and suggestions for options for further adjusting and optimizing the selective.DesignWhole slide images (WSI) were anonymized and students were given remote access to university computers, which were prepared with two freely available WSI viewers. Each topic was taught in a four-part module: Self-assigned reading, lecture via Zoom, quiz based on digital slide sets, and a frontal review of the slides via Zoom. Fifty-nine students participated in the selective. Following the course, students completed an anonymous questionnaire.ResultsOf the 59 participants, 42% (n = 25) responded. None of the respondents had any previous instruction in diagnostic pathology. Overall, the course was rated very favorably: 68% (n = 17) gave at least 3 points on a 4-point scale on questions relating to course interest, improvement in understanding of the covered diseases, and how strongly they would recommend a student take this course if given an option. The most significant disadvantage of the class, as reported by 80% (n = 20) were technical challenges in accessing the slides.ConclusionWe believe the course was a success and can be a model for future virtual pathology electives. Great effort should be done to provide technical support to the students. The selective demonstrated value for students and provided much-needed exposure to diagnostic pathology in clinical practice.
| S-EPMC7455795 | biostudies-literature
Project description: Not available
| S-EPMC7592817 | biostudies-literature
Project description: Not available
| S-EPMC7691187 | biostudies-literature
Project description:The COVID-19 pandemic and social distancing rules necessitated the suspension of all in-person learning activities at our institution. Consequently, distance learning became essential. We adapted a high-fidelity immersive case-based simulation scenario for telesimulation by using the virtual meeting platform Zoom® to meet our curricular needs. The use of telesimulation to teach a complex case-based scenario is novel. Two cohorts of anesthesiology residents participated 2 weeks apart. All learners were located at home. Four faculty members conducted the telesimulation from different locations within our simulation center in the roles of director, simulation operator, confederate anesthesiologist, and confederate surgeon. The anesthesiologist performed tasks as directed by learners. The scenario was divided into four scenes to permit reflection on interventions/actions by the participants based on the clinical events as the scenario progressed, to facilitate intermittent debriefing and learner engagement. All residents were given a medical knowledge pretest before the telesimulation and a posttest and learner satisfaction survey at the conclusion. The scenario was authentic and immersive, represented an actual case, and provided the opportunity to practice lessons that could be applied in the clinical setting. Participants rated telesimulation a reasonable substitution for in-person learning and expressed gratitude for continuation of their simulation-based education in this format during the pandemic. Participants in the second cohort reported feeling more engaged (p = 0.008) and stimulated to think critically (p = 0.003). Audio quality was the most frequently noted limitation. Fifty-three residents completed both pre- and posttests. The two cohorts did not differ in knowledge pretest scores (62% vs 60%, p = 0.80) or posttest scores (78% vs. 77%, p = 0.87). Overall, knowledge scores improved with the telesimulation intervention (pretest mean = 61% [SD = 14%]; posttest mean = 78% [SD = 12%]; t (41) = - 7.89, p < 0.001). Thus, using a Zoom format, we demonstrated the feasibility of adapting a complex case for telesimulation and effective knowledge gain. Furthermore, we improved our process in real time based on participant feedback. Participants were satisfied with their learning experience, suggesting that this format may be used in other distance learning situations.
| S-EPMC7522907 | biostudies-literature
Project description: Not available
| S-BSST563 | biostudies-other
Project description:An emerging consensus in public health views testing for Covid-19 as key to managing the pandemic. It is often assumed that citizens have a strong desire to know their Covid-19 status, and will therefore take advantage of testing opportunities. This may not be the case in all contexts, however, especially those where citizens perceive stigma associated with the Covid-19, have low trust in health institutions, and doubt the procedural integrity of the testing process. This article explores willingness to receive a free Covid-19 test via a vignette experiment (conjoint design) embedded in a phone survey conducted in Malawi in May 2020. The experiment varied test provider (public clinic versus international health organization), proximity to illness, and reassurance of confidentiality. We find that Malawians expect higher uptake of testing in their community when the international health organization offered the test rather than a public clinic, an effect we attribute to higher trust in the organization and/or perceptions of greater capacity to ensure procedural integrity. The confidentiality reassurance did not substantially alter beliefs about the privacy of results, but did increase doubts about the willingness of community members to get tested in a public health clinic. Our findings suggest the importance of considering the demand side of testing in addition to well-known challenges of supply.
