Beginning Of July Research Articles

Roles and Experiences of Registered Nurses on Labor and Delivery Units in the United States During the COVID-19 Pandemic

ObjectiveTo examine the roles and experiences of labor and delivery (LD) nurses during the COVID-19 pandemic. DesignCross-sectional survey. SettingOnline distribution between the beginning of July and end of August 2020. ParticipantsLD nurses (N = 757) responded to an open-ended question about changes to their roles during the COVID-19 pandemic as part of a larger national survey. MethodsWe calculated descriptive statistics on respondents’ characteristics and their hospitals’ characteristics. We applied conventional content analysis to free-text comments. ResultsWe derived four major categories from the responses: Changes in Roles and Responsibilities, Adaptations to Changes, Psychological Changes, and Perceived Effects on LaborSupport. Nearly half (n = 328) of respondents reported changes in their roles and responsibilities during the COVID-19 pandemic. They described adaptations and responses to these changes and perceived effects on patient care. Infection control policies and practices as well as the stress of a rapidly changing work environment affected the provision of labor support and personal well-being. ConclusionThe experiences described by respondents conveyed considerable changes in their roles and subsequent direct and indirect effects on quality of patient care and personal well-being. Policies and practices that can facilitate the ability of LD nurses to safely and securely remain at the bedside and provide high-touch, hands-on labor support are needed. The findings of our study can help facilitate the provision of labor support during times of disruption and foster the resiliency of the nursing workforce.

Connecting research and practice

Connecting research and practice

Adjusted dynamics of COVID-19 pandemic due to herd immunity in Bangladesh

Amid growing debate between scientists and policymakers on the trade-off between public safety and reviving economy during the COVID-19 pandemic, the government of Bangladesh decided to relax the countrywide lockdown restrictions from the beginning of June 2020. Instead, the Ministry of Public Affairs officials have declared some parts of the capital city and a few other districts as red zones or high-risk areas based on the number of people infected in the late June 2020. Nonetheless, the COVID-19 infection rate had been increasing in almost every other part of the country. Ironically, rather than ensuring rapid tests and isolation of COVID-19 patients, from the beginning of July 2020, the Directorate General of Health Services restrained the maximum number of tests per laboratory. Thus, the health experts have raised the question of whether the government is heading toward achieving herd immunity instead of containing the COVID-19 pandemic. In this paper, the dynamics of the pandemic due to SARS-CoV-2 in Bangladesh is analyzed with integrated the Unscented Kalman Filter (UKF) in the SIRD model. We demonstrate that the herd immunity threshold can be reduced to 31% than that of 60% by considering age group cluster analysis resulting in a total of 53.0 million susceptible populations. With the data of COVID-19 cases till January, 2021, the time-varying reproduction numbers are used to explain the nature of the pandemic. Based on the estimations of active, severe and critical cases, we discuss a set of policy recommendations to improve the current pandemic control methods in Bangladesh.

Participatory Nutrition Capacity Assessment and Capacity Development in Six Regions of Ethiopia

Abstract Objectives The multi-faceted causes of malnutrition make capacity development in nutrition complex. Defining capacity development actions requires an understanding of the landscape actors utilize to address the determinants. Thus, six regional health bureaus (RHB) in Ethiopia, in collaboration with Alive & Thrive (A&T), conducted participatory capacity assessments to identify capacity strengths and gaps, and co-developed appropriate maternal, infant, and young child nutrition (MIYCN) capacity development plans linked to achieving targets outlined in the national nutrition program. Methods From April to June 2019, 143 nutrition practitioners in six regions of Ethiopia conducted rapid participatory assessments of their respective regional capacity. They used an adapted assessment tool based on WHO's six system building blocks, and a four-level scoring guide to identify MIYCN capacity strengths and gaps on 87 statements of excellence. Validated by RHB's leadership, the assessors and A&T co-developed region-specific MIYCN capacity development plans for areas rated ‘poor’ and ‘fair’. Results An aggregate assessment score for six regions revealed presence of adequate MIYCN implementation capacity – excellent (25.3%), moderate capacity with basic ones in place or in use – good (37.9%), low capacity needing attention – ‘fair’ (23.6%), and no capacity or critical capacity limitation needing urgent attention – ‘poor’ (9.4%). Using a prioritization matrix, MIYCN-focused performance strengthening plans were designed, tailored to each region's context. Beginning in July 2019, the six RHBs incorporated key MIYCN improvement action items targeted towards ‘poor’ and ‘fair’ performance areas with relevant indicators into their annual plans, budget structure, and M&E framework. A&T and other partners provided technical assistance and coordinated their efforts with RHBs to spirally build regional MIYCN implementation capacities. Conclusions The participatory capacity assessment served to establish a baseline of existing MIYCN implementation capability; and create a strong and shared commitment within the health sector identifying areas for improvement that can be addressed by the government, with little or no external assistance. Funding Sources The Bill & Melinda Gates Foundation.

