Diagnostic value of cutaneous manifestation of SARS-CoV-2 infection

AbstractImportanceSARS-CoV-2 causes multiple immune-related reactions at various stages of the disease, and the wide variety of cutaneous presentations has delayed linking these to the virus. Previous studies had attempted to look at the prevalence and timing of COVID-19 rashes but were mostly based on hospitalized severe cases with limited follow up.ObjectiveTo assess the diagnostic value of new skin rashes in SARS-CoV-2 infection.DesignObservational study including data collected longitudinally via the COVID Symptom Study app between May 7th and June 22nd, 2020, as well as data from an independent online survey on skin-related symptoms.SettingCommunity-basedParticipantsVolunteer sample of 336,847 UK users of the COVID Symptom Study app and 11,546 surveyees, aged 1 to 90 years old.ExposureUsers self-reporting a positive or negative SARS-CoV-2 swab test result, untested symptomatic users, and survey respondents.Main Outcome(s) and Measure(s)the diagnostic value of new skin rashes in SARS-CoV-2 infection, and observation on their duration and timing in relation to other COVID-19 symptomsResultsIn the app data, 8.8% of the swab positive cases (N=2,021) reported either a body rash or an acral rash, compared to 5.4% of those with a negative swab test (N=25,136). Together, these two cutaneous presentations showed an odds ratio (OR) of 1.67 (95% confidence interval [CI]: 1.42-1.97) for being swab positive. Skin rashes were also predictive in the larger untested group of symptomatic app users (N=54,652), as 8.2% of those who had reported at least one classic COVID-19 symptom, i.e., fever, persistent cough, and/or anosmia, also reported a rash. Data from the independent online survey showed that in 17% of swab positive cases, the rash was the initial presentation. Furthermore, in 21%, the rash was the only clinical sign.Conclusions and RelevanceSkin rashes cluster with other COVID-19 symptoms, are predictive of a positive swab test and occur in a significant number of cases, either alone or before other symptoms. Recognising rashes is important for the early detection of COVID-19 cases. To help healthcare professionals in this task we have established a large library of high-quality manually curated photos, available at: https://covidskinsigns.comKey pointsQuestionWhat is the diagnostiv value of the cutaneous manifestation of SARS-CoV-2 infection?FindingsWe confirmed, in a community-based setting, that the presence of a rash is predictive of SARS-CoV-2 infection, and provided a large library of cutaneous manifestation photos to help healthcare professionals in diagnosing COVID-19.MeaningSkin rashes should be considered as part of the clinical presentation of COVID-19 to aid earlier diagnosis and curb the spread of the infection.

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Walk the Doc Talk

Clinical Lactation ◽

10.1891/2158-0782.7.2.49 ◽

2016 ◽

Vol 7 (2) ◽

pp. 49-56

Author(s):

Tristan Kiraly ◽

Shelagh Quinn ◽

Janice Fyfe ◽

Edith Kernerman

Keyword(s):

Online Survey ◽

Healthcare Professionals ◽

Interdisciplinary Communication ◽

Negative Experiences ◽

Lactation Consultant ◽

Breastfeeding Knowledge ◽

Contact Information ◽

Lactation Consultants ◽

Positive Experiences

There is limited research on interdisciplinary communication between lactation consultants (International Board Certified Lactation Consultant [IBCLC]) and other healthcare professionals. An online survey assessed how healthcare professionals (physicians, surgeons, and alternative practitioners) perceive lactation consultants and what language, forms of communication, and practices are helpful. Participants (N = 75) indicated mostly positive experiences. Negative experiences included lack of communication or dissatisfaction with experience or outcome. Breastfeeding terms were, on average, “somewhat clear,” and several were correlated with perceived adequacy of breastfeeding knowledge. Participants indicated that communications from lactation consultants should include a plan for follow-up, an outline of the safety and rationale for use of potentially unfamiliar treatments, and contact information. The preferred form of communication varied. Improving interdisciplinary communication and collaboration will likely result in better support for breastfeeding dyads.

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Health and Community-Based Services for Individuals with Neurological Conditions

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2017.207 ◽

2017 ◽

Vol 44 (6) ◽

pp. 670-675

Author(s):

Sarah E.P. Munce ◽

Kristen B. Pitzul ◽

Sara J.T. Guilcher ◽

Tarik Bereket ◽

Mae Kwan ◽

...

