Advice for journalists covering Covid-19: Welsh NHS confederation

The outbreak of COVID-19 is placing an unprecedented strain on health services in Wales and across the world. At the same time, coverage of the outbreak is essential, and there is a great demand from media organisations and their audiences to receive information about the outbreak and its frontline. This can put additional pressures on health care organisations and staff and may in certain cases interfere with their operations in dealing with the outbreak. This document has been prepared by Professor Karin Wahl-Jorgensen, Cardiff University, to support the work of the Welsh NHS Confederation. It draws on input from leading academics, journalists and PR practitioners (full list of contributors on p. 9). The document provides a number of suggestions for media organisations designed to facilitate coverage in and around healthcare facilities in Wales. The experts involved in preparing this document are independent from the NHS, and the document does not reflect official NHS policy. Here is a summary of our advice: 1. Responsible, detailed, and accurate reporting of COVID-19 is an essential public service. 2. Use credible experts as sources and be wary of unverified rumour 3. News organisations should use pooled materials whenever possible. 4. If looking for information verification, check other sources first before contacting NHS. 5. Ensure compliance with procedures for risk assessment and consent. 6. Enforce social distancing and ensure safe use of equipment. 7. Ensure risk assessments have been carried out prior to hospital visits and face-toface interactions with NHS staff. 8. Obtain consent from anyone interviewed or filmed. 9. When making requests for interviews or information, be specific about who you need to speak to, and where, what and how the information will be used

Conservative versus interventional treatment for spontaneous pneumothorax

BACKGROUND: Whether conservative management is an acceptable alternative to interventional management for uncomplicated, moderate-to-large primary spontaneous pneumothorax is unknown. METHODS: In this open-label, multicenter, noninferiority trial, we recruited patients 14 to 50 years of age with a first-known, unilateral, moderate-to-large primary spontaneous pneumothorax. Patients were randomly assigned to immediate interventional management of the pneumothorax (intervention group) or a conservative observational approach (conservative-management group) and were followed for 12 months. The primary outcome was lung reexpansion within 8 weeks. RESULTS: A total of 316 patients underwent randomization (154 patients to the intervention group and 162 to the conservative-management group). In the conservative-management group, 25 patients (15.4%) underwent interventions to manage the pneumothorax, for reasons prespecified in the protocol, and 137 (84.6%) did not undergo interventions. In a complete-case analysis in which data were not available for 23 patients in the intervention group and 37 in the conservative-management group, reexpansion within 8 weeks occurred in 129 of 131 patients (98.5%) with interventional management and in 118 of 125 (94.4%) with conservative management (risk difference, -4.1 percentage points; 95% confidence interval [CI], -8.6 to 0.5; P = 0.02 for noninferiority); the lower boundary of the 95% confidence interval was within the prespecified noninferiority margin of -9 percentage points. In a sensitivity analysis in which all missing data after 56 days were imputed as treatment failure (with reexpansion in 129 of 138 patients [93.5%] in the intervention group and in 118 of 143 [82.5%] in the conservative-management group), the risk difference of -11.0 percentage points (95% CI, -18.4 to -3.5) was outside the prespecified noninferiority margin. Conservative management resulted in a lower risk of serious adverse events or pneumothorax recurrence than interventional management. CONCLUSIONS: Although the primary outcome was not statistically robust to conservative assumptions about missing data, the trial provides modest evidence that conservative management of primary spontaneous pneumothorax was noninferior to interventional management, with a lower risk of serious adverse events. (Funded by the Emergency Medicine Foundation and others; PSP Australian New Zealand Clinical Trials Registry number, ACTRN12611000184976.)

Expressions 1980

Expressions contains selected work from the 1980 Creative Writing Contest winners and honorable mentions, Campus Chronicle Photography Contest entrants, and the Commercial Art students at Des Moines Area Community College. Design, typography and layout was done by Journalism students.https://openspace.dmacc.edu/expressions/1002/thumbnail.jp

Advice for journalists covering Covid-19: Welsh NHS confederation

The outbreak of COVID-19 is placing an unprecedented strain on health services in Wales and across the world. At the same time, coverage of the outbreak is essential, and there is a great demand from media organisations and their audiences to receive information about the outbreak and its frontline. This can put additional pressures on health care organisations and staff and may in certain cases interfere with their operations in dealing with the outbreak. This document has been prepared by Professor Karin Wahl-Jorgensen, Cardiff University, to support the work of the Welsh NHS Confederation. It draws on input from leading academics, journalists and PR practitioners (full list of contributors on p. 9). The document provides a number of suggestions for media organisations designed to facilitate coverage in and around healthcare facilities in Wales. The experts involved in preparing this document are independent from the NHS, and the document does not reflect official NHS policy. Here is a summary of our advice: 1. Responsible, detailed, and accurate reporting of COVID-19 is an essential public service. 2. Use credible experts as sources and be wary of unverified rumour 3. News organisations should use pooled materials whenever possible. 4. If looking for information verification, check other sources first before contacting NHS. 5. Ensure compliance with procedures for risk assessment and consent. 6. Enforce social distancing and ensure safe use of equipment. 7. Ensure risk assessments have been carried out prior to hospital visits and face-toface interactions with NHS staff. 8. Obtain consent from anyone interviewed or filmed. 9. When making requests for interviews or information, be specific about who you need to speak to, and where, what and how the information will be used

COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records

BACKGROUND: Updatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, we aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework. METHODS: In this cohort study, we used eight linked National Health Service (NHS) datasets for people in England alive on Jan 23, 2020. Data on COVID-19 testing, vaccination, primary and secondary care records, and death registrations were collected until Nov 30, 2021. We defined ten COVID-19 phenotypes reflecting clinically relevant stages of disease severity and encompassing five categories: positive SARS-CoV-2 test, primary care diagnosis, hospital admission, ventilation modality (four phenotypes), and death (three phenotypes). We constructed patient trajectories illustrating transition frequency and duration between phenotypes. Analyses were stratified by pandemic waves and vaccination status. FINDINGS: Among 57 032 174 individuals included in the cohort, 13 990 423 COVID-19 events were identified in 7 244 925 individuals, equating to an infection rate of 12·7% during the study period. Of 7 244 925 individuals, 460 737 (6·4%) were admitted to hospital and 158 020 (2·2%) died. Of 460 737 individuals who were admitted to hospital, 48 847 (10·6%) were admitted to the intensive care unit (ICU), 69 090 (15·0%) received non-invasive ventilation, and 25 928 (5·6%) received invasive ventilation. Among 384 135 patients who were admitted to hospital but did not require ventilation, mortality was higher in wave 1 (23 485 [30·4%] of 77 202 patients) than wave 2 (44 220 [23·1%] of 191 528 patients), but remained unchanged for patients admitted to the ICU. Mortality was highest among patients who received ventilatory support outside of the ICU in wave 1 (2569 [50·7%] of 5063 patients). 15 486 (9·8%) of 158 020 COVID-19-related deaths occurred within 28 days of the first COVID-19 event without a COVID-19 diagnoses on the death certificate. 10 884 (6·9%) of 158 020 deaths were identified exclusively from mortality data with no previous COVID-19 phenotype recorded. We observed longer patient trajectories in wave 2 than wave 1. INTERPRETATION: Our analyses illustrate the wide spectrum of disease trajectories as shown by differences in incidence, survival, and clinical pathways. We have provided a modular analytical framework that can be used to monitor the impact of the pandemic and generate evidence of clinical and policy relevance using multiple EHR sources. FUNDING: British Heart Foundation Data Science Centre, led by Health Data Research UK

Advice for journalists covering Covid-19:Welsh NHS confederation

The outbreak of COVID-19 is placing an unprecedented strain on health services in Wales and across the world. At the same time, coverage of the outbreak is essential, and there is a great demand from media organisations and their audiences to receive information about the outbreak and its frontline. This can put additional pressures on health care organisations and staff and may in certain cases interfere with their operations in dealing with the outbreak. This document has been prepared by Professor Karin Wahl-Jorgensen, Cardiff University, to support the work of the Welsh NHS Confederation. It draws on input from leading academics, journalists and PR practitioners (full list of contributors on p. 9). The document provides a number of suggestions for media organisations designed to facilitate coverage in and around healthcare facilities in Wales. The experts involved in preparing this document are independent from the NHS, and the document does not reflect official NHS policy. Here is a summary of our advice: 1. Responsible, detailed, and accurate reporting of COVID-19 is an essential public service. 2. Use credible experts as sources and be wary of unverified rumour 3. News organisations should use pooled materials whenever possible. 4. If looking for information verification, check other sources first before contacting NHS. 5. Ensure compliance with procedures for risk assessment and consent. 6. Enforce social distancing and ensure safe use of equipment. 7. Ensure risk assessments have been carried out prior to hospital visits and face-to-face interactions with NHS staff. 8. Obtain consent from anyone interviewed or filmed. 9. When making requests for interviews or information, be specific about who you need to speak to, and where, what and how the information will be used

Distributive justice in northern Mexico and the U. S.: A cross-cultural comparison.

A comparison of distributive justice strategies was made between a collectivistic culture, i.e., Mexico, and an individualistic culture, i.e., the United States. This study is the first to include the effect of ingroup/outgroup on the distribution strategies as Fischer and Smith (2003) called for in their extensive meta-analysis of the topic. Distributive justice was operationalized as the monetary rewards given by Northern Mexicans and American in sixteen different allocation vignettes. The results showed that the two groups were significantly different in only one of the allocation vignettes. These results indicate a convergence between the cultures of the northern maquiladora region of Mexico and of the United States. Northern Mexicans and Americans were not significantly different in their distributive justice strategies