Medicine and Health Sciences Commons^™

Primary Care Practices In Western North Carolina: Adaptation To The Covid-19 Pandemic And Ongoing Challenges, Hannah R. Friedman, Joseph Konstanzer, Erica Richman, Brian Cass, Bryan Hodge, Sheri Denslow, Jacqueline Halladay

HCA Healthcare Journal of Medicine

Introduction

The COVID-19 pandemic has created unique challenges for primary care practices while also highlighting their importance in the pandemic response. To understand primary care practice needs, a survey was conducted of practices in Western North Carolina.

Methods

Phase 2 of a primary care needs assessment was administered to 63 practices in Western North Carolina over the course of six weeks, from July 23 to August 31, 2021.

Results

Most practices were operating with normal hours, though some still operated with reduced hours. Many practices reported insufficient personal protective equipment (PPE) supplies. While most practices provided at least some care …

Evaluation Of The United States Covid-19 Vaccine Allocation Strategy, Md Rafiul Islam, Tamer Oraby, Audrey Mccombs, Mohammad Mihrab Chowdhury, Mohammad Al-Mamun, Michael G. Tyshenko, Claus Kadelkai

School of Mathematical and Statistical Sciences Faculty Publications and Presentations

Background: Anticipating an initial shortage of vaccines for COVID-19, the Centers for Disease Control (CDC) in the United States developed priority vaccine allocations for specific demographic groups in the population. This study evaluates the performance of the CDC vaccine allocation strategy with respect to multiple potentially competing vaccination goals (minimizing mortality, cases, infections, and years of life lost (YLL)), under the same framework as the CDC allocation: four priority vaccination groups and population demographics stratified by age, comorbidities, occupation and living condition (congested or non-congested).

Methods and findings: We developed a compartmental disease model that incorporates key elements of the …

Which Outcomes Are Most Important To Measure In Patients With Covid-19 And How And When Should These Be Measured? Development Of An International Standard Set Of Outcomes Measures For Clinical Use In Patients With Covid-19: A Report Of The International Consortium For Health Outcomes Measurement (Ichom) Covid-19 Working Group., William H Seligman, Luz Fialho, Nick Sillett, Christina Nielsen, Farhala M Baloch, Philip Collis, Ingel K M Demedts, Marcelo P Fleck, Maiara A Floriani, Lucinda E K Gabriel, Joel J Gagnier, Anju Keetharuth, Ana Londral, Ingvar I L Ludwig, Carlos Lumbreras, Alejandro Moscoso Daza, Nasreen Muhammad, Gisele A Nader Bastos, Christine W Owen, John H. Powers, Anne-Marie Russell, Michaela K Smith, Tracy Y-P Wang, Evan K Wong, Douglas C Woodhouse, Eyal Zimlichman, Kees Brinkman

Medicine Faculty Publications

No abstract provided.

Accounting And Finance Lessons In The Time Of Covid-19: Views From The Pacific Basin: Part 2, Kuan Yong David Ding, Julie Harrison, Martien Lubberink, Chris Van Staden

Research Collection Lee Kong Chian School Of Business

The global COVID-19 pandemic is now in its second year, and we are fast approaching the third. The year 2021 has brought some hope that vaccination will lead to the end of the pandemic. But it has also brought a more infectious variant of COVID-19 and multiple waves of surging cases that show no immediate sign of disappearing. As the pandemic continues to impact global societies and economies, it is imperative that we study its impact to try and understand how it will affect us in both the short-term and long-term. While the longer-term impacts are still unknown, there is …

Positron Emission Tomography In The Covid-19 Pandemic Era, Chentao Jin, Xiaoyun Luo, Shufang Qian, Kai Zhang, Yuanxue Gao, Rui Zhou, Peili Cen, Zhoujiao Xu, Hong Zhang, Mei Tian

