# ent

id: cord-103220-abatwr1k
type: ORG
entity:
  Supportive Supervision and Staff Intent to Turn Over in Long Term Care Homes Burnout After Patient Death Challenges for Direct Care Workers


id: cord-103220-abatwr1k
type: WORK_OF_ART
entity:
  Creating Cultures of Care Exploring the Social Organisation of Care Delivery in Long Term Care Homes Consistent Assignment of Nurse Aides Association with Turnover and Absenteeism Care


id: cord-103220-abatwr1k
type: ORG
entity:
  Factors Associated with Care Workers Intention to Leave Employment in Nursing Homes A Secondary Data Analysis


id: cord-264651-cqxmpxyq
type: LAW
entity:
  the Child Development Supplement of the Panel Study of Income Dynamics Hofferth Davis Kean Davis Finkelstein 1997


id: cord-264651-cqxmpxyq
type: DISEASE
entity:
  autism spectrum disorder thrive on routines and tend to also be reliant on in school therapists and other services


id: cord-103020-ckuma42j
type: GGP
entity:
  PCO 2 2 2kPa p 0 05 and bicarbonate 4 9mmol L p 0 05 measured at followup after initiation of home NIV relative to measurements at baseline indicate control of hypercapnic respiratory failure Figure 4 CC BY ND 4 0 International license It is made available under a is the author funder


id: cord-324642-uk4ir8po
type: CELL_LINE
entity:
  UK COVID 19 Response A Behavioural Irony The attentional mechanism of message sensation value Interaction between message sensation value and argument quality on message effectiveness Features of Empathy Arousing Strategic Messages Ethical decision making and patient autonomy A comparison of physicians and patients in Japan


id: cord-260257-phmd0u6d
type: ORG
entity:
  JAMA Health Forum2020 Detection of SARS CoV 2 RNA and Antibodies in Diverse Samples Protocol to Validate the Sufficiency of Provider


id: cord-034169-nkosr3br
type: ORG
entity:
  National Nurse Led Care Consortium Public Health Management Corporation Trauma Informed Care and Communication with Children Trauma Informed Care Training


id: cord-338686-evzl7v39
type: ORG
entity:
  Coronavirus Spotlight Recent NHS Discharges into Care Homes Using Electronic Health Records for Population Health Research A Review of Methods and Applications


id: cord-291461-jzkh7rgm
type: ORG
entity:
  Care Care Home Residential Home Residential Facility Institutional Care Skilled Nursing Facility Institutionalisation Care Facility and Homes for the Aged


id: cord-333153-hjgf3ay8
type: ORG
entity:
  Division of Nursing Homes Quality Safety and Oversight Group Center for Clinical Standards and Quality Special Programs


id: cord-356156-jjdkwalk
type: ORG
entity:
  Determinants of Neck Pain in Workers The Short Term Musculoskeletal and Cognitive Effects of Prolonged Sitting During Office Computer Work American Psychiatric Association Foundation


id: cord-344491-93ggxzxu
type: PROTEIN
entity:
  cord 344491 93ggxzxu authors Husebo Bettina Sandgathe Allore Heather Achterberg Wilco Angeles Renira Corinne Ballard Clive Bruvik Frøydis Kristine Fæø


id: cord-324635-27q3nxte
type: GGP
entity:
  Rev Esp Quimioter DOI 10 37201 req 057 2020 sha 96acef8fc17006257afbfef2a7a40c9e19aaed75 doc_id 324635 cord_uid 27q3nxte Infection


id: cord-324635-27q3nxte
type: WORK_OF_ART
entity:
  A Composite of Functional Status and Pneumonia Severity Index Improves the Prediction of Pneumonia Mortality in Older Patients Estimating the proportion of


id: cord-324635-27q3nxte
type: WORK_OF_ART
entity:
  The Core Curriculum and Educaton Committee for the International Federation for Emergency Medicine Informe


id: cord-324635-27q3nxte
type: FAC
entity:
  Medidas de prevención de la trasmisión de organismos entre pacientes hospitalizados Higiene de manos


id: cord-330051-vskolc4g
type: ORG
entity:
  the Rally Round the Flag Phenomenon Joining and Leaving the Rally Understanding the Surge and Decline in Presidential


id: cord-316842-mnt12ot2
type: DNA
entity:
  COVID 19 pandemic 6 17 16 18 19 20 21 22 Our analysis supports a protective effect of earlier implementation of stay athome orders


id: cord-316842-mnt12ot2
type: ORG
entity:
  COVID 19 Pandemic A Review Association of Public Health Interventions With the Epidemiology of the COVID 19 Outbreak


id: cord-316842-mnt12ot2
type: WORK_OF_ART
entity:
  The Benefits and Costs of Using Social Distancing to Flatten the Curve for COVID 19 Impact of policy


id: cord-333950-e0hd3iuu
type: WORK_OF_ART
entity:
  A Microbiological Survey of Campylobacter Contamination in Fresh While UK Produced Chilled Chickens at Retail Sale Centers for Disease Control and Prevention Campylobacteriosis


id: cord-333950-e0hd3iuu
type: ORG
entity:
  Home Hygiene Minimum Infective Dose of the Major Human Respiratory and Enteric Viruses Transmitted Through Food and


id: cord-333950-e0hd3iuu
type: ORG
entity:
  Multiple Cleaning and Disinfection Interventions on Infectious Diseases in Children A Group Randomized Trial


id: cord-333950-e0hd3iuu
type: ORG
entity:
  Preservation Wolters Kluwer Philadelphia Scientific Committee on Emerging and Newly Identified Health Risks SCENIHR Recent


id: cord-337842-q03884i9
type: ORG
entity:
  Achieving Safe Effective and Compassionate Quarantine or Isolation of Older Adults with Dementia in Nursing Homes date 2020


id: cord-336467-w528t92h
type: WORK_OF_ART
entity:
  A Person Centred Framework for Assessment and Support Planning Disaster Preparedness for Seniors A Comprehensive Guide for Healthcare Professionals


id: cord-356223-8qn164k5
type: WORK_OF_ART
entity:
  Home Monitoring of Age Related Macular Degeneration Real World Utility of the ForeseeHome Device for Detection of Neovascularization


id: cord-356223-8qn164k5
type: GPE
entity:
  the United States Age Related Macular Degeneration AMD Tables National Eye Institute National Institute 461


# bib

id: cord-004971-jwpb7862
title: The Role of the Home Environment in the Transmission of Infectious Diseases
author: Kagan, Lori J.
date: 2002
txt: ./txt/cord-004971-jwpb7862.txt
cache: ./cache/cord-004971-jwpb7862.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7087835/
doi: 10.1023/a:1016378226861
summary:
  The home environment, particularly the kitchen and bathroom, serves as a reservoir of large numbers of microorganisms, particularly Enterobacteriacae,and infectious disease transmission has been demonstrated to occur in 6–60% of households in which one member is ill. Recent events, including widespread media coverage of foodborne outbreaks and increased marketing of a variety of antibacterial products for personal hygiene and hard surface disinfection, have resulted in a resurgence of interest and public concern about hygiene and cleanliness in the home. 17 In a study to evaluate the survival of bacteria and enteric viruses during washing and drying as performed in U.S. homes, sterile cotton swabs were inoculated with Mycobacterium fortuitum, Salmonella typhimurium, Staphylococcus aureus, E. This body of research suggests that a product containing an ingredient with disinfectant properties, such as alcohol, bleach or a phenolic, may be indicated for home use if a household member is ill with an infectious disease or in other high-risk situations.

abstract:
  The purpose of this paper is to examine current health care literature (1980–2000) regarding the microbiology of the home environment, to summarize evidence of transmission within the home, and to assess effectiveness of cleaning practices and products. The home environment, particularly the kitchen and bathroom, serves as a reservoir of large numbers of microorganisms, particularly Enterobacteriacae,and infectious disease transmission has been demonstrated to occur in 6–60% of households in which one member is ill. Current food preparation and cleaning practices provide multiple opportunities for intra-household member spread. Routine cleaning is often sufficient, but in cases of household infection, may not adequately reduce environmental contamination. The effectiveness of disinfectants varies considerably and depends on how they are used as well as their intrinsic efficacy. The behavioral aspects of infection prevention in the home (e.g., foodhandling and cleaning practices) warrant increased public attention and education.


id: cord-025971-09u3kn1k
author: Mills, William R.
date: 2020-06-02
txt: ./txt/cord-025971-09u3kn1k.txt
cache: ./cache/cord-025971-09u3kn1k.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270573/
doi: 10.1177/1084822320933567
summary:
  A highly coordinated and frequently communicated approach to infection control, case identification and employee screening can be performed by home health and personal home care organizations. In this report, we present the mitigation methods we have utilized in our home health and personal home care affiliates in the 100 days since the first case of COVID-19 was confirmed in the U.S. on January 20, 2020. In addition, we report a COVID-19 positive case series of home health and personal home care patients, summarizing our initial experience in supporting patients during the pandemic. In the 100-day period between January 20, 2020 and April 30, 2020, our home health and personal home care affiliates provided services to 67 COVID-19 positive patients (<0.3% of census). A highly coordinated and frequently communicated approach to infection control, case identification and caregiver and clinician screening can be performed by home health and personal home care organizations.

title:
  An Outbreak Preparedness and Mitigation Approach in Home Health and Personal Home Care During the COVID-19 Pandemic

abstract:
  The acute respiratory disease COVID-19, caused by the novel Coronavirus SARS-CoV-2, is a worldwide pandemic affecting millions of people. The methodology that organizations who provide home health and personal home care services are using to respond to this pandemic has not yet been characterized. In this report, we describe our approach to comprehensive outbreak suppression and report an initial case series of COVID-19 positive patients receiving home-based services. We implemented enhanced infection control procedures across our affiliates, and we communicated these protocols to our offices using multi-faceted methods. Using custom built software applications enabling us to track patient and employee cases and exposures, we leveraged current public health recommendations to identify cases and to suppress transmission. In the 100-day period between January 20, 2020 and April 30, 2020, our affiliates provided services to 67 COVID-19 positive patients (<0.3% of census). Twenty patients were referred to home health post hospitalization for COVID-19 related illness, whereas 47 were found to have COVID-19 while living in community settings. Of those who were found to have COVID-19 in the community, 17 (39%) required subsequent hospitalization. Hospitalized patients had an average age of 74.5 ± 18, and 53% were male. There were 13 deaths (76%) among those hospitalized from the community with COVID-19 related illness. A highly coordinated and frequently communicated approach to infection control, case identification and employee screening can be performed by home health and personal home care organizations. Studies that further assess risks and predictors of illness severity in home-based COVID-19 patients are needed.


id: cord-030506-mqsgqfbs
title: Covid-19 on Route of the Fourth Industrial Revolution
author: Bonilla-Molina, Luis
date: 2020-08-15
txt: ./txt/cord-030506-mqsgqfbs.txt
cache: ./cache/cord-030506-mqsgqfbs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428423/
doi: 10.1007/s42438-020-00179-4
abstract: nan
summary:
  Following Covid-19 lockdowns and transitions to online education, the Global Pedagogical Blackout is now more clearly evidenced as a consequence of the transformation of the capitalist mode of production through the acceleration of scientific-technological innovation (Bonilla-Molina 2020a, b, c, d) . The preventive quarantine has been used to enhance the construction of hegemony upon a new model of education, virtual education at home (Bonilla-Molina 2020e, f), which is already in proposal by the Inter-American Development Bank (IDB), World Bank, Organization for Economic Development (OECD), and the US Trump administration. During the Covid-19 pandemic and its social distancing context, parents and families are abruptly given the responsibility to endow their students with equipped computers, the Internet, access to platforms, and a ''virtual pedagogy.'' This is not a temporary situation as we are led to believe, but an integral part of the political and ideological architecture of education and schooling that has been in the making for a long time (Bonilla-Molina 2020g).


id: cord-031229-9hjhujv9
title: Will working from home become the ‘new normal’ in the public sector?
author: Williamson, Sue
date: 2020-08-26
txt: ./txt/cord-031229-9hjhujv9.txt
cache: ./cache/cord-031229-9hjhujv9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7461424/
doi: 10.1111/1467-8500.12444
summary:
  Research has found continued widespread resistance of managers to enable lower level employees to work from home (Williamson, Colley, Foley, & Cooper, 2018) . It also considers the messaging emerging during the development of transitional arrangements as employees began to return to their usual workplace, in order to assess whether working from home will become ''the new normal''. This range of responses seemed less related to rates of COVID-19 infection across jurisdictions at the time, but rather indicated varying levels of acceptance or resistance to the practice of working from home. Prior to the pandemic, there was evidence of considerable resistance to working from home from some managers who had concerns about technology, compliance with employment regulation, and employees'' productivity and performance (Williamson et al., 2018) . The continued take-up and normalisation of working from home will vary across and within jurisdictions, due to the institutional arrangements for public sector human resource management.

abstract:
  The COVID‐19 pandemic compelled large sections of the workforce out of their workplaces and into their homes to work. Many commentators suggest this has forever changed how and where we work. This article analyses how Australia's biggest employers – state and federal governments – approached the transitions to working from home, and back into regular workplaces. It considers the timing of policy responses to the pandemic as one indicator of resistance to, or acceptance of, widespread working from home. The article also demonstrates previous resistance to working from home for public servants, and questions widespread conjecture that it will become the ‘new normal’.


id: cord-031544-clzt6kyg
author: Clavijo, Raul
date: 2020-09-08
txt: ./txt/cord-031544-clzt6kyg.txt
cache: ./cache/cord-031544-clzt6kyg.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476901/
doi: 10.1016/j.fertnstert.2020.07.017
abstract: nan
summary:
  Thus, owing to the lack of physical exposure to clinical settings, it is likely that our patients with sexual dysfunction, with or without infertility, who stand to benefit the most from our taking a potential risk of prescribing medications after virtual care. Overall, the availability of prescription medications with well-defined risk profiles to patients through virtual sources is only likely to enhance the access to care for sexual and reproductive health conditions by easing the pain of embarrassment some patients may experience. In light of the current situation of the COVID pandemic along with the boom of telemedicine, physicians should consider incorporating home-based kits for both male and female fertility testing with the caveats that even though we may not get accurate data all the time, data from these kits can be used to guide care. Although physical examination and in-office diagnostics are paramount for the evaluation of both female and male fertility, an initial telehealth visit can uncover pertinent history, identify risk factors, and establish the physician-patient relationship.

