scholarly journals Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 530
Author(s):  
Giovanni Trisolino ◽  
Renato Maria Toniolo ◽  
Lorenza Marengo ◽  
Daniela Dibello ◽  
Pasquale Guida ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Nationwide Survey ◽  
Emergency Department Visits ◽  
Pediatric Orthopedics ◽  
Significant Drop ◽  
Surgical Interventions ◽  
Pediatric Orthopedic ◽  
Orthopedic Patients ◽  
The Impact ◽  
Second Wave

Background: We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed. Methods: We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the “SITOP Priority Panel”. An additional classification in “high-priority” and “low-priority” surgery was also applied. Results: Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with “high-priority” surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of “low-priority” surgery and outpatient visits were observed. Conclusion: Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.

Decrease of oncological patients’ hospital visits during Covid-19 pandemic: The experience of a tertiary Romanian center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13607-e13607
Author(s):  
Cristina Crisan ◽  
Calin Ioan Cainap ◽  
Andrada Larisa Deac ◽  
Andrei Dan Havasi ◽  
Ovidiu Balacescu ◽  
...  
Keyword(s):  
Medical Oncology ◽  
Cancer Center ◽  
Significant Drop ◽  
Surgical Interventions ◽  
Oncological Patients ◽  
Number Of Patients ◽  
Mri Scans ◽  
Outpatient Departments ◽  
Pathology Reports ◽  
The Impact

e13607 Background: The outbreak of COVID-19 pandemic has changed the provision of medical services worldwide. Oncological patients continued receiving specialty treatments. We assess the impact of the pandemic on the oncological patients' visits to a tertiary cancer center. Methods: We analyzed registrations from the administrative data system of in and outpatients in all departments of the Cluj-Napoca Oncology Institute, during March-October 2020, compared to the same 7-month period of the previous year. Results: The decrease during March-October 2020 was of 40.2% for new referrals overall (with the most significant drop in April, of 80%), of 52.5% for medical oncology inpatients, 39% for pediatric oncology department inpatients, 69% for radiotherapy inpatients, 34.9% for surgical interventions and 31% decrease of issued pathology reports. The decrease was less important for outpatients: only 10% for medical oncology outpatient department, 33% for radiotherapy, and 27% for breast cancer unit outpatients. Imaging investigations were only slightly influenced by the pandemic (reduction of 5% for MRI scans, 19% for mammograms, whereas performed CT scans were even more after the outbreak of COVID-19). Conclusions: Our results show a decrease in the number of patients during the period after the outbreak of the COVID-19 pandemic, more for inpatients and less significant for outpatient departments, probably because of the internal circuits reorganization but also because of healthcare measures taken nationally and locally to limit the spread of the pandemic. Keywords: COVID-19, pandemic, oncology referrals, disruption.

scholarly journals Pediatric Orthopedic Trauma Care During the COVID-19 Pandemic: A Survey of the Pediatric Orthopedic Society of North America

2021 ◽  
pp. 155633162110560
Author(s):  
Mitchell A. Johnson ◽  
Theodore J. Ganley ◽  
Lindsay Crawford ◽  
Ishaan Swarup
Keyword(s):  
North America ◽  
Trauma Care ◽  
Care Delivery ◽  
Trauma Surgery ◽  
Trauma Patients ◽  
Orthopedic Trauma ◽  
Fracture Management ◽  
Pediatric Orthopedic ◽  
The Impact

Background: The COVID-19 pandemic has dramatically altered the practice of pediatric orthopedic trauma surgery in both outpatient and inpatient settings. While significant declines in patient volume have been noted, the impact on surgeon decision-making is unclear. Purpose: We sought to investigate changes in pediatric orthopedic trauma care delivery as a result of COVID-19 and determine their implications for future orthopedic practice. Methods: An electronic survey was distributed to all members (N = 1515) of the Pediatric Orthopedic Society of North America (POSNA) in March to April 2021; only members who provided care for pediatric orthopedic trauma patients were asked to complete it. The survey included questions on hospital trauma call, inpatient care, outpatient clinic practice, and 3 unique fracture case scenarios. Results: A total of 147 pediatric orthopedic surgeons completed the survey, for a 9.7% response rate, with 134 (91%) taking trauma call at a hospital as part of their practice. Respondents reported significant differences across institutions regarding COVID-19 testing, hospital rounding, and employee COVID-19 screening. Changes in outpatient fracture management were observed, including a decreased number of follow-up visits for nondisplaced clavicle fractures, distal radius buckle fractures, and toddler’s fractures. Of respondents who changed their fracture follow-up schedules due to COVID-19, over 75% indicated that they would continue these outpatient treatment schedules after the pandemic. Conclusions: This survey found changes in pediatric orthopedic trauma care as a result of the COVID-19 pandemic. The use of telemedicine and abbreviated follow-up practices for common fracture types are likely to persist following the resolution of the COVID-19 pandemic.