Journal Articles

Coronavirus disease 2019 (COVID-19) has become a major public health problem worldwide since its outbreak in 2019. Currently, the spread of COVID-19 is far from over, and various complications have roused increasing awareness of the public, calling for novel techniques to aid at diagnosis and treatment. Based on the principle of molecular imaging, positron emission tomography (PET) is expected to offer pathophysiological alternations of COVID-19 in the molecular/cellular perspectives and facilitate the clinical management of patients. A number of PET-related cases and research have been reported on COVID-19 over the past one year. This article reviews the current studies of …

Perfect Storm, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Barriers To Symptom Management Care Pathway Implementation In Pediatric Cancer, L Lee Dupuis, Allison Grimes, Emily Vettese, Lisa M Klesges, Lillian Sung

2020-Current year OA Pubs

BACKGROUND: Objectives were to describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation.

METHODS: We included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized trial in which the intervention encompassed care pathways for symptom management. A survey was distributed to site principal investigators prior to randomization to measure contextual elements related to care pathway implementation. Questions included the inner setting measures of the Consolidated Framework for Implementation Research (CFIR), study-specific potential barriers and the impact of …

Ua94/6/1 Pandemic Personal Narrative, Leah Painter

Student/Alumni Personal Papers

COVID-19 personal narrative written by student Leah Painter for History 241 class.

The 2021 Ipr Future Of Communications In Asia Report, Tina Mccorkindale, Sarah Crawshaw, Su Lin Yeo, Stephen Thomas, Alexis B. Fitzsimmons, Pang, A.

Research Collection Lee Kong Chian School Of Business

The communication function within Asian-headquartered organizations is undergoing significant growth and changes that will be pivotal for its future success, according to a new Institute for Public Relations (IPR) research report. The “IPR Future of Communications in Asia” research report investigates key changes that will impact the future of the communications function. The analysis is based on interviews with 30 senior communications executives based in Asia in a variety of industries from 2019 to 2020, and three focus groups with nearly 20 senior communication leaders in late 2020.

Interpreting Covid-19 Deaths Among Nursing Home Residents In The Us: The Changing Role Of Facility Quality Over Time, Debasree Das Gupta, Uma Kelekar, Sidney C. Turner, Anupam A. Sule, Taya G. Jerman

Kinesiology and Health Science Faculty Publications

A report published last year by the Centers for Medicare & Medicaid Services (CMS) highlighted that COVID-19 case counts are more likely to be high in lower quality nursing homes than in higher quality ones. Since then, multiple studies have examined this association with a handful also exploring the role of facility quality in explaining resident deaths from the virus. Despite this wide interest, no previous study has investigated how the relation between quality and COVID-19 mortality among nursing home residents may have changed, if at all, over the progression of the pandemic. This understanding is indeed lacking given that …

Obesity, Race, And Covid-19 Mortality: Results From A Large Cohort Early In The Pandemic, Eric K. Shaw, Anyul Ferez-Pinzon, Micah Mabe, Mike Flynn, Christopher K. Senkowski

HCA Healthcare Journal of Medicine

Background

Obesity has increased progressively in the United States and is a known risk factor for several diseases such as type 2 diabetes, coronary artery disease, stroke and hypertension. Amid the current pandemic, concerns have been raised about obesity as a risk factor for COVID-19 positive patients. The primary goal of this study was to explore the association between obesity and hospital mortality in COVID-19 patients. Our secondary objective was to explore the relationship between obesity and race on hospital mortality in COVID-19 patients.

Methods

This was a cross-sectional, retrospective analysis using data from 186 hospitals from across the United …

Telemedicine Visits In An Established Multidisciplinary Central Nervous System Clinic For Radiation Oncology And Neurosurgery (Radians) In A Community Hospital Setting., S C Bowen R, R Gheewala, Wa Paez, B Lucke-Wold, T Mitin, Jn Ciporen

Clinical Research and Leadership Faculty Publications

OBJECTIVE: To determine the impact of telemedicine visits, compared to in-person visits, on patient satisfaction in an established community hospital-based multidisciplinary central nervous system (CNS) clinic.

