Telephone Questionnaire Research Articles

Immune response and severity of Omicron BA.5 reinfection among individuals previously infected with different SARS-CoV-2 variants.

COVID-19 continues to spread worldwide, with an increasing number of individuals experiencing reinfection after recovering from their primary infection. However, the nature and progression of this infection remain poorly understood. We aimed to investigate the immune response, severity and outcomes of Omicron BA.5 reinfection among individuals previously infected with different SARS-CoV-2 variants. We enrolled 432 COVID-19 cases who had experienced prior infection with the ancestral SARS-CoV-2 virus, Delta variant or Omicron BA.2 variant between January 2020 and May 2022 in Guangzhou, China. All cases underwent follow-up from March to April, 2023 through telephone questionnaires and clinical visits. Nasal lavage fluid and peripheral blood were collected to assess anti-RBD IgA, anti-RBD IgG and virus-specific IFN-γ secreting T cells. Our study shows that 73.1%, 56.7% and 12.5% of individuals with a prior infection of the ancestral virus, Delta or Omicron BA.2 variant experienced reinfection with the BA.5 variant, respectively. Fever, cough and sore throat were the most common symptoms of BA.5 reinfection, with most improving within one week and none progressing to a critical condition. Compared with individuals without reinfection, reinfected patients with a prior Delta infection exhibited elevated levels of nasal anti-RBD IgA, serum anti-RBD IgG and IFN-γ secreting T cells, whereas there was no noticeable change in reinfected individuals with a prior BA.2 infection. These results suggest that BA.5 reinfection is common but severe outcomes are relatively rare. Reinfection with a novel SARS-CoV-2 variant different from the prior infection may induce a more robust immune protection, which should be taken into account during vaccine development.

Life expectancy of patients with diabetic foot sepsis post-lower extremity amputation at a regional hospital in a South African setting. A retrospective cohort study

BackgroundDiabetes foot sepsis (DFS) is the leading cause of amputation of lower extremities. Over 50 % of patients who have had major lower extremity amputation due to DFS are dead within 4 years following the procedure. AimTo determine the life expectancy of patients following amputation for DFS at a regional hospital in South Africa. MethodsWe conducted an audit of patients who had DFS and were admitted over a 5-year period. The duration from admission to time of death was recorded in days. Occurrence of death was confirmed from family members of the deceased using structured telephonic interview questionnaires. Categorical findings were summarized using actual counts and percentages and compared using either the Chi-square or Fisher's exact test. We used the mean with standard deviation or median and range to compare parametric and non-parametric continuous data, respectively. The Shapiro-Wilk test was used to test normality of data. Multivariate logistic regression was done to establish factors that were strongly associated with the mortalities. Adjusted survival curves were added to compare the rate of occurrence of mortality between males and females with age as a confounder. Statistical significance was set at a p-value below 0.05. Results197 were found of which 100 % of participants had Type 2 diabetes mellitus and 63.5 % were males. Associated comorbidities included hypertension in 73.6 %, obesity in 66 %, alcohol use in 64.5 % and smoking in 58.4 %. 190 participants had an amputation and 19.3 % died. ConclusionDFS was more common in males and 96 % of the patients had an amputation. Mortality rate within 4 years following amputation was 19.3 % and was higher in females and individuals with multiple comorbidities.

Patient-perceived dysphagia and voice change post thyroid surgery: a telephone questionnaire.

This study analyses the incidence of subjectively experienced dysphagia and voice change in post-thyroidectomy and parathyroidectomy patients without recurrent laryngeal nerve palsy. A total of 400 patients were invited to participate in a telephone questionnaire based on the Dysphagia Handicap Index and Voice Handicap Index. At 6-24 months following surgery, participants were divided into: post-thyroid surgery (total, hemi-, parathyroidectomy) groups and controls (other ENT procedures). A total of 254 responses were received (127 following thyroid surgery, 127 controls). Twenty-two per cent of post-thyroidectomy patients had a Voice Handicap Index score of more than 3, compared to 15 per cent of parathyroid patients and 4 per cent of controls. The mean Dysphagia Handicap Index score for patients post thyroidectomy and hemi-thyroidectomy was 2.0. Parathyroidectomy patients had a mean Dysphagia Handicap Index score of 1.3, higher than controls at 1.0. Dysphagia and voice alteration are common following thyroid surgery, even in the absence of recurrent laryngeal nerve injury. Both deficits occur more frequently following thyroid surgery than parathyroid surgery.