title:
  “Online” and “at-home” versus traditional models of health care: enhancing access or impeding optimal therapeutics?


id: cord-032750-sjsju0qp
title: Navigating ‘Home Schooling’ during COVID-19: Australian public response on Twitter
author: Ewing, Lee-Ann
date: 2020-09-24
txt: ./txt/cord-032750-sjsju0qp.txt
cache: ./cache/cord-032750-sjsju0qp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520655/
doi: 10.1177/1329878x20956409
summary:
  title: Navigating ''Home Schooling'' during COVID-19: Australian public response on Twitter Choice to send children to school lies with families, and distance education packages and resources or online remote learning will be provided to any student who is kept home. Parents can choose not to send their children to school, but are then ''responsible for the student''s learning, safety and wellbeing at home or elsewhere''. We adopt both quantitative (descriptive) and qualitative approaches to analysing the contents of the collected tweets to identify their major themes and concerns of the Australian public in relation to home schooling during the pandemic. Arguably, the frustration over the definition of the learning is highlighting how unsure parents feel in this new role: I came across some online twitter debate on whether it was technically home schooling when in reality you aren''t setting the work.

abstract:
  COVID-19 has wreaked havoc worldwide. Schools have escaped neither the pandemic nor its consequences. Indeed, by April 2020, schools had been suspended in 189 countries, affecting 89% of learners globally. While the Australian government has implemented variously effective health and economic policies in response to COVID-19, their inability to agree with states on education policy during the pandemic caused considerable confusion and anxiety. Accordingly, this study analyses 3 weeks of Tweets during April, leading up to the beginning of term 2, during the height of Government policy incongruity. Findings confirm a wide and rapidly changing range of public responses on Twitter. Nine themes were identified in the quantitative analysis, and six of these (positive, negative, humorous, appreciation for teachers, comments aimed at Government/politicians and definitions) are expanded upon qualitatively. Over the course of 3 weeks, the public began to lose its sense of humour and negative tweets almost doubled.


id: cord-034169-nkosr3br
title: Home visiting: A lifeline for families during the COVID-19 pandemic
author: Williams, Katie
date: 2020-10-22
txt: ./txt/cord-034169-nkosr3br.txt
cache: ./cache/cord-034169-nkosr3br.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581421/
doi: 10.1016/j.apnu.2020.10.013
abstract: nan
summary:
  Home visiting is an essential preventative social service model that builds on the families'' own strengths J o u r n a l P r e -p r o o f and supports them to navigate circumstances and stressors contributing to health inequities in underserved communities. Home visitors provide services that improve health care access and education to participants; they collaborate with families to assist in navigating health and social systems and give dedicated attention that may be more problematic to obtain in the traditional health system (Centers for Disease Control and Prevention, 2014) . Nurses and clinically trained technicians are also direct-care providers in some home visiting models, including Nurse Family Partnership, supporting individuals with health education, counseling, and medical services outside of the clinic system.


id: cord-035342-sf0zld5z
title: The home bias and the local bias: A survey
author: Gaar, Eduard
date: 2020-11-12
txt: ./txt/cord-035342-sf0zld5z.txt
cache: ./cache/cord-035342-sf0zld5z.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658434/
doi: 10.1007/s11301-020-00203-8
summary:
  Following the home bias and the intra-national local bias investors are inclined to invest disproportionately into local and domestic assets, not following portfolio diversification strategies. But, even in a model without barriers to international investments, investors hold a higher share of domestic assets than expected by standard portfolio theory (Stulz 1981a) . Since home bias is a type of portfolio concentration, this finding means that an investor is inclined to learn more and more about the assets he already knows in order to obtain specific information. Though, different to many studies, in this review not all of the analyses, that state a not-better performance of biased portfolios, are considered to be in favour of the familiarity explanation for home and local bias but have to provide explicit evidence that pure familiarity plays a significant role to explain the bias.

abstract:
  The home bias like the disposition effect is a well-researched economic phenomenon in investor behaviour which has been examined in finance journal articles for decades. While there is little doubt about the existence of the bias, its magnitude varies across countries and investor groups. The home bias has to be regarded as a multifactorial phenomenon, a combination of numerous causes which all synergistically contribute. In contrast to other biases the home bias can at least partially be explained by reasons beyond irrational investor behaviour. While institutional restrictions play a minor role, informational asymmetries and superior information of domestic investors are important factors. Thus, the performance of investments may well benefit from a home bias, and the bias then no longer would be a puzzle but rather rational behaviour as a lower diversification level may lead to higher returns. The contemporary understanding of the home bias gains in relevance as the ongoing political debate in Germany has to clarify an institutional framework for long-run retirement savings plans of private households based on equity investments.


id: cord-103020-ckuma42j
author: McDowell, G.
date: 2020-11-12
txt: ./txt/cord-103020-ckuma42j.txt
cache: ./cache/cord-103020-ckuma42j.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.11.08.20227892v1?rss=1
doi: 10.1101/2020.11.08.20227892
summary:
  Background Outcomes for chronic obstructive pulmonary disease (COPD) patients with persistent hypercapnic respiratory failure are improved by long-term home non-invasive ventilation (NIV). The primary outcome of this study was time to readmission or death at 12 months in patients receiving home-NIV versus a retrospectively identified control cohort of 27 patients with hypercapnic COPD who had not been referred for home-NIV. The present study retrospectively analysed all patients who were commenced on therapy over the first 12 months of this service, with aim of determining whether outcomes similar to RCTs were achieved in a real-world cohort of hypercapnic COPD patients with typical comorbidities (which would have excluded many from NIV RCTs) who are managed with remote-monitored home NIV. Changes in healthcare usage (number of hospital admissions, OBDs, and respiratory nurse home visits) and capillary blood gas PCO 2 and bicarbonate between NIV users, NIV non-users and the control cohort were analysed using Wilcoxon signed-rank test.

title:
  Two-way remote monitoring allows effective and realistic provision of home-NIV to COPD patients with persistent hypercapnia.

abstract:
  Background Outcomes for chronic obstructive pulmonary disease (COPD) patients with persistent hypercapnic respiratory failure are improved by long-term home non-invasive ventilation (NIV). Provision of home-NIV presents clinical and service challenges. The aim of this study was to assess outcomes of home-NIV in hypercapnic COPD patients managed remotely. Methods Retrospective analysis of a dataset of 46 COPD patients with persistent hypercapnic respiratory failure who commenced home-NIV managed by two-way remote monitoring (Lumis, AirView, ResMed) between February 2017 and January 2018. The primary outcome of this study was time to readmission or death at 12 months in patients receiving home-NIV versus a retrospectively identified control cohort of 27 patients with hypercapnic COPD who had not been referred for home-NIV. Results The median time to readmission or death was significantly prolonged in patients who commenced home-NIV (median 160 days, 95% CI 69.38-250.63) versus the control cohort (66 days, 95% CI 21.9-110.1; p<0.01). Average time to hospital readmission was 221 days (95% CI, 47.77-394.23) and 70 days (95% CI, 55.31-84.69; p<0.05), respectively. Median decrease in bicarbonate level of 4.9mmol/L (p<0.0151) and daytime PCO2 2.2kPa (p<0.032) demonstrate efficacy of home-NIV. A median reduction of 14 occupied bed days per annum versus previous year prior to NIV was observed per patient who continued home-NIV throughout the study period (N=32). Conclusion These findings confirm the benefits of home-NIV in clinical practice and support the use of two-way remote monitoring as a feasible solution to managing the delivery of home-NIV for COPD patients with persistent hypercapnia.


id: cord-103220-abatwr1k
author: Johnston, L.
date: 2020-09-08
txt: ./txt/cord-103220-abatwr1k.txt
cache: ./cache/cord-103220-abatwr1k.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.09.05.20188847v1?rss=1
doi: 10.1101/2020.09.05.20188847
summary:
  The COVID-19 pandemic has reinforced the need to ensure that strategic and operational approaches to retain high quality, resilient frontline care home workers, who are not registered nurses, are informed by context specific, high quality evidence. The COVID-19 pandemic has reinforced the need to ensure that strategic and operational approaches to retain high quality, resilient frontline care home workers, who are not registered nurses, are informed by specific, quality evidence. We therefore conducted this scoping review to address the question: What is the current evidence for best practice to support the resilience and retention of frontline care workers in care homes for older people? We therefore conducted this scoping review to address the question: What is the current evidence for best practice to support the resilience and retention of frontline care workers in care homes for older people?

title:
  Supporting the resilience and retention of frontline care workers in care homes for older people: A systematic scoping review and thematic synthesis

abstract:
  The COVID-19 pandemic has reinforced the need to ensure that strategic and operational approaches to retain high quality, resilient frontline care home workers, who are not registered nurses, are informed by context specific, high quality evidence. We therefore conducted this scoping review to address the question: What is the current evidence for best practice to support the resilience and retention of frontline care workers in care homes for older people? MEDLINE, PubMed, PsycINFO, Embase, MedRxiv, CINAHL, ASSIA, Social Science Premium were searched for literature published between 2010 and 2020. The search strategy employed combinations of search terms to target frontline care workers in care homes for older people and the key concepts relevant to resilience and retention were applied and adapted for each database. Thirty studies were included. Evidence for best practice in supporting the resilience and retention specifically of frontline care workers in care homes is extremely limited, of variable quality and lacks generalisability. At present, it is dominated by cross-sectional studies mostly from out with the UK. The small number of intervention studies are inconclusive. The review found that multiple factors are suggested as being associated with best practice in supporting resilience and retention, but few have been tested robustly. The thematic synthesis of these identified the analytical themes of - Culture of Care; Content of Work; Connectedness with Colleagues; Characteristics and Competencies of Care Home Leaders and Caring during a Crisis. The evidence base must move from its current state of implicitness. Only then can it inform intervention development, implementation strategies and meaningful indicators of success. High quality, adequately powered, co-designed intervention studies, that address the fundamentally human and interpersonal nature of the resilience and retention of frontline care workers in care homes are required.


id: cord-168579-w2lsg7go
title: Human Mobility Trends during the COVID-19 Pandemic in the United States
author: Lee, Minha
date: 2020-05-04
txt: ./txt/cord-168579-w2lsg7go.txt
cache: ./cache/cord-168579-w2lsg7go.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2005.01215v2.pdf
doi: nan
summary:
  We aim to provide tangible evidence of the human mobility trends by comparing the day-by-day variations across the U.S. Large-scale public mobility at an aggregated level is observed by leveraging mobile device location data and the measures related to social distancing. We explore the mobility variations regarding the COVID-19 progression and government stay-at-home orders by applying the metrics that are closely related to social distancing. Then the statewide trend analysis further evaluates the public reaction stability based on one measure, the percentage of people staying home, which we believe to have a high correlation with social distancing. In order to provide an integrated perspective on public reactions related to the pandemic propagation and the non-pharmaceutical interventions, we examine the day-by-day mobility variations across the U.S. by leveraging mobile device location data and the measures related to social distancing.

abstract:
  In March of this year, COVID-19 was declared a pandemic and it continues to threaten public health. This global health crisis imposes limitations on daily movements, which have deteriorated every sector in our society. Understanding public reactions to the virus and the non-pharmaceutical interventions should be of great help to fight COVID-19 in a strategic way. We aim to provide tangible evidence of the human mobility trends by comparing the day-by-day variations across the U.S. Large-scale public mobility at an aggregated level is observed by leveraging mobile device location data and the measures related to social distancing. Our study captures spatial and temporal heterogeneity as well as the sociodemographic variations regarding the pandemic propagation and the non-pharmaceutical interventions. All mobility metrics adapted capture decreased public movements after the national emergency declaration. The population staying home has increased in all states and becomes more stable after the stay-at-home order with a smaller range of fluctuation. There exists overall mobility heterogeneity between the income or population density groups. The public had been taking active responses, voluntarily staying home more, to the in-state confirmed cases while the stay-at-home orders stabilize the variations. The study suggests that the public mobility trends conform with the government message urging to stay home. We anticipate our data-driven analysis offers integrated perspectives and serves as evidence to raise public awareness and, consequently, reinforce the importance of social distancing while assisting policymakers.


id: cord-181770-3771n22i
title: The Home Office in Times of COVID-19 Pandemic and its impact in the Labor Supply
author: Oliveira, Jos''e Nilmar Alves de
date: 2020-07-05
txt: ./txt/cord-181770-3771n22i.txt
cache: ./cache/cord-181770-3771n22i.txt
extension: .txt
mime: text/plain
url: https://arxiv.org/pdf/2007.02935v2.pdf
doi: nan
summary:
  We assume that the effort attached to human capital depends on the time spent on distracting activities, occurring during the working period. We show that in the long run the intertemporal elasticity of substitution of home-office labor is sufficiently small only if the intertemporal elasticity of substitution of the time spent on distracting activities is small enough too. We show that in the long run the intertemporal elasticity of substitution of home-office labor is sufficiently small only if the intertemporal elasticity of substitution of the time spent on distracting activities is small enough too. The benevolent planner''s problem is then to chose paths of consumption c, labor l, and time spent s on distracting activities in order to maximise the discounted stream of payoffs by every identical agent in the economy ∞ 0 e −ρt V (c t , l t , s t )dt (5) subject to (3) and (4) with k o > 0 and h o > given.

abstract:
  We lightly modify Eriksson's (1996) model to accommodate the home office in a simple model of endogenous growth. By home office we mean any working activity carried out away from the workplace which is assumed to be fixed. Due to the strong mobility restrictions imposed on citizens during the COVID-19 pandemic, we allow the home office to be located at home. At the home office, however, in consequence of the fear and anxiety workers feel because of COVID-19, they become distracted and spend less time working. We show that in the long run, the intertemporal elasticity of substitution of the home-office labor is sufficiently small only if the intertemporal elasticity of substitution of the time spent on distracting activities is small enough also.