Increasing Biosimilar Utilization at a Pediatric Inflammatory Bowel Disease Center and Associated Cost Savings: Show Me the Money.

Tumor necrosis factor-alpha inhibitors (anti-TNFs) are a primary treatment for inflammatory bowel disease. Pharmaceutical expenditures and usage of specialty drugs are increasing. In the United States, biosimilars continue to be underutilized, despite opportunities for health care cost savings. Through quality improvement (QI) methodology, we aimed to increase biosimilar utilization among eligible patients initiating intravenous (IV) anti-TNF therapy and describe patient outcomes and associated cost savings. Beginning in July 2019, all patients initiating IV anti-TNF therapy were identified and tracked. Using the Institute of Healthcare Improvement Plan-Do-Study-Act cycle, a four-stage problem-solving model used for carrying out change, we trialed interventions to increase biosimilar utilization, including provider, staff, and family education, and utilization of a clinical pharmacist and insurance specialist. Statistical process control charts were used to show improvement over time. Patients' clinical outcome and cost savings were reviewed. Using QI methodology, we increased biosimilar utilization from a baseline of 1% in June 2019 to 96% by February 2021, with sustained improvement. The originator (infliximab) was the insurance company's preferred product for 20 patients (20%). Patient outcomes (IV anti-TNF levels, absence of antidrug antibodies, and physician global assessment) between biosimilars and originators were similar. Estimated cost savings over the project duration were nearly $381,000 (average sales price) and $651,000 (wholesale acquisition cost). Through QI methodology, we increased biosimilar utilization from 1% to 96% with sustained improvement, without compromising patient outcomes or safety. Estimated cost savings were substantial. Similar methodology could be implemented at other institutions to increase biosimilar utilization and potentially decrease health care costs.

ECOLOGICAL AND BIOLOGICAL STUDY OF Vespula. Germanica

Vespula germanica ( German wasp) is considered a dangerous pest that attacks bees and orchards, and its sting harmful to humans , found in much of the Northern Hemisphere, Khalaf was recorded in Iraq in 1958, it was limited to registration within the Iraqi insects fauna only, and no any biological or environmental studies in Iraq. Therefore, study aimed for understanding of some aspects of the insect. During three years, 2018-2019- and 2020, field survey in different fields in Duhok, Iraqi Kurdistan, collected 27 nests to investigate several colony characteristics. Our study showed the size of mature nests is correlated to number of individuals produced. observed that the German hornet builds its nests in different places as on trees and shrubs, on roofs of houses , buildings, animal pens, poultry fields, and near water sources. Queen begins to appear at beginning of May, workers at beginning of July, as for the males and virgins, they appeared in October. And all members cast die in winter except newly fertilized queens remain, who hibernate to next season. Showed the activity of workers increases with the progression of the hours of the day and that their highest activity is during the hour (9-11) in the morning, at rate 100 wasps/hour. seasonal activity starts from May to November, and highest activity recording during July, August, and September. The highest average of sealed brood area 3.11inch during July , highest average number of hexagonal eyes 91 eyes/nest in October.