| S-EPMC7803152 | biostudies-literature
Project description:To outline a set of recommendations on the management of pediatric cases who requiring airway surgery in the context of COVID 19 pandemic. A set of recommendations have been prepared based on National and International published scientific literature and recent updates on COVID 19. These has been implemented in our tertiary care centre. Due to the evolving nature of COVID 19 and existing knowledge gaps, these recommendations may have to be revised periodically. The incidence of COVID 19 is very low (1-5%) in the pediatric age group with relatively good prognosis. Pediatric airway surgeries should be restricted to emergency cases only. The decision of postponement of the surgical cases should be taken by the team of senior pediatric airway surgeons. Flexible laryngoscopy should be avoided. Foreign body cases should undergo a computed tomography scan to avoid diagnostic bronchoscopies. All the measures should be taken to prevent direct contact of aerosol so powered instruments should not be used unless mandatory. Protective draping method should be adopted to prevent aerosol exposure. As paediatric airway surgeries are aerosol generating procedure where the risk of contracting COVID 19 by the surgeons and support staff is very high, we suggest recommendations to prevent the contact with infected aerosol. We assure these recommendations are easy to follow and can impact good quality outcome during this pandemic crisis.
| S-EPMC7384273 | biostudies-literature
Project description:Influenza spreads globally annually with significant paediatric and adult attack rates and considerable morbidity, mortality and the exacerbation of extant chronic disease. In the northern and southern hemispheres, outbreaks occur mainly in the respective winter seasons. Influenza vaccination is available but only partially effective. In the absence of a vaccine, in winter, novel coronavirus COVID-19 will also circulate in parallel with seasonal influenza. Thus far it appears that with the current strains of these two viruses, the clinical outcome of co-infection is not significantly worse than infection with COVID-19 alone. However, several strains of influenza circulate, including strains still to come. Similarly, COVID-19 has several strains, with probably more to come. This paper discusses these issues and estimates ideal minimum influenza vaccination coverage based on an estimated influenza Basic Reproduction Number (R0) of 0.9-2.1 so as to obtain herd immunity or approach it. There is a strong argument for attempting near universal population coverage with the annual influenza vaccine leading up to next winter.
| S-EPMC7301816 | biostudies-literature
Project description:Recommendations were made recently to limit or stop the use of oral and systemic immunotherapies for skin diseases due to potential risks to the patients during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 pandemic. Herein, we attempt to identify potentially safe immunotherapies that may be used in the treatment of cutaneous diseases during the current COVID-19 pandemic. We performed a literature review to approximate the risk of SARS-CoV-2 infection, including available data on the roles of relevant cytokines, cell subsets, and their mediators in eliciting an optimal immune response against respiratory viruses in murine gene deletion models and humans with congenital deficiencies were reviewed for viral infections risk and if possible coronaviruses specifically. Furthermore, reported risk of infections of biologic and non-biologic therapeutics for skin diseases from clinical trials and drug data registries were evaluated. Many of the immunotherapies used in dermatology have data to support their safe use during the COVID-19 pandemic including the biologics that target IgE, IL-4/13, TNF-?, IL-17, IL-12, and IL-23. Furthermore, we provide evidence to show that oral immunosuppressive medications such as methotrexate and cyclosporine do not significantly increase the risk to patients. Most biologic and conventional immunotherapies, based on doses and indications in dermatology, do not appear to increase risk of viral susceptibility and are most likely safe for use during the COVID-19 pandemic. The limitation of this study is availability of data on COVID-19.
| S-EPMC7361427 | biostudies-literature
Project description:Since the start of the pandemic, some U.S. communities have faced record storms, fires, and floods. Communities have confronted the increased challenge of curbing the spread of COVID-19 amid evacuation orders and short-term displacement that result from hazards. This raises the question of whether disasters, evacuations, and displacements have resulted in above-average infection rates during the COVID-19 pandemic. This study investigates the relationship between disaster intensity, sheltering-in-place, evacuation-related mobility, and contagion following Hurricane Zeta in Southeastern Louisiana and The Wildfires in Napa and Sonoma Counties, California, known as the Glass Fire. We draw on data from the county subdivision level and mapped and aggregated tallies of Facebook user movement from the Facebook Data for Good program's GeoInsights Portal. We test the effects of disasters, evacuation, and shelter-in-place behaviors on COVID-19 spread using panel data models, matched panel models, and synthetic control experiments. Our findings suggest associations between disaster intensity and higher rates of COVID-19 cases. We also find that while sheltering-in-place led to decreases in the spread of COVID-19, evacuation-related mobility did not result in our hypothesized surge of cases immediately after the disasters. The findings from this study aim to inform policymakers and scholars about how to better respond to disasters during multi-crisis events, such as offering hotel accommodations to evacuees instead of mass shelters and updating intake and accommodation procedures at shelters, such as administration temperature screenings, offering hand sanitizing stations, and providing isolated areas for ill evacuees.
| S-EPMC8747941 | biostudies-literature