Nine recommendations for the emergency department for patients presenting with low back pain based on management and post-discharge outcomes in an Australian, tertiary emergency department.

To ascertain and develop recommendations for analgesic management, discharge planning and further healthcare utilisation of adults presenting to an Australian tertiary ED with radicular or low back pain (LBP). This prospective cohort study included adults presenting with non-specific LBP or radicular pain to an Australian tertiary ED. Participants with trauma/cancer-related pain, and those requiring hospital admission or surgical interventions were excluded. The primary outcome was pharmacological and non-pharmacological management delivered in ED, retrospectively collected via electronic medical records. The secondary outcomes include discharge management use, and changes made due to post-discharge healthcare utilisation, as observed by weekly telephone questionnaires over 4-weeks follow-up. Of the 100 participants recruited, 94 completed follow-up. In ED, pharmacological management was received by 85%, including opioids (62%) and non-steroidal anti-inflammatory drugs (NSAIDS, 63%). Non-pharmacological management was received by 73%, including patient education (71%) and exercise prescription (37%). In the first-week post-discharge, changes to initial discharge plan occurred in 50%, mostly carried out by GPs (76%). Over the follow-up period, 51% received additional investigations/referrals. Pharmacological use decreased by 38% and non-pharmacological use decreased by 10%. 16% of opioid-naïve patients continued using opioids 4-weeks post-discharge. ED presentations for LBP were more often treated pharmacologically than non-pharmacologically, with opioids commonly prescribed and NSAIDs potentially under-utilised. Post-discharge, additional investigations/referrals, discharge analgesia reductions and maintenance of non-pharmacological management were common. Opioid initiation as a result of LBP presentations, signifies a potential 'gateway' towards unintentional long-term use. Key study findings form our nine recommendations to inform ED LBP pain management.

Should You Fix Testicular Prosthesis? A Satisfaction Survey From a Monocentric Cohort

Objective:To evaluate whether testicular prosthesis should be fixed MethodsRetrospective monocentric study including 169 patients who had implantation of testicular prosthesis between January 2013 and December 2022. Patients answered a telephone questionnaire regarding prosthesis characteristics and satisfaction. ResultsProsthesis was sutured for 59 patients (34.9%) out of 169. 146 patients answered the questionnaire. Satisfaction was excellent regarding size, weight, consistency and shape. A position too high was a major complain in both groups. Pain and discomfort were significantly higher in the fixed group (30.8% vs 9.78%, p<0,001). Few patients reported discomfort with the anchor prosthesis (22,9%). ConclusionsOverall satisfaction of the prosthesis is high but discomfort and high positioning are the two items remaining to improve. Our study suggests that fixing prosthesis is a cause of discomfort and won’t allow a better positioning

Gender Comparisons of Surgical Outcomes in Patients Undergoing One Anastomosis Gastric Bypass (OAGB): a Historical Cohort Study.

Clinical trials in the field of bariatrics have frequently been gender imbalanced, with males representing only 20% of examinees. Long-term gender-oriented results in one anastomosis gastric bypass (OAGB), and specifically quality of life (QOL) parameters, have not been addressed sufficiently. A better understanding of gender's effect on OAGB outcomes can play an important role in selecting the appropriate bariatric surgery for patients. Our study was aimed at examining mid-term gender-associated outcome of OAGB, including the effect on QOL. A retrospective cohort study of patients who underwent OAGB at surgical ward A, SUMC, Israel, between 2015 and 2020. Demographics, body mass index (BMI), and comorbidities were extracted from the national medical records system. Follow-up quality of life (QOL) and weight parameters were supplemented via telephone questionnaires, using the Bariatric Analysis and Reporting Outcome System (BAROS). A total of 152 patients were included; of these, 51 (33.6%) were males, with an average follow-up period of 4.1 (± 1.3) years post-surgery. Basic demographics showed no significant pre- or post-surgery differences between males and females, except for pre-op weight (which as expected was higher for males). Males had a higher overall BAROS score than females (3.8 ± 2.1 vs. 2.6 ± 2.1, p < 0.001). OAGB surgery results in better outcomes for male than for female patients as measured by the BAROS, despite a similar BMI reduction, and with no difference in complications. Gender-specific outcomes are one of the variables that one should be aware of in optimizing patient selection and pre-operative patient counseling.