id: cord-255799-3j8axc4d
title: Atypical presentation of Covid-19 in an older adult with severe Alzheimer Disease
author: Isaia, Gianluca
date: 2020-04-22
txt: ./txt/cord-255799-3j8axc4d.txt
cache: ./cache/cord-255799-3j8axc4d.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32381283/
doi: 10.1016/j.jagp.2020.04.018
abstract: nan
summary:
  We would like to report the case of an Alzheimer Disease patient affected by Covid-19 admitted to the Hospital at Home Service (HHS) of the University Teaching Hospital of Turin, Italy. She was then moved to an Acute Medical Ward, where she was treated with cephalosporin and fluid supplementation with marginal improvement of clinical conditions (oxygen supplementation was stopped) and blood chemistries (creatinine 1.01 mg/dL, PCR 59 mg/L), but persistently high WBC count (14310 cells/mm 3 March 23rd, the patient returned home with the support of HHS program. Substitutive "hospital at home" versus inpatient care for elderly patients with exacerbations of chronic obstructive pulmonary disease: a prospective randomized, controlled trial Hospital at home for elderly patients with acute decompensation of chronic heart failure: a prospective randomized controlled trial Delirium in elderly home-treated patients: a prospective study with 6-month follow-up


id: cord-256030-5xzuilc1
author: Michel, Pierre-Antoine
date: 2020-11-11
txt: ./txt/cord-256030-5xzuilc1.txt
cache: ./cache/cord-256030-5xzuilc1.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s40620-020-00893-z
doi: 10.1007/s40620-020-00893-z
abstract: nan
summary:
  According to the data from the French Biomedicine Agency, during the peak period of the epidemic, between March 1 and June 15, 2020, only 7 of the 423 patients on home hemodialysis in France were diagnosed with COVID-19; the incidence is similar to that observed in patients treated with peritoneal dialysis (1.8%). For instance, in the Ile de France region, one of the most affected by the pandemic, data from the Biomedicine Agency indicate that 930 out of 8,025 patients (11.5%) on in-center hemodialysis were diagnosed with COVID-19, whereas only 4 out of 109 patients on home hemodialysis developed the disease (3.6%) (p = 0.001). Furthermore, globally 52 of our 55 patients later agreed to have a SARS-CoV-2 serology test performed, which was positive in the 2 patients Therefore, within the limits of a small series, and while waiting for additional data, we would like to confirm that our experience underlines the importance of developing an efficient home hemodialysis network, able to patients in a time of epidemic.

title:
  Home hemodialysis during the COVID-19 epidemic: comment on the French experience from the viewpoint of a French home hemodialysis care network


id: cord-260257-phmd0u6d
author: Siegler, Aaron J
date: 2020-06-30
txt: ./txt/cord-260257-phmd0u6d.txt
cache: ./cache/cord-260257-phmd0u6d.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1093/ofid/ofaa269
doi: 10.1093/ofid/ofaa269
summary:
  METHODS: A cross-sectional, online survey in the United States measured willingness to seek testing if feeling ill under different specimen collection scenarios: home-based saliva, home-based swab, drive-through facility swab, and clinic-based swab. 8, 9 Calls for home-based specimen collection or drive-through specimen collection models to address SARS-CoV-2 virus test scale-up have cogently argued that these approaches have the benefit of (1) avoiding burdening hospitals at a critical time, (2) avoiding potential nosocomial infections (the risk of acquiring disease from clinical or laboratory settings), (3) likely lowering costs, and (4) potentially achieving rapid scale-up due to laboratory centralization. We conducted an online survey to assess patient willingness to use the following SARS-CoV-2 testing modalities for clinical care: home-based specimen collection, drive-through testing, and clinic-based testing. Across a diverse sample of 1,435 participants, one-third more persons reported that they would be willing to collect specimens at home for SARS-CoV-2 testing if they experienced illness, compared to clinic-based testing.

title:
  Willingness to seek laboratory testing for SARS-CoV-2 with home, drive-through, and clinic-based specimen collection locations

abstract:
  BACKGROUND: SARS-CoV-2 virus testing for persons with COVID-19 symptoms, and contact tracing for those testing positive, will be critical to successful epidemic control. Willingness of persons experiencing symptoms to seek testing may determine the success of this strategy. METHODS: A cross-sectional, online survey in the United States measured willingness to seek testing if feeling ill under different specimen collection scenarios: home-based saliva, home-based swab, drive-through facility swab, and clinic-based swab. Instructions clarified that home-collected specimens would be mailed to a laboratory for testing. We presented similar willingness questions regarding testing during follow-up care. RESULTS: Of 1435 participants, comprising a broad range of sociodemographic groups, 92% were willing to test with a home saliva specimen, 88% with home swab, 71% with drive-through swab, and 60% with clinic collected swab. Moreover, 68% indicated they would be more likely to get tested if there was a home testing option. There were no significant differences in willingness items across sociodemographic variables or for those currently experiencing COVID-19 symptoms. Results were nearly identical for willingness to receive testing for follow-up COVID-19 care. CONCLUSIONS: We observed a hierarchy of willingness to test for SARS-CoV-2, ordered by the degree of contact required. Home specimen collection options could result in up to one-third more symptomatic persons seeking testing, facilitating contact tracing and optimal clinical care. Remote specimen collection options may ease supply chain challenges and decrease the likelihood of nosocomial transmission. As home specimen collection options receive regulatory approval, they should be scaled rapidly by health systems.


id: cord-262594-kzt09vmf
title: Time-series clustering for home dwell time during COVID-19: what can we learn from it?
author: Huang, X.
date: 2020-09-30
txt: ./txt/cord-262594-kzt09vmf.txt
cache: ./cache/cord-262594-kzt09vmf.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.09.27.20202671v1?rss=1
doi: 10.1101/2020.09.27.20202671
summary:
  Taking Metro Atlanta as a study case, we perform a trend-driven analysis by conducting Kmeans time-series clustering using fine-grained home dwell time records from SafeGraph, and further assess the statistical significance of sixteen demographic/socioeconomic variables from five major categories. The objective of this study is to explore the capability of time-series clustering in categorizing fine-grained mobility records during the COVID-19 pandemic, and further investigate what demographic/socioeconomic variables differ among the categories with statistical significance. Taking advantage of the home dwell time at Census Block Group (CBG) level from the SafeGraph [17] , and using the Atlanta-Sandy Springs-Roswell metropolitan statistical area (MSA) (hereafter referred to as Metro Atlanta) as a study case, this study investigates the potential driving factors that lead to the disparity in the time-series of home dwell time during the COVID-19 pandemic, providing fundamental knowledge that benefits policy-making for better mitigation measures of future pandemics.

abstract:
  In this study, we investigate the potential driving factors that lead to the disparity in the time-series of home dwell time, aiming to provide fundamental knowledge that benefits policy-making for better mitigation strategies of future pandemics. Taking Metro Atlanta as a study case, we perform a trend-driven analysis by conducting Kmeans time-series clustering using fine-grained home dwell time records from SafeGraph, and further assess the statistical significance of sixteen demographic/socioeconomic variables from five major categories. We find that demographic/socioeconomic variables can explain the disparity in home dwell time in response to the stay-at-home order, which potentially leads to disparate exposures to the risk from the COVID-19. The results further suggest that socially disadvantaged groups are less likely to follow the order to stay at home, pointing out the extensive gaps in the effectiveness of social distancing measures exist between socially disadvantaged groups and others. Our study reveals that the long-standing inequity issue in the U.S. stands in the way of the effective implementation of social distancing measures. Policymakers need to carefully evaluate the inevitable trade-off among different groups, making sure the outcomes of their policies reflect interests of the socially disadvantaged groups.


id: cord-264651-cqxmpxyq
title: Parenting Activities and the Transition to Home-based Education During the COVID-19 Pandemic
author: Lee, Shawna J.
date: 2020-10-13
txt: ./txt/cord-264651-cqxmpxyq.txt
cache: ./cache/cord-264651-cqxmpxyq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33071407/
doi: 10.1016/j.childyouth.2020.105585
summary:
  During previous global health crises, such as severe acute respiratory syndrome (SARS) and influenza A (H1N1), research documented issues related to school closures such as conflicts between parental work responsibilities and child care needs, lack of effective communication between parents and schools, and a lack of inclusive procedures to provide students access to needed resources and services (Boon et al., 2011; Braunack-Mayer et al., 2013; O''Sullivan et al., 2009 ). To the best of our knowledge, to date there are no national estimates of how many parents were able to use online resources to provide at-home education for their children during the time period examined in the current study (April 2020). We present qualitative analyses using thematic content coding to examine parents'' responses to open-ended questions about common daily disruptions, the use of technology for children''s education, parents'' perceived changes in child behavior, and parents'' perceptions of what children need during the pandemic.

abstract:
  This study reports on parent-child dynamics following COVID-19 related school closures, based on cross-sectional analyses of a survey that utilized a convenience sampling approach. Data were collected approximately five weeks after the World Health Organization declared that the Coronavirus was a pandemic. Participants (N = 405) were adults recruited throughout the U.S. This study examines data from parents (69% mothers and 31% fathers) with at least one child 0-12 years of age. The majority were White (71%) and 41% had at least a bachelor’s degree. 78% of parents said they were educating their child at home due to COVID-19. Most (77.1%) reported use of online tools for at-home education, including educational apps, social media, and school-provided electronic resources. More than one-third (34.7%) of parents said their child’s behavior had changed since the pandemic, including being sad, depressed, and lonely. Most parents were spending more time involved in daily caregiving of their children since COVID-19. Two out of every five parents met the PHQ-8 criteria for major depression or severe major depression (40.0%) and the GAD-7 criteria for moderate or severe anxiety (39.9%). Multivariate analyses indicated that, compared to non-depressed parents, parents who met criteria for probable major or severe depression (B = -.16, 95% CI = [-.29, -.02], p = .021) and parenting stress (B = -.37, 95% CI = [-.47, -.27], p < .001) were negatively associated with parents’ perceived preparation to educate at home. Compared to parents with minimal or mild anxiety, parents with moderate or severe anxiety reported higher child anxiety scores (B = .17, 95% CI = [.06, .28], p = .002). Parenting stress was also positively associated with higher child anxiety scores (B = .40, 95% CI = [.32, .48], p < .001). Content analyses of open-ended questions indicated that school closures were a significant disruption, followed by lack of physical activity, and social isolation. Overall, study results suggested that parents’ mental health may be an important factor linked to at-home education and child wellbeing during the pandemic.


id: cord-272923-5ekgb0zx
author: Hjálmsdóttir, Andrea
date: 2020-09-19
txt: ./txt/cord-272923-5ekgb0zx.txt
cache: ./cache/cord-272923-5ekgb0zx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1111/gwao.12552
doi: 10.1111/gwao.12552
summary:
  In Iceland, as elsewhere, women work part-time jobs in higher numbers, and mothers reduce their labor participation following childbirth more often than do fathers (Gíslason & Símonardóttir, 2018) . In the following example, a mother of a 2-year-old working in mass media, who worked entirely from home as did her husband, described one of her days like this: "I''m a little anxious because of all this, the situation in society. This is in accordance with previous studies on gendered control of time among parents (Bryson, 2016; Friedman, 2015) and new research conducted during Covid-19 that indicate that unpaid work performed by mothers has increased during the pandemic (Craig & Churchill, 2020; Manzo & Minello, 2020) . One of the patterns identified in the reflections of the women in our study was how they seemed to be stunned by how uneven the division of labor turned out to be during the pandemic and how much time and energy they devoted to household chores and the management of the household, carrying out the mental work within the family.

title:
  “I have turned into a foreman here at home.” Families and work‐life balance in times of Covid‐19 in a gender equality paradise.

abstract:
  This article explores the gendered realities of work‐life balance in Iceland during the Covid‐19 pandemic, in particular how these societal changes reflect and affect the gendered division of unpaid labor, such as childcare and household chores. The study draws on open ended real‐time diary entries, collected for two weeks during the peak of the pandemic in Iceland. The entries represent the voices of 37 mothers in heteronormative relationships. The findings imply that, during the pandemic, the mothers took on greater mental work than before. They also described intense emotional labor, as they tried to keep everyone calm and safe. The division of tasks at home lay on their shoulders, causing them stress and frustration. The findings suggest that, even in a country that has been at the top of the Gender Gap Index for several years, an unprecedented situation like Covid‐19 can reveal and exaggerate strong gender norms and expectations towards mothers. This article is protected by copyright. All rights reserved.


id: cord-275281-baxst5an
author: Dimke, C.
date: 2020-07-26
txt: ./txt/cord-275281-baxst5an.txt
cache: ./cache/cord-275281-baxst5an.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.07.20.20153577
doi: 10.1101/2020.07.20.20153577
summary:
  We match census block group level Safegraph mobile device data with demographic data from the American Community Survey to identify trends amongst different subgroups of the population. Our method yields up-to-date estimates of time spent at home across demographic groups, a classification unavailable using mobile device data alone. (2020) , who document heterogeneous mobility by income quintiles, 25 by evaluating education levels and occupations with the ability to work from home. We classify each CBG based on the composition of the population along the following characteristics: education, 40 household income, and occupations with ability to work from home. . https://doi.org/10.1101 We explore the heterogeneity of this response along education, income, and ability to work from home (Figure 1 ). We find that those with Bachelor''s degrees or higher, household incomes greater than $100,000, and a greater ability to work from home spent significantly more time at home relative to the rest 100 of the population.

title:
  Working from a distance: Who can afford to stay home during COVID-19? Evidence from mobile device data

abstract:
  As local and state governments reopen parts of the economy while balancing public health through social distancing, it is important to understand the heterogeneity in how the population has reacted to the COVID-19 pandemic. We match census block group level Safegraph mobile device data with demographic data from the American Community Survey to identify trends amongst different subgroups of the population. We find evidence that people's ability to work from home is a determinant of time spent at home since the beginning of the pandemic. On April 15th, census block groups classified as being better able to work from home spent 3 more hours at home compared to those who were not. We see supporting trends amongst block groups with differences in income and educational attainment.


id: cord-283288-e2a2955u
title: Statewide Implementation of Virtual Perinatal Home Visiting During COVID-19
author: Marshall, Jennifer
date: 2020-07-20
txt: ./txt/cord-283288-e2a2955u.txt
cache: ./cache/cord-283288-e2a2955u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32691359/
doi: 10.1007/s10995-020-02982-8
summary:
  The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Initiative is funded by the Health Resources and Services Administration (HRSA) to all U.S. states and territories to provide perinatal home visiting support to pregnant women and families with infants in high-need communities. By the second week of March, Florida MIECHV leadership announced plans for transitioning to virtual operations, and by the third week provided written guidance that included: overarching principles; basic CDCinformed guidance on preventing COVID-19 transmission for staff, for their families, and for their clients; considerations for technology, security/confidentiality, and fidelity to home visiting model; guidance for educating families on COVID-19 resources (e.g., CDC and FDOH updates, mental health resources, contacting health care providers for concerns, and preparing supplies, quarantine and childcare); and suggestions for the LIA organizations to support their staff with contact information, regular communication, data entry contingency plans, restructuring group activities/events, and staff supervision.

