Meta-analysis of COVID-19 patients to understand the key predictors of mortality in the non-vaccinated groups in remote settings

Various studies have looked into the impact of the COVID-19 vaccine on large populations. However, very few studies have looked into the remote setting of hospitals where vaccination is challenging due to social structure, myths, and misconceptions. There is a consensus that elevated inflammatory markers such as CRP, ferritin, D-dimer correlate with increased severity of COVID-19 and are associated with worse outcomes. In the present study, through retrospective meta-analysis, we have looked into ~20 months of SARS-COV2 infected patients with known mortality status and identified predictors of mortality concerning their comorbidities, various clinical parameters, inflammatory markers, superimposed infections, length of hospitalization, length of mechanical ventilation and ICU stay. Studies with larger sample sizes have covered the outcomes through epidemiological, social, and survey-based analysis; however, most studies cover larger cohorts from tertiary medical centers. In the present study, we assessed the outcome of non-vaccinated COVID 19 patients in a remote setting for 20 months from January 1, 2020, to August 30, 2021, at CHI Mercy Health in Roseburg, Oregon. We also included two vaccinated patients from September 2021 to add to the power of our cohort. The study will provide a comprehensive methodology and deep insight into multi-dimensional data in the unvaccinated group, translational biomarkers of mortality, and state-of-art to conduct such studies in various remote hospitals.

Evaluation of Remote Categorical Loudness Scaling

Purpose: The aims of this study were to (a) demonstrate the feasibility of administering categorical loudness scaling (CLS) tests in a remote setting, (b) assess the reliability of remote compared with laboratory CLS results, and (c) provide preliminary evidence of the validity of remote CLS testing. Method: CLS data from 21 adult participants collected in a home setting were compared to CLS data collected in a laboratory setting from previous studies. Five participants took part in studies in both settings. Precalibrated equipment was delivered to participants who performed headphone output level checks and measured ambient noise levels. After a practice run, CLS measurements were collected for two runs at 1 and 4 kHz. Results: Mean headphone output levels were within 1.5 dB of the target calibration level. Mean ambient noise levels were below the target level. Within-run variability was similar between the two settings, but across-run bias was smaller for data collected in the laboratory setting compared with the remote setting. Systematic differences in CLS functions were not observed for the five individuals who participated in both settings. Conclusions: This study demonstrated that precise stimulus levels can be delivered and background noise levels can be controlled in a home environment. Across-run bias for remote CLS was larger than for in-laboratory CLS, indicating that further work is needed to improve the reliability of CLS data collected in remote settings. Supplemental Material https://doi.org/10.23641/asha.17131856

Exploring Tobacco and E-Cigarette Use among Queer Adults during the Early Days of the COVID-19 Pandemic

The purpose of this narrative study is to describe the vaping and smoking characteristics of Queer people ages 18–34 before March of 2020 and to better understand how the COVID-19 pandemic has impacted those behaviors since March of 2020. In total, 31 participants were screened. Thirteen participants were screened prior to the emergence of COVID-19, and 18 were screened when study protocols transitioned to a remote setting (pre and during). Of the 27 eligible participants, a total of 25 participants completed the study. Most participants (n = 13) self-identified as male, followed by five identified as female, four self-identified as gender non-binary, and three identified as transgender. The most common sexual orientation amongst participants was gay (n = 10), with bisexual being the second-most reported. Approximately 20 Queer participants reported using cigarettes, 14 participants self-reported using electronic devices, and 11 reported using hookah. Twenty participants reported smoking ten or less, and four self-reported using 11–20 cigarettes per day. Approximately, 92% of participants (n = 23) indicate that they are using an e-cigarette and regular cigarettes, and 57% of participants (n = 12) report using one pod or cartridge per day. The three themes that emerged in this study are: (1) Queer people during COVID-19 are experiencing heightened minority stress; (2) Queer people are unfamiliar with smoking cessation; and (3) vaping and smoking are attributed to stress and anxiety. Queer participants are likely to be dual users of cigarette and vaping products. This present study provides increasing evidence that Queer people are experiencing heightened stress and anxiety and using cigarette smoking and vaping to cope during the COVID-19 pandemic.

Cognitive Performance in Remote Work - Evidence from Professional Chess

During the COVID-19 pandemic, traditional (offline) chess tournaments were prohibited and instead held online. We exploit this unique setting to assess the impact of remote–work policies on the cognitive performance of individuals. Using the artificial intelligence embodied in a powerful chess engine to assess the quality of chess moves and associated errors, we find a statistically and economically significant decrease in performance when an individual competes remotely versus offline in a face-to-face setting. The effect size decreases over time, suggesting an adaptation to the new remote setting.

Echocardiography Screening for Diagnosis of Latent RHD Using Nurses: Is the Project Feasible for Nepal?

Rheumatic Heart Disease (RHD) is a preventable disease which occurs years or decades after the onset of Acute Rheumatic Fever (ARF) in childhood. The prevalence of RHD is still high in Nepal, with most cases of latent RHD concentrated in the rural, resource-limited setting. The sequelae of latent RHD cases often manifest decades later, causing a significant burden on the health system. Training of non-experts with simple protocols in such remote setting for screening of latent RHD is showing promising results worldwide. Screening of latent RHD is advocated in RHD endemic areas where early detection by echo screening can alleviate a massive burden on morbidity and mortality in the future. More research is needed to explore this possibility in the context of an endemic country like Nepal to tackle the burden of RHD.

Transition from Conventional Teaching to Remote Setting in Health Education

The global pandemic has introduced uncertainty in almostall aspects of society; similarly it has caused a drastictransformation in the education field. The way student’slearn and the way knowledge is being delivered to them hasall changed, as a result, education has been affecteddramatically.1

Exploring the Question: “Does Empathy Work in the Same Way in Online and In-Person Therapeutic Settings?”

Providing remote psychotherapy using technology is a growing practice, especially since the outbreak of the COVID-19 pandemic. Even if in numerous studies video conferencing psychotherapy (VCP) was found to be clinically effective, some doubts continue to exist about how the psychotherapeutic alliance works in the online setting, and the characteristics of the empathic process are still poorly understood. This is an exploratory study aimed at analyzing the degree of empathy between the psychotherapist and client pair, and the degree of support perceived by the client who shall be referred to as the patient interchangeably in this study, comparing the sessions in person with those online, during the current pandemic, in order to discriminate the impact of empathy in the digital setting. The sample analyzed was composed of 23 patients with different severity of pathology engaged in online and in-person therapeutic sessions with five psychotherapists of different theoretical leanings. The scores of the support and empathy scale, obtained by both members of the psychotherapeutic couple in the two settings, were analyzed and compared. The test used belongs to an Italian adaptation of the Empathic Understanding (EU) of the Relationship Inventory. What emerged from comparing the scores was interesting: Unlike the psychotherapists, the patients perceived their therapists as significantly more empathic and supportive in the remote setting. These are rather important data, because the literature documents that client empathic perception measures represent a more accurate measure of the empathic relationship and, in general, can predict a good treatment outcome. Although these results need further investigation, they represent an important contribution in filling the scientific gap in the understanding of digital empathy. Also, this study provides new insights for future research on the characteristics and impact empathy has on the practice of remote psychotherapy.