Assessment of Knowledge and Attitudes Over Time in Postacute COVID-19 Environments: Protocol for an Epidemiological Study.

Globally, COVID-19 is in transition from the acute pandemic phase into a postacute phase, and special attention should be paid at this time to COVID-19 control strategies. Understanding public knowledge and attitudes plays a pivotal role in controlling COVID-19's spread and provides information about the public's adherence to preventive and control measures. This study protocol describes the planning and management of a survey to investigate the persistent or changing trends in knowledge and attitudes regarding COVID-19, vaccination, and nonpharmaceutical preventive measures among COVID-19 cases' household contacts aged 18 years and older, after the acute phase of the pandemic in Catalonia and Navarre in Spain. The secondary objectives include investigating the rate of secondary transmission in households, taking into account the demographic characteristics, clinical manifestations, and preventive measures toward COVID-19. A telephone questionnaire was designed to assess the changing trends in knowledge, preventive measures, and attitudes toward COVID-19 in 3 rounds (after identification as a household contact, 3 months later, and 6 months later). The questionnaire was developed following an extensive literature review and through discussions with a panel of experts who designed and assessed the validity of the questionnaire in terms of relevance, consistency, completeness, and clarity. The questionnaire consists of the following 7 sections: social and demographic characteristics (ie, gender, age, educational level, and workplace), comorbidities and risk factors (according to the recommendations from the COVID-19 vaccination strategy), epidemiological data (ie, exposure time, relationship with index cases, and frequency of use of nonpharmaceutical preventive measures), COVID-19 vaccination status (ie, the number and date of doses received), knowledge and attitudes toward COVID-19 (assessed using a 5-point Likert scale-totally agree, agree, neither agree nor disagree, disagree, and totally disagree), and sources of information (including traditional mass media, social media, and official sources). A pilot study was performed in May 2022 to evaluate the questionnaire with 22 household contacts. Preliminary findings indicated that the questionnaire was feasible and acceptable in the general population. The average response time was 15 minutes, with greater variations in responses by older participants. After the pilot study, recruitment of participants began and is expected to be completed at the end of the year 2023, after which the final results will be available in 2024. Despite the low transmission levels of SARS-CoV-2 and the relaxation of containment measures, the implementation of the survey during the postacute phase will provide valuable insight to assist public health decision-making and control the transmission of SARS-CoV-2 and other respiratory viruses, thereby attenuating the negative effects of COVID-19 at individual and population level. DERR1-10.2196/52114.

Diagnostic Performance of a telephone questionnaire for fracture-related infections (FRIs) in open tibia fracture patients in Tanzania

IntroductionFracture-related infections (FRIs) are a major cause of trauma-associated morbidity worldwide. In 2018, an expert group supported by the AO Foundation, European Bone and Joint Infection Society developed a consensus definition of FRI. Still, there is limited knowledge on the applicability of this definition in low- and middle-income countries (LMICs). Given the unique barriers that cause low follow-up rates for orthopaedic trauma patients in LMICs, this study aims to evaluate the diagnostic performance of a telephone questionnaire in identifying patients with FRIs after open tibia fracture fixation in Tanzania. Materials and MethodsPatients from a randomized controlled trial investigating the infection prevention benefit of locally applied gentamycin for open tibial fractures were included. Patients completed FRI based telephone questionnaires 7–10 days prior to scheduled follow-ups at 6 weeks, 3 months, 6 months, 9 months, and 1 year. The questionnaire included two “confirmatory” criteria questions for FRI (i.e., open wound and purulent drainage) and three “suggestive” criteria questions (i.e., wound drainage, fever, and warmth). Contingency tests were performed to identify the sensitivity and specificity between answers and adjudicated FRI diagnoses at the corresponding in-person follow-up. Data was analysed using STATA version 15.0 and MedCalc's online diagnostic test calculator. ResultsThere were a total of 234 complete questionnaires and 85 unique patients included. The sensitivity and specificity of having any positive answer in the questionnaire was highest at 6 months (100 % and 92.5 %, respectively). For all time-points pooled, sensitivity was 71.4 % and specificity was 93.0 %. Drainage had the highest sensitivity (71.4 %) while fever had the highest specificity (99.6 %). For confirmatory criteria, sensitivity was 14.3 % and specificity was 96.0 %. Contrastingly, the sensitivity for suggestive criteria was higher (71.4 %), with a similar specificity (93.8 %). ConclusionOur study indicates that telephone questionnaires have adequate diagnostic performance when assessing FRIs. The presence of drainage identified the majority of patients with FRI, and specificities were high across confirmatory and suggestive criteria. Our study is one of the first to evaluate telephone questionnaires as a diagnostic tool for FRIs in patients with open tibia fractures in a LMIC hospital and validates the FRI consensus definition criteria.