Impact of Foliar Application of Various Forms of Silicon on the Chemical Composition of Sugar Beet Plants

The effect of marine calcite, a mixture of ortho- and polysilicic acid as well as orthosilicic acid applied as a foliar spray on the chemical composition of sugar beet leaves in the critical phase of nutrient supply (beginning of July) but also leaves and roots during harvest time in 2015–2016, was studied. The content of silicon in the leaves ranged from 1.24 to 2.36 g kg−1 d.m. at the beginning of July, 3.85–5.34 g kg−1 d.m. during harvest and 2.91–4.20 g kg−1 d.m. in the roots. The foliar application of silicon caused a significant increase in the content of magnesium and calcium in leaves (in July) as compared to the control. The sugar beet consumes approx. 75 kg Si ha−1, which is almost 3.5 times more than P and 20% more than Mg thus proving its importance for its species. About 70% of the silicon taken up by sugar beet is stored in roots and 30% in leaves. The pure sugar yield is most favorably influenced by two- and threefold foliar application of the product containing silicon in the form of orthosilicic acid stabilized with choline, and a threefold mixture of ortho- and polysilicic acid. The increase in the pure sugar yield is not the result of a change in the chemical composition of sugar beet plants, but their more efficient functioning after foliar application of silicon under stress conditions caused by water shortage.

Assessment of food intensity and growth rate young sevryuga (Acipenser stellatus Pallas, 1771) depending on from the terms of fishing of growing ponds

Artificial reproduction of sturgeon fish in the Volga-Caspian basin in modern conditions is the only real opportunity to replenish natural populations with juveniles, therefore, increasing its efficiency is the key to restoring the stocks of these relict fish species. Improving the technological processes of growing juvenile sturgeon fish, including the Caspian stellate sturgeon, the number of which has been rapidly decreasing in recent years, is one of the main tasks at present. We studied the conditions for growing stellate sturgeon larvae in the nursery ponds for artificial reproduction at different periods of their watering. It is known that the stocking of ponds with larvae that have switched to exogenous feeding occurs at the end of June or the beginning of July, this coincides with the time of maximum water heating in nursery ponds to extreme (26–28 °C) values and with a depletion of the food supply in them. Hydrobiological studies were carried out to assess the food supply in water bodies that were watered in the traditional (June 12–14) terms (control option) and earlier (May 28) 2 weeks earlier than usual (experimental option). In addition, the intensity of feeding and the growth rate of juvenile starred sturgeon in the indicated ponds was studied for 20–24 days. The results of the studies performed showed that the food supply in the experimental pond was higher, so the zooplankton was represented by four orders, the biomass on average ranged from 2,8 to 4,6 g/m³, and in the control variant, planktonic organisms were represented by three orders, total biomass from 0,3 to 2,5 g/m³. The same tendency can be traced for zoobenthos. The feeding intensity of stellate sturgeon fry reared in ponds of early watering had indicators in terms of the gastrointestinal tract filling index, fatness coefficient and growth rates higher than the juveniles kept in water bodies of traditional watering periods.

Detection of B.1.351 SARS-CoV-2 Variant Strain - Zambia, December 2020.

The first laboratory-confirmed cases of coronavirus disease 2019 (COVID-19), the illness caused by SARS-CoV-2, in Zambia were detected in March 2020 (1). Beginning in July, the number of confirmed cases began to increase rapidly, first peaking during July-August, and then declining in September and October (Figure). After 3 months of relatively low case counts, COVID-19 cases began rapidly rising throughout the country in mid-December. On December 18, 2020, South Africa published the genome of a SARS-CoV-2 variant strain with several mutations that affect the spike protein (2). The variant included a mutation (N501Y) associated with increased transmissibility.†,§ SARS-CoV-2 lineages with this mutation have rapidly expanded geographically.¶,** The variant strain (PANGO [Phylogenetic Assignment of Named Global Outbreak] lineage B.1.351††) was first detected in the Eastern Cape Province of South Africa from specimens collected in early August, spread within South Africa, and appears to have displaced the majority of other SARS-CoV-2 lineages circulating in that country (2). As of January 10, 2021, eight countries had reported cases with the B.1.351 variant. In Zambia, the average number of daily confirmed COVID-19 cases increased 16-fold, from 44 cases during December 1-10 to 700 during January 1-10, after detection of the B.1.351 variant in specimens collected during December 16-23. Zambia is a southern African country that shares substantial commerce and tourism linkages with South Africa, which might have contributed to the transmission of the B.1.351 variant between the two countries.

