Articles: pandemics.
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Eur J Trauma Emerg Surg · Apr 2022
Trauma epidemiology after easing of lockdown restrictions: experience from a level-one major trauma centre in England.
The COVID-19 pandemic transformed the delivery of trauma care. We examined the effect of lockdown easing on trauma presentation and management from one Major Trauma Centre (MTC). ⋯ This is the first study to document trauma trends through a lockdown and thereafter. After lockdown easing, trauma footfall rapidly rebounded to 2019 levels. This should be acknowledged in resource allocation decisions if future lockdowns are necessitated.
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Annals of family medicine · Apr 2022
Family physician virtual care during COVID-19 in London-Middlesex, Ontario, Canada: a mixed methods exploration.
Context: On March 14, 2020, the Ontario, Canada health insurance plan approved COVID-19 physician virtual billing codes; family physicians (FPs) rapidly adopted a new model of care. Virtual care may remain post-pandemic; however, its future should be informed by evidence that considers access and continuity. Objective: 1) to determine FP virtual visit volumes and patient characteristics and 2) to explore FPs' perspectives on virtual visit adoption and implementation. ⋯ FP offices remained open despite PPE concerns but overall volumes dropped initially. Vulnerable and sicker patients received care but FPs expressed concern for highly vulnerable and rural residents. FPs believed they could offer patient-centred care over the phone but indicated the importance of maintaining in-person care to build relationships.
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Annals of family medicine · Apr 2022
Patient perspectives on diabetes shared medical appointments before, during, and after the COVID-19 pandemic.
Context: Shared Medical Appointments for diabetes (SMAs) are an evidence-based strategy improve health outcomes. However, which elements of SMAs are important remain unknown. Invested in Diabetes studied two implementation approaches (standardized [STD] vs. patient-driven [PTD]), using a curriculum focused on mental health and skill building in addition to diabetes self-management. ⋯ The peer mentor role was not always well received, likely due to variations in the peer mentor. Teaching style was very important to satisfaction, and all patients wanted guest speakers with varied expertise. A virtual format was acceptable. .
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Annals of family medicine · Apr 2022
The role of Canadian family physicians in the response to the COVID-19 pandemic.
Context: In Canada, most medical care is delivered through front line, first contact primary care. As nations traverse the most significant health event in a century, it is important to understand how primary care has been engaged in the challenge. Objective: Assess the patterns of direct clinical patient care involvement of Canadian family physicians (FPs) in the response to the COVID-19 pandemic by province, age, remuneration model, and practice setting. ⋯ Conclusions: While most family physicians have been involved in the COVID-19 response, discrepancies exist across jurisdiction, ages, remuneration types, and practice models. These results suggest that there were obstacles to the full involvement of Canada's primary care system in the response to the pandemic. Evidence generated by this study points to factors that could enable a more responsive future primary health care system.
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Journal of critical care · Apr 2022
Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic.
We aim to describe the action plan and clinical results of a COVID-19 unit for adult patient care in units intended for critically ill children, proposing a clinical/administrative framework. ⋯ We propose an organizational framework for the role of PICU in the hospital action plan to increase adult critical beds. The cohort of patients admitted to a PICU repurposed as a COVID-19 ICU had good outcomes. These data are valuable to plan coordinated actions of the healthcare system for future scenarios.