Mindset matters: contributions from grit and growth mindsets to successful aging

Objective Though we all age, some age more successfully than others. Health and social connections have been identified as cornerstones to successful aging, yet the contributions from psychological factors are less clear. Our goal was to examine the influence of grit and growth mindset in successful aging in middle and older age. We also assessed whether grit or growth mindset mediated the lifestyle-successful aging relationship. Method We used a telephone questionnaire to measure grit and growth mindset, successful aging, and lifestyle for 263 adults, ages 40–80 years. Results Higher grit-effort and growth mindset predicted more successful aging in younger (40–64 years) and older groups (65–80 years). Additionally, exercise frequency predicted successful aging for the combined sample and partially mediated the relationship between growth mindset and successful aging. Conclusions Our findings reveal grit-effort and a growth mindset as important contributors to successful aging in middle and older adulthood. Because psychological constructs are malleable, continued study of grit and growth mindsets is essential to enable their eventual application in changing the aging process.

Bariatric Surgery and COVID-19: a Change of Perspective in a New Phase of the Pandemic.

The protective role of bariatric surgery (BS) against COVID-19 has been reported by several studies, showing, in the first pandemic waves, better outcome of the infection in patients that had undergone BS. With the virus progressive endemicity, BS benefits on COVID-19 clinical course could appear less evident, while COVID-19 effects on BS outcomes must be investigated. In this national multicentric cross-sectional study, we compared COVID-19 incidence and clinical course between a cohort of patients that had undergone BS (OP) and a cohort of candidates to BS (WS); moreover, we analyzed BS outcomes based on SARS-CoV-2 positivity/negativity. From June to December 2021, 522 patients from five Italian referral centers were administered an 87-item telephonic questionnaire completing the analysis of electronic medical records. Demographics, COVID-19 "tested" incidence, suggestive symptoms and clinical outcome parameters of OP and WS were compared. BS outcomes parameters were compared between OP that developed the disease or not. COVID-19 incidence was the same in OP and WS, while symptoms and clinical course seemed milder in OP, with no data individually reaching statistical significance. OP who developed SARS-CoV-2 infection had higher excess weight loss than negative OP (66.8% ± 22.1 vs. 57.7% ± 22.8, p = 0.029). Positive OP had had gastric-bypass (RYGB/OAGB) more frequently than negative ones (38.4% vs. 18.2%, p = 0.025). With the disease becoming endemic, BS protective role against COVID-19 seems clinically less relevant. BS outcomes can be affected by COVID-19, thus imposing careful follow-up for positive patients, especially if undergoing gastric-bypass.

Impact of COVID-19 on patient follow-up during supportive periodontal therapy: a retrospective study based on phone call survey

BackgroundCOVID-19 and the subsequent intermittent lockdown measures from 2020 to 2022 in China critically disrupted regular medical activities, including dental care. This study aimed to investigate the impact of COVID-19 on long-term follow-up at the Stomatology Hospital, Zhejiang University School of Medicine and to evaluate potential causes of loss to follow-up.MethodsA total of 1062 patients with periodontitis who visited the hospital from January 2019 to June 2022 were included in this study, and patient information was collected retrospectively in the form of a telephone questionnaire. The questionnaire consisted of 19 questions in four areas: demographic characteristics, clinical periodontal parameters, oral hygiene habits, and follow-up-related open-ended questions (specific reasons for loss to follow-up, attitudes toward follow-up and suggestions for increasing participation in future follow-ups). Regression analysis of factors influencing the follow-up of patients with periodontitis were analyzed by regression analysis using R (v4.2.3) software.ResultsA total of 536 (50.47%) valid questionnaires were collected from 1062 patients. Personal factors (42.5%), instead of the COVID-19 epidemic (20.0%), were the main factors that impacted the loss to follow-up in long-term periodontal treatment, while work factors (19.8%), hospital factors (16.4%), and transportation or distance factors (14.7%) were all important factors. A family history of periodontitis [odds ratio (OR) = 0.567, 95% confidence interval (CI): 0.393, 0.817, p = 0.002], as well as frequent use of dental devices (OR = 0.540, 95% CI: 0.375, 0.777, p = 0.001), were significantly associated with a “negative” attitude toward follow-up visits.ConclusionThis survey suggests that the COVID-19 epidemic factor was an important cause contributed to the loss to follow-up during supportive periodontal therapy (SPT) among a variety of potential factors. Majority of patients had negative attitudes toward subsequent continued participation in supportive care.

