Severe Acute Respiratory Syndrome (SARS) not only paralysed economic activities in SARS-affected cities, it also affected sporting activities. SARS was identified in Hong Kong in late February 2003 and the WHO issued a global alert on 12 March, 2003. The incubation period of SARS is usually 4-6 days and patients commonly present with high fever (temperature >38 degrees C), dry cough, chills and rigor, dyspnoea and diarrhoea. Although a specific antiviral agent and vaccines for SARS are not available at the time of writing, a standard treatment protocol for SARS has been developed. The average mortality rate is about 16% in Hong Kong.The coronavirus is a common pathogen for upper respiratory tract infection and is the most probable pathogen for SARS. Transmission methods may, therefore, be similar for both these infections. Transmission is possible when aerosolised viral particles come into contact with the susceptible host's mucous membrane, most commonly the nose, but also the mouth and eyes. With appropriate preventive measures to avoid contact with virus, the probability of infection is minimal. Isolation of those who have had close contact with confirmed or suspected SARS patients and/or who have persistent fever will be the most effective and practical method of avoiding contact. Maintaining personal hygiene and frequent hand washing can also reduce the risk of infection. Using diluted bleach (1 part bleach in 99 parts water) to cleanse training areas and equipment is also recommended. With proper event planning to conform with quarantine measures, special travel arrangements, facility sterilisation and use of venues with good ventilation and filtering systems, sport competition can still proceed.
<p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>Inpatient rehabilitation presents a unique opportunity for smoking interventions, given the typical lengths of stay, the relevance of smoking to the admission diagnosis of many patients, and the occurrence of nicotine withdrawal during the hospital stay.</p><p><strong>Objective: </strong>To evaluate the feasibility of implementing a pharmacist-led version of the Ottawa Model for Smoking Cessation (OMSC) program at a rehabilitation hospital, using the indicators of reach, effectiveness, adoption, and implementation.</p><p><strong>Methods: </strong>A before-and-after pilot study was conducted. Smoking cessation data were collected from 2 cohorts of eligible smokers identified during 4-month periods before (control) and after (intervention) implementation of the OMSC program. Control participants received usual care (i.e., no cessation intervention). Intervention participants received initial in-hospital smoking cessation support (counselling and nicotine replacement therapy), inpatient follow-up during the hospital stay, and 3 months of postdischarge follow-up calls, with all aspects led by hospital pharmacists.</p><p><strong>Results: </strong>Among all patients admitted to participating inpatient rehabilitation units during the 2 study periods, smoking prevalence was 7.8% (127/1626). After exclusions, deaths, and withdrawals, 111 patients were retained for analysis: 55 in the control group and 56 in the intervention group. The overall mean age of participants was 64.9 (standard deviation [SD] 14.3) years, with a mean smoking history of 35.0 (SD 24.8) pack-years. There were no significant differences between groups in terms of baseline characteristics. Self-reported abstinence rates (determined 3 months after discharge) were higher after compared with before implementation of the OMSC program: for continuous abstinence, 16/56 (28.6%) versus 9/55 (16.4%), <strong>_</strong>2 = 4.462, <em>p </em>= 0.035; for 7-day point prevalence abstinence, 21/56 (37.5%) versus 10/55 (18.2%), <strong>_</strong>2 = 6.807, <em>p </em>= 0.009.</p><p><strong>Conclusions: </strong>Implementation of the OMSC program at a large rehabilitation hospital was feasible and led to an increase in 3-month smoking abstinence. This study provides preliminary evidence to support inclusion of smoking interventions as part of inpatient rehabilitation care.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>La réadaptation des patients hospitalisés représente une occasion unique de procéder à des interventions de désaccoutumance du tabac, notamment en raison de la durée habituelle des séjours, du rapport entre le tabagisme et le diagnostic posé à l’admission, et de la survenue du syndrome de sevrage de la nicotine durant le séjour.