METHODS: Telemedicine options - virtual visits and teleconferencing - were introduced in July 2020. Both radiation oncologist and neurosurgeon were simultaneously present for the telemedicine visit. Descriptive patient demographics, survey responses, and travel time and distance calculations were analyzed. Satisfaction score was compared to previously published data.

RESULTS: A total of twenty-five telemedicine visits (n=22 video; n=3 phone) were completed since July 2020. Patient demographics are as follows: mean age was 59 years (range=22-81), …

Association Between Post-Hospital Clinic And Telephone Follow-Up Provider Visits With 30-Day Readmission Risk In An Integrated Health System, Huong Q. Nguyen, Aileen Baecker, Timothy Ho, Dan N. Huynh, Heather L. Watson, Jing Li, Ernest Shen

Center for Health Services Research Faculty Publications

BACKGROUND: Follow-up visits with clinic providers after hospital discharge may not be feasible for some patients due to functional limitations, transportation challenges, need for physical distancing, or fear of exposure especially during the current COVID-19 pandemic.

METHODS: The aim of the study was to determine the effects of post-hospital clinic (POSH) and telephone (TPOSH) follow-up provider visits versus no visit on 30-day readmission. We used a retrospective cohort design based on data from 1/1/2017 to 12/31/2019 on adult patients (n = 213,513) discharged home from 15 Kaiser Permanente Southern California hospitals. Completion of POSH or TPOSH provider visits within …

Developing Methods To Detect And Diagnose Chronic Traumatic Encephalopathy During Life: Rationale, Design, And Methodology For The Diagnose Cte Research Project, Michael L Alosco, Daniel S Marcus, Et Al.

2020-Current year OA Pubs

BACKGROUND: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that has been neuropathologically diagnosed in brain donors exposed to repetitive head impacts, including boxers and American football, soccer, ice hockey, and rugby players. CTE cannot yet be diagnosed during life. In December 2015, the National Institute of Neurological Disorders and Stroke awarded a seven-year grant (U01NS093334) to fund the "Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) Research Project." The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine …

Structural Distress: Experiences Of Moral Distress Related To Structural Stigma During The Covid-19 Pandemic, Javeed Sukhera, Chetana Kulkarni, Taryn Taylor

Obstetrics & Gynaecology Publications

INTRODUCTION: The COVID-19 pandemic has taken a significant toll on the health of structurally vulnerable patient populations as well as healthcare workers. The concepts of structural stigma and moral distress are important and interrelated, yet rarely explored or researched in medical education. Structural stigma refers to how discrimination towards certain groups is enacted through policy and practice. Moral distress describes the tension and conflict that health workers experience when they are unable to fulfil their duties due to circumstances outside of their control. In this study, the authors explored how resident physicians perceive moral distress in relation to structural stigma. …

Nurses' Pandemic Lives: A Mixed-Methods Study Of Experiences During Covid-19., Kathleen Gray, Paulette Dorney, Lori Hoffman, Albert Crawford

College of Nursing Faculty Papers & Presentations

BACKGROUND: The US healthcare settings and staff have been stretched to capacity by the COVID-19 pandemic. While COVID-19 continues to threaten global healthcare delivery systems and populations, its impact on nursing has been profound.

OBJECTIVES: This study aimed to document nurses' immediate reactions, major stressors, effective measures to reduce stress, coping strategies, and motivators as they provided care during COVID-19.

DESIGN: Mixed-methods, cross sectional design. Participants responded to objective and open-ended questions on the COVID-19 Nurses' Survey.

PARTICIPANTS: The survey, was sent to nurses employed in health care settings during the pandemic; 110 nurses participated.