Chronological Changes in Emotional Status and Vaccine Implementation Rate Among Patients on the Waiting List for Deceased-Donor Kidney Transplantation During the Prolonged COVID-19 Pandemic

To investigate the emotional attributes and vaccine implementation rate of patients waiting for kidney transplants during the prolonged COVID-19 pandemic. We included 145 patients who were on the waiting list at our institution. Clinical information was obtained from medical charts, and emotional changes were assessed using a telephone questionnaire comprising 13 questions, including vaccine implementation. We also investigated factors affecting the decision to accept or decline deceased-donor kidney transplantation during the COVID-19 pandemic. Of the 145 patients, 121 (83.4%) provided informed consent and completed the questionnaire. The median age at registration on the waiting list for deceased-donor kidney transplantation and the median waiting period was 45.5 years and 103 months, respectively. This cohort comprised 84 males and 37 females. Twenty patients (16.5%) were diagnosed with COVID-19, and 15 (12.4%) were more curious about deceased-donor kidney transplantation. One hundred patients (82.6%) were vaccinated against COVID-19 more than thrice. Thirty patients (24.8%) declined, and 91 patients (75.2%) accepted an organ transplant offer during the COVID-19 pandemic. Multivariate analysis revealed that the long-term waiting period (P=.038) and anxiety about COVID-19, such as visiting the transplant facility (P < .0001) and prudence over time (P < .0001), were independent factors influencing the decline of a kidney transplant offer. Our findings suggest that some patients hesitated to undergo deceased-donor kidney transplantation during the pandemic. There is a need to develop an appropriate system to ensure safe and secure kidney transplantation during prolonged pandemics.

Identification of Psycho-Socio-Judicial Trajectories and Factors Associated With Posttraumatic Stress Disorder in People Over 15 Years of Age Who Recently Reported Sexual Assault to a Forensic Medical Center: Protocol for a Multicentric Prospective Study Using Mixed Methods and Artificial Intelligence.

Sexual assault (SA) can lead to a range of adverse effects on physical, sexual, and mental health, as well as on one's social life, financial stability, and overall quality of life. However, not all people who experience SA will develop negative functional outcomes. Various risk and protective factors can influence psycho-socio-judicial trajectories. However, how these factors influence trauma adaptation and the onset of early posttraumatic stress disorder (PTSD) is not always clear. Guided by an ecological framework, this project has 3 primary objectives: (1) to describe the 1-year psycho-socio-judicial trajectories of individuals recently exposed to SA who sought consultation with a forensic practitioner; (2) to identify predictive factors for the development of PTSD during the initial forensic examination using artificial intelligence; and (3) to explore the perceptions, needs, and experiences of individuals who have been sexually assaulted. This longitudinal multicentric cohort study uses a mixed methods approach. Quantitative cohort data are collected through an initial questionnaire completed by the physician during the first forensic examination and through follow-up telephone questionnaires at 6 weeks, 3 months, 6 months, and 1 year after the SA. The questionnaires measure factors associated with PTSD, mental, physical, social, and overall functional outcomes, as well as psycho-socio-judicial trajectories. Cohort participants are recruited through their forensic examination at 1 of the 5 participating centers based in France. Eligible participants are aged 15 or older, have experienced SA in the last 30 days, are fluent in French, and can be reached by phone. Qualitative data are gathered through semistructured interviews with cohort participants, individuals who have experienced SA but are not part of the cohort, and professionals involved in their psycho-socio-judicial care. Bivariate and multivariate analyses will be conducted to examine the associations between each variable and mental, physical, social, and judicial outcomes. Predictive analyses will be performed using multiple prediction algorithms to forecast PTSD. Qualitative data will be integrated with quantitative data to identify psycho-socio-judicial trajectories and enhance the prediction of PTSD. Additionally, data on the perceptions and needs of individuals who have experienced SA will be analyzed independently to gain a deeper understanding of their experiences and requirements. This project will collect extensive qualitative and quantitative data that have never been gathered over such an extended period, leading to unprecedented insights into the psycho-socio-judicial trajectories of individuals who have recently experienced SA. It represents the initial phase of developing a functional artificial intelligence tool that forensic practitioners can use to better guide individuals who have recently experienced SA, with the aim of preventing the onset of PTSD. Furthermore, it will contribute to addressing the existing gap in the literature regarding the accessibility and effectiveness of support services for individuals who have experienced SA in Europe. This comprehensive approach, encompassing the entire psycho-socio-judicial continuum and taking into account the viewpoints of SA survivors, will enable the generation of innovative recommendations for enhancing their care across all stages, starting from the initial forensic examination. DERR1-10.2196/46652.