abstract:
  PURPOSE: This evaluation describes efforts taken by MIECHV administrators and staff during the pandemic using data collected from 60 MIECHV staff surveys and nine statewide weekly focus groups. DESCRIPTION: The Florida Maternal, Infant and Early Childhood Home Visiting (MIECHV) Initiative funds perinatal home visiting for pregnant women and families with infants throughout the state. Florida MIECHV has shown resilience to disasters and times of crises in the past, while generating a culture of adaptation and continuous quality improvement among local implementing agencies. Florida MIECHV responded to the COVID-19 pandemic crisis within the first few days of the first reported case in Florida by providing guidance on virtual home visits and working remotely. ASSESSMENT: Findings highlight the role of administrative leadership and communication, staff willingness/morale, logistical considerations, and the needs of enrolled families who face hardships during the pandemic such as job loss, limited supplies, food insecurity, technology limitations, and stress. Home visitors support enrolled families by connecting them with resources, providing public health education and delivering evidence-based home visiting curricula virtually. They also recognized the emotional burden surrounding COVID-19 impacts and uncertainties along with achieving work-life balance by caring for their own children. CONCLUSION: This evaluation helped in understanding the impact of the pandemic on this maternal and child health program and fundamentals of transition to virtual home visiting services. Virtual home visiting appears to be feasible and provides an essential connection to supports for families who may not otherwise have the means or knowledge to access them.


id: cord-285056-b2iltrqx
author: Dichter, Martin N.
date: 2020-05-12
txt: ./txt/cord-285056-b2iltrqx.txt
cache: ./cache/cord-285056-b2iltrqx.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32393407/
doi: 10.1017/s1041610220000897
abstract: nan
summary:
  title: COVID-19: it is time to balance infection management and person-centered care to maintain mental health of people living in German nursing homes In cases where people with cognitive impairment (e.g. dementia) and challenging behavior need to be isolated, this is usually done in a separate unit or room (e.g. in the rooms of a closed day care facility which can be a subsidiary facility of a nursing home) and often with a caregiver who is then responsible only for that particular resident. Therefore, infection management and person-centered care have to be weighed carefully in order to maintain the residents'' social participation, mental health, and quality of life. Based on this information, residents and caregivers have to negotiate the implementation of infection management measures and to deal with the need for the provision of person-centered care under the current circumstances.

title:
  COVID-19: it is time to balance infection management and person-centered care to maintain mental health of people living in German nursing homes


id: cord-286193-3yy9exry
author: Burton, Jennifer K
date: 2020-10-31
txt: ./txt/cord-286193-3yy9exry.txt
cache: ./cache/cord-286193-3yy9exry.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S266675682030012X
doi: 10.1016/s2666-7568(20)30012-x
summary:
  The aim of our study was to describe the evolution of outbreaks of COVID-19 in all care homes in one health region in Scotland, specifically the timing of outbreaks, number of confirmed cases in residents, care home characteristics associated with the presence of an outbreak, and deaths of residents in both care homes and hospitals. We used publicly available national data for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing and deaths from COVID-19, which were linked to regulatory public health data, to describe the evolution of outbreaks of COVID-19 in all care homes in one large health region in Scotland. In accordance with NHS Lothian public health team practice during the COVID-19 pandemic, we defined the start of a COVID-19 outbreak in a care home as the date when the first resident had a positive test for SARS-CoV-2, using regional virology laboratory PCR testing of nasopharyngeal swabs.

title:
  Evolution and effects of COVID-19 outbreaks in care homes: a population analysis in 189 care homes in one geographical region of the UK

abstract:
  Background COVID-19 has affected care home residents internationally, but detailed information on outbreaks is scarce. We aimed to describe the evolution of outbreaks of COVID-19 in all care homes in one large health region in Scotland. Methods We did a population analysis of testing, cases, and deaths in care homes in the National Health Service (NHS) Lothian health region of the UK. We obtained data for COVID-19 testing (PCR testing of nasopharyngeal swabs for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and deaths (COVID-19-related and non-COVID-19-related), and we analysed data by several variables including type of care home, number of beds, and locality. Outcome measures were timing of outbreaks, number of confirmed cases of COVID-19 in care home residents, care home characteristics associated with the presence of an outbreak, and deaths of residents in both care homes and hospitals. We calculated excess deaths (both COVID-19-related and non-COVID-19-related), which we defined as the sum of deaths over and above the historical average in the same period over the past 5 years. Findings Between March 10 and Aug 2, 2020, residents at 189 care homes (5843 beds) were tested for COVID-19 when symptomatic. A COVID-19 outbreak was confirmed at 69 (37%) care homes, of which 66 (96%) were care homes for older people. The size of care homes for older people was strongly associated with a COVID-19 outbreak (odds ratio per 20-bed increase 3·35, 95% CI 1·99–5·63). 907 confirmed cases of SARS-CoV-2 infection were recorded during the study period, and 432 COVID-19-related deaths. 229 (25%) COVID-19-related cases and 99 (24%) COVID-related deaths occurred in five (3%) of 189 care homes, and 441 (49%) cases and 207 (50%) deaths were in 13 (7%) care homes. 411 (95%) COVID-19-related deaths occurred in the 69 care homes with a confirmed COVID-19 outbreak, 19 (4%) deaths were in hospital, and two (<1%) were in one of the 120 care homes without a confirmed COVID-19 outbreak. At the 69 care homes with a confirmed COVID-19 outbreak, 74 excess non-COVID-19-related deaths were reported, whereas ten non-COVID-19-related excess deaths were observed in the 120 care homes without a confirmed COVID-19 outbreak. 32 fewer non-COVID-19-related deaths than expected were reported among care home residents in hospital. Interpretation The effect of COVID-19 on care homes has been substantial but concentrated in care homes with known outbreaks. A key implication from our findings is that, if community incidence of COVID-19 increases again, many care home residents will be susceptible. Shielding care home residents from potential sources of SARS-CoV-2 infection, and ensuring rapid action to minimise outbreak size if infection is introduced, will be important for any second wave. Funding None.


id: cord-287765-nsdequl9
title: Smart healthcare support for remote patient monitoring during covid-19 quarantine
author: Taiwo, Olutosin
date: 2020-09-15
txt: ./txt/cord-287765-nsdequl9.txt
cache: ./cache/cord-287765-nsdequl9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32953970/
doi: 10.1016/j.imu.2020.100428
summary:
  To this end, a remote smart home healthcare support system (ShHeS) is proposed for monitoring patients'' health status and receiving doctors'' prescriptions while staying at home. In this paper, we propose a mobile application-based prototype smart home healthcare system for efficient and effective health monitoring for the elderly and disabled for their convenient and independent living while at home. Smart home automation as an emerging area of IoT has been applied in various areas such as: easy and assisted daily living especially for the provision of support to humans [17] , remote control of home appliances [18, 19] , detection of movement in the house [20] , energy management in the home [21] and security [22] , and provision of healthcare services to out-patients, disabled and elderly persons [10, 23, 24] . The proposed system described in our work is intended to perform a dual function of controlling home appliances as well as monitoring and recording the patient''s physiological data such as blood pressure, body temperature, pulse rate, body weight and sugar level and other symptoms related to a specific virus.

abstract:
  Social distancing and quarantining are now standard practices which are implemented worldwide since the outbreak of the novel coronavirus (COVID-19) disease pandemic in 2019. Due to the full acceptance of the above control practices, frequent hospital contact visits are being discouraged. However, there are people whose physiological vital needs still require routine monitoring for improved healthy living. Interestingly, with the recent technological advancements in the areas of Internet of Things (IoT) technology, smart home automation, and healthcare systems, contact-based hospital visits are now regarded as non-obligatory. To this end, a remote smart home healthcare support system (ShHeS) is proposed for monitoring patients’ health status and receiving doctors’ prescriptions while staying at home. Besides this, doctors can also carry out the diagnosis of ailments using the data collected remotely from the patient. An android based mobile application that interfaces with a web-based application is implemented for efficient patients-doctors dual real-time communication. Sensors are incorporated in the system for automatic capturing of physiological health parameters of patients. Also, a hyperspace analogue to context (HAC) was incorporated into the current monitoring framework for service discovery and context change in the home environment towards accurate readings of the physiological parameters and improved system performance. With the proposed system, patients can be remotely monitored from their homes, and can also live a more comfortable life through the use of some features of smart home automation devices on their phones. Therefore, one main significant contribution of this study is that patients in self-isolation or self-quarantine can use the new platform to send daily health symptoms and challenges to doctors via their mobile phones. Thus, improved healthy living and a comfortable lifestyle can still be achieved even during such a problematic period of the 2019 COVID-19 pandemic that has already recorded 20,026,186 million cases so far with 734,020 thousand deaths globally.


id: cord-291461-jzkh7rgm
author: Chadborn, Neil H.
date: 2020-09-04
txt: ./txt/cord-291461-jzkh7rgm.txt
cache: ./cache/cord-291461-jzkh7rgm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32888183/
doi: 10.1007/s41999-020-00389-w
summary:
  Data extraction forms were developed (see Appendix 2) to collate, firstly, the following information about the quality improvement strategy (name of the QI strategy, number of staff, occupational groups involved, number of participating care homes, any control of comparator, and which process or outcome measures were reported), and, secondly, the resident-level intervention (number of participants, intervention descriptor, any control or comparator, outcome measures and results). The strengths of this review relate to the structured approach to the literature using both academic and grey literature databases, the inclusive search terms used, and the way in which we separated out quality improvement strategies (change management) from resident-level outcomes in our analysis. We advocate for a more robust approach to reporting QI interventions in care homes, with attention to describing both the quality improvement strategy (change management), how it leads to improved processes of resident-level care and finally to health outcomes.

title:
  Quality improvement in long-term care settings: a scoping review of effective strategies used in care homes

abstract:
  PURPOSE: We conducted a scoping review of quality improvement in care homes. We aimed to identify participating occupational groups and methods for evaluation. Secondly, we aimed to describe resident-level interventions and which outcomes were measured. METHODS: Following extended PRISMA guideline for scoping reviews, we conducted systematic searches of Medline, CINAHL, Psychinfo, and ASSIA (2000–2019). Furthermore, we searched systematic reviews databases including Cochrane Library and JBI, and the grey literature database, Greylit. Four co-authors contributed to selection and data extraction. RESULTS: Sixty five studies were included, 6 of which had multiple publications (75 articles overall). A range of quality improvement strategies were implemented, including audit feedback and quality improvement collaboratives. Methods consisted of controlled trials, quantitative time series and qualitative interview and observational studies. Process evaluations, involving staff of various occupational groups, described experiences and implementation measures. Many studies measured resident-level outputs and health outcomes. 14 studies reported improvements to a clinical measure; however, four of these articles were of low quality. Larger randomised controlled studies did not show statistically significant benefits to resident health outcomes. CONCLUSION: In care homes, quality improvement has been applied with several different strategies, being evaluated by a variety of measures. In terms of measuring benefits to residents, process outputs and health outcomes have been reported. There was no pattern of which quality improvement strategy was used for which clinical problem. Further development of reporting of quality improvement projects and outcomes could facilitate implementation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s41999-020-00389-w) contains supplementary material, which is available to authorized users.


id: cord-303731-yrlzxtbw
title: Management of Dysphagia in Nursing Homes During the COVID-19 Pandemic: Strategies and Experiences
author: Fong, Raymond
date: 2020-08-18
txt: ./txt/cord-303731-yrlzxtbw.txt
cache: ./cache/cord-303731-yrlzxtbw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838197/
doi: 10.1007/s42399-020-00464-0
summary:
  The global 2019 novel coronavirus disease (COVID-19) pandemic has had devastating effects not only on healthcare systems worldwide but also on different aspects of the care provided to nursing home residents. This article has summarised the actions taken in this regard and may serve as a reference to clinicians who are responsible for swallowing assessments and dysphagia management in nursing homes. Residents who had been diagnosed with COVID-19 were assessed after discharged to the nursing home as patients with COVID-19 were considered at high risk for oropharyngeal dysphagia [18] , especially those who have been previously intubated [19] . Therefore, standard and at-risk residents should be considered differently with respect to dysphagia assessments and management and personal protective equipment usage. Consequently, a surge in the use of telepractice for dysphagia management in nursing home settings was not observed during the COVID-19 pandemic.

abstract:
  The global 2019 novel coronavirus disease (COVID-19) pandemic has had devastating effects not only on healthcare systems worldwide but also on different aspects of the care provided to nursing home residents. Dysphagia management is a crucial component of the care provided to many nursing home residents. This article presents the dysphagia management strategies applied in Hong Kong during the COVID-19 pandemic and the related experiences. A two-tier protection system was implemented wherein residents were categorised according to their contact and hospitalisation histories. The provided swallowing management and personal protective equipment level differed between the two tiers. The article also discusses the referral and prioritisation of clinical services for residents requiring swallowing management, as well as the adaptations of swallowing assessment and management during the pandemic. The possible effects of COVID-19 on mealtime arrangements in nursing homes, the implications of the pandemic on the use of personal protective equipment and the use of telepractice in nursing homes were also discussed. This article has summarised the actions taken in this regard and may serve as a reference to clinicians who are responsible for swallowing assessments and dysphagia management in nursing homes.


id: cord-304450-1ub3xzsv
title: Pandemic programming: How COVID-19 affects software developers and how their organizations can help
author: Ralph, Paul
date: 2020-09-14
txt: ./txt/cord-304450-1ub3xzsv.txt
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mime: text/plain
url: https://doi.org/10.1007/s10664-020-09875-y
doi: 10.1007/s10664-020-09875-y
summary:
  Confirmatory results include: (1) the pandemic has had a negative effect on developers'' wellbeing and productivity; (2) productivity and wellbeing are closely related; (3) disaster preparedness, fear related to the pandemic and home office ergonomics all affect wellbeing or productivity. Research question: How is working from home during the COVID-19 pandemic affecting software developers'' emotional wellbeing and productivity? (2007) found that organizational and job-related factors (e.g. management culture, human resources support, structure of feedback) are more likely to affect teleworking employees'' satisfaction and perceived productivity than work styles (e.g. planning vs. Research on working from home has been criticized for relying on self-reports of perceived productivity, which may inflate its benefits (Bailey and Kurland 2002) ; however, objective measures often lack construct validity (Ralph and Tempero 2018) and perceived productivity correlates well with managers'' appraisals (Baruch 1996) .

