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IntroductionPost-COVID-19 complications require simultaneous characterisation and management to plan policy and health system responses. We describe the 12-month experience of the first UK dedicated post-COVID-19 clinical service to include hospitalised and non-hospitalised patients.MethodsIn a single-centre, observational analysis, we report the demographics, symptoms, comorbidities, investigations, treatments, functional recovery, specialist referral and rehabilitation of 1325 individuals assessed at the University College London Hospitals post-COVID-19 service between April 2020 and April 2021, comparing by referral route: posthospitalised (PH), non-hospitalised (NH) and post emergency department (PED). Symptoms associated with poor recovery or inability to return to work full time were assessed using multivariable logistic regression.Results1325 individuals were assessed (PH: 547, 41.3%; PED: 212, 16%; NH: 566, 42.7%). Compared with the PH and PED groups, the NH group were younger (median 44.6 (35.6–52.8) years vs 58.3 (47.0–67.7) years and 48.5 (39.4–55.7) years), more likely to be female (68.2%, 43.0% and 59.9%), less likely to be of ethnic minority (30.9%, 52.7% and 41.0%) or seen later after symptom onset (median (IQR): 194 (118–298) days, 69 (51–111) days and 76 (55–128) days; all p<0.0001). All groups had similar rates of onward specialist referral (NH 18.7%, PH 16.1% and PED 18.9%, p=0.452) and were more likely to require support for breathlessness (23.7%, 5.5% and 15.1%, p<0.001) and fatigue (17.8%, 4.8% and 8.0%, p<0.001). Hospitalised patients had higher rates of pulmonary emboli, persistent lung interstitial abnormalities and other organ impairment. 716 (54.0%) individuals reported <75% optimal health (median 70%, IQR 55%–85%). Less than half of employed individuals could return to work full time at first assessment.ConclusionPost-COVID-19 symptoms were significant in PH and NH patients, with significant ongoing healthcare needs and utilisation. Trials of interventions and patient-centred pathways for diagnostic and treatment approaches are urgently required.

BackgroundOcular myasthenia gravis (oMG), characterised by ptosis and diplopia, may progress to generalised MG (gMG). Thymectomy is established for seropositive gMG, but its role in oMG remains unclear. Robotic-assisted thoracoscopic surgery (RATS) offers minimally invasive advantages, yet outcomes in oMG are understudied. This case series describes the outcomes of seven patients at University College London Hospitals (UCLH) (2019−2025) undergoing robotic thymectomy for oMG.MethodsWe describe seven oMG patients undergoing robotic thymectomy at UCLH (2019−2025), focusing on improvement in daily life using the MG activities of daily living (MG-ADL) score and medication reduction.ResultsPatients showed significant pyridostigmine reduction (mean decrease: 246 mg) and improved MG-ADL scores (mean=4.00 to 0.57) with no major complications. No patients progressed to gMG.ConclusionWe saw robotic thymectomy (RATS) reduce pyridostigmine dependence and improve quality of life (MG-ADL) in the seven oMG patients, with no complications. These cases demonstrated successful cases of RATS as a transformative, minimally invasive option for early MG. While thymectomy may reduce the risk of generalisation, further multicentre studies are needed. Careful patient selection remains critical, but RATS may expand feasibility in oMG.

ObjectiveTo characterise long-term trajectory of recovery in individuals with long covid.DesignProspective cohort.SettingSingle-centre, specialist post-COVID service (London, UK).ParticipantsIndividuals aged ≥18 years with long covid (hospitalised and non-hospitalised) from April 2020 to March 2024.Main outcome measuresRoutine, prospectively collected data on symptoms, quality of life (including Fatigue Assessment Scale (FAS) and EuroQol 5 Dimensions (EQ-5D), return to work status and healthcare utilisation (investigations, outpatient and emergency attendances). The primary outcome was recovery by self-reported >75% of ‘best health’ (EQ-5D Visual Analogue Scale) and was assessed using Cox proportional hazards regression models over 4 years. Linked National Health Service England registry data provided secondary care healthcare utilisation and expenditure.ResultsWe included 3590 individuals (63.3% female, 73.5% non-hospitalised, median age 50.0 years, 71.9% with ≥2 doses of COVID-19 vaccination), who were followed up for a median of 136 (0–346) days since first assessment and 502 (251–825) days since symptom onset. At first assessment, 33.2% of employed individuals were unable to work. Dominant symptoms were fatigue (78.7%), breathlessness (68.1%) and brain fog (53.5%). 33.4% of individuals recovered to >75% of best health prior to clinic discharge (recovery occurred median 202 (94–468) days from symptom onset). Vaccinated individuals were more likely to recover faster (pre: HR 2.93 (2.00–4.28) and post: HR 1.34 (1.05–1.71) COVID-19 infection), whereas recovery hazard was inversely associated with FAS (HR 0.37 (0.33–0.42)), myalgia (HR 0.59 (0.45–0.76)) and dysautonomic symptoms (HR 0.46 (0.34–0.62)). There was high secondary care healthcare utilisation (both emergency and outpatient care). Annual inpatient and outpatient expenditure was significantly lower in hospitalised individuals while under the service. When compared with the prereferral period, emergency department attendances were reduced in non-hospitalised patients with long covid, but outpatient costs increased.ConclusionsIn the largest long covid cohort from a single specialist post-COVID service to date, only one-third of individuals under follow-up achieved satisfactory recovery. Fatigue severity and COVID-19 vaccination at presentation, even after initial COVID-19 infection, was associated with long covid recovery. Ongoing service provision for this and other post-viral conditions is necessary to support care, progress treatment options and provide capacity for future pandemic preparedness. Research and clinical services should emphasise these factors as the strongest predictors of non-recovery.