Scientific effort in combating COVID-19 in obstetrics and gynecology.

Scientific effort in combating COVID-19 in obstetrics and gynecology.

Intake Vaccinations Reduced Signs of Canine Respiratory Disease During an Outbreak at an Animal Shelter.

Animal shelters provide an ideal environment for the spread of disease. Dogs are often housed in close quarters with others of unknown vaccine histories, and experience high levels of sustained stress. As a result, Canine Infection Respiratory Disease (CIRD) is often prevalent and difficult to control. The aims of this study were to (1) identify specific pathogens responsible for CIRD in a city shelter in West Texas, USA, and (2) determine whether intake vaccinations decrease proportion of dogs exhibiting signs of CIRD even during an outbreak. A laboratory analysis of conjunctival, pharyngeal, and nasal swabs (n = 15 dogs) and fecal samples (n = 6 kennels) showed prevalence of various CIRD pathogens (e.g., canine adenovirus-2, canine parainfluenza virus, canine distemper virus). All fifteen dogs tested positive for at least one pathogen, with the most prevalent pathogen being Canine Distemper Virus (CDV; n = 12). All of the kennels (n=6) tested positive for Canine Distemper Virus. Health data on dogs (n = 1,258) over the age of 6 weeks were assessed from May to August 2017. Beginning in July, both stray and owner-surrendered dogs were vaccinated with Nobivac® Canine 1-DAPPv 5 Way and Nobivac® Intra-Trac® 3 upon intake, which differed from the previous policy. For each day in the study, we calculated the proportion of dogs in each nasal discharge category, the proportion of dogs observed coughing, and the mean fecal score across all dogs. We conducted a linear regression between the proportion of the shelter vaccinated and the proportion of dogs coughing. At the beginning of the vaccination phase, ~25% of the dogs were coughing. However, as the proportion of the dogs vaccinated increased, the proportion of dogs coughing decreased. There was a significant decrease of 7% of the proportion of dogs coughing when vaccination was at least at 90% compared to when it was <90%. These data suggest that the shelter in this study was experiencing a CIRD outbreak, with CDV being primary pathogen, and that it is possible to substantially reduce illness by implementing a vaccination on intake protocol. The current study provides support for the importance of vaccination in animal shelter welfare.

Spring deficit irrigation promotes significant reduction on vegetative growth, flowering, fruit growth and production in hedgerow olive orchards (cv. Arbequina)