Impact of Mobile Telecommunication Access on Porters' Living Standard: A Study based on Street Porters in Kathmandu City

This paper examines how telecommunication access has affected the living standard of street porters and what are their mobile telecom service usage. The study used income, expenditure, saving, and factors affecting these variables to assess the change in living standard of street porters. The study used descriptive and explorative research design with a before-after approach. Primary data obtained from 440 street porters using purposive random sampling method was used. Both telephone questionnaire and interview schedule consisting comprehensive 54 items were administered. The tools of analysis used were descriptive statistics and inferential parametric (t- test, paired t- test) and non-parametric statistics (McNemar test). The study found that street porters use voice service mainly to talk to family and to take load orders. More than half of the sample (56%) were found to use less than 5 minutes call per day on average with 5 to 10 call counts for load per day. The study also found that mobile communication access has increased the income per day, expenditure per day and monthly saving of street porters. Further, the study also found mobile communication has enhanced the income generating factors like efficiency of street porters, bargaining power, market exploration and reduction in travel and search cost. Based on the analysis of income and expenditure, the study concluded that mobile communication access has improved the living standard of street porters.

Driving Difficulties and Preferences of Advanced Driver Assistance Systems by Older Drivers With Central Vision Loss.

The purpose of this study was to investigate driving difficulties and Advanced Driver Assistance Systems (ADAS) use and preferences of drivers with and without central vision loss (CVL). Fifty-eight drivers with CVL (71 ± 13 years) and 68 without (72 ± 8 years) completed a telephone questionnaire. They rated their perceived driving difficulty and usefulness of technology support in 15 driving situations under good (daytime) and reduced visibility conditions, and reported their use experience and preferences for 12 available ADAS technologies. Drivers with CVL reported more difficulty (P = 0.002) and greater usefulness of technology support (P = 0.003) than non-CVL drivers, especially in reduced visibility conditions. Increased driving difficulty was associated with higher perceived technology usefulness (r = 0.34, P < 0.001). Dealing with blind spot road users, glare, unexpected pedestrians, and unfamiliar areas were perceived as the most difficult tasks that would benefit from technology support. Drivers with CVL used more advanced ADAS features than non-CVL drivers (P = 0.02), preferred to own the blind spot warning, pedestrian warning, and forward collision avoidance systems, and favored ADAS support that provided both information and active intervention. The perceived benefits of and willingness to own ADAS technologies were high for both groups. Drivers with CVL used more advanced ADAS and perceived greater usefulness of driver assistance technology in supporting difficult driving situations, with a strong preference for collision prevention support. This study highlights the specific technology needs and preferences of older drivers with CVL, which can inform future ADAS development, evaluation, and training tailored to this group.