Keyword(s):

Online Survey ◽

Healthcare Professionals ◽

Healthcare Providers ◽

Mental Healthcare ◽

Community Based ◽

Term Care ◽

Neurological Patient ◽

Suburban Areas ◽

Neurological Conditions ◽

Community Based Services

AbstractBackground:The current study involves a national survey of healthcare providers who offer services for individuals with a variety of neurological conditions. It aims to describe the provision of health and community-based services as well as the admission criteria, waitlist practices, and referral sources of these services.Methods:An online survey was directed at administrators/managers from publicly funded hospital programs, long-term care homes, and community-based healthcare provider agencies that were believed to be providing information and/or services to patients with a variety of neurological conditions.Results:Approximately 60% (n=254) of respondents reported providing services in either urban/suburban areas or rural/remote areas only, whereas the remaining 40% (n=172) provided services regardless of patient location. A small proportion of respondents reported providing services for individuals with dystonia (28%), Tourette syndrome (17%), and Rett syndrome (13%). There was also a paucity of diverse healthcare professionals across all institutions, but particularly mental healthcare professionals in hospitals. Lastly, the majority of respondents reported numerous exclusion criteria with regard to service provision, including prevalent comorbid conditions.Conclusions:If the few services provided for these neurological patient populations exclude common comorbidities, it is likely that there will be no other place for these individuals to seek care.

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The State of Education and Training for Antimicrobial Stewardship Programs in Indian Hospitals―A Qualitative and Quantitative Assessment

Antibiotics ◽

10.3390/antibiotics8010011 ◽

2019 ◽

Vol 8 (1) ◽

pp. 11 ◽

Cited By ~ 1

Author(s):

Sanjeev Singh ◽

Esmita Charani ◽

Chand Wattal ◽

Anita Arora ◽

Abi Jenkins ◽

...

Keyword(s):

Antimicrobial Stewardship ◽

Online Survey ◽

Healthcare Professionals ◽

Qualitative Interviews ◽

Education And Training ◽

Healthcare Organizations ◽

Telephone Interviews ◽

And Training

Background: To understand the role of infrastructure, manpower, and education and training (E&T) in relation to Antimicrobial Stewardship (AMS) in Indian healthcare organizations. Methods: Mixed method approach using quantitative survey and qualitative interviews was applied. Through key informants, healthcare professionals from 69 hospitals (public & private) were invited to participate in online survey and follow up qualitative interviews. Thematic analysis was applied to identify the key emerging themes from the interviews. The survey data were analyzed using descriptive statistics. Results: 60 healthcare professionals from 51 hospitals responded to the survey. Eight doctors participated in semi-structured telephone interviews. 69% (27/39) of the respondents received E&T on AMS during undergraduate or postgraduate training. 88% (15/17) had not received any E&T at induction or during employment. In the qualitative interviews three key areas of concern were identified: (1) need for government level endorsement of AMS activities; (2) lack of AMS programs in hospitals; and, (3) lack of postgraduate E&T in AMS for staff. Conclusion: No structured provision of E&T for AMS currently exists in India. Stakeholder engagement is essential to the sustainable design and implementation of bespoke E&T for hospital AMS in India.

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High Exhaustion in Geriatric Healthcare Professionals During the COVID-19 Second Lockdown

Journal of Alzheimer s Disease ◽

10.3233/jad-210615 ◽

2021 ◽

pp. 1-8

Author(s):

Mohamad El Haj ◽

Philippe Allain ◽

Cédric Annweiler ◽

Claire Boutoleau-Bretonnière ◽

Guillaume Chapelet ◽

...

Keyword(s):

Healthcare Workers ◽

Online Survey ◽

Healthcare Professionals ◽

Physical Fatigue ◽

Follow Up Study ◽

High Exhaustion

Background: In a previous study, we assessed burnout in geriatric healthcare workers during the first lockdown that lasted from March to May 2020 in France, in response to the COVID-19 crisis. Objective: We carried out a follow-up study to assess burnout in the same population during the second lockdown that was implemented at the end of October 2020. Methods: We used an online survey to assess burnout in terms of exhaustion and disengagement in a sample of 58 geriatric healthcare workers. Results: We found higher levels of exhaustion, disengagement, and burnout among geriatric healthcare workers during the second than during the first lockdown. We also found high levels of exhaustion but moderate disengagement and burnout during the second lockdown. Conclusion: The increased exhaustion, disengagement, and burnout during the second lockdown can be attributed to the increased workload in geriatric facilities throughout this crisis and during the second lockdown due to shortage in staff and increased number of shifts and allocated duties. The high levels of exhaustion reported among geriatric healthcare workers during the second lockdown can reflect their physical fatigue, as well as their feelings of being emotionally overextended and exhausted by their workload.