An irrigation experiment was conducted during 5 years in two hedgerow olive orchards (C and L) cv. Arbequina in Central Spain. The control treatments (C1 and L1) were irrigated to maintain the “wetted bulb” near field capacity throughout the season. Three deficit-irrigation treatments were applied from shoot growth (April-May) until pit hardening (beginning of July) with water applications relative to control, C2, C3, C4 (50, 25, 0%) and L2, L3, L4 (40, 17, 0%), respectively. Treatments reverted to full irrigation after pit hardening. During the treatment period a series of phenological events occurs: bud break, shoot growth, flower differentiation, flowering, fruit set, fruit drop and pit hardening. Responses of vegetative growth, flowering, fruiting, fruit characteristics and production were evaluated through their relationships with midday stem water potential (Ψstem). Flowering was shown to be the most sensitive period to deficit irrigation and the major determinant of final production through reductions on fruit number and oil content. With high water during flowering (mean Ψstem before irrigation >−1.0 MPa) trees developed more nodes, leaves, fertile inflorescences and fruits per inflorescence with consequent high production (1278 kg oil ha−1). Oil production was significantly reduced (64% of maximum) when Ψstem was allowed to fall below −1.5 MPa at flowering and was halved at −1.7 MPa, reducing water productivity from 0.26 to 0.21 kg oil m−3. In contrast, Ψstem could be reduced to −1.8 MPa after flowering until pit hardening without effects on fruit drop, fruit size or oil content. Fruit drop increased when Ψstem from flowering until pit hardening was below −2.71 MPa. Fruit oil content at harvest was strongly related with fruit dry weight at pit hardening. Vegetative growth occurred continuously during spring, although mainly during flowering, and could not be reduced by deficit irrigation without reducing production. The results are advantageous to irrigation management in this and similar climatic regions where Spring is a critical period for olive production due to variable temperature, rainfall and crop water demand. They establish the high thresholds of Ψstem required to guide irrigation management during Spring without yield loss, and the substantial resulting loss when this threshold is exceeded. They also reveal that deficit irrigation strategies cannot be used in Spring to control canopy size in hedgerow orchard without serious impact on yield.

Covid-19 Y Tuberculosis: El Encuentro Entre Nuevas Amenazas Y Viejas Enfermedades

A storm called COVID-19 has been destabilizing the health systems of almost everything the world. In almost 8 months it has gone from being a report of atypical pneumonia with etiology unknown to be the pandemic of the 21st century. In Peru, the first confirmed case was March 6, and until the beginning of July has been claiming the lives of more than 10,000 people.

The Relation Between Technologies for Late Blight (Phytophthora Infestans) and the Yield Components (Biomass) of Different Potato Varieties

Phytophthora infestans, the causal agent of late blight, is a major threat to potato crop all over the world. Fungicides play a crucial role in the integrated control of late blight. Variety choice is dictated by end users who demand cultivars with specific agronomic characters and these are difficult to combine with late blight resistance. The main aim of this research was to test the influence of two different densities (53300 plants/ha and 44400 plants/ha) and two different late blight control technologies (using only contact fungicides - TECH1 and alternative systemic and contact fungicides - TECH2) on the biomass of three highly cultivated varieties (Riviera, Christian and Roclas). The potato canopy of different varieties present large difference regarding stem length and leaf number, shoot and tubers weight in response to the applied technologies. In 2014 conditions, the total biomass of the varieties and combinations of treatments studied did not differ significantly. In 2015 and 2016 conditions, the varieties were differentiated both by the amount of biomass accumulate on July 1-4 and by the statistical differentiation of the variants within the varieties. The studied densities had significant effects on plant biomass accumulations at the beginning of July. In all years, at the beginning of July, due to the earliness and sensitivity to late blight, the green mass in Riviera variety was significantly lower, compared to the green mass in the middle early varieties Roclas and Christian.