abstract:
  CONTEXT: As a novel coronavirus swept the world in early 2020, thousands of software developers began working from home. Many did so on short notice, under difficult and stressful conditions. OBJECTIVE: This study investigates the effects of the pandemic on developers’ wellbeing and productivity. METHOD: A questionnaire survey was created mainly from existing, validated scales and translated into 12 languages. The data was analyzed using non-parametric inferential statistics and structural equation modeling. RESULTS: The questionnaire received 2225 usable responses from 53 countries. Factor analysis supported the validity of the scales and the structural model achieved a good fit (CFI = 0.961, RMSEA = 0.051, SRMR = 0.067). Confirmatory results include: (1) the pandemic has had a negative effect on developers’ wellbeing and productivity; (2) productivity and wellbeing are closely related; (3) disaster preparedness, fear related to the pandemic and home office ergonomics all affect wellbeing or productivity. Exploratory analysis suggests that: (1) women, parents and people with disabilities may be disproportionately affected; (2) different people need different kinds of support. CONCLUSIONS: To improve employee productivity, software companies should focus on maximizing employee wellbeing and improving the ergonomics of employees’ home offices. Women, parents and disabled persons may require extra support.


id: cord-313173-0u4s5y20
title: Sheltering at Our Common Home
author: ten Have, H.A.M.J.
date: 2020-08-25
txt: ./txt/cord-313173-0u4s5y20.txt
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mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32840840/
doi: 10.1007/s11673-020-10014-x
summary:
  The current COVID-19 pandemic has reactivated ancient metaphors (especially military ones) but also initiated a new vocabulary: social distancing, lockdown, self-isolation, and sheltering in place. The global threat of pandemics therefore does not emerge spontaneously as a natural event but is the product of human behaviour. What is missing in the pandemic management responses so far is the ecological perspective that pandemics are related to the current economic global order which assumes a separation of humans and nature and regards nature as a resource to be exploited and commodified. This shift has been advocated by many environmental ethicists as well as in indigenous worldviews (Rolston 1988; Johnson 2020) .The ecological perspective implies that the military language of the pandemic is distorting the human embeddedness in the natural world. In an ecological perspective, vulnerability to infectious diseases is not confined to specific individuals, populations, or nations.

abstract:
  The current COVID-19 pandemic has reactivated ancient metaphors (especially military ones) but also initiated a new vocabulary: social distancing, lockdown, self-isolation, and sheltering in place. Terminology is not ethically neutral but reflects prevailing value systems. I will argue that there are two metaphorical vocabularies at work: an authoritarian one and a liberal one. Missing is an ecological vocabulary. It has been known for a long time that emerging infectious diseases are associated with the destruction of functioning ecosystems and biodiversity. Ebola and avian influenza viruses have been significant warnings. Obviously, this pandemic will not be the last one. As the planet is our common home, the major metaphor to explore is sheltering at this home.


id: cord-313218-4rbxdimf
author: Narushima, Miya
date: 2020-09-09
txt: ./txt/cord-313218-4rbxdimf.txt
cache: ./cache/cord-313218-4rbxdimf.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0890406520300451
doi: 10.1016/j.jaging.2020.100875
summary:
  However, we also found that older women are largely silent about their needs, and that experiences varied depending on life histories, health conditions, and the availability of supports in their wider environment (home care, alternative housing options, accessible transportation, opportunities for social and physical activities). Comparing the 2011 and 2016 censuses, the ratio of people aged 65 and older living in "collective dwellings" (e.g., assisted living, supportive housing, retirement residences, seniors'' apartments, continuum care facilities, and nursing homes) has dropped from 7.9% to 6.9% (Garner, Tanuseputro, Manuel, & Sanmartin, 2018; Statistics Canada, 2012) . For example, in a public guide issued by the federal government, "aging in place" is defined as "having access to services and the health and social supports and services you need to live safely and independently in your home or your community for as long as you wish and are able" (Federal/Provincial/Territorial Ministers Responsible for Seniors, 2015, p.1).

title:
  “Fiercely independent”: Experiences of aging in the right place of older women living alone with physical limitations

abstract:
  This study explores the experience of aging among older Canadian women with physical limitations who live by themselves. While aging in place has been a policy priority in rapidly greying Canada, a lack of complementary public supports poses challenges for many older adults and their family members. Employing a qualitative methodology, and drawing from the notion of aging in the right place, we collected personal narratives of 12 women (aged 65 to 92) in two geographic areas in Ontario, including residents of regular houses, apartments, condominiums, assisted living and community housing for seniors. Through thematic analysis, we identified four overarching themes: 1) striving to continue on “at home”, 2) living as a “strong independent woman”, 3) the help needed to support their “independence”, and 4) social activities to maintain self. Our findings illustrate how, despite their mobility limitations, older women can change their residential environment and their behavior by deploying the coping strategies and resources they have developed over time. However, we also found that older women are largely silent about their needs, and that experiences varied depending on life histories, health conditions, and the availability of supports in their wider environment (home care, alternative housing options, accessible transportation, opportunities for social and physical activities). We hope these findings will incite further studies and discussion to help make aging in the right place a real choice for anyone who wishes to do so.


id: cord-316842-mnt12ot2
title: Evaluating the Efficacy of Stay-At-Home Orders: Does Timing Matter?
author: Medline, MPH
date: 2020-06-03
txt: ./txt/cord-316842-mnt12ot2.txt
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mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.05.30.20117853v1?rss=1
doi: 10.1101/2020.05.30.20117853
summary:
  RESULTS: For US states and countries, a larger number of days between the first reported case and stay-at-home mandates was associated with a longer time to reach the peak daily case and death counts. CONCLUSIONS: Our study supports the potential beneficial effect of earlier stay-at-home mandates, by shortening the time to peak case and death counts for US states and countries. Specific terms used in our online searches included ''date of stay-at-home orders 2020,'' ''non-pharmaceutical interventions COVID-19,'' and ''stay-at-home mandates.'' We conducted a search for each respective country and US state analyzed in the study. For both our country and US state-level-data, a larger number of days between the first reported case and the stay-at-home mandate was associated with a longer time to reach both the peak of daily cases and deaths for each respective region (Tables 1a and 1b is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

abstract:
  BACKGROUND: The many economic, psychological, and social consequences of pandemics and social distancing measures create an urgent need to determine the efficacy of non-pharmaceutical interventions (NPIs), and especially those considered most stringent, such as stay-at-home and self-isolation mandates. This study focuses specifically on the efficacy of stay-at-home orders, both nationally and internationally, in the control of COVID-19. METHODS: We conducted an observational analysis from April to May 2020 and included countries and US states with known stay-at-home orders. Our primary exposure was the time between the date of the first reported case of COVID-19 to an implemented stay-at-home mandate for each region. Our primary outcomes were the time from the first reported case to the highest number of daily cases and daily deaths. We conducted simple linear regression analyses, controlling for the case rate of the outbreak. RESULTS: For US states and countries, a larger number of days between the first reported case and stay-at-home mandates was associated with a longer time to reach the peak daily case and death counts. The largest effect was among regions classified as the latest 10% to implement a mandate, which in the US, predicted an extra 35.3 days to the peak number of cases (95 % CI: 18.2, 52.5), and 38.3 days to the peak number of deaths (95 % CI: 23.6, 53.0). CONCLUSIONS: Our study supports the potential beneficial effect of earlier stay-at-home mandates, by shortening the time to peak case and death counts for US states and countries. Regions in which mandates were implemented late experienced a prolonged duration to reaching both peak daily case and death counts.


id: cord-321497-c7l88gjn
author: Tull, Matthew T.
date: 2020-05-12
txt: ./txt/cord-321497-c7l88gjn.txt
cache: ./cache/cord-321497-c7l88gjn.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.psychres.2020.113098
doi: 10.1016/j.psychres.2020.113098
summary:
  This study examined relations of both stay-at-home orders and the perceived impact of COVID-19 on daily life to psychological outcomes (depression, health anxiety, financial worry, social support, and loneliness) in a nationwide U.S. community adult sample (N = 500; 47% women, mean age = 40). To extend this research to the psychological impact of COVID-19 in the U.S., the present study examined associations of stay-at-home orders and the perceived impact of COVID-19 on daily life to relevant psychological outcomes (i.e., depression, health anxiety, financial worry, perceived social support, and loneliness). Descriptive statistics for the primary variables of interest (stay-athome order status, perceived impact of COVID-19, depression symptom severity, health anxiety, financial worry, loneliness, and social support) were computed, as were point-biserial and Pearson product-moment correlations to examine zero-order associations among variables. The goal of the present study was to examine associations of stay-athome orders and the perceived impact of COVID-19 on daily life to relevant psychological outcomes (i.e., depression, health anxiety, financial worry, perceived social support, and loneliness).

title:
  Psychological Outcomes Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life

abstract:
  The COVID-19 pandemic has resulted in the widespread implementation of extraordinary physical distancing interventions (e.g., stay-at-home orders) to slow the spread of the virus. Although vital, these interventions may be socially and economically disruptive, contributing to adverse psychological outcomes. This study examined relations of both stay-at-home orders and the perceived impact of COVID-19 on daily life to psychological outcomes (depression, health anxiety, financial worry, social support, and loneliness) in a nationwide U.S. community adult sample (N = 500; 47% women, mean age = 40). Participants completed questionnaires assessing psychological outcomes, stay-at-home order status, and COVID-19’s impact on their daily life. Being under a stay-at-home order was associated with greater health anxiety, financial worry, and loneliness. Moreover, the perceived impact of COVID-19 on daily life was positively associated with health anxiety, financial worry, and social support, but negatively associated with loneliness. Findings highlight the importance of social connection to mitigate negative psychological consequences of the COVID-19 pandemic.


id: cord-323207-cbyd53dr
author: O’Neill, Desmond
date: 2020-06-17
txt: ./txt/cord-323207-cbyd53dr.txt
cache: ./cache/cord-323207-cbyd53dr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32557250/
doi: 10.1007/s41999-020-00347-6
summary:
  The EuGMS, as a society representing national organisations for geriatric medicine in Europe, instituted the Special Interest Group for Long Term Care in 2011, providing a European focus for the development of standards of care, research and education for the medical care of residents of NHs. We reported from a survey across members that only 12% of EUGMS countries had written medical care standards for physicians applicable to nursing home care provided by professional organizations [20] . These standards comprised of seven core principles of medical care for physicians working in NHs as a first step in developing a programme of clinical, academic and policy engagement in improving medical care for older people who are living and frequently also dying as residents in nursing homes. 3) Given the complexity of care associated with older people in nursing homes, physicians providing medical care to nursing home residents should have a formal competence in geriatric medicine and old age psychiatry.

title:
  COVID-19 highlights the need for universal adoption of standards of medical care for physicians in nursing homes in Europe

abstract:
  The nursing home sector has seen a disproportionately high number of deaths as part of the COVID-19 pandemic. This reflects, in part, the frailty and vulnerability of older people living in care homes but has also, in part, been a consequence of the failure to include care homes in the systematic planning of a response to COVID, as well as a measure of neglect of standards and quality improvement in the sector. In response, the EUGMS published a set of medical standards of care developed in consultation with experts across its member national societies in 2015. The standards consisted of seven core principles of medical care for physicians working in nursing homes as a first step in developing a programme of clinical, academic and policy engagement in improving medical care for older people who are living and frequently also dying as residents in nursing homes. The gravity of the concerns arising for nursing home care from the COVID-19 pandemic, as well as emerging insights on care improvement in nursing homes indicate that an update of these medical standards is timely. This was performed by the writing group from the original 2015 guidelines and is intended as an interim measure pending a more formal review incorporating a systematic review of emerging literature and a Delphi process.


id: cord-323251-yd29gk7q
title: Smart home technology for telemedicine and emergency management
author: Li, Kin Fun
date: 2012-05-11
txt: ./txt/cord-323251-yd29gk7q.txt
cache: ./cache/cord-323251-yd29gk7q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s12652-012-0129-8
doi: 10.1007/s12652-012-0129-8
summary:
  Using the appropriate sensing apparatus at a smart home setting, patients, elderlies and people with disabilities can have their health signals and information examined on a real-time and archival basis. The associated Borboleta system enables healthcare professionals to use PDAs (personal digital assistants) and mobile communication technologies for providing on-site home healthcare and improving the quality of public health services. One can view sensors being the foundation and communication networks as the pillars of a building, supporting various telemedicine applications under the roof to facilitate and provide a smart home environment to individuals, as shown in Fig. 1 . Applications of smart telemedicine technologies for specific diseases, emergency management, and the elderly and physically challenged, are presented in Sect. Many telemedicine systems leverage the latest mobile and wireless communication technologies as well as the widely available internet infrastructure to deliver quality services to home patients (Castro et al.

abstract:
  With the ageing population, mobility is an important issue and it deters the elderlies to visit health clinics on a regular basis. Individuals with disabilities also face the same obstacles for their out-of-home medical visits. In addition, people living in remote areas often do not get the needed health care attention unless they are willing to spend the time, effort and cost to travel. Advances in information and telecommunication technologies have made telemedicine possible. Using the latest sensor technologies, a person’s vital data can be collected in a smart home environment. The bio-information can then be transferred wirelessly or via the Internet to medical databases and the healthcare professionals. Using the appropriate sensing apparatus at a smart home setting, patients, elderlies and people with disabilities can have their health signals and information examined on a real-time and archival basis. Recovery process can be charted on a regular basis. Remote emergency alerts can be intercepted and responded quickly. Health deterioration can be monitored closely enabling corrective actions. Medical practitioners can therefore provide the necessary health-related services to more people. This paper surveys and compiles the state-of-the-art smart home technologies and telemedicine systems.


