Care Delivery for Children With Epilepsy During the COVID-19 Pandemic: An International Survey of Clinicians

Objective: To evaluate the effect of the COVID-19 pandemic on global access to care and practice patterns for children with epilepsy. Methods: We conducted a cross-sectional, online survey of pediatric neurologists across the world affiliated with the International Child Neurology Association, the Chinese Child Neurology Society, the Child Neurology Society, and the Pediatric Epilepsy Research Consortium. Results were analyzed in relation to regional burden of COVID-19 disease. Results: From April 10 to 24, 2020, a sample of 212 respondents from 49 countries indicated that the COVID-19 pandemic has dramatically changed many aspects of pediatric epilepsy care, with 91.5% reporting changes to outpatient care, 90.6% with reduced access to electroencephalography (EEG), 37.4% with altered management of infantile spasms, 92.3% with restrictions in ketogenic diet initiation, 93.4% with closed or severely limited epilepsy monitoring units, and 91.3% with canceled or limited epilepsy surgery. Telehealth use had increased, with 24.7% seeing patients exclusively via telehealth. Changes in practice were related both to COVID-19 burden and location. Conclusions: In response to COVID-19, pediatric epilepsy programs have implemented crisis standards of care that include increased telemedicine, decreased EEG use, changes in treatments of infantile spasms, and cessation of epilepsy surgery. The long-term impact of these abrupt changes merit careful study.

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One year of child neurology telemedicine: a data-driven analysis of 14,820 encounters

10.1101/2021.12.15.21267868 ◽

2021 ◽

Author(s):

Michael C Kaufman ◽

Julie Xian ◽

Peter D Galer ◽

Shridhar Parthasarathy ◽

Alexander K Gonzalez ◽

...

Keyword(s):

Neuromuscular Disorders ◽

Pediatric Epilepsy ◽

Patient Portal ◽

Child Neurology ◽

Time Period ◽

Vulnerable Families ◽

Observational Cohort ◽

One Year ◽

Long Term Impact ◽

Activation Rates

Introduction Determining the long-term impact of telemedicine in care across the diagnostic and age spectrum of child neurology during the COVID-19 pandemic and with the re-opening of outpatient clinics. Methods An observational cohort study of 34,837 in-person visits and 14,820 telemedicine outpatient pediatric neurology visits between October 1, 2019 and April 9, 2021. We assessed differences in care across visit types, time-period observed, time between follow-ups, patient portal activation rates and demographic factors. Results 26,399 patients were observed in this study (median age 11.4 years [interquartile range, 5.5-15.9]; 13,209 male). We observed a higher proportion of telemedicine for epilepsy (ICD10 G40: OR 1.4, 95% CI 1.3-1.5) and a lower proportion for movement disorders (ICD10 G25: OR 0.7, 95% CI 0.6-0.8; ICD10 R25: OR 0.7, 95% CI 0.6-0.9). Infants were more likely to be seen in-person after re-opening clinics than by telemedicine (OR 1.6, 95% CI 1.5-1.8) as were individuals with neuromuscular disorders (OR 0.6, 95% CI 0.6-0.7). Racial and ethnic minority populations and those with highest social vulnerability had lower rates of telemedicine participation throughout the pandemic (OR 0.8, 95% CI 0.8-0.8; OR 0.7, 95% CI 0.7-0.8). Discussion Telemedicine implementation was followed by continued use even once in-person clinics were available. Pediatric epilepsy care can often be performed using telemedicine while young children and patients with neuromuscular disorders often require in-person assessment. Prominent barriers for socially vulnerable families and racial and ethnic minorities persist.

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Dental Practice during COVID-19 in Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5022 ◽

2020 ◽

Vol 58 (230) ◽

Author(s):

Manoj Humagain ◽

Rashmi Humagain ◽

Dinesh Rokaya

Keyword(s):