ДІЯЛЬНІСТЬ УКРАЇНСЬКОГО ВИЗВОЛЬНОГО РУХУ В КРИМУ У 1941–1943 РОКАХ: ВІД ІДЕОЛОГІЧНОГО ОБҐРУНТУВАННЯ ДО ПРАКТИЧНИХ КРОКІВ

The article examines the Crimean aspect of the Ukrainian liberation movement. The program and ideological documents of the Organization of Ukrainian Nationalists regarding their vision of the role and place of Crimea in the geopolitical strategies of the future independent Ukrainian state are analyzed. The second part of the article is devoted to the deployment of Ukrainian nationalist structures on the Crimean peninsula, the peculiarities of their work under German occupation and relations with certain national groups, including the Crimean Tatars. Even in the interwar period, the ideologues of Ukrainian nationalists developed geostrategic concepts in which Crimea occupied a key place, as a certain outpost of the Black Sea region, which under no circumstances can be inferior. Accordingly, these documents proved the ideas of historical and physical-geographical unity of mainland Ukraine with the Crimea from the times of Kievan Rus, the Cossacks and modern history. In the future vision, Ukrainian nationalists viewed Crimea as the main base of the Ukrainian navy and Ukrainian merchant navy. The issue of the Navy and Crimean ports occupies a special place in these documents. Ukrainian nationalists were able to begin to implement their plans and implement their own ideas during the German-Soviet war. As early as the beginning of July 1941, the first OUN marching groups moved to the central Ukrainian lands, from where they planned to seize all ethnic Ukrainian lands, creating their own bodies of power and administration, and Crimea was one of their key destinations. Respectively, the OUN (B) and the OUN (M) created special «Crimean» marching groups, which were to move directly to the peninsula. In November 1941, the first OUN groups managed to enter the territory of the Crimea. At that time there was a split in relations between the German occupation regime and Ukrainian nationalists, German repressions against members and supporters of the OUN began in the summer of 1941, so marching groups to the Crimea were under threat of exposure and physical destruction. Simferopol became the center of OUN activity in Crimea. Separate OUN structures were also established in Dzhankoi, Yalta, and other cities on the peninsula. Under persecution by the Gestapo and the SD, Ukrainian nationalists were still able to gain a foothold in the Crimea and begin systematic organizational work, which consisted of established networks of sympathizers and agents, volunteer and cultural structures. This article will be of interest to those who are interested in the activities of the Ukrainian liberation movement, OUN groups and the history of Crimea during the German occupation.

Influence of the COVID-19 Pandemic Outbreak on Ground Transport CO2 Emission

Coronavirus pandemic brought about stay-at-home strategies to diminish the danger of uncontrolled spread of the infection. This paper looks at the effect that these activities had on emissions caused by ground transport among different countries. CO2 emission year-to-date dropped by 5.4% with respect to the 2019 statistics, which means that the scope of the decrease is much more abrupt than during past financial crises or World War II. The circumstance of emissions relates to lockdown measures in every nation. By the beginning of July 2020, the pandemic’s impacts on worldwide emission reduced as lockdown limitations were loosened and some monetary exercises restarted, although the air pollution is still lower in contrast to 2019. The article traces back the reasons for the observed decline from the perspective of different countries and economy sectors. While there is no doubt that the major vector of changes was the COVID-19 pandemic, an increasingly important role of climate changes is also visible in the analysed data.

A modified SEIR model to predict the COVID-19 outbreak in Spain and Italy: Simulating control scenarios and multi-scale epidemics

After the spread of the SARS-CoV-2 epidemic out of China, evolution in the pandemic worldwide shows dramatic differences among countries. In Europe, the situation of Italy first and later Spain has generated great concen, and despite other countries show better prospects, large uncertainties yet remain on the future evolution and the efficacy of containment, mitigation, or attack strategies. This Manuscript was originally written in the last days of March as a way to report on the first current wave of the pandemic. The results were updated several times for March and also for the month of July. Here we applied a modified SEIR compartmental model accounting for the spread of infection during the latent period, in which we also incorporate effects of varying proportions of containment. We fit data to reported infected populations at the beginning of the first peak of the pandemic to account for the uncertainties in case reporting and study the scenario projections for the individual regions (CCAA). The aim of this model it’s to evaluate the confinement rate at the first stages of the epidemic outbreak in order to assess the scenarios that minimize the incidence but also the mortality. Results indicate that with data for March 23, the epidemics follow an evolution similar to the isolation of 1,5 percent of the population, and if there were no effects of intervention actions it might reach a maximum of over 1.4M infected around April 27. The effect on the epidemics of the ongoing partial confinement measures is yet unknown (an update of results with data until March 31st is included), but increasing the isolation around ten times more could drastically reduce the peak to over 100k cases by early April, while each day of delay in taking this hard containment scenario represents a 90 percent increase of the infected population at the peak. Dynamics at the sub aggregated levels of CCAA show epidemics at the different levels of progression with the most worrying situation in Madrid and Catalonia. Increasing alpha values up to 10 times, in addition to a drastic reduction in clinical cases, would also more than a half the number of deaths. Updates for March 31st simulations indicate a substantial reduction in burden is underway. A similar approach conducted for Italy pre-and post-intervention also begins to suggest a substantial reduction in both infected and deaths has been achieved, showing the efficacy of drastic social distancing interventions. By last we show the real evolution of the pandemic up to the end of May and the beginning of July in order to calculate the real confinement rate from data to compare with the scenarios formulated at March.