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Changing the narrative around obesity in the UK: a survey of people with obesity and healthcare professionals from the ACTION-IO study

BMJ Open ◽

10.1136/bmjopen-2020-045616 ◽

2021 ◽

Vol 11 (6) ◽

pp. e045616

Author(s):

Carly A Hughes ◽

Amy L Ahern ◽

Harsha Kasetty ◽

Barbara M McGowan ◽

Helen M Parretti ◽

...

Keyword(s):

Weight Loss ◽

Weight Management ◽

Online Survey ◽

Healthcare Professionals ◽

Individual Responsibility ◽

Registration Number ◽

Blame Culture ◽

Using Data ◽

The Uk

ObjectivesTo investigate the perceptions, attitudes, behaviours and potential barriers to effective obesity care in the UK using data collected from people with obesity (PwO) and healthcare professionals (HCPs) in the Awareness, Care, and Treatment In Obesity maNagement–International Observation (ACTION-IO) study.DesignUK’s PwO (body mass index of ≥30 kg/m2 based on self-reported height and weight) and HCPs who manage patients with obesity completed an online survey.ResultsIn the UK, 1500 PwO and 306 HCPs completed the survey. Among the 47% of PwO who discussed weight with an HCP in the past 5 years, it took a mean of 9 years from the start of their struggles with weight until a discussion occurred. HCPs reported that PwO initiated 35% of weight-related discussions; PwO reported that they initiated 47% of discussions. Most PwO (85%) assumed full responsibility for their own weight loss. The presence of obesity-related comorbidities was cited by 76% of HCPs as a top criterion for initiating weight management conversations. The perception of lack of interest (72%) and motivation (61%) in losing weight was reported as top reasons by HCPs for not discussing weight with a patient. Sixty-five per cent of PwO liked their HCP bringing up weight during appointments. PwO reported complex and varied emotions following a weight loss conversation with an HCP, including supported (36%), hopeful (31%), motivated (23%) and embarrassed (17%). Follow-up appointments were scheduled for 19% of PwO after a weight discussion despite 62% wanting follow-up.ConclusionsThe current narrative around obesity requires a paradigm shift in the UK to address the delay between PwO struggling with their weight and discussing weight with their HCP. Perceptions of lack of patient interest and motivation in weight management must be challenged along with the blame culture of individual responsibility that is prevalent throughout society. While PwO may welcome weight-related conversations with an HCP, they evoke complex feelings, demonstrating the need for sensitivity and respect in these conversations.Trial registration numberNCT03584191.

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Facilitating Parental Involvement in Speech Therapy for Children With Speech Sound Disorders: A Survey of Speech-Language Pathologists' Practices, Perspectives, and Strategies

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00071 ◽

2020 ◽

Vol 29 (4) ◽

pp. 1987-1996

Author(s):

Sherine R. Tambyraja

Keyword(s):

Parental Involvement ◽

Online Survey ◽

Speech Therapy ◽

Speech Sound ◽

Speech Sound Disorders ◽

Speech Sound Disorder ◽

Speech Language Pathologists ◽

School Based ◽

Homework Completion

Purpose This study investigated the extent to which speech-language pathologists (SLPs) facilitate parents' completion of homework activities for children with speech sound disorder (SSD). In addition, this study explored factors related to more consistent communication about homework completion and strategies considered particularly effective for supporting this element of parental involvement. Method Licensed SLPs serving at least one child with SSD were invited to participate in an online survey. Questions relevant to this study gathered information regarding (a) frequency of communication about homework distribution and follow-up, (b) demographic and workplace characteristics, and (c) an open-ended question about the specific strategies used to support parental involvement and completion of homework activities. Results Descriptive results indicated considerable variability with respect to how frequently SLPs engaged in communication about homework completion, but that school-based SLPs were significantly less likely to engage in this type of follow-up. Strategies considered effective, however, were similar across therapy contexts. Conclusion These results suggest potentially important differences between school-based services and therapy in other contexts with respect to this particular aspect of service provision for children with SSD.