RESULTS: Immediate reactions of respondents …

A Multi-Country Test Of Brief Reappraisal Interventions On Emotions During The Covid-19 Pandemic, Ka Wang, Amit Goldenberg, Charles Dorison, Et Al., Nadyanna Mohamed Majeed, Andree Hartanto

Research Collection School of Social Sciences

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across …

Media In A Time Of Crisis: Newspaper Coverage Of Covid-19 In East Asia;, Colm A. Fox

Research Collection School of Social Sciences

How have newspapers covered Covid-19 in Asia? To answer this question, I studied East Asian English-language newspapers published between January and July 2020. First, I measured the level of news media attention on Covid-19 among all reports. Second, I analyzed the tone and content of 330 editorials. I divided the analysis into two time periods: the initial crisis breakout period, when the number of infections was rising or high, and the crisis abatement period, when new infections declined to manageable levels. Findings show that although newspapers were slow to begin addressing the pandemic, their early editorials carried an alarming tone, …

Impact Of Coronavirus Disease 2019 On Prevention And Elimination Strategies For Hepatitis B And Hepatitis C, Syed Tabish Rehman, Hareem Rehman, Shahab Abid

Section of Pulmonary & Critical Care

The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality since its first case was discovered in December 2019. Since then, multiple countries have witnessed a healthcare system collapse due to the overwhelming demand for COVID-19 care. Drastic measures have been taken globally in order to curb the spread of the virus. However, those measures have led to the disruption of other aspects of healthcare, increasing the burden due to other medical conditions. We have also stepped back in achieving the ambitious goal set in place by World Health Organization to eliminate viral hepatitis as a public …

Epidemics And Pandemics: That Changed The Public Health History, Suja Karkada Dr., Mickael Antonie Joseph Dr., Celastin Susan, Veena Sophiya Menezes, Lanet Smitha Karkada

Manipal Journal of Nursing and Health Sciences

Epidemics and Pandemics: that changed the public health history

Abstract

Currently, the world is experiencing one of the most disruptive pandemics in the modern history of disease and illness. As human beings became more civilized, started building cities, establishing trade routes between cities and countries, the conditions needed for these diseases to spread were greatly enhanced and hence history has recorded many more epidemics and pandemics since the advent of global travel. Many of these epidemics and pandemics have disrupted the life of common human being from BC 430(Athens Plague) until date (Covid 19). Most of the recorded epidemics in …

Clinical Characteristics And Laboratory Biomarkers For Patients With Suspected Covid-19 Infection Within Hca Healthcare, Scott Gutovitz, Justin Hanson, Christian Vandever, Dietrich Jehle

HCA Healthcare Journal of Medicine

Background

The coronavirus infection (COVID-19), also known as the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2), caused significant illness and a worldwide pandemic beginning in 2020. Early case reports showed common patient characteristics, clinical variables and laboratory values in these patients. We compared a large population of American COVID-19 patients to see if they had similar findings to these smaller reports. In addition, we examined our population to identify any differences between mild or severe COVID-19 infections.

Methods

We retrospectively accessed a de-identified, multi-hospital database managed by HCA Healthcare to identify all adult emergency department (ED) patients that were tested …

Covid-19 Treatment Combinations And Associations With Mortality In A Large Multi-Site Healthcare System., Dagan Coppock, Michael Baram, Anna Marie Chang, Patricia Henwood, Alan Kubey, Ross Summer, John Zurlo, Michael Li, Bryan Hess

Division of Infectious Diseases and Environmental Medicine Faculty Papers

INTRODUCTION: During the early months of the COVID-19 pandemic, mortality associated with the disease declined in the United States. The standard of care for pharmacological interventions evolved during this period as new and repurposed treatments were used alone and in combination. Though these medications have been studied individually, data are limited regarding the relative impact of different medication combinations. The objectives of this study were to evaluate the association of COVID-19-related mortality and observed medication combinations and to determine whether changes in medication-related practice patterns and measured patient characteristics, alone, explain the decline in mortality seen early in the COVID-19 …

A Comparison Of Prospective Space-Time Scan Statistics And Spatiotemporal Event Sequence Based Clustering For Covid-19 Surveillance, Fuyu Xu, Kate Beard

Teaching, Learning & Research Documents

The outbreak of the COVID-19 disease was first reported in Wuhan, China, in December 2019. Cases in the United States began appearing in late January. On March 11, the World Health Organization (WHO) declared a pandemic. By mid-March COVID-19 cases were spreading across the US with several hotspots appearing by April. Health officials point to the importance of surveillance of COVID-19 to better inform decision makers at various levels and efficiently manage distribution of human and technical resources to areas of need. The prospective space-time scan statistic has been used to help identify emerging COVID-19 disease clusters, but results from …