scholarly journals Effects of COVID-19 on Facial Plastic and Reconstructive Surgery Fellowship Training and Director Practices

OTO Open ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 2473974X2110141
Author(s):  
Parsa P. Salehi ◽  
Sina J. Torabi ◽  
Yan Ho Lee ◽  
Babak Azizzadeh
Keyword(s):  
Facial Nerve ◽  
Reconstructive Surgery ◽  
Trauma Surgery ◽  
The United States ◽  
Fellowship Training ◽  
Craniofacial Surgery ◽  
Worker Safety ◽  
Plastic And Reconstructive Surgery ◽  
Facial Plastic ◽  
The Impact

Objectives The objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training. Study Design Cross-sectional survey. Setting Online. Methods A survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery FDs and co-FDs in September 2020. Descriptive analyses were performed. Results Of 77 eligible FDs, 45 responded (58.4%) representing a diverse group across the United States. All but 1 FD routinely screened patients for COVID-19 in the preoperative setting. FDs largely believed that universal preoperative testing was cost-effective (66.7%), improved patient safety (80.0%) and health care worker safety (95.6%), and was not burdensome for patients (53.3%). With regard to volume of cosmetic/aesthetic, reconstructive, facial nerve, and trauma surgery, FDs indicated largely no change in volume (34.9%, 71.0%, 68.4%, and 80.0%, respectively) or fellow experience (67.4%, 80.6%, 84.2%, and 80.0%). Half (50.0%) of the FDs reported decreased volume of congenital/craniofacial surgery, but 75.0% did not believe that there was a change in fellow experience. Overall, of the 15 responses indicating “worsened training” across all domains of FPRS, 14 were located in the Northeast (93.33%). Conclusions The COVID-19 pandemic has had the least impact on the volume of reconstructive procedures, facial nerve operations, and trauma surgery and a negative impact on congenital/craniofacial surgery volume, and it has accelerated the demand for cosmetic/aesthetic operations. Overall, the majority of FDs did not feel as though their fellows’ trainings would be adversely affected by the ongoing pandemic.

scholarly journals Volatility Modeling: An Overview of Equity Markets in the Euro Area during COVID-19 Pandemic

Mathematics ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1212
Author(s):  
Pierdomenico Duttilo ◽  
Stefano Antonio Gattone ◽  
Tonio Di Di Battista
Keyword(s):  
Stock Market ◽  
Euro Area ◽  
Risk Premium ◽  
Stock Markets ◽  
Market Volatility ◽  
Stock Market Volatility ◽  
Volatility Modeling ◽  
The Impact ◽  
Second Wave ◽  
Daily Returns

Volatility is the most widespread measure of risk. Volatility modeling allows investors to capture potential losses and investment opportunities. This work aims to examine the impact of the two waves of COVID-19 infections on the return and volatility of the stock market indices of the euro area countries. The study also focuses on other important aspects such as time-varying risk premium and leverage effect. This investigation employed the Threshold GARCH(1,1)-in-Mean model with exogenous dummy variables. Daily returns of the euro area stock markets indices from 4th January 2016 to 31st December 2020 has been used for the analysis. The results reveal that euro area stock markets respond differently to the COVID-19 pandemic. Specifically, the first wave of COVID-19 infections had a notable impact on stock market volatility of euro area countries with middle-large financial centres while the second wave had a significant impact only on stock market volatility of Belgium.

scholarly journals The impact of the Covid-19 pandemic on adult diagnostic neuroradiology in Europe

2021 ◽  
Author(s):  
Marion Smits ◽  
M. W. Vernooij ◽  
N. Bargalló ◽  
A. Ramos ◽  
T. A. Yousry
Keyword(s):  
Online Courses ◽  
Mental Wellbeing ◽  
Personal Protection Equipment ◽  
Work Training ◽  
Healthcare Crisis ◽  
Area Of Concern ◽  
Media Channels ◽  
The Impact ◽  
Second Wave ◽  
Diagnostic Neuroradiology