id: cord-324635-27q3nxte
title: The situation of infection in the elderly in Spain: a multidisciplinary opinion document
author: Bouza, Emilio
date: 2020-09-08
txt: ./txt/cord-324635-27q3nxte.txt
cache: ./cache/cord-324635-27q3nxte.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.37201/req/057.2020
doi: 10.37201/req/057.2020
summary:
  Thus, for long-term care facility (LTCF) residents and in hospitalised elderly people, UTI is the number one cause of infection and is the second most common in older women living in the community [19] . The first data on infection in nursing homes in Spain come from the EPINGER study, conducted in community health centres in Catalonia, which reported a prevalence of 6.5%, although it should be pointed out that in Catalonia the concept of the community health centre would include medium-long term patients, while in the rest of the Spanish autonomous communities this concept would be limited to nursing homes [40] . This is a multi-centre system for monitoring nosocomial infections, based on the production of an annual prevalence study, which has been conducted since 1990 in a large group of hospitals in Spain and was promoted by the Spanish Society of Preventive Medicine, Public Health and Hygiene. The studies reviewed allow us to estimate a prevalence of infection of between 4 and 10% in nursing homes in Spain, depending on their complexity, and between 6 and 9% in hospitalised elderly people.

abstract:
  Infection in the elderly is a huge issue whose treatment usually has partial and specific approaches. It is, moreover, one of the areas where intervention can have the most success in improving the quality of life of older patients. In an attempt to give the widest possible focus to this issue, the Health Sciences Foundation has convened experts from different areas to produce this position paper on Infection in the Elderly, so as to compare the opinions of expert doctors and nurses, pharmacists, journalists, representatives of elderly associations and concluding with the ethical aspects raised by the issue. The format is that of discussion of a series of pre-formulated questions that were discussed by all those present. We begin by discussing the concept of the elderly, the reasons for their predisposition to infection, the most frequent infections and their causes, and the workload and economic burden they place on society. We also considered whether we had the data to estimate the proportion of these infections that could be reduced by specific programmes, including vaccination programmes. In this context, the limited presence of this issue in the media, the position of scientific societies and patient associations on the issue and the ethical aspects raised by all this were discussed.


id: cord-324642-uk4ir8po
author: Okuhara, Tsuyoshi
date: 2020-08-21
txt: ./txt/cord-324642-uk4ir8po.txt
cache: ./cache/cord-324642-uk4ir8po.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.pec.2020.08.016
doi: 10.1016/j.pec.2020.08.016
summary:
  title: Examining persuasive message type to encourage staying at home during the COVID-19 pandemic and social lockdown: A randomized controlled study in Japan RESULTS: Compared with other messages, the message from a physician significantly increased participants'' intention to stay at home in areas with high numbers of people infected (versus a governor, p = .002; an expert, p = .023; a resident, p = .004). Such articles convey messages from governors, public health experts, physicians, COVID-19 patients, and residents of outbreak areas, encouraging people to stay at home. In areas with high numbers of infected people, the message from a physician, which conveyed the crisis of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment, increased the intention to stay at home to a greater extent than other messages from a governor, a public health expert, a patient with COVID-19, and a resident of an outbreak area.

title:
  Examining persuasive message type to encourage staying at home during the COVID-19 pandemic and social lockdown: A randomized controlled study in Japan

abstract:
  OBJECTIVE: Behavioral change is the only prevention against the COVID-19 pandemic until vaccines become available. This is the first study to examine the most persuasive message type in terms of narrator difference in encouraging people to stay at home during the COVID-19 pandemic and social lockdown. METHODS: Participants (n = 1,980) were randomly assigned to five intervention messages (from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area) and a control message. Intention to stay at home before and after reading messages was assessed. A one-way ANOVA with Tukey’s or Games–Howell test was conducted. RESULTS: Compared with other messages, the message from a physician significantly increased participants’ intention to stay at home in areas with high numbers of people infected (versus a governor, p = .002; an expert, p = .023; a resident, p = .004). CONCLUSION: The message from a physician―which conveyed the crisis of overwhelmed hospitals and consequent risk of people being unable to receive treatment―increased the intent to stay at home the most. PRACTICE IMPLICATIONS: Health professionals and media operatives may be able to encourage people to stay at home by disseminating the physicians’ messages through media and the internet.


id: cord-326173-3x435v6q
author: Beck, Matthew J.
date: 2020-08-18
txt: ./txt/cord-326173-3x435v6q.txt
cache: ./cache/cord-326173-3x435v6q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.tranpol.2020.08.004
doi: 10.1016/j.tranpol.2020.08.004
summary:
  We find that work from home has been a generally positive experience with a significant number of respondents liking to work from home moving forward, with varying degrees of employer support, at a level above those seen before COVID-19. Likewise, the Google Community Mobility Report (Google 2020) presented in Figure 4 (which aggregates data across Australia and compares to the median value for the corresponding day of the week during the 5-week period Jan 3-Feb 6, 2020 as a baseline) shows a sustained increase in time spent at work, retail and recreation, and parks, while time at home has slowly diminished. Given the anecdotal evidence in new media sources about increased use of active travel modes (Abano 2020, Landis-Hanley 2020) and greater use of public spaces for exercise and recreation (O''Sullivan 2020), questions were included in Wave 2 around whether or not respondents had felt they had increased or decreased use of different modes in the previous week, and how they were planning to change their use as restrictions were eased.

title:
  Insights into the impact of COVID-19 on household travel and activities in Australia – The early days of easing restrictions

abstract:
  The COVID-19 disease continues to cause unparalleled disruption to life and the economy world over. This paper is the second in what will be an ongoing series of analyses of a longitudinal travel and activity survey. In this paper we examine data collected over a period of late May to early June in Australia, following four-to-six weeks of relatively flat new cases in COVID-19 after the initial nationwide outbreak, as many state jurisdictions have begun to slowly ease restrictions designed to limit the spread of the SARS-CoV-2 virus. We find that during this period, travel activity has started to slowly return, in particular by private car, and in particular for the purposes of shopping and social or recreational activities. Respondents indicate comfort with the idea of meeting friends or returning to shops, so authorities need to be aware of potential erosion of social distancing and appropriate COVID-safe behaviour in this regard. There is still a concern about using public transport, though it has diminished noticeably since the first wave of data collection. We see that working from home continues to be an important strategy in reducing travel and pressure on constrained transport networks, and a policy measure that if carried over to a post-pandemic world, will be an important step towards a more sustainable transport future. We find that work from home has been a generally positive experience with a significant number of respondents liking to work from home moving forward, with varying degrees of employer support, at a level above those seen before COVID-19. Thus, any investment to capitalise on current levels of work from home should be viewed as an investment in transport.


id: cord-328565-3jzcdy1a
author: Hollinghurst, Joe
date: 2020-09-19
txt: ./txt/cord-328565-3jzcdy1a.txt
cache: ./cache/cord-328565-3jzcdy1a.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32951042/
doi: 10.1093/ageing/afaa207
summary:
  title: The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: a retrospective population-based cohort study for mortality in 2016–2020 AIM: to analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4 years. In this study, we utilise the Secure Anonymised Information Linkage (SAIL) Databank [17] [18] [19] to investigate mortality in care homes in Wales in the initial phase of the UK lockdown and compare this with corresponding data from the four most recent years to estimate excess mortality. We aimed to compare the mortality risk for older care home residents (60+) in Wales for each year between 2016 and 2020. When compared with previous years and after adjustment for age, sex, deprivation and HFRS, our results show substantial excess mortality in care home residents during the first phase of the COVID-19 lockdown.

title:
  The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: a retrospective population-based cohort study for mortality in 2016–2020

abstract:
  BACKGROUND: mortality in care homes has had a prominent focus during the COVID-19 outbreak. Care homes are particularly vulnerable to the spread of infectious diseases, which may lead to increased mortality risk. Multiple and interconnected challenges face the care home sector in the prevention and management of outbreaks of COVID-19, including adequate supply of personal protective equipment, staff shortages and insufficient or lack of timely COVID-19 testing. AIM: to analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4 years. STUDY DESIGN AND SETTING: we used anonymised electronic health records and administrative data from the secure anonymised information linkage databank to create a cross-sectional cohort study. We anonymously linked data for Welsh residents to mortality data up to the 14th June 2020. METHODS: we calculated survival curves and adjusted Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of mortality. We adjusted HRs for age, gender, social economic status and prior health conditions. RESULTS: survival curves show an increased proportion of deaths between 23rd March and 14th June 2020 in care homes for older people, with an adjusted HR of 1.72 (1.55, 1.90) compared with 2016. Compared with the general population in 2016–2019, adjusted care home mortality HRs for older adults rose from 2.15 (2.11, 2.20) in 2016–2019 to 2.94 (2.81, 3.08) in 2020. CONCLUSIONS: the survival curves and increased HRs show a significantly increased risk of death in the 2020 study periods.


id: cord-330051-vskolc4g
title: Defying the Rally During COVID‐19 Pandemic: A Regression Discontinuity Approach
author: Shino, Enrijeta
date: 2020-07-23
txt: ./txt/cord-330051-vskolc4g.txt
cache: ./cache/cord-330051-vskolc4g.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32836477/
doi: 10.1111/ssqu.12844
summary:
  RESULTS: Using survey data from Florida''s registered voters, we find that Governor DeSantis''s approval dropped by 7 percentage points following his "Safer at Home" order press conference on April 1. On April 1, 2020 at 12:00 pm, DeSantis announced the issuing of Executive Order 20-19 "Safer at Home." We use this event in Florida politics to analyze how the public reacted to the preventative measures taken by the governor. Using an original survey of Florida registered voters, the main question we address in this study is how the Florida governor''s announcement of the "Safer at Home" order affected his public support. For example, 82.8 percent of Republicans who consider the virus to be an economic threat support the governor''s handling of the COVID-19 pandemic compared to 73.5 percent of the those who think it is more of a public health risk.

abstract:
  OBJECTIVE: Do people set aside their partisan differences and rally around elected officials during a pandemic? President Trump's delegation of responsibility to the states during the COVID‐19 pandemic placed governors on the frontlines of the battle; some have shined and garnered positive national attention, others have wilted under the pressure of the national spotlight. METHODS: We use regression discontinuity design and exploit a discontinuity in the state's political events to assess the support of a governor's response to the pandemic. RESULTS: Using survey data from Florida's registered voters, we find that Governor DeSantis's approval dropped by 7 percentage points following his “Safer at Home” order press conference on April 1. CONCLUSION: Our results suggest that under certain circumstances partisanship can blunt a “rally around the flag” effect. This finding provides context to understanding when and under which circumstances elected officials can expect increases (or decreases) in public support.


id: cord-333153-hjgf3ay8
author: Griffith, Matthew F.
date: 2020-10-21
txt: ./txt/cord-333153-hjgf3ay8.txt
cache: ./cache/cord-333153-hjgf3ay8.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1525861020307933
doi: 10.1016/j.jamda.2020.09.010
summary:
  15 Among patients with mild to moderate functional limitation at baseline, loss of 1 ADL could have a profound effect on a patient''s health-related quality of life and lead to the perception that such a loss would be "worse than death." 16, 17 Although patients and their surrogates may be familiar with the risks of hospitalization for exacerbations of chronic diseases that they have suffered for many years (eg, chronic obstructive pulmonary disease or congestive heart failure), providing them with an estimate of functional outcomes following hospitalization for an unplanned acute illness like pneumonia allows for shared decision making through scenario planning. 42 Our study demonstrates that nursing home admission, particularly with individuals suffering from cognitive and physical limitations who are admitted for long-term care, is likely the right time to initiate advance care planning around the decision to hospitalize for COVID or other pneumonias, as we found that residents are more likely to experience functional decline or death at 60 days following hospitalization than individuals diagnosed with metastatic nonesmall cell lung cancer.

title:
  Nursing Home Residents Face Severe Functional Limitation or Death After Hospitalization for Pneumonia

abstract:
  OBJECTIVES: Pneumonia is a common cause of hospitalization for nursing home residents and has increased as a cause for hospitalization during the COVID-19 pandemic. Risks of hospitalization, including significant functional decline, are important considerations when deciding whether to treat a resident in the nursing home or transfer to a hospital. Little is known about postdischarge functional status, relative to baseline, of nursing home residents hospitalized for pneumonia. We sought to determine the risk of severe functional limitation or death for nursing home residents following hospitalization for treatment of pneumonia. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: Participants included Medicare enrollees aged ≥65 years, hospitalized from a nursing home in the United States between 2013 and 2014 for pneumonia. METHODS: Activities of daily living (ADL), patient sociodemographics, and comorbidities were obtained from the Minimum Data Set (MDS), an assessment tool completed for all nursing home residents. MDS assessments from prior to and following hospitalization were compared to assess for functional decline. Following hospital discharge, all patients were evaluated for a composite outcome of severe disability (≥4 ADL limitations) following hospitalization or death prior to completion of a postdischarge MDS. RESULTS: In 2013 and 2014, a total of 241,804 nursing home residents were hospitalized for pneumonia, of whom 89.9% (192,736) experienced the composite outcome of severe disability or death following hospitalization for pneumonia. Although we found that prehospitalization functional and cognitive status were associated with developing the composite outcome, 53% of residents with no prehospitalization ADL limitation, and 82% with no cognitive limitation experienced the outcome. CONCLUSIONS AND IMPLICATIONS: Hospitalization for treatment of pneumonia is associated with significant risk of functional decline and death among nursing home residents, even those with minimal deficits prior to hospitalization. Nursing homes need to prepare for these outcomes in both advance care planning and in rehabilitation efforts.


id: cord-333518-67md81fq
author: Sofo, Adriano
date: 2020-04-22
txt: ./txt/cord-333518-67md81fq.txt
cache: ./cache/cord-333518-67md81fq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32322132/
doi: 10.1007/s10745-020-00150-8
summary:
  title: Converting Home Spaces Into Food Gardens At the Time of Covid-19 Quarantine: All the Benefits of Plants in This Difficult and Unprecedented Period Home vegetable gardens could provide a small-scale approach to the sustainable use of natural resources, leading towards self-sufficiency, self-regulation, sustainability, and environmental protection. The selection of plant species to cultivate in outside home spaces should be based primarily on their ability to cope with the harsh conditions of the urban environment, such as high wind and irradiance, lack of organic material and nutrients, and intermittent drought (Pavao-Zuckerman 2008). In Mediterranean climates, the hot late spring/summer days can raise soil temperature in the pots to even reach 40-50°C and air temperature 30-35°C , so it is advisable to use shade cloth or shading vegetation on the scaffolding to avoid burning roots and shoots of the plants so laboriously cultivated.