Online Survey ◽

Financial Burden ◽

Cross Sectional Study ◽

Standards Of Care ◽

Dental Practice ◽

Sectional Study ◽

Cross Sectional ◽

High Standards ◽

Financial Burdens ◽

The Impact

Introduction: Currently, coronavirus disease (COVID-19) has become pandemic and spread globally. In Nepal, the number of COVID-19 is increasing day-by-day. This research was done to find out the impact of COVID-19 on dentists, patients, and dental practice in Nepal. Methods: This study is a cross-sectional study conducted using an online survey from May 10 to17, 2020. A questionnaire was designed and uploaded in Freeonlinesurveys.com. Following ethical approval, the questionnaire was distributed among 500 dentists, and 406 dentists participated in the study. The survey link was dispersed to the Nepali dentists through social media and e-mail, and the results of the responses were received online. The questionnaire consisted of a total of 34 closed-ended questions containing three parts; demographic details, knowledge of dentists on COVID-19, and the impact of COVID-19 on dentists, patients, and dental treatments. Results: It showed that majority of the participants were females 243 (60%) of the age group 25-29 years with the clinic as the workplace. Patients receive dental treatments only from 40 (10%) of the dentist. A high number of dentists: 284 (70%) were severely affected by the financial burden and were not receiving a salary during this lockdown. About 349(86%) of the dentist think they should do regular dental treatments, but only 101 (25%) think the dentist should do only dental emergency treatments for COVID-19 infected cases. Conclusions: Dentists, patients, and dental practice are severely affected by the COVID-19.The majority of the dentists have faced financial burdens. The dental treatments should be done with high standards of care and infection control following proper recommendations.

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Sources of Medical Information for Oncology Physicians During the COVID-19 Pandemic: Results From a National Cross-Sectional Survey

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa095 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Helen M Parsons ◽

Rachel I Vogel ◽

Anne H Blaes ◽

Emil Lou ◽

Heather Beckwith ◽

...

Keyword(s):

Disease Control ◽

Online Survey ◽

Medical Information ◽

Care Delivery ◽

The United States ◽

Sources Of Information ◽

Cross Sectional ◽

Professional Societies ◽

Control And Prevention ◽

Centers For Disease Control

Abstract Because the coronavirus disease 2019 (COVID-19) has completely transformed the accepted norms and approaches to cancer care delivery in the United States, we sought to understand the sources of medical information that oncology physicians seek and trust. We recruited 486 oncology physicians to an anonymous cross-sectional online survey through social media from March 27, 2020, to April 10, 2020, with 79.2% reporting their sources of medical information during the COVID-19 pandemic. We found a diverse array of reported sources for COVID-19 information that most commonly included professional societies (90.7%), hospital or institutional communications (88.6%), and the Centers for Disease Control and Prevention (69.9%); however, trust in these sources of information varied widely, with professional societies being the most trusted source. These results highlight the important role that professional societies, hospitals, and the Centers for Disease Control and Prevention play in ensuring dissemination of consistent, high-quality practice recommendations for oncology physicians.

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An Asian Perspective of the Management of COVID-19: the Asian National Cancer Centers Alliance Led Regional Comparison

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2020.5.s1.27-42 ◽

2020 ◽

Vol 5 (S1) ◽

pp. 27-42

Author(s):

Luh Komang Mela Dewi ◽

Laureline Gatellier ◽

Kanaga Sabapathy ◽

C S Pramesh ◽

Min Dai ◽

...

Keyword(s):

Cancer Care ◽

Online Survey ◽

Care Delivery ◽

Standards Of Care ◽

Survey Analysis ◽

Think Tank ◽

Survey Tool ◽

Cancer Centers ◽

Care Workers ◽

High Standards

Objective: To describe how the Asian National Cancer Centers Alliance (ANCCA) members preserve high standards of care for cancer patients while battling the COVID-19 pandemic and to propose new strategies in the Asian Cancer Centers’ preparedness to future pandemics. Methods: A 41-question-based survey was developed using an online survey tool and conducted among 15 major Asian National Cancer Centers, including 13 ANCCA members. Direct interviews of several specialists were conducted subsequently to obtain additional answers to key questions that emerged during the survey analysis. Result: Institution/country-specific results provided a strong insight on the diverse ways of managing the pandemic around Asia, while maintaining well-balanced cancer care. Pragmatic strategies were put in place in each NCC hospital, including zoning and intensive triage depending on the pandemic impact. Distancing strategies and telemedicine were implemented in different capacity depending on the national healthcare system. In addition, there was a diverse impact on the manpower and financial aspect of cancer care across surveyed NCCs relating to magnitude of the pandemic impact on the country. Conclusion: The priorities nevertheless remain on maintaining cancer care delivery while protecting both patients and health care workers from the risk of COVID-19 infection. The role of a think-tank such as ANCCA to help share experiences in a timely manner can enhance preparedness in future pandemic scenarios.

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Management of Infantile Spasms During the COVID-19 Pandemic

Journal of Child Neurology ◽

10.1177/0883073820933739 ◽

2020 ◽

Vol 35 (12) ◽

pp. 828-834 ◽

Cited By ~ 5

Author(s):

Zachary M. Grinspan ◽

John R. Mytinger ◽

Fiona M. Baumer ◽

Michael A. Ciliberto ◽

Bruce H. Cohen ◽

...

