Otoskills training during covid-19 pandemic: a before-after study.
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ABSTRACT: Background
The ongoing COVID-19 pandemic has disrupted the surgical training of residents. There is a real concern that trainees will not be able to meet their training requirements. Low-fidelity surgical simulation appears to be an alternative for surgical training. The educational benefits of repeating ossiculoplasty simulations under a microscope have never been evaluated. With this study we aimed to evaluate the differences in performance scores and on a global rating scale before and after training on an ossiculoplasty simulator.Methods
In this quasi-experimental, prospective, single-centre, before-after study with blinded rater evaluation, residents performed five microscopic ossiculoplasty tasks with a difficulty gradient (sliding beads onto rods, the insertion of a partial prosthesis, the insertion of a total prosthesis, and the insertion of a stapedotomy piston under microscopic or endoscopic surgery) before and after training on the same simulator. Performance scores were defined for each task, and total performance scores (score/min) were calculated. All data were collected prospectively.Results
Six out of seven intermediate residents and 8/9 novices strongly agreed that the simulator was an effective training device and should be included in the ENT residency program. The mean effect of training was a significant increase in the total performance score (+ 0.52 points/min, [95 % CI, 0.40-0.64], p < 0.001), without a significant difference between novice and intermediate residents.Conclusions
This preliminary study shows that techniques for middle-ear surgery can be acquired using a simulator, avoiding any risk for patients, even under lockdown measures.
SUBMITTER: Fieux M
PROVIDER: S-EPMC8129703 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-BSST1055 | biostudies-other
Project description:BackgroundCardiothoracic training during the Coronavirus disease 2019 (COVID-19) pandemic witnessed a dramatic change in the United Kingdom, resulting in changes in surgical provisions, centralization of services, and reduced surgical case volume. The aim of this study was to assess the impact COVID-19 on surgical training and seek opinions regarding the future role of surgical simulation in cardiothoracic training.MethodsA cross-sectional survey was designed and distributed to 200 cardiothoracic national and non-national trainees in the United Kingdom. The survey consisted of 31 questions in 4 sections: Demographics, Service Provision, Training, and Simulation Training.ResultsEighty-three of the 200 trainees (41.5%) completed the survey, including 44 of 129 national trainees (34.1%) and 39 of 71 non-national trainees (54.9%). Sixty-seven respondents (80.7%) agreed that cardiothoracic training had been negatively impacted as a result of COVID-19 (P < .001). In addition, 12% agreed that adequate resources were available for learning/practicing technical skills, 87% agreed that simulation had a role in cardiothoracic training, 81% recognized simulations is an important tool in improving their surgical skills, and 79.5% agreed that simulation should be used to meet the increasing need in training/education moving forward.ConclusionsCOVID-19 has had a significant impact on surgical training, with concerns that these effects could have further implications downstream. Simulation training has been underused thus far, and trainees face an uphill challenge to enhance their skills and technical abilities in the operating room. Simulation is recommended by trainees and may represent a solution to the challenges of safe and effective cardiothoracic surgical training.
| S-EPMC8282444 | biostudies-literature
Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.
| 2346925 | ecrin-mdr-crc
Project description:ObjectiveThe purpose of the study is to examine the prevalence of loneliness in Europe in 2016 and during the first months - April-July 2020 - of the COVID-19 pandemic, and to assess whether the risk factors associated with loneliness have changed after the outbreak of the pandemic.MethodThe analysis is based on two cross-country surveys, namely the 2016 European Quality of Life Survey and the 2020 Living, Working and COVID-19 Online Survey.ResultsThe COVID-19 pandemic has magnified already worrying levels of loneliness in Europe. Young adults have been the most severely hit by social distancing measures. Living alone has made social distancing measures more painful. Health and financial status are strong associates of loneliness, irrespective of the time period.ConclusionThis analysis will help anticipate the potential consequences that forced social isolation might have triggered in the population and identify populations more vulnerable to loneliness. Further monitoring is important to assess whether the registered increase in loneliness is transient or chronic and to design targeted loneliness interventions.