Learning to drive with neurological conditions: profile of users of an adapted driver training program and cognitive factors associated with success

Purpose To describe the sociodemographic and cognitive profile of participants enrolled in an adapted driving program for individuals with neurological conditions, to explore the association between cognitive functioning and driving program outcome, and to describe driving habits after program completion. Methods This study combined retrospective chart review and cross-sectional data collection. Results The sample included 71 participants with neurological disorders (aged 15–56 years, M = 22.2 ± 8.6; 39% women). Driving program was either successful (47%), failed (7%), discontinued (34%), or ongoing (13%). Among 35 participants with complete neuropsychological and driving program outcome data, those who successfully completed the program showed better attention functioning, and better performance relative to global functioning for attention, executive functions, and working memory, compared to those who discontinued/failed the program. Among 21 participants who completed a telephone questionnaire on average 3.7 years after program enrollment, 67% obtained their driver’s license and drove regularly. Participants reported high levels of satisfaction with the program. Conclusion These results suggest that approximately half of the persons enrolled in a driver training program designed for learners with neurological conditions, obtain a driver’s license; and that attention, and to a lesser extent executive functioning and working memory, are related to driving program success. IMPLICATIONS FOR REHABILITATION In individual with neurological conditions, learning how to drive can be challenging. An adapted driver training program, involving collaboration between driving instructors and healthcare professionals, simplification of theoretical learning, and increasing driving practice opportunities, can be effective, both in terms of licensing success and client satisfaction. Conducting a pre-driving program neuropsychological assessment, with identification of cognitive strengths and weaknesses, can provide valuable information for clinicians and driving instructors for optimizing training and predicting outcome. Better performance in attention, and better relative to global cognitive functioning in attention, executive functions, and working memory, are related to higher success rate of an adapted driving program.

531 Virtual Fracture Clinic Management During the COVID-19 Pandemic at Glasgow Royal Infirmary: The MAVCOV Study

Abstract Aim To evaluate the efficacy of the Virtual Fracture Clinic (VFC) in terms of patient satisfaction and clinical outcome, pre and during COVID at Glasgow Royal Infirmary (GRI). The impact of the pandemic on the quality of patient management was assessed by comparing two sets of patients who (1) presented to the clinic when British Orthopaedic Association Standards for Trauma and Orthopaedics (BOAST) COVID-19 guidelines were first introduced (Pre-Lockdown Cohort) and (2) presented after practitioners were familiar with these guidelines (Lockdown Cohort). Method This was a retrospective review of VFC patients. Data extracted included demographic information, management plans and three-month follow-up outcomes. Patients discharged without further follow-up underwent a telephone questionnaire to assess patient satisfaction. Results 286 patients were included in this study. 96.7% of patients in the pre-lockdown cohort presented to the VFC within 3 days of presentation as opposed to 93.3% of the lockdown cohort. 54.1% of the pre-lockdown cohort were referred to face-face/specialty clinics as opposed to 44.8% of the lockdown cohort. 6.9% of a subset of the lockdown cohort had an unplanned re-attendance to hospital for associated pain as opposed to 1.12% of a subset of the pre-lockdown cohort. 72% of the pre-lockdown cohort reported they were ‘very satisfied’ as opposed to 40% of the lockdown cohort. Conclusions The data reflects that there was a net shift from face-face consultations to discharge with nurse call between the pre-lockdown cohort and lockdown cohort however, this came with a substantial drop in patient satisfaction and an increased re-attendance rate.

Rates of Delayed Postcochlear Implant Pain in the Pediatric Population-Role of Proactive Approach.

To investigate the rates of delayed postoperative cochlear implantation pain (DPCIP) in the pediatric population, using a "reach-out" proactive approach. Secondary aims included the possible impact of surgery extent or the patient ethnicity on DPCIP rates. A cross-sectional study was conducted at Soroka University Medical Center in Israel. Demographics and data regarding the surgery and surgical complications were collected from the medical records of the patients. A telephone questionnaire was conducted for parents of all children who underwent cochlear implantation (CI) between 2007 and 2020. The questions addressed pain at four time periods: during hospitalization after surgery, 3 months, 2 years, and 5 years after surgery. Out of 213 patients, 129 (60%) were included in this study. The mean age was 41 months (±40). Unilateral CI was performed in 72 (56%) patients. At 3 months and 2 years after surgery, 8.5% of patients reported pain (visual analog scale [VAS] ≥ 1). Five years after surgery, a slight increase in the number of patients who reported pain (12%) was observed. Of those experiencing pain 2 years and 5 years after surgery, 10/12 (83%) and 11/16 (69%), respectively, reported a new onset of the pain. Surgery extent and cultural background were not significantly associated with DPCIP rates. No correlations were found between patients complaining of pain and any surgical complications. DPCIP rates may be underrecognized and higher than previously reported, reaching up to 12%. This long-term effect should be acknowledged and discussed with parents upon informed consent.