Abstract Purpose The purpose of this survey was to understand the impact the Covid-19 pandemic has or has had on the work, training, and wellbeing of professionals in the field of diagnostic neuroradiology. Methods A survey was emailed to all ESNR members and associates as well as distributed via professional social media channels. The survey was held in the summer of 2020 when the first wave had subsided in most of Europe, while the second wave was not yet widespread. The questionnaire featured a total of 46 questions on general demographics, the various phases of the healthcare crisis, and the numbers of Covid-19 patients. Results One hundred sixty-seven responses were received from 48 countries mostly from neuroradiologists (72%). Most commonly taken measures during the crisis phase were reduction of outpatient exams (87%), reduction of number of staff present in the department (83%), reporting from home (62%), and shift work (54%). In the exit phase, these measures were less frequently applied, but reporting from home was still frequent (33%). However, only 22% had access to a fully equipped work station at home. While 81% felt safe at work during the crisis, fewer than 50% had sufficient personal protection equipment for the duration of the entire crisis. Mental wellbeing is an area of concern, with 61% feeling (much) worse than usual. Many followed online courses/congresses and considered these a viable alternative for the future. Conclusion The Covid-19 pandemic substantially affected the professional life as well as personal wellbeing of neuroradiologists.

scholarly journals Measuring the impact of an acute visiting scheme on emergency department attendances – a pre-post cohort design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Axel Kaehne ◽  
Paula Keating
Keyword(s):  
Emergency Department ◽  
Service Use ◽  
Emergency Department Visits ◽  
Service Utilisation ◽  
Specific Patient ◽  
Access Points ◽  
Latent Demand ◽  
Frequent Attenders ◽  
Cohort Design ◽  
The Impact

Abstract Background Emergency department (ED) attendances are contributing to rising costs of the National Health Service (NHS) in England. Critically assessing the impact of new services to reduce emergency department use can be difficult as new services may create additional access points, unlocking latent demand. The study evaluated an Acute Visiting Scheme (AVS) in a primary care context. We asked if AVS reduces overall ED demand and whether or not it changed utilisation patterns for frequent attenders. Method The study used a pre post single cohort design. The impact of AVS on all-cause ED attendances was hypothesised as a substitution effect, where AVS duty doctor visits would replace emergency department visits. Primary outcome was frequency of ED attendances. End points were reduction of frequency of service use and increase of intervals between attendances by frequent attenders. Results ED attendances for AVS users rose by 47.6%. If AVS use was included, there was a more than fourfold increase of total service utilisation, amounting to 438.3%. It shows that AVS unlocked significant latent demand. However, there was some reduction in the frequency of ED attendances for some patients and an increase in time intervals between ED attendances for others. Conclusion The study demonstrates that careful analysis of patient utilisation can detect a differential impact of AVS on the use of ED. As the new service created additional access points for patients and hence introduces an element of choice, the new service is likely to unlock latent demand. This study illustrates that AVS may be most useful if targeted at specific patient groups who are most likely to benefit from the new service.

Didactic education in paediatric cardiology during the COVID-19 pandemic: a national fellow survey

2020 ◽  
pp. 1-4
Author(s):  
Madhusudan Ganigara ◽  
Chetan Sharma ◽  
Fernando Molina Berganza ◽  
Krittika Joshi ◽  
Andrew D. Blaufox ◽  
...  
Keyword(s):  
United States ◽  
Online Learning ◽  
United States Of America ◽  
Formal Education ◽  
Medical Training ◽  
Nationwide Survey ◽  
The United States ◽  
Negative Consequences ◽  
Paediatric Cardiology ◽  
The Impact

Abstract The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on medical educational curricula. We aimed to examine the impact of these unprecedented changes on the formal education of paediatric cardiology fellows through a nationwide survey. A REDCap™-based voluntary anonymous survey was sent to all current paediatric cardiology fellows in the United States of America in May, 2020. Of 143 respondents, 121 were categorical fellows, representing over one-fourth of all categorical paediatric cardiology fellows in the United States of America. Nearly all (140/143, 97.9%) respondents utilised online learning during the pandemic, with 134 (93.7%) reporting an increase in use compared to pre-pandemic. The percentage of respondents reporting curriculum supplementation with outside lectures increased from 11.9 to 88.8% during the pandemic. Respondents considered online learning to be “equally or more effective” than in-person lectures in convenience (133/142, 93.7%), improving fellow attendance (132/142, 93.0%), improving non-fellow attendance (126/143, 88.1%), and meeting individual learning needs (101/143, 70.6%). The pandemic positively affected the lecture curriculum of 83 respondents (58.0%), with 35 (24.5%) reporting no change and 25 (17.5%) reporting a negative effect. A positive effect was most noted by those whose programmes utilised supplemental outside lectures (62.2 versus 25.0%, p = 0.004) and those whose lecture frequency did not decrease (65.1 versus 5.9%, p < 0.001). Restrictions imposed by the COVID-19 pandemic have greatly increased utilisation of online learning platforms by medical training programmes. This survey reveals that an online lecture curriculum, despite inherent obstacles, offers advantages that may mitigate some negative consequences of the pandemic on fellowship education.