</p><p><strong>Objectif : </strong>Étudier la possibilité de mettre en oeuvre une version dirigée par des pharmaciens du programme Modèle d’Ottawa pour l’abandon du tabac (MOAT) dans un centre de réadaptation en employant les indicateurs pour la portée, l’efficacité, l’adoption et la mise en oeuvre.</p><p><strong>Méthodes : </strong>Une étude pilote avant-après a été menée. Des données sur la désaccoutumance ont été recueillies auprès de deux cohortes de fumeurs admissibles qui ont été repérés pendant des périodes de quatre mois avant (groupe témoin) et après (groupe expérimental) la mise en oeuvre du programme du MOAT. Les participants du groupe témoin ont reçu les soins habituels (c.-à-d. sans intervention de désaccoutumance). Les participants du groupe expérimental ont reçu un soutien initial à l’hôpital pour la désaccoutumance du tabac (des conseils et un traitement de remplacement de la nicotine), un suivi pendant le séjour à l’hôpital, et des appels de suivi pendant les trois mois suivant le congé, le tout sous la direction de pharmaciens d’hôpitaux.</p><p><strong>Résultats : </strong>Parmi l’ensemble des patients admis dans les unités de réadaptation participantes au cours des deux périodes de l’étude, la prévalence du tabagisme était de 7,8 % (127/1626). Mis à part les exclusions, les décès et les abandons, 111 patients ont été retenus pour l’analyse : 55 dans le groupe témoin et 56 dans le groupe expérimental. L’âge moyen des participants était de 64,9 (écart-type de 14,3) ans et leur antécédent de tabagisme moyen était de 35,0 (écart-type de 24,8) paquets-années. Aucune différence significative n’a été relevée entre les groupes en ce qui touche aux caractéristiques de base. Les taux d’abstinence autodéclarée (déterminée 3 mois après le congé) étaient plus élevés après la mise en oeuvre du programme du MOAT : pour une abstinence continue, 16/56 (28,6 %) contre 9/55 (16,4 %), <strong>_</strong>2 = 4,462, <em>p </em>= 0,035; pour une abstinence ponctuelle de sept jours consécutifs, 21/56 (37,5 %) contre 10/55 (18,2 %), <strong>_</strong>2 = 6,807, <em>p </em>= 0,009.</p><p><strong>Conclusions : </strong>La mise en oeuvre du programme du MOAT dans un important centre de réadaptation a été possible et a mené à une amélioration de l’abstinence du tabac à trois mois. Cette étude donne des résultats préliminaires en appui à l’inclusion d’interventions de désaccoutumance du tabac aux soins de réadaptation de patients hospitalisés.</p>
Despite the limitations associated with cross-sectional, observational data, rates of prescribing of psychotropic medication, apart from antipsychotics, were high. Future research will be performed to assess appropriateness of prescribing and adverse events.
Background: Cancer types eligible for treatment with immune checkpoint inhibitors (ICI) have increased over the past decade thus simultaneously growing the number of patients presenting to emergency departments (ED) with immune mediated toxicities. Objectives: The objective of this study was to ascertain information regarding the knowledge and management of immune checkpoint inhibitor mediated toxicities amongst emergency department physicians. Methods: A multiple-choice questionnaire was developed assessing the understanding of ICI usage and management of immune mediated toxicities, amongst ED physicians in 6 major ED departments in London. Participating clinicians included all levels of trainees and ED physicians. Questionnaires were distributed during weekly ED educational sessions, followed by training on immune-mediated toxicities. Results: Between March 2019 and September 2019, the questionnaire was delivered to 126 participants (80% junior grade, 20% specialist ED consultants). There was no significant association between clinician's seniority and overall score reached on the questionnaire. Amongst all participants, 56, 49, and 36% identified correctly ICIs as the first-line treatment regimen for melanoma, renal cell carcinoma, and non-small cell lung cancer, respectively. Overall, 90% of the participants recognized correctly cisplatin as a chemotherapy agent and 77% pembrolizumab as an ICI agent. Generally, there was a good understanding of chemotherapy related toxicities, however, the participants scored less well on questions relating to ICIs. Ten months following the initial audit and educational intervention, a single site re-audit was performed. The total average correct score was similar pre- and post-intervention (8, 13%, respectively). Conclusions: Knowledge and management of immune mediated toxicities is inferior compared to chemotherapy across physicians working in major ED departments in London. This survey highlights the need for increased education on ICI amongst ED clinicians.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.