| S-EPMC9479375 | biostudies-literature
Project description:Objective: To investigate prevalence of life satisfaction in the Thai population before and during the COVID-19 epidemic, and factors associated with life satisfaction during the epidemic. Methods: Multistage sampling was used to draw a sample from the Thai population. A total of 3,115 Thai participants age 15 years or older from a nationally-representative longitudinal survey in 2019 and in 2021 were included in this study. The study applied the Scale with Life Satisfaction (SWLS) instrument to measure life satisfaction among the Thai population before and during the COVID-19 epidemic. Multiple regression analysis was used to investigate the association between life satisfaction and other variables. The follow-up survey response rate for individuals was 44.8%. Results: An average life satisfaction score during the COVID-19 epidemic (in 2021) was 22.4 which decreased from 25.5 before the COVID-19 epidemic (in 2019). More than one-third of the participants (36.5%) reported having less life satisfaction during the epidemic, which was nearly 20 percentage points higher than before the epidemic (17.7%). Controlling for life satisfaction in 2019, the analysis found statistical associations between demographic and economic characteristics and health-related behaviours, and life satisfaction during 2021. People in the older age cohorts (p ≤ 0.001), in a rural area (p ≤ 0.05), having higher education (p ≤ 0.001), still being employed (p ≤ 0.01) and becoming unemployed (p ≤ 0.01) had higher life satisfaction. The possibility of higher life satisfaction was also found in people who maintained good health (p ≤ 0.01), sufficient physical activity (p ≤ 0.001), and fruit and vegetable intake (p ≤ 0.01). People with income loss during the epidemic had lower life satisfaction (p ≤ 0.05). Conclusion: The findings suggest that policies and systems for resilience and social protection are needed for empowering individuals-especially the poor and vulnerable-to cope with crises, and improve health and wellbeing outcomes.
| S-EPMC10372220 | biostudies-literature
Project description:ObjectivesEarly in the coronavirus 2019 (COVID-19) pandemic, a high frequency of pulmonary embolism was identified. This audit aims to assess the frequency and severity of pulmonary embolism in 2020 compared to 2019.MethodsIn this retrospective audit, we compared computed tomography pulmonary angiography (CTPA) frequency and pulmonary embolism severity in April and May 2020, compared to 2019. Pulmonary embolism severity was assessed with the Modified Miller score and the presence of right heart strain was assessed. Demographic information and 30-day mortality was identified from electronic health records.ResultsIn April 2020, there was a 17% reduction in the number of CTPA performed and an increase in the proportion identifying pulmonary embolism (26%, n = 68/265 vs 15%, n = 47/320, p < 0.001), compared to April 2019. Patients with pulmonary embolism in 2020 had more comorbidities (p = 0.026), but similar age and sex compared to 2019. There was no difference in pulmonary embolism severity in 2020 compared to 2019, but there was an increased frequency of right heart strain in May 2020 (29 vs 12%, p = 0.029). Amongst 18 patients with COVID-19 and pulmonary embolism, there was a larger proportion of males and an increased 30 day mortality (28% vs 6%, p = 0.008).ConclusionDuring the COVID-19 pandemic, there was a reduction in the number of CTPA scans performed and an increase in the frequency of CTPA scans positive for pulmonary embolism. Patients with both COVID-19 and pulmonary embolism had an increased risk of 30-day mortality compared to those without COVID-19.Advances in knowledgeDuring the COVID-19 pandemic, the number of CTPA performed decreased and the proportion of positive CTPA increased. Patients with both pulmonary embolism and COVID-19 had worse outcomes compared to those with pulmonary embolism alone.
| S-EPMC8248223 | biostudies-literature
Project description:The COVID-19 pandemic has had a huge impact on people's lives and may influence mental health in the general population. In a unique representative Danish longitudinal study, we examined mental well-being measured just before and during the COVID-19 pandemic. The Danish Health and Wellbeing Survey is the Danish contribution to the European Health Interview Survey. In this study, we included the wave from autumn 2019, which we re-invited in the autumn 2020. The study population consisted of 4,234 persons. The main outcome was mental well-being measured by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear and logistic regression models were conducted to evaluate change in SWEMWBS between 2019 and 2020. The SWEMWBS distribution was similar in 2019 and 2020, although the distribution moved to lower scores in 2020 compared to 2019. Mean SWEMWBS decreased significantly from 25.5 in 2019 to 24.6 in 2020 corresponding to a mean change of -1.0 (95%CI, -1.1. to -0.8). The proportion with low SWEMWBS increased from 16.5% in 2019 to 20.1% in 2020 (p < 0.001). The mean change was similar for men and women and for different age groups. The most negative development was observed among persons without depression or long-standing illnesses at baseline and among persons with higher educational level. Among persons with depression SWEMWBS increased. As expected, mental well-being significantly decreased in the adult Danish population during the COVID-19 pandemic. However, somewhat more unexpectedly, the decrease was most pronounced among persons without depression or long-standing illnesses and among higher educated groups.
