Browsing by Author "Kellner, James D."
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- ItemOpen AccessDevelopment and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion(2024-02-25) Doucette, Emily J.; Fullerton, Madison M.; Pateman, Margaret; Lip, Alyssa; Houle, Sherilyn K.; Kellner, James D.; Leal, Jenine; MacDonald, Shannon E.; McNeil, Deborah; Tyerman, Jane; Luctkar-Flude, Marian; Davidson, Sandra; Constantinescu, CoraAbstract Background Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs’ effectiveness using a pre-post self-assessment pilot study. Methods A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy. Results There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4–5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education. Conclusions Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.
- ItemOpen AccessImpacts of the SARS-CoV-2 pandemic on the seasonal pattern of hospitalizations for acute respiratory diseases among children in Alberta, Canada(2024) Lukac, Christine D; Simms, Brett; Kwong, Grace P.S.; Holodinsky, Jessalyn K.; Johnson, David W.; Kellner, James D.Introduction: Acute infectious respiratory diseases (ARD) among children generally have a biennial pattern – peak incidence is highest every other winter. This seasonal pattern of ARD was interrupted in 2020 by SARS-CoV-2 and non-pharmaceutical interventions (NPI). We conducted a population based retrospective cohort study in Alberta, that measured the impact on (i) the weekly incidence of hospitalizations to quantify healthcare use, (ii) the weekly percent of PICU admissions to monitor clinical severity, and (iii) the weekly average age at discharge to characterise the affected population. Methods: From Apr 2003-Dec 2023, all hospital discharges and PICU admissions for ARD (i.e. bronchiolitis, pneumonia, influenza-like-illness, and croup) among children < 18 years old were identified in the provincial hospital Discharge Abstract Database. Weekly incidence of hospital discharge was calculated using population denominators. Weekly percent PICU admissions was calculated using all hospital discharges as the denominator. Weekly average age at discharge was calculated from birth to discharge in months. Seasonal autoregressive-integrated-moving-average (SARIMA) models predicted the expected weekly outcomes from Apr 2020 onward. Incidence ratios and percent change compared observed versus expected outcomes. Analyses were conducted in R version 4.2.2 (2022-10-31) and R studio build 2022.12.0+353. Results: There were 63,776 hospitalizations for ARD among children from Apr 2003-Dec 2023: 22,963 (36.01%) for bronchiolitis, 23,977 (37.44%) for pneumonia, 10,833 (16.97%) for influenza-like-illness, and 4,984 (7.81%) for croup. Of the hospitalizations, 4,167 (6.53%) included a PICU admission. The average weekly incidence of hospitalization for ARD per 100,000 children decreased 12.71-fold during Dec 2020-Feb 2021 (0.82 observed vs. 10.42 [95%CI 5.11, 15.73] expected) and increased 1.51-fold during Dec 2022-Feb 2023 (16.28 observed vs. 10.77 [95%CI 4.71, 16.83] expected). The average percentage of PICU admissions steadily increased from 4.07% (95%CI 1.22%, 6.91%) in Dec 2003-Feb 2004 to 10.48% (95%CI 8.36%, 12.60%) in Dec 2019-Feb 2020. There was no significant change in the percentage of PICU admissions in Dec 2020-Feb 2021 and Dec 2022-Feb 2023, 11.17% (95%CI 0.00%, 26.32%) and 11.86% (95%CI 9.33%, 14.39%) respectively. During each winter season, the average age at discharge decreased to 25 months (95%CI 17.85, 33.74) annually. Similar patterns for incidence of hospitalizations, percent PICU admissions, and average age at discharge were observed for bronchiolitis, pneumonia, influenza-like-illness, and croup. Discussion: SARS-CoV-2 and NPI had significant impacts on provincial hospitalization for ARD among children. Initially hospitalizations for ARD decreased 12.71-fold during Dec 2020-Feb 2021. With SARS-CoV-2 vaccine availability, increased population immunity, and relaxation of NPI, hospitalizations for ARD increased 1.51-fold during Dec 2022-Feb 2023. However, there was no change in clinical severity based on percent PICU admissions, and no change in affected population based on average age at discharge.
- ItemOpen AccessStreptococcus pneumoniae meningitis in Alberta pre- and postintroduction of the 7-valent pneumococcal conjugate vaccine(2011-01-01) Johnstone, Jennie; Tyrrell, Gregory J.; Marrie, Thomas J.; Garg, Sipi; Kellner, James D.; the Streptococcus pneumoniae Alberta Team (SPAT) group,The objective of this study was to describe the epidemiology, clinical characteristics, microbiology and outcomes of patients of all ages with Streptococcus pneumoniae meningitis between 2000 and 2004; two years pre- and postintroduction of an S pneumoniae 7-valent conjugate vaccine program in Alberta in children younger than two years of age. The high mortality rate associated with S pneumoniae meningitis, despite appropriate therapy, suggests that prevention of S pneumoniae meningitis is critical. Despite implementation of a PCV-7 program in Alberta, rates of S pneumoniae meningitis in children younger than two years of age is still high. Thus, continued research into safe and efficacious vaccines covering a broader range of S pneumoniae serotypes is necessary.OBJECTIVE: To describe the epidemiology, clinical characteristics, microbiology and outcomes of patients of all ages with Streptococcus pneumoniae meningitis two years pre- and postintroduction of a S pneumoniae 7-valent conjugate vaccine program in Alberta in children ud_less_than2 years of age.METHODS: Between 2000 and 2004, all cases of invasive pneumococcal disease in Alberta were identified. From this cohort, patients with S pneumoniae meningitis were identified by chart review. Clinical data, laboratory data and in-hospital outcomes were collected.RESULTS: Of the 1768 cases of invasive pneumococcal disease identified between 2000 and 2004, 110 (6.2%) had S pneumoniae meningitis. The overall incidence was 0.7 per 100,000 persons and remained unchanged over the study period. The rate in children ud_less_than2 years of age appeared to fall over time, from 10.5 per 100,000 persons in 2000 to five per 100,000 persons in 2004, although there was insufficient evidence of a statistically significant time trend within any age group. Overall, the mean age was 30 years and 47% were male. In-hospital mortality was 20%, ranging from 6% in those ≤2 years of age to 31% for those ≥18 years of age, despite appropriate antimicrobial therapy.CONCLUSION: The high mortality rate associated with S pneumoniae meningitis suggests that prevention by vaccination is critical. In children ud_less_than2 years of age, there was a downward trend in the rate of S pneumoniae meningitis after implementation of the S pneumoniae 7-valent conjugate vaccine program, but rates were still high.