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Optimizing Breast Cancer Follow-up Care: Diagnostic Value and Costs of Additional Routine Breast Ultrasound

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0030-1266891 ◽

2010 ◽

Vol 31 (S 01) ◽

Author(s):

S Wojcinski ◽

A Farrokh ◽

U Hille ◽

E Hirschauer ◽

W Schmidt ◽

...

Keyword(s):

Breast Cancer ◽

Diagnostic Value ◽

Breast Ultrasound ◽

Follow Up Care

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Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

Nuklearmedizin ◽

10.1055/s-0038-1629824 ◽

1996 ◽

Vol 35 (04) ◽

pp. 116-121 ◽

Cited By ~ 4

Author(s):

G. E Fueger ◽

M. Vejda ◽

R. M. Aigner

Keyword(s):

Bone Scintigraphy ◽

Antibiotic Treatment ◽

Diagnostic Value ◽

Clinical Findings ◽

Laboratory Findings ◽

Radiographic Findings ◽

Serum Parameters ◽

Wbc Count ◽

Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

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Evaluating the implementation potential of a transcultural tool for Tamil migrants with gestational diabetes mellitus living in Switzerland

Medical & Clinical Research ◽

10.33140/mcr.02.02.06 ◽

2017 ◽

Vol 2 (2) ◽

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Online Survey ◽

Healthcare Professionals ◽

Binary Logistic Regression ◽

Private Practices ◽

Populations At Risk ◽

Management Procedures

Background: Gestational diabetes mellitus is a condition that affects many pregnancies and ethnicity appears to be a risk factor. Data indicate that approximately 18% of Tamil women are diagnosed with gestational diabetes mellitus. Today, approximately 50,000 of Tamils live in Switzerland. To date, there is no official tool available in Switzerland that considers the eating and physical activity habits of this migrant Tamil population living in Switzerland, while offering a quick overview of gestational diabetes mellitus and standard dietetics management procedures. The NutriGeD project led by Bern University of Applied Sciences in Switzerland aimed at closing this gap. The aim of this present study was to evaluate the implementation potential of the tools developed in the project NutriGeD for dietetic counseling before their wide scale launch in Swiss hospitals, clinics and private practices. Method: An online survey was developed and distributed to 50 recruited healthcare professionals working in the German speaking region of Switzerland from October – December 2016 (31% response rate). The transcultural tools were sent to participants together with the link to the online survey. The evaluation outcome was analysed using binary logistic regression and cross tabulation analysis with IBM SPSS version 24.0, 2016. Results: 94% (N=47) respondents believed that the transcultural tools had good potential for implementation in hospitals and private practices in Switzerland. A binary logistic regression analysis revealed that the age of participants had a good correlation (42.1%) on recommending the implementation potential of the transcultural tool. The participants with age group 34- 54 years old where the highest group to recommend the implementation potential of the transcultural tool and this was found to be statistically significant (p=0.05). 74% (34 out of 50) of the respondents clearly acknowledged the need for transcultural competence knowledge in healthcare practices. 80% (N =40) of the respondents agreed that the information presented in the counseling display folder was important and helpful while 60% (N= 30) agreed to the contents being clinically applicable. 90% (N=45) participants recommended the availability of the evaluated transcultural tools in healthcare settings in Switzerland. Conclusion: The availability in healthcare practice of the evaluated transcultural tools was greatly encouraged by the Swiss healthcare practitioners participating in the survey. While they confirmed the need for these transcultural tools, feed-backs for minor adjustments were given to finalize the tools before their official launch in practice. The developed materials will be made available for clinical visits, in both hospitals and private practices in Switzerland. The Migmapp© transcultural tool can serve as a good approach in assisting healthcare professionals in all fields, especially professionals who practice in areas associated with diet - related diseases or disorders associated with populations at risk.

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The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients

Pharmacy ◽

10.3390/pharmacy9020086 ◽

2021 ◽

Vol 9 (2) ◽

pp. 86

Author(s):

Fauna Herawati ◽

Yuni Megawati ◽

Aslichah ◽

Retnosari Andrajati ◽

Rika Yulia

Keyword(s):

Intervention Group ◽

Personal Control ◽

Control Group ◽

P Value ◽

Interactive Approach ◽

Community Based ◽

Tuberculosis Patients ◽

Level Of Knowledge ◽

The Impact

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.

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