| S-EPMC8460161 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has led to a notable increase in telemedicine adoption. However, the impact of the pandemic on telemedicine use at a population level in rural and remote settings remains unclear.ObjectiveThis study aimed to evaluate changes in the rate of telemedicine use among rural populations and identify patient characteristics associated with telemedicine use prior to and during the pandemic.MethodsWe conducted a repeated cross-sectional study on all monthly and quarterly rural telemedicine visits from January 2012 to June 2020, using administrative data from Ontario, Canada. We compared the changes in telemedicine use among residents of rural and urban regions of Ontario prior to and during the pandemic.ResultsBefore the pandemic, telemedicine use was steadily low in 2012-2019 for both rural and urban populations but slightly higher overall for rural patients (11 visits per 1000 patients vs 7 visits per 1000 patients in December 2019, P<.001). The rate of telemedicine visits among rural patients significantly increased to 147 visits per 1000 patients in June 2020. A similar but steeper increase (P=.15) was observed among urban patients (220 visits per 1000 urban patients). Telemedicine use increased across all age groups, with the highest rates reported among older adults aged ≥65 years (77 visits per 100 patients in 2020). The proportions of patients with at least 1 telemedicine visit were similar across the adult age groups (n=82,246/290,401, 28.3% for patients aged 18-49 years, n=79,339/290,401, 27.3% for patients aged 50-64 years, and n=80,833/290,401, 27.8% for patients aged 65-79 years), but lower among younger patients <18 years (n=23,699/290,401, 8.2%) and older patients ≥80 years (n=24,284/290,401, 8.4%) in 2020 (P<.001). There were more female users than male users of telemedicine (n=158,643/290,401, 54.6% vs n=131,758/290,401, 45.4%, respectively, in 2020; P<.001). There was a significantly higher proportion of telemedicine users residing in relatively less rural than in more rural regions (n=261,814/290,401, 90.2% vs n=28,587/290,401, 9.8%, respectively, in 2020; P<.001).ConclusionsTelemedicine adoption increased in rural and remote areas during the COVID-19 pandemic, but its use increased in urban and less rural populations. Future studies should investigate the potential barriers to telemedicine use among rural patients and the impact of rural telemedicine on patient health care utilization and outcomes.
| S-EPMC8023379 | biostudies-literature
Project description:ImportanceRespiratory syncytial virus (RSV) is a leading cause of pediatric hospitalizations.ObjectiveTo describe the epidemiology and burden of RSV-associated hospitalizations among children and adolescents in Canadian tertiary pediatric hospitals from 2017 to 2022, including changes during the COVID-19 pandemic.Design, setting, and participantsThis cross-sectional study was conducted during 5 RSV seasons (2017-2018 to 2021-2022) at 13 pediatric tertiary care centers from the Canadian Immunization Monitoring Program Active (IMPACT) program. Hospitalized children and adolescents aged 0 to 16 years with laboratory-confirmed RSV infection were included.Main outcomes and measuresThe proportion of all-cause admissions associated with RSV and counts and proportions of RSV hospitalizations with intensive care unit (ICU) admission, prolonged stay (≥7 days), and in-hospital mortality were calculated overall and by season, age group, and region. Seasonality was described using epidemic curves. RSV hospitalizations for 2021-2022 were compared with those in the prepandemic period of 2017-2018 through 2019-2020. Bonferroni corrections were applied to P values to adjust for multiple statistical comparisons.ResultsAmong 11 014 RSV-associated hospitalizations in children and adolescents (6035 hospitalizations among male patients [54.8%]; 5488 hospitalizations among patients aged <6 months [49.8%]), 2594 hospitalizations (23.6%) had admission to the ICU, of which 1576 hospitalizations (60.8%) were among children aged less than 6 months. The median (IQR) hospital stay was 4 (2-6) days. The mean (SD) number of RSV-associated hospitalizations during prepandemic seasons was 2522 (88.8) hospitalizations. There were 58 hospitalizations reported in 2020-2021, followed by 3170 hospitalizations in 2021-2022. The proportion of all-cause hospitalizations associated with RSV increased from a mean of 3.2% (95% CI, 3.1%-3.3%) before the pandemic to 4.5% (95% CI, 4.3%-4.6%) in 2021-2022 (difference, 1.3 percentage points; 95% CI, 1.1-1.5 percentage points; corrected P < .001). A significant increase in RSV-associated hospitalizations was found in 2021-2022 for 3 provinces (difference range, 2.5 percentage points; 95% CI, 1.4-3.6 percentage points for Quebec to 2.9 percentage points; 95% CI, 1.4-3.5 percentage points for Alberta; all corrected P < .001). Age, sex, ICU admission, prolonged length of stay, and case fatality rate did not change in 2021-2022 compared with the prepandemic period. Interregional differences in RSV seasonality were accentuated in 2021-2022, with peaks for 1 province in October, 4 provinces in December, and 3 provinces in April, or May.Conclusions and relevanceThis study found that the burden of RSV-associated hospitalizations in Canadian pediatric hospitals was substantial, particularly among infants aged less than 6 months, and RSV hospitalizations increased in 2021-2022 compared with the prepandemic period, while severity of illness remained similar. These findings suggest that RSV preventive strategies for infants aged less than 6 months would be associated with decreased RSV disease burden in children.
| S-EPMC10551765 | biostudies-literature
Project description:BackgroundA number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum.AimsWe aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic.MethodWe analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020.ResultsThere were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown.ConclusionsUK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.
| S-EPMC8314272 | biostudies-literature