Keyword(s):

Health Care ◽

Health Care Delivery ◽

Care Delivery ◽

Infantile Spasms ◽

Child Neurology ◽

First Line ◽

Standard Management ◽

Health Care Crisis ◽

Selection Of

Circumstances of the COVID-19 pandemic have mandated a change to standard management of infantile spasms. On April 6, 2020, the Child Neurology Society issued an online statement of immediate recommendations to streamline diagnosis and treatment of infantile spasms with utilization of telemedicine, outpatient studies, and selection of first-line oral therapies as initial treatment. The rationale for the recommendations and specific guidance including follow-up assessment are provided in this manuscript. These recommendations are indicated as enduring if intended to outlast the pandemic, and limited if intended only for the pandemic health care crisis but may be applicable to future disruptions of health care delivery.

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Psychological Distress and Coping Strategies among Nurses during the COVID-19 Pandemic: A Cross-Sectional Online Survey

The Open Nursing Journal ◽

10.2174/1874434602115010262 ◽

2021 ◽

Vol 15 (1) ◽

pp. 262-272

Author(s):

Eman K. Alnazly ◽

Anees A. Hjazeen

Keyword(s):

Health Care ◽

Psychological Distress ◽

Coping Strategies ◽

Health Care Professionals ◽

Online Survey ◽

Coping Styles ◽

Careful Study ◽

Cross Sectional ◽

Care Community ◽

Fear And Anxiety

Background: The emergence of COVID-19 has a significant impact on nurse’s overall health. The severity and magnitude of the COVID-19 pandemic means it is extremely likely that health-care professionals will experience psychological distress as a result of their direct contact with patients who have contracted the infection. Objectives: This study aimed to evaluate levels of psychological distress among nurses during the COVID-19 pandemic, determine the associated factors, and identify nurses’ coping strategies. Methods: This study is a cross-sectional design. Overall, 130 nurses answered online questionnaires. The questionnaires measured sociodemographic characteristics, Fear of COVID-19 Scale, the Depression, Anxiety, and Stress Scale, and the Brief Coping Inventory. Results: Nurses have a moderate level of fear (mean score: 24.34 ± 13.43) and depression (43.8% of the sample), and severe anxiety (73.8%) and stress (45.4%). Anxiety and fear were positively correlated (r = .675, p < .001). Independent t-tests revealed that female nurses had higher psychological distress and fear than male nurses (p = 0.015 and p = 0.038, respectively). Nurses who cared for patients who had tested positive for coronavirus disease 2019 and those who had a friend or family member who had tested positive had higher fear and psychological distress than their respective counterparts (p < .001 and p = .010, respectively). Working more hours was moderately correlated with fear and anxiety (p = 0.016). Nurses were found to generally adopt maladaptive coping styles. Conclusion: Through careful study of the factors determined through this research to be associated with psychological distress among nurses, the health-care community can better prepare to mitigate nurses’ emotional and psychological toll in future pandemic situations. Working with patients who have tested positive for COVID-2019 causes psychological distress for nurses.

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Athletic Trainers' Perceptions of Accessibility to Necessary Resources for Those Working Per Diem Services

Journal of Athletic Training ◽

10.4085/1062-6050-0095.20 ◽

2020 ◽

Author(s):

Tara A. Armstrong ◽

Elizabeth R. Neil ◽

Alisha M. Pennington ◽

K. Ellis F. Mair ◽

Lindsey E. Eberman

Keyword(s):

Athletic Training ◽

Online Survey ◽

Underserved Populations ◽

Care Delivery ◽

Athletic Trainers ◽

Cross Sectional Study ◽

Medical Services ◽

Cross Sectional ◽

Independent Contractors ◽

Transient Nature

Context As the demand for athletic training services has grown, the per diem athletic training setting has expanded to fulfill this need. Per diem services are provided by athletic trainers (ATs) who are hired as independent contractors for short time periods. These service opportunities help to increase access to care for medically underserved populations; however, due to the transient nature of the work, the quality of care may be compromised. Objective To examine current practices in per diem services and evaluate ATs' accessibility to resources. Design Cross-sectional study. Setting Online survey. Patients or Other Participants A total of 448 participants responded (access rate = 9.57%), of whom 210 were ineligible (46.9%). Of those who were eligible, 192 participants completed the entire tool (completion rate = 80.7%, age = 38 ± 12 years, years certified = 14 ± 11, years providing per diem services = 8 ± 8). Main Outcome Measure(s) The survey comprised 3 sections: (1) demographics, (2) accessibility to resources and influence on patient care, and (3) domains of athletic training while providing per diem services. Resources assessed included those that are relevant to ATs practicing in accordance with the Board of Certification Standards of Professional Practice. The final instrument included approximately 30 questions (depending on display logic) and took an average of 12 minutes to complete. Results Of the 11 primary resources assessed, participants had limited accessibility to 6. Critical resources related to informatics, legalities, and health care delivery were often not available, were seen as unimportant to providing medical services, or both. Conclusions Participants indicated varied perceptions about the need for and access to these resources. Yet such resources contribute to the creation of a safe infrastructure for providing medical services and should be part of the routine dialogue regarding independent contracting.