scholarly journals A data-driven metapopulation model for the Belgian COVID-19 epidemic: assessing the impact of lockdown and exit strategies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pietro Coletti ◽  
Pieter Libin ◽  
Oana Petrof ◽  
Lander Willem ◽  
Steven Abrams ◽  
...  
Keyword(s):  
Phase 1 ◽  
Leisure Activities ◽  
National Level ◽  
Social Contact ◽  
Exit Strategy ◽  
Initial Wave ◽  
Contact Data ◽  
Stochastic Data ◽  
The Impact ◽  
Second Wave

Abstract Background In response to the ongoing COVID-19 pandemic, several countries adopted measures of social distancing to a different degree. For many countries, after successfully curbing the initial wave, lockdown measures were gradually lifted. In Belgium, such relief started on May 4th with phase 1, followed by several subsequent phases over the next few weeks. Methods We analysed the expected impact of relaxing stringent lockdown measures taken according to the phased Belgian exit strategy. We developed a stochastic, data-informed, meta-population model that accounts for mixing and mobility of the age-structured population of Belgium. The model is calibrated to daily hospitalization data and is able to reproduce the outbreak at the national level. We consider different scenarios for relieving the lockdown, quantified in terms of relative reductions in pre-pandemic social mixing and mobility. We validate our assumptions by making comparisons with social contact data collected during and after the lockdown. Results Our model is able to successfully describe the initial wave of COVID-19 in Belgium and identifies interactions during leisure/other activities as pivotal in the exit strategy. Indeed, we find a smaller impact of school re-openings as compared to restarting leisure activities and re-openings of work places. We also assess the impact of case isolation of new (suspected) infections, and find that it allows re-establishing relatively more social interactions while still ensuring epidemic control. Scenarios predicting a second wave of hospitalizations were not observed, suggesting that the per-contact probability of infection has changed with respect to the pre-lockdown period. Conclusions Contacts during leisure activities are found to be most influential, followed by professional contacts and school contacts, respectively, for an impending second wave of COVID-19. Regular re-assessment of social contacts in the population is therefore crucial to adjust to evolving behavioral changes that can affect epidemic diffusion.

scholarly journals COVID-19 Inequalities: Individual and Area Socioeconomic Factors (Aragón, Spain)

2021 ◽  
Vol 18 (12) ◽  
pp. 6607
Author(s):  
Isabel Aguilar-Palacio ◽  
Lina Maldonado ◽  
Sara Malo ◽  
Raquel Sánchez-Recio ◽  
Iván Marcos-Campos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Social Inequalities ◽  
Deprivation Level ◽  
Social Consequences ◽  
Multilevel Analyses ◽  
The Social ◽  
The Individual ◽  
The Impact ◽  
Second Wave

It is essential to understand the impact of social inequalities on the risk of COVID-19 infection in order to mitigate the social consequences of the pandemic. With this aim, the objective of our study was to analyze the effect of socioeconomic inequalities, both at the individual and area of residence levels, on the probability of COVID-19 confirmed infection, and its variations across three pandemic waves. We conducted a retrospective cohort study and included data from all individuals tested for COVID-19 during the three waves of the pandemic, from March to December 2020 (357,989 individuals) in Aragón (Spain). We studied the effect of inequalities on the risk of having a COVID-19 confirmed diagnosis after being tested using multilevel analyses with two levels of aggregation: individuals and basic healthcare area of residence (deprivation level and type of zone). Inequalities in the risk of COVID-19 confirmed infection were observed at both the individual and area level. There was a predominance of low-paid employees living in deprived areas. Workers with low salaries, unemployed and people on minimum integration income or who no longer receive the unemployment allowance, had a higher probability of COVID-19 infection than workers with salaries ≥ €18,000 per year. Inequalities were greater in women and in the second wave. The deprivation level of areas of residence influenced the risk of COVID-19 infection, especially in the second wave. It is necessary to develop individual and area coordinated measures by areas in the control, diagnosis and treatment of the epidemic, in order to avoid an increase in the already existing inequalities.

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