title:
  Converting Home Spaces Into Food Gardens At the Time of Covid-19 Quarantine: All the Benefits of Plants in This Difficult and Unprecedented Period

abstract:
  People are facing uncertain and difficult times in the face of the Covid-19 pandemic. The benefits of plants (psychological, health, economic, productive) in this period of forced isolation can be of key importance. If many of us have to self-isolate in urban or suburban environments, we need something to do to keep our bodies and minds active and fed. In such a challenging scenario, a vegetable garden in home spaces can bring recreational, health, economic and environmental benefits. Regardless of the Covid-19 pandemic, there is untapped potential for this kind of garden to impact environmental outcomes, public awareness, and market trends. Home vegetable gardens could provide a small-scale approach to the sustainable use of natural resources, leading towards self-sufficiency, self-regulation, sustainability, and environmental protection.


id: cord-333950-e0hd3iuu
author: Maillard, Jean-Yves
date: 2020-04-18
txt: ./txt/cord-333950-e0hd3iuu.txt
cache: ./cache/cord-333950-e0hd3iuu.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320302091?v=s5
doi: 10.1016/j.ajic.2020.04.011
summary:
  The authors call upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR. 3, 4 The main driver is overuse and misuse of antibiotics in medicine and agriculture including unregulated over-the-counter sales, while global spread of resistant bacteria or resistance genes is attributed to poor infection prevention and control in healthcare facilities, and sub-optimal hygiene and sanitation in communities, confounded by poor infrastructure and weak governance. 94 Studies in day-care centers and schools in which hand hygiene was combined with cleaning and/or disinfection of environmental surfaces indicate a positive impact on illness rates and reduction in the use of antibiotics. The evidence set out in this paper suggests that, if combined with measures ensuring clean water and adequate sanitation, targeted hygiene practices in home and everyday life settings could make a significant contribution to tackling AMR through infection prevention and a consequential reduction in antibiotic prescribing.

title:
  Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A Position Paper

abstract:
  Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of healthcare facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms. This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in healthcare settings requires a mirrored reduction in the community. The authors call upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.


id: cord-334524-8uqnlpvc
author: Johannson, Kerri A.
date: 2020-08-01
txt: ./txt/cord-334524-8uqnlpvc.txt
cache: ./cache/cord-334524-8uqnlpvc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1164/rccm.202005-1532ed
doi: 10.1164/rccm.202005-1532ed
abstract: nan
summary:
  Mobile health tools have been proposed as useful for patients with idiopathic pulmonary fibrosis (IPF) given the complex progressive nature of disease and challenges associated with clinical trials of therapeutics. Beyond simple spirometry, home monitoring in IPF has extended to include measures of physical activity, symptoms, quality of life, and medication tolerability (4) (5) (6) (7) . Ninety patients were randomized at antifibrotic treatment initiation (46 to home monitoring and 44 to standard care), with between-group change in the King''s Brief ILD score as the primary outcome. Lung function data should be unblinded and accessible in real time for disease monitoring and management while providing reassurance or medical follow-up as clinically indicated. Home monitoring in patients with idiopathic pulmonary fibrosis: a randomized controlled trial It is critical to understand the risks posed by exposures to occupational lung carcinogens to develop effective control programs for this deadly disease.In this issue of the Journal, two papers by Ge and colleagues (pp.

title:
  Remote Monitoring in Idiopathic Pulmonary Fibrosis: Home Is Where the Bluetooth-enabled Spirometer Is


id: cord-336467-w528t92h
title: Nursing Home Design and COVID-19: Balancing Infection Control, Quality of Life, and Resilience
author: Anderson, Diana C.
date: 2020-10-31
txt: ./txt/cord-336467-w528t92h.txt
cache: ./cache/cord-336467-w528t92h.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S152586102030788X
doi: 10.1016/j.jamda.2020.09.005
summary:
  Residential care settings for older people are known variously as "nursing homes," "long-term care facilities," or "care homes." 1 In general, it is argued that the design of many of these facilities do not adequately support quality of life for older people, 2,3 and now this is compounded by the COVID-19 pandemic which illustrates how they are ill-designed for infection control and the protection of older people who are most at risk in our society. Quality of life and care issues pertain to all aspects of the nursing home built environment (ie, from nursing home location and interaction with the community, down to building details, components, and technology), therefore we adopt a spatial framework spanning macro (overall urban setting), meso (neighborhoods and districts), and micro-scale level issues (site/building design). Examining any new approaches to nursing home design through the lens of quality of life and resilience will help reduce fragility of long-term care and protect against ongoing infectious threats such as influenza or COVID-19, or future pandemics.

abstract:
  Many nursing home design models can have a negative impact on older people and these flaws have been compounded by Coronavirus Disease 2019 and related infection control failures. This article proposes that there is now an urgent need to examine these architectural design models and provide alternative and holistic models that balance infection control and quality of life at multiple spatial scales in existing and proposed settings. Moreover, this article argues that there is a convergence on many fronts between these issues and that certain design models and approaches that improve quality of life, will also benefit infection control, support greater resilience, and in turn improve overall pandemic preparedness.


id: cord-337842-q03884i9
author: Iaboni, Andrea
date: 2020-05-04
txt: ./txt/cord-337842-q03884i9.txt
cache: ./cache/cord-337842-q03884i9.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1064748120303262
doi: 10.1016/j.jagp.2020.04.025
summary:
  As policy changes and interventions designed to support nursing homes are put into place, there are barriers to implementing a fundamental, highly effective element of infection control, namely the isolation of suspected or confirmed cases. Nursing homes that have not yet been impacted by COVID-19 have a narrow window of opportunity to prepare for the isolation of residents with dementia and front-line staff are now looking to their leadership and government bodies to help prepare to take these actions as safely and compassionately as possible Nursing home staff are experiencing moral distress due to the potential harms associated isolation of residents, as well as the severe consequences if these infection control measures are not effectively implemented. While international guidance has been consistent in recommending isolation of residents of nursing homes with confirmed or suspected COVID-19 (1), none of these guidelines directly address the practical challenges faced when trying to isolate people with dementia effectively while maintaining their safety and human dignity.

title:
  Achieving Safe, Effective and Compassionate Quarantine or Isolation of Older Adults with Dementia in Nursing Homes.

abstract:
  Nursing homes are facing the rapid spread of COVID-19 among residents and staff and are at the centre of the public health emergency due to the COVID-19 pandemic. As policy changes and interventions designed to support nursing homes are put into place, there are barriers to implementing a fundamental, highly effective element of infection control, namely the isolation of suspected or confirmed cases. Many nursing home residents have dementia, associated with impairments in memory, language, insight and judgment that impact their ability to understand and appreciate the necessity of isolation and to voluntarily comply with isolation procedures. While there is a clear ethical and legal basis for the involuntary confinement of people with dementia, the potential for unintended harm with these interventions is high, and there is little guidance for nursing homes on how to isolate safely, while maintaining the human dignity and personhood of the individual with dementia. In this commentary, we discuss strategies for effective, safe and compassionate isolation care planning, and present a case vignette of a person with dementia who is placed in quarantine on a dementia unit.


id: cord-338686-evzl7v39
author: Hollinghurst, J.
date: 2020-07-04
txt: ./txt/cord-338686-evzl7v39.txt
cache: ./cache/cord-338686-evzl7v39.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.07.03.20145839
doi: 10.1101/2020.07.03.20145839
summary:
  title: The Impact of COVID-19 on Adjusted Mortality Risk in Care Homes for Older Adults in Wales, United Kingdom: A retrospective population-based cohort study for mortality in 2016-2020 Aim: To analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4-years. Study Design and Setting: We used anonymised Electronic Health Records (EHRs) and administrative data from the Secure Anonymised Information Linkage (SAIL) Databank to create a cross-sectional cohort study. In this study, we utilise the Secure Anonymised Information Linkage (SAIL) Databank [14] [16] to investigate mortality in care homes in Wales in the initial phase of the UK lockdown, and compare this with corresponding data from the four most recent years to estimate excess mortality. We used anonymised Electronic Health Records (EHRs) and administrative data from the Secure Anonymised Information Linkage (SAIL) Databank to create a cross-sectional cohort study.

title:
  The Impact of COVID-19 on Adjusted Mortality Risk in Care Homes for Older Adults in Wales, United Kingdom: A retrospective population-based cohort study for mortality in 2016-2020

abstract:
  Background: Mortality in care homes has had a prominent focus during the COVID-19 outbreak. Multiple and interconnected challenges face the care home sector in the prevention and management of outbreaks of COVID-19, including adequate supply of personal protective equipment, staff shortages, and insufficient or lack of timely COVID-19 testing. Care homes are particularly vulnerable to infectious diseases. Aim: To analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4-years. Study Design and Setting: We used anonymised Electronic Health Records (EHRs) and administrative data from the Secure Anonymised Information Linkage (SAIL) Databank to create a cross-sectional cohort study. We anonymously linked data for Welsh residents to mortality data up to the 14th June 2020. Methods: We calculated survival curves and adjusted Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of mortality. We adjusted hazard ratios for age, gender, social economic status and prior health conditions. Results: Survival curves show an increased proportion of deaths between 23rd March and 14th June 2020 in care homes for older people, with an adjusted HR of 1.72 (1.55, 1.90) compared to 2016. Compared to the general population in 2016-2019, adjusted care home mortality HRs for older adults rose from 2.15 (2.11,2.20) in 2016-2019 to 2.94 (2.81,3.08) in 2020. Conclusions: The survival curves and increased HRs show a significantly increased risk of death in the 2020 study periods.


id: cord-339300-xherv9wt
author: Suner, C.
date: 2020-11-10
txt: ./txt/cord-339300-xherv9wt.txt
cache: ./cache/cord-339300-xherv9wt.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.11.09.20228171v1?rss=1
doi: 10.1101/2020.11.09.20228171
summary:
  The investigated factors included characteristics of the residents (age, gender, comorbidities, and complexity and/or advanced disease), structural features of the nursing home (total number of residents, residents who return home during the pandemic, and capacity for pandemic response, based on an ad hoc score of availability of twelve essential items for implementing preventive measures), and sociodemographic profile of the catchment district (household income, population density, and population incidence of Covid-19). Interpretation Presence of residents with complex/advance disease, low capacity for pandemic response and location in areas with high incidence of Covid-19 are risk factors for Covid-19 mortality in nursing homes and may help policymakers to prioritize preventative interventions for pandemic containment. We used data from nursing homes, including residents'' health characteristics, structural features, and the demographic and epidemiological profile of the district where the nursing home is located, to investigate the association between potential risk factors at the facility level and mortality in the residential setting during the SARS-CoV-2 outbreak in Spain.

title:
  Risk factors for mortality of residents in nursing homes with Covid-19: a retrospective cohort study

abstract:
  Background Nursing homes have shown remarkably high Covid-19 incidence and mortality. We aimed to explore the contribution of structural factors of nursing home facilities and the surrounding district to all-cause and Covid-19-related deaths during a SARS-CoV-2 outbreak. Methods In this retrospective cohort study, we investigated the risk factors of Covid-19 mortality at the facility level in nursing homes in Catalonia (North-East Spain). The investigated factors included characteristics of the residents (age, gender, comorbidities, and complexity and/or advanced disease), structural features of the nursing home (total number of residents, residents who return home during the pandemic, and capacity for pandemic response, based on an ad hoc score of availability of twelve essential items for implementing preventive measures), and sociodemographic profile of the catchment district (household income, population density, and population incidence of Covid-19). Study endpoints included all-cause death and Covid-19-related death (either PCR-confirmed or clinical suspicion). Findings The analysis included 167 nursing homes that provide long-term care to 8,716 residents. Between March 1 and June 1, 2020, 1,629 deaths were reported in these nursing homes; 1,089 (66,9%) of them were Covid-19-confirmed. The multivariable regression showed a higher risk of death associated with a higher percentage of complex patients (HR 1,09; 95%CI 1,05 to 1,12 per 10% increase) or those with advanced diseases (1,13; 1,07 to 1,19), lower capacity for implementing preventive measures (1,08; 1,05 to 1,10 per 1-point increase), and districts with a higher incidence of Covid-19 (2,98; 2,53 to 3,50 per 1000 cases/100,000 population increase). A higher population density of the catchment area was a protective factor (0,60; 0,50 to 0,72 per log10 people/Km2 increase). Interpretation Presence of residents with complex/advance disease, low capacity for pandemic response and location in areas with high incidence of Covid-19 are risk factors for Covid-19 mortality in nursing homes and may help policymakers to prioritize preventative interventions for pandemic containment.


id: cord-344491-93ggxzxu
author: Husebo, Bettina Sandgathe
date: 2020-06-09
txt: ./txt/cord-344491-93ggxzxu.txt
cache: ./cache/cord-344491-93ggxzxu.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s13063-020-04414-y
doi: 10.1186/s13063-020-04414-y
summary:
  In the COSMOS trial, a randomized implementation hybrid trial carried out in Norwegian nursing homes during 2014-2015, our group successfully developed, implemented and effect evaluated a multicomponent intervention addressing COmmunication, Systematic assessment and treatment of pain, Medication review, Organization of activities and Safety [22] . In practice in the LIVE@Home.Path: the coordinator will encourage and facilitate that both the PWD and the caregiver participate in local educational programs arranged by the municipality or the specialist health services several times yearly. PWDs are eligible for inclusion if they: are aged ≥ 65 years; are home-dwelling; have a minimum 1 h/week regular face-to-face contact with the caregiver; are diagnosed with dementia according to standardized protocol [60] ; have Mini-Mental State Examination (MMSE) score of 15-25; have a Functional Assessment Staging Test (FAST) score of 4-7; and provide written informed consent. A randomized controlled trial of a community-based dementia care coordination intervention: effects of MIND at Home on caregiver outcomes

title:
  LIVE@Home.Path—innovating the clinical pathway for home-dwelling people with dementia and their caregivers: study protocol for a mixed-method, stepped-wedge, randomized controlled trial

abstract:
  BACKGROUND: The global health challenge of dementia is exceptional in size, cost and impact. It is the only top ten cause of death that cannot be prevented, cured or substantially slowed, leaving disease management, caregiver support and service innovation as the main targets for reduction of disease burden. Institutionalization of persons with dementia is common in western countries, despite patients preferring to live longer at home, supported by caregivers. Such complex health challenges warrant multicomponent interventions thoroughly implemented in daily clinical practice. This article describes the rationale, development, feasibility testing and implementation process of the LIVE@Home.Path trial. METHODS: The LIVE@Home.Path trial is a 2-year, multicenter, mixed-method, stepped-wedge randomized controlled trial, aiming to include 315 dyads of home-dwelling people with dementia and their caregivers, recruited from 3 municipalities in Norway. The stepped-wedge randomization implies that all dyads receive the intervention, but the timing is determined by randomization. The control group constitutes the dyads waiting for the intervention. The multicomponent intervention was developed in collaboration with user-representatives, researchers and stakeholders to meet the requirements from the national Dementia Plan 2020. During the 6-month intervention period, the participants will be allocated to a municipal coordinator, the core feature of the intervention, responsible for regular contact with the dyads to facilitate L: Learning, I: Innovation, V: Volunteering and E: Empowerment (LIVE). The primary outcome is resource utilization. This is measured by the Resource Utilization in Dementia (RUD) instrument and the Relative Stress Scale (RSS), reflecting that resource utilization is more than the actual time required for caring but also how burdensome the task is experienced by the caregiver. DISCUSSION: We expect the implementation of LIVE to lead to a pathway for dementia treatment and care which is cost-effective, compared to treatment as usual, and will support high-quality independent living, at home. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04043364. Registered on 15 March 2019.