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Assessing the knowledge, attitudes and practices regarding COVID-19 and homoeopathy among the citizens of Delhi and national capital region, India: a cross-sectional online survey

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204752 ◽

2020 ◽

Vol 7 (11) ◽

pp. 4504

Author(s):

Gyandas G. Wadhwani ◽

Anupriya Chaudhary ◽

Aditi Chadha ◽

Lovepreet Kaur ◽

Khushbu Chaudhary ◽

...

Keyword(s):

Online Survey ◽

Therapeutic Potential ◽

Care Delivery ◽

Knowledge Score ◽

Attitude Score ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Attitudes And Practices ◽

Adequate Knowledge ◽

Knowledge Attitudes And Practices

Background: Delhi and NCR of India is densely populated with access to an integrated health care delivery system, with a promoted preventive homoeopathic medicine for flu like illnesses. To assess knowledge, attitudes and practices to this unanticipated situation and infectious disease pandemic of COVID-19 continues to be a global and public health challenge.Methods: A survey was conducted. An online cross-sectional survey was conducted in a sample of the residents of Delhi and NCR using a self-prepared pilot-tested structured format. The obtained data was analysed using descriptive and inferential statistics.Results: 925 people completed the survey with 55.5% of the study group being females. Mean knowledge score obtained was 7.57±1.41 while mean attitude score was 3.27±1.31. Majority of the respondents (86%) had an adequate knowledge about the disease in general and were optimistic about recovery from the disease. Gender had negligible impact on the average knowledge score, while the score differed significantly with education and occupation. In the absence of an available vaccine, 29.47% respondents considered prophylactic potential of homoeopathy.Conclusions: Results reveal adequate knowledge and practices in the educated residents but below average mean attitude score. Public has welcomed the governmental initiative of homoeopathic prophylactic, and their belief in its therapeutic potential furthers the studies to determine its role as an adjuvant. Further extensive cross-sectional surveys to cover various strata of population are required to assess the widespread pattern of KAP in the general population.

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Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽

10.1027/0227-5910/a000604 ◽

2020 ◽

Vol 41 (2) ◽

pp. 82-88 ◽

Cited By ~ 1

Author(s):

Bob Lew ◽

Ksenia Chistopolskaya ◽

Yanzheng Liu ◽

Mansor Abu Talib ◽

Olga Mitina ◽

...

Keyword(s):

Social Support ◽

Suicidal Behavior ◽

Online Survey ◽

Perceived Social Support ◽

Strain Theory ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Psychological Strains ◽

Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conﬂicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

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Does Dispositional Mindfulness Predict the Development of Grit?

Journal of Individual Differences ◽

10.1027/1614-0001/a000252 ◽

2018 ◽

Vol 39 (2) ◽

pp. 76-87 ◽

Cited By ~ 9

Author(s):

Buaphrao Raphiphatthana ◽

Paul Jose ◽

Karen Salmon

Keyword(s):

Undergraduate Students ◽

Online Survey ◽

Cross Sectional Study ◽

Self Report ◽

Dispositional Mindfulness ◽

Cross Sectional ◽

Report Data ◽

Self Report Data ◽

Acting With Awareness ◽

Mindfulness Facets

Abstract. Grit, that is, perseverance and passion for long-term goals, is a novel construct that has gained attention in recent years ( Duckworth, Peterson, Matthews, & Kelly, 2007 ). To date, little research has been performed with the goal of identifying the antecedents of grit. Thus, in order to fill this gap in the literature, self-report data were collected to examine whether mindfulness, a mindset of being-in-the-present in a nonjudgmental way, plays a role in fostering grittiness. Three hundred and forty-three undergraduate students completed an online survey once in a cross-sectional study, and of these, 74 students completed the survey again 4.5 months later. Although the cross-sectional analyses identified a number of positive associations between mindfulness and grit, the longitudinal analysis revealed that the mindfulness facets of acting with awareness and non-judging were the most important positive predictors of grit 4.5 months later. This set of findings offers implications for future grit interventions.

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