Observation of urinary tract infection signs and symptoms in nursing home residents with impaired awareness or ability to communicate signs and symptoms: The development of supportive tools.

Antibiotics are often inappropriately prescribed for urinary tract infections (UTIs) in nursing home (NH) residents. Research emphasises the importance of prescribing antibiotics only if there are UTI-related signs and symptoms (S&S). However, for many NH residents it is challenging to find out whether such S&S are present, for example due to cognitive disorders. To provide insight into the assessment of UTI-related S&S in NH residents with impaired awareness or ability to communicate S&S, and to develop supportive tools for the observation of UTI-related S&S in this subgroup of NH residents, by nursing staff. We performed a practice-based study using mixed methods. Data of 295 cases of suspected UTI were analysed to determine how often UTI-related S&S were 'not assessed/non-assessable' in residents with and without dementia. Barriers and facilitators in observing UTI-related S&S in NH residents with impaired awareness or ability to communicate S&S were derived from interviews and focus groups with nursing staff. Literature review, focus group data, additional telephone interviews and questionnaires with nursing staff were used in a step-by-step process, including pilot testing, to develop supportive tools for the observation of UTI-related S&S. UTI-related S&S were assessable in the majority of NH residents with dementia. The proportion 'not assessed/non-assessable' S&S in residents with dementia increased with increasing severity of dementia. In residents with very severe dementia, up to 58% of the S&S were 'not assessed/non-assessable'. Knowing the resident, working methodologically, and being sufficiently skilled to interpret observations in residents facilitate the assessment of UTI-related S&S. Insights acquired during the different study elements resulted in the development of an observation checklist and a 24-h observation tool. The more NH residents have impaired awareness of ability to communicate S&S, the more difficult it seems to be to assess UTI-related S&S. The observation checklist and 24-h observation tool developed in the current study may support nursing staff in their observation of UTI-related S&S in this group of NH residents.

Cognitive Behavioural and Art-based program (CB-ART): a pilot study in an early parenting centre

BackgroundThe period of pregnancy and early motherhood is a substantial life change associated with psychological turbulence. During this period, some women experience symptoms of anxiety and depression of sufficient severity to warrant professional psychological assistance. Psychosocial and psychological interventions are key therapeutic approaches for women at this life stage. There is growing evidence of the value of the arts in the prevention and treatment of mental health problems. Evidence suggests that women prefer psychological interventions that provide social support and shared space for reflection.Cognitive Behavioural and Art-based intervention (CB-ART) is a novel therapy for prevention and treatment of perinatal mental health problems. The aim of this study was to implement and evaluate CB-ART for acceptability, feasibility, safety and preliminary efficacy among women admitted to a residential early parenting unit.MethodsThe pilot study used a single-centre, mixed-methods pre- and post-test design to evaluate CB-ART among women admitted to a 5-day residential early parenting service in Melbourne, Australia. Participants completed questionnaires before and after attendance at two 1-h CB-ART group sessions on day 2 and day 5 of admission during which field notes were taken. Evaluation interviews were conducted by telephone 1 week after discharge. The Short Profile of Emotional Competence and the Edinburgh Postnatal Depression Scale were used to assess emotional insight and symptoms of depression, respectively. Feasibility, acceptability and safety were assessed using an analysis of field notes, with quantitative data collected by telephone questionnaire and qualitative data by telephone interviews.ResultsNine participants enrolled in the program; eight provided complete data. Two CB-ART groups were conducted. Before and after comparisons showed that there was an improvement in symptoms of postnatal depression and a marginal improvement in emotional insight. Thematic analysis of qualitative data indicated CB-ART was a feasible and acceptable means of assisting reflection.ConclusionThe preliminary data indicate that the CB-ART program is a feasible, acceptable and safe addition to the 5-day residential program, with potentially therapeutic benefits. A larger randomised study is required to assess the effects of the CB-ART intervention on symptom measures in this and other postnatal settings.Trial registrationAustralian and New Zealand Clinical Trials Registry, ACTRN126220000354785. Registered 1 January 2022—retrospectively registered.