Opportunities To Improve Symptom Control With Somatostatin Congeners In Gep-Nets: A Review Of Key Issues, Lowell B. Anthony, Thomas M. O'Dorisio

Internal Medicine Faculty Publications

Octreotide acetate (octreotide) is the most prescribed and most studied somatostatin congener, or analog, for gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and carcinoid syndrome, the latter of which may be characterized by debilitating diarrhea and flushing. Approved in the U.S. more than 30 years ago, octreotide is widely used to control the symptoms of carcinoid syndrome and has been shown to demonstrate antiproliferative activity. The two formulations available in the U.S. include a subcutaneous immediate-release (IR) injection introduced in 1989 and a long-acting repeatable (LAR) intramuscular injection approved in 1999. Lanreotide depot (lanreotide), a more recent somatostatin congener, has been available in …

Social Intervention By The Numbers: Evidence Behind The Specific Public Health Guidelines In The Covid-19 Pandemic., Michael P. Savage, David L. Fischman, Mamas A. Mamas

Department of Medicine Faculty Papers

Coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic ushering in a global health and economic crisis. In the absence of vaccines or definitive drug therapies, current strategies against COVID-19 rely on preventing the transmission of disease through nonpharmaceutical interventions such as social distancing and proper hand hygiene. For practical and perhaps ethical reasons, the clinical efficacy of these public health measures for managing pandemics has not been demonstrated in randomized controlled clinical trials. Accordingly, guideline recommendations for using nonpharmaceutical interventions are based primarily on observational and modeling studies and on expert opinion. A recent position paper from the …

Association Of Clinical Factors And Recent Anticancer Therapy With Covid-19 Severity Among Patients With Cancer: A Report From The Covid-19 And Cancer Consortium, P Grivas, K E Stockerl-Goldstein, A Y Zhou, Et Al.

2020-Current year OA Pubs

BACKGROUND: Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies.

PATIENTS AND METHODS: Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). …

An Assessment Of Outpatient Clinic Room Ventilation Systems And Possible Relationship To Disease Transmission, Kristin G King, George L Delclos, Eric L Brown, Susan Tortolero Emery, Jose Miguel Yamal, Robert J Emery

Journal Articles

BACKGROUND: With healthcare shifting to the outpatient setting, this study examined whether outpatient clinics operating in business occupancy settings were conducting procedures in rooms with ventilation rates above, at, or below thresholds defined in the American National Standards Institute/American Society of Heating, Refrigerating and Air-Conditioning Engineers/American Society for Health Care Engineering Standard 170 for Ventilation in Health Care Facilities and whether lower ventilation rates and building characteristics increase the risk of disease transmission.

METHODS: Ventilation rates were measured in 105 outpatient clinic rooms categorized by services rendered. Building characteristics were evaluated as determinants of ventilation rates, and risk of disease …

Meeting Minutes, Wku Council Of Academic Deans

Council of Academic Deans

Meeting regarding post-COVID instructional modality and international travel.

Covid-19-The American Perspective., Karl Saardi, Vesna Petronic-Rosic

Dermatology Faculty Publications

No abstract provided.

Goals-Of-Care Course For Emergency Physicians During The Covid-19 Pandemic., Mari Siegel, Erica Westlake

Department of Emergency Medicine Faculty Papers

BACKGROUND

COVID-19 increased the need for goals of care (GOC) discussions in the Emergency Department (ED). Many Emergency Physicians (EPs) report no formal training in holding GOC discussions. COVID-19 created unique teaching challenges given social distancing requirements.

METHODS

Eight teaching sessions were held using Zoom in March and April at an urban institution in the United States. Sessions were limited to 4-8 participants. They were comprised of a 30-minute lecture and 15 minutes of role-playing, in which providers read scripts to practice communication skills. The lecture introduced vocabulary and models to shape GOC discussions. Participants were invited to complete an …