id: cord-345458-st9fltpy
title: Statewide COVID‐19 Stay‐at‐Home Orders and Population Mobility in the United States
author: Jacobsen, Grant D.
date: 2020-07-29
txt: ./txt/cord-345458-st9fltpy.txt
cache: ./cache/cord-345458-st9fltpy.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1002/wmh3.350
doi: 10.1002/wmh3.350
summary:
  The pandemic led to large decreases in mobility even in states without legal restrictions on travel, but statewide orders were effective public health policy tools for reducing human movement below the level achieved through voluntary behavior change. In the United States, the first coronavirus-related activity restrictions were issued on March 12, 2020, when a community within New Rochelle, New York, was declared to be a "containment area." A traditional quarantine order would require individuals presumed to be exposed to stay at home. The first statewide order in the United States that restricted mobility to reduce the transmission of coronavirus was issued by California''s governor on March 19, 2020, and it required all residents to remain at home except when engaging in essential activities (Friedson, McNichols, Sabia, & Dave, 2020) . The observed differences in statewide mobility patterns provide evidence that stay-at-home orders are effective in reducing population-level movement below the rate that can be achieved by individuals voluntarily changing their behaviors.

abstract:
  Many jurisdictions enacted stay‐at‐home orders (also called shelter‐in‐place orders, safer‐at‐home orders, or lockdowns) when SARS‐CoV‐2 began spreading in the United States. Based on Google mobility data, every state had substantially fewer visits to transit stations, retail and recreation facilities, workplaces, grocery stores, and pharmacies by the end of March 2020 than in the previous two months. The mean decrease in visitation rates across destination categories was about 30 percent in states without stay‐at‐home orders and 40 percent in states with stay‐at‐home orders. Similarly, there were fewer routing requests received by Apple in large cities for public transportation, walking, and driving, with a 10 percentage point greater mean reduction in metropolitan areas under statewide stay‐at‐home orders. The pandemic led to large decreases in mobility even in states without legal restrictions on travel, but statewide orders were effective public health policy tools for reducing human movement below the level achieved through voluntary behavior change.


id: cord-351262-0lyfc564
author: Levin, R.
date: 2020-11-04
txt: ./txt/cord-351262-0lyfc564.txt
cache: ./cache/cord-351262-0lyfc564.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1101/2020.10.31.20223776
doi: 10.1101/2020.10.31.20223776
summary:
  We investigate mobility data collected, aggregated, and anonymized by SafeGraph Inc. which measures how populations at the census block-group geographic scale stayed at home in California, Georgia, Texas, and Washington since the beginning of the pandemic. Using nonlinear dimensionality reduction techniques, we find patterns of mobility behavior that align with stay at-home orders, correlate with socioeconomic factors, cluster geographically, and reveal subpopulations that likely migrated out of urban areas. The SafeGraph stay-at-home data offers insight into the levels and trends of human mobility at the census block group (CBG) geographic scale during the 2020 COVID-19 pandemic in the United States ( Figure 1 ). Nonlinear dimensionality reduction of the time-series data from Washington state revealed a low-dimensional embedding providing insight into the consistency of mobility behavior across CBGs ( Figure 1D .).

title:
  Cell phone mobility data reveals heterogeneity in stay-at-home behavior during the SARS-CoV-2 pandemic

abstract:
  As COVID-19 cases resurge in the United States, understanding the complex interplay between human behavior, disease transmission, and non pharmaceutical interventions during the pandemic could provide valuable insights to focus future public health efforts. Cell-phone mobility data offers a modern measurement instrument to investigate human mobility and behavior at an unprecedented scale. We investigate mobility data collected, aggregated, and anonymized by SafeGraph Inc. which measures how populations at the census block-group geographic scale stayed at home in California, Georgia, Texas, and Washington since the beginning of the pandemic. Using nonlinear dimensionality reduction techniques, we find patterns of mobility behavior that align with stay at-home orders, correlate with socioeconomic factors, cluster geographically, and reveal subpopulations that likely migrated out of urban areas. The analysis and approach provides policy makers a framework for interpreting mobility data and behavior to inform actions aimed at curbing the spread of COVID-19.


id: cord-354704-xgytkcs4
author: Micocci, M.
date: 2020-11-04
txt: ./txt/cord-354704-xgytkcs4.txt
cache: ./cache/cord-354704-xgytkcs4.txt
extension: .txt
mime: text/plain
url: http://medrxiv.org/cgi/content/short/2020.11.02.20224550v1?rss=1
doi: 10.1101/2020.11.02.20224550
summary:
  title: Understanding COVID-19 testing pathways in English care homes to identify the role of point-of-care testing: an interview-based process mapping study Results Four main steps were identified in testing: infection prevention, preparatory steps, swabbing procedure, and management of residents. However, little is known about the most effective way to implement these tests into existing procedures and COVID-19 management in the care home setting. ; https://doi.org/10.1101/2020.11.02.20224550 doi: medRxiv preprint Fig. 1 Overall swabbing and management process of resident in care homes Table 1 Summary of relevant stakeholders, guidance, resources, gaps in the pathway, needs and opportunities for POCT These findings illustrate the complexity of the processes in testing care home residents for COVID-19. Also, consideration needs to be given to how to help care homes staff interpret and respond to POCT results without introducing unacceptable variation in practice and what the role of clinicians in this process would be.

title:
  Understanding COVID-19 testing pathways in English care homes to identify the role of point-of-care testing: an interview-based process mapping study

abstract:
  Introduction Care home residents are at high risk of dying from COVID-19. Regular testing producing rapid and reliable results is important in this population because infections spread quickly and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care tests (POCTs). Methods Ten staff from eight care homes, purposively sampled to reflect care organisational attributes that influence outbreak severity, underwent a semi-structured remote videoconference interview. Transcripts were analysed using process mapping tools and framework analysis focussing on perceptions about, gaps within, and needs arising from, current pathways. Results Four main steps were identified in testing: infection prevention, preparatory steps, swabbing procedure, and management of residents. Infection prevention was particularly challenging for mobile residents with cognitive impairment. Swabbing and preparatory steps were resource-intensive, requiring additional staff resource. Swabbing required flexibility and staff who were familiar to the resident. Frequent approaches to residents were needed to ensure they would participate at a suitable time. After-test management varied between sites. Several homes reported deviating from government guidance to take more cautious approaches, which they perceived to be more robust. Conclusion Swab-based testing is organisationally complex and resource-intensive in care homes. It needs to be flexible to meet the needs of residents and provide care homes with rapid information to support care decisions. POCT could help address gaps but the complexity of the setting means that each technology must be evaluated in context before widespread adoption in care homes.


id: cord-355256-7ksbvisv
author: Sloane, Philip D.
date: 2020-04-30
txt: ./txt/cord-355256-7ksbvisv.txt
cache: ./cache/cord-355256-7ksbvisv.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1525861020303509
doi: 10.1016/j.jamda.2020.04.020
abstract: nan
summary:
  title: Cruise Ships, Nursing Homes and Prisons as COVID-19 Epicenters: A ''Wicked Problem" with Breakthrough Solutions? Each has health care regulations that, while extensive, could not possibly have fully prepared them for COVID-19; instead, in the face of an impending outbreak, rapid, nimble responses were needed, and these have proven hard to initiate and coordinate in all three settings. Nursing homes have been known for years to be an especially hazardous component of the health care system, with high rates of multidrug resistance and multiple problems around infectious disease prevention. 32 The COVID-19 pandemic has exposed a wicked problem for the cruise ship industry, the prison system, and the nursing home industry. However, by virtue of having worked in post-acute and long-term care for over 40 years, I feel prepared to highlight a few issues that need priority attention: physical plant limitations, chronic staffing problems, poor infection control, and limited health care capacity.

title:
  Cruise Ships, Nursing Homes and Prisons as COVID-19 Epicenters: A ‘Wicked Problem” with Breakthrough Solutions?


id: cord-356156-jjdkwalk
title: Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis
author: Moretti, Antimo
date: 2020-08-28
txt: ./txt/cord-356156-jjdkwalk.txt
cache: ./cache/cord-356156-jjdkwalk.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32872321/
doi: 10.3390/ijerph17176284
summary:
  The purpose of this cross-sectional study was to examine the impact of home working on perceived job productivity and satisfaction, work-related stress, and musculoskeletal (MSK) issues. Depending on our data, the home environment seems to be not adequate in the mobile worker population, with an increased risk for mental health and MSK problems, particularly affecting the spine. The aim of this study is to investigate the role of home working on job satisfaction, occupational stress, perceived productivity, and MSK issues. We characterized a population of mobile workers in terms of work-related outcomes, such as perceived productivity and job satisfaction, and onset or changes of previous MSK disorders, particularly LBP and neck pain. Concerning physical health issues related to remote working, increased sedentariness and poor posture due to the use of non-ergonomic equipment in our population seemed to promote the onset of MSK disorders, particularly LBP and neck pain.

abstract:
  Evidence about the characterization of home workers in terms of both work-related outcomes and health issues is lacking. The purpose of this cross-sectional study was to examine the impact of home working on perceived job productivity and satisfaction, work-related stress, and musculoskeletal (MSK) issues. We included 51 mobile workers, collecting data about demographic characteristics, working experience, job productivity, and stress. Job satisfaction was assessed through the Utrecht Work Engagement Scale (UWES), while MSK pain was investigated by the Brief Pain Inventory (BPI) and Fear Avoidance Beliefs Questionnaire (FABQ). Moreover, a home workplace analysis had to be carried out according to current Italian regulations. Participants declared that they were less productive (39.2%) but less stressed (39.2%) and equally satisfied (51%) compared to the time of office working. Regarding MSK disorders, low back pain (LBP) was referred by 41.2% of home workers and neck pain by 23.5% of them. Neck pain worsened in 50% of home workers, while LBP did not exacerbate in 47.6% of cases. Home workers with MSK pain reported a lower job satisfaction. Depending on our data, the home environment seems to be not adequate in the mobile worker population, with an increased risk for mental health and MSK problems, particularly affecting the spine. Addressing these issues can significantly reduce risks for health, thus, improving job productivity and satisfaction and reducing cost.


id: cord-356223-8qn164k5
author: Yu, Hannah J.
date: 2020-08-15
txt: ./txt/cord-356223-8qn164k5.txt
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url: https://api.elsevier.com/content/article/pii/S2468653020303316
doi: 10.1016/j.oret.2020.08.003
summary:
  title: Home Monitoring of Age-Related Macular Degeneration: Real-World Utility of the ForeseeHome Device for Detection of Neovascularization PURPOSE: To evaluate real-world utility of the ForeseeHome monitoring device for the detection of conversion from intermediate age-related macular degeneration (iAMD) to neovascular AMD (nAMD) and compare with results published by the HOME study. In 2014, the HOME study reported beneficial results from a randomized trial using the 122 ForeseeHome device (Notal Vision Ltd, Tel Aviv, Israel) for early detection of 123 conversion to nAMD. 34 The purpose of the current analysis was to determine the compliance of patients For each patient, the eye prescribed, age at first use, length of use, days since last 159 exam, total number of tests, ability to establish baseline, alert number and alert types 160 were collected from the ForeseeHome portal (www.foreseehomeonline.com). Randomized trial of the ForeseeHome 553 monitoring device for early detection of neovascular age-related macular degeneration

title:
  Home Monitoring of Age-Related Macular Degeneration: Real-World Utility of the ForeseeHome Device for Detection of Neovascularization

abstract:
  PURPOSE: To evaluate real-world utility of the ForeseeHome monitoring device for the detection of conversion from intermediate age-related macular degeneration (iAMD) to neovascular AMD (nAMD) and compare with results published by the HOME study. DESIGN: Retrospective analysis of electronic health records. SUBJECTS: Eyes prescribed use of the ForeseeHome device across 4 retinal practices in the USA. METHODS: Usage information was collected from the online ForeseeHome portal for all eyes prescribed. For a pre-determined subset of eyes, additional clinical information was collected through chart review and analyzed for clinical utility. MAIN OUTCOME MEASURES: Outcome measures include frequency and length of use, number of eyes that used the device, established baseline and converted to nAMD, and number of alerts. RESULTS: 775 eyes of 448 patients were prescribed use of the ForeseeHome device. 649 eyes (83.7%) used the device at least once; among this population, 478 (73.7%) established baseline. Patients who established baseline were significantly younger than those who did not establish baseline (p<0.001). Among eyes that established baseline, 126 (26.4%) had an overall inadequate frequency of use (≥2 tests per week), and 250 (52.3%) did not use the device as frequently as instructed by the manufacturer (≥3 tests per week); 112 (24.7%) discontinued use within one year. Over a mean of 20.35 months, 106 patients had 152 alerts, indicating possible conversions to nAMD. Out of the 136 eyes that established baseline among 211 eyes prescribed the device at one clinical site, 52 alerts were recorded, 3 (6.8%) correctly identified conversion to nAMD and 47 (93.2%) represented false-positive alerts. CONCLUSIONS: Compared to the prospective HOME study, utility of the ForeseeHome device in the current analysis of real-world clinical-practice application was limited. A meaningful proportion of eyes never used the device or could not establish baseline. Overall frequency of use was low and continuous usage of the device decreased over time. There is a need for improvement in home monitoring technology for eyes with iAMD at risk of conversion to nAMD.