Narrativas docentes em podcast

Diante do período pandêmico gerado pelo COVID-19, um novo formato de ensino foi exigido simultaneamente à necessidade do distanciamento social, com o uso de tecnologias digitais. Estas, apesar de incentivadas na educação em períodos anteriores, ainda não tinham sido integradas significativamente no cotidiano escolar. O cenário da pandemia, no entanto, apontou para a necessidade da adoção dessas tecnologias, recomendada pelos documentos expedidos pelo MEC e CNE no período. Dessa forma, o objetivo desta pesquisa é relatar a partir de um podcast, as experiências e percepções de professores de Ciências atuando prioritariamente na Amazônia brasileira, ainda que professores de outros estados tenham sido convidados, quanto ao uso de recursos digitais em sala de aula, bem como divulgar projetos e produções educacionais voltadas para o ensino de Ciências. Para tanto, foram entrevistados onze profissionais da educação dos municípios: Rio Branco (AC), Xapuri (AC), Coari (AM), Oriximiná (PA), Santo Antônio do Tauá (PA), Belém (PA), Ponta de Pedras (PA), Barreiras (BA), Barra do Bugres (MT), Guarantã do Norte (MT) e Cabedelo (PB). As entrevistas foram gravadas e editadas em softwares livres e distribuídas em diversas plataformas de streaming desde o início de julho de 2020, tendo atualmente um total de 434 audições. Constatou-se que apesar das inúmeras dificuldades relatadas pelos docentes com o uso de tecnologias digitais, principalmente em tempos de pandemia, a incorporação das Tecnologias Digitais da Informação e Comunicação no ensino, bem como a utilização do podcast como instrumento de divulgação científica e democratização do acesso à informação.

Disruptions to Care and the Use of Telehealth Among Older Adults During the COVID-19 Pandemic

Reports emerged early in the 2020 COVID-19 pandemic that older adults were foregoing non-COVID19-related care, due to fears of contracting the virus during appointments and because of healthcare providers’ reduced operations. Beginning in July, 2020, we explored the impact of the pandemic on disruptions to care and older adults’ use of telehealth. Preliminary results from 53 older adults aged 66 to 93 (mean: 72.6) found that many older adults experienced disruptions in their care, ranging from 30-50% depending on the type of care. The most commonly disrupted care types were mental health and rehabilitation care (occupational, physical, or speech therapy), with 50% of older adults reporting disruptions to mental health and 50% to rehabilitation care. The most common reason for the disruptions was closed care providers’ offices. Similar results were found for primary care (46% reporting disruptions), dental care (44%), and vision care (30%), with between 62-71% citing closed offices as a reason for the disruption. The use of telehealth among the sample was high (44%), and the majority (83%) of these older adults reported never having used it previously. All who used it reported being very or somewhat comfortable with the technology, and 83% said they would use it again even if in-person care was available. These findings suggest the pandemic has had a significant impact on older adults’ care and that the expansion of telehealth could be increase access to care during and after the pandemic.

A surge in the incidence of telogen effluvium in minority predominant communities heavily impacted by COVID-19

To the Editor: In March 2020, New York City (NYC) experienced a surge of coronavirus infections, becoming the epicenter of the global pandemic. Low-income, communities of color were the hardest hit, with morbidity and mortality far outweighing that of more affluent white areas.1 Our dermatology departments operate out of 2 safety net hospitals in Brooklyn and Manhattan serving racially diverse neighborhoods that experienced some of the highest death rates in NYC.2 Beginning in July, we began to notice an abrupt uptick in cases of hair shedding in our clinics.