The Experiences and Challenges Faced by COVID-19 Family Survivors: A Phenomenological Study of Mothers' Perspectives.

Due to the outbreak of COVID-19 many families experience the threat of the COVID-19. This study aims to explore the lived experiences, challenges, and coping mechanisms of COVID-19 Family Survivors. The study employed the Interpretative Phenomenological Analysis with ten (10) participants. Based on the findings, the following conclusions were drawn: (1) Most of the participants consulted health professionals for their medications and advised herbal medicines in boosting their immune system. (2) Family survivors had to make adaptations to their daily routines and established stringent health standards in their homes, such as separating the parents' and children's rooms, using disposable utensils, and ensuring that every surface of their homes was clean. (3) They were able to meet their necessities due to the generosity of their neighbors. These people were helped financially by their employers, neighbors, churchmates, and loved ones. Similarly, the government offered a different forum for the COVID-19 Family survivors to receive help and assistance. (4) Despite the hardships they faced, COVID-19 family survivors did not lose hope that they would be cured of COVID-19. These people tried their hardest to maintain their health by eating good meals, sleeping early, obtaining enough sunlight in the morning, and carefully selecting the vitamins they took. (5) Finally, despite the difficult battle against COVID19, these individuals grew resilient by building their spiritual lives, exercising their faith, and being brave for the sake of their loved ones

Post-acute COVID-19 outcomes including participant-reported long COVID: amubarvimab/romlusevimab versus placebo in the ACTIV-2 trial

BackgroundIt is unknown if early COVID-19 monoclonal antibody (mAb) therapy can reduce risk of Long COVID. The mAbs amubarvimab/romlusevimab were previously demonstrated to reduce risk of hospitalization/death by 79%. This study assessed the impact of amubarvimab/romlusevimab on late outcomes, including Long COVID.MethodsNon-hospitalized high-risk adults within 10 days of COVID-19 symptom onset enrolled in a randomized, double-blind, placebo-controlled phase 2/3 trial of amubarvimab/romlusevimab for COVID-19 treatment. Late symptoms, assessed using a participant-completed symptom diary, were a pre-specified exploratory endpoint. The primary outcome for this analysis was the composite of Long COVID by participant self-report (presence of COVID-19 symptoms as recorded in the diary at week 36) or hospitalization or death by week 36. Inverse probability weighting (IPW) was used to address incomplete outcome ascertainment, giving weighted risk ratios (wRR) comparing amubarvimab/romlusevimab to placebo.FindingsParticipants received amubarvimab/romlusevimab (n = 390) or placebo (n = 390) between January and July 2021. Median age was 49 years, 52% were female, 18% Black/African American, 49% Hispanic/Latino, and 9% COVID-19-vaccinated at entry. At week 36, 103 (13%) had incomplete outcome ascertainment, and 66 (17%) on amubarvimab/romlusevimab and 92 (24%) on placebo met the primary outcome (wRR = 0.70, 95% confidence interval (CI) 0.53-0.93). The difference was driven by fewer hospitalizations/deaths with amubarvimab/romlusevimab (4%) than placebo (13%). Among 652 participants with available diary responses, 53 (16%) on amubarvimab/romlusevimab and 44 (14%) on placebo reported presence of Long COVID.InterpretationAmubarvimab/romlusevimab treatment, while highly effective in preventing hospitalizations/deaths, did not reduce risk of Long COVID. Additional interventions are needed to prevent Long COVID.FundingNational Institute of Allergy and Infectious Diseases of the National Institutes of Health. Amubarvimab and romlusevimab supplied by Brii Biosciences

MYUZ

INTRODUCTION One of the first things we agreed to as an editorial staff was that our university???s literary journal needed an updated title. There was nothing inherently wrong with the name Island Fox, per se, but we preferred something that might better demonstrate the joie de vivre of writing. After batting about a few names, we settled on MYUZ ??? a nod of appreciation to the nine daughters of Zeus ??? the Greek goddesses of artistic inspiration. A muse is something (or someone) every writer needs ??? an inspirational influence to whisper in their ear, to help lift their words and voice above the mundane.\ud During this past year, newspapers, television, and internet blogs have been filled with bad news ??? some of it terrifying. Here in Ventura County we were jolted by the huge loss of life in the Chatsworth Metrolink crash ??? the worst train accident in California history. We have decided to open our journal this year\ud with a non-fiction piece by Joshua Bauer that deals with this tragedy. Bauer begins his first person narrative with a group of friends getting together for a few games of bowling. The Metrolink disaster, which had happened just two days before, is not really on their radar. The story takes a dramatic turn when Katie, a young woman who had been quiet all evening, suddenly reveals the news that a friend of theirs from high school was one of the Metrolink victims. Another short story you???ll be sure to want to check out is Bishara, Avi, Always, Kristi Kellog???s narrative of what happens when a conservative Hindu boy meets a worldly Indian girl hell-bent on winning a major beauty contest. Poetry is well represented in this year???s journal, making up about one-half of the entries. Adam Piccirilli electrifies us with his love poem Arc Eyes, Sara Parker introduces us to the horrors of nursing home life in A Part of Adulthood I???d Rather Avoid, and Krista Wilbur, last year???s managing editor, takes us into the dark, blood-stained alleys of poesie noir with Kaleidoscope. Current events were popular with our submitters this year; Sara Parker comes through again, delivering a sarcastic political elbow-punch with Hooray For Proposition 8, Chris O???Neal tells us the advantages of pet ownership during a recessionary economy in Do Rabbits Dream of Electric People, and Sean Colletti???s esoteric Now Serving Number 44 will have you puzzling over its meaning. Look closely ??? the clues are there.\ud Our editorial committee offers up their own contributions, of course. MYUZ???s mamma capa, Kellie Griffin, brings us into the lives of two young friends on their way to a blood test in Transposition, Julie Fontes shows us what can happen when you meet up with your past at a downtown club in And Hearts, and Guy MacLaury illustrates the perils of beachcombing after dark in Jamaica with A Walk on the Seven Mile Beach. In addition,\ud Luis Maranan takes us into the gravity-prone forest of One Hundred Hills, there???s the aforementioned reflective non-fiction short story from Joshua Bauer ??? Spared ??? and George Morgan squeezes in a few pages with a story about cul-de-sac culture, helicopters, and Polynesian cannabis in Where the Road Ends. We broke some new ground this year, using technology in innovative ways. This is the first time the CSUCI literary journal has been published by an online publishing company: lulu.com. This will allow copies of MYUZ to be available in perpetuity. All in all we believe our readers will enjoy the writing in this year???s campus journal. It???s been a pleasure putting it together. If you have any comments, or ideas to improve the next one, please write to us at [email protected]. The MYUZ Committe

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used