Background. Most patients have moderate or severe pain after surgery. Opioids are the cornerstone of treating severe pain after surgery but cause problems when continued long after discharge. We investigated the efficacy of multifunction pain management software (MServ) in improving postoperative pain control and reducing opioid prescription at discharge. Methods. We recruited 234 patients to a prospective cohort study into sequential groups in a nonrandomised manner, one day after major thoracic or urological surgery. Group 1 received standard care (SC, n = 102), group 2 were given a multifunctional device that fed back to the nursing staff alone (DN, n = 66), and group 3 were given the same device that fed back to both the nursing staff and the acute pain team (DNPT, n = 66). Patient-reported pain scores at 24 and 48 hours and patient-reported time in severe pain, medications, and satisfaction were recorded on trial discharge. Findings. Odds of having poor pain control (>1 on 0–4 pain scale) were calculated between standard care (SC) and device groups (DN and DNPT). Patients with a device were significantly less likely to have poor pain control at 24 hours (OR 0.45, 95% CI 0.25, 0.81) and to report time in severe pain at 48 hours (OR 0.62, 95% CI 0.47–0.80). Patients with a device were three times less likely to be prescribed strong opioids on discharge (OR 0.35, 95% CI 0.13 to 0.95). Interpretation. Using an mHealth device designed for pain management, rather than standard care, reduced the incidence of poor pain control in the postoperative period and reduced opioid prescription on discharge from hospital.

The purpose of this study was to describe how an accomplished teacher taught second-grade students to design games that integrated movement and mathematics content. The participants were one physical education teacher, a classroom teacher, and an intact class of 20 second-grade students. Qualitative data were gathered through videotaping of all lessons, descriptions of all 20 children's responses to all lesson segments, and interviews with all participants. In keeping with constructivist principles, the teacher used a progression of tasks and multiple instructional techniques to scaffold the design process allowing children to design games that were meaningful to them. Contrary to descriptions of scaffolding fading across a unit, in this study the scaffolding was a function of the interaction between learners' needs and task content. Verf.-Referat.

Dance could be an essential component of the educational program that contributes to learning the psychomotor, cognitive and affective skills related to any physical activity. This article describes how dance could be integrated as a part of the physical education curriculum.

In this letter to the editor of \"Strategies: A Journal for Physical and Sport Educators\", the authors write that they recently read the \"Strategies\" article by Antony Parish, \"Using Immersion as a Teaching Method to Develop an Understanding, Appreciation and Empathy for Special Needs Populations,\" in the May/June 2016 issue. Theresa Cone and Stephen Cone comment that Parish offers one perspective on how simulations were used to evoke understanding of and empathy for individuals with disabilities, but offer an alternative point of view. They argue that although some professionals continue to use simulations for this purpose, there is another perspective that should be considered to gain insight into what life is like for an individual with a disability. They present the perspective that simulations offer a limited experience, where people \"try on\" a disability that focuses on what individuals with disabilities cannot do rather than how successful they are when assistive devices and environmental accommodations provide access to learning, buildings, transportation and communication. The article encourages people to acknowledge what people can do and be advocates for equality, respect and inclusion for individuals with disabilities in all aspects of life. They call upon educators in particular to make informed decisions, read multiple perspectives, and question the effectiveness of simulation experiences. The authors ask that in courses where students learn about disability characteristics, laws, adaptations, accommodations and teaching strategies, that understanding be gained from research, reading current literature in the field, and, most importantly, meaningful and personal interactions with individuals with disabilities.

Dance is a vibrant element of SHAPE America -- Society of Health and Physical Educators, beginning with the organizatiorfs mission statement, where dance is included as one of the essential components. The mission states, SHAPE America's mission is to advance professional practice and promote research related to health and physical education, physical activity, dance, and sport. SHAPE America is now partnering with Zumba Fitness to introduce students across the country to how dance improves coordination, fitness, social interaction and stress reduction This dance craze is popular in physical education programs, community centers, recreations programs and dance studios. As a dance form, it blends dance steps from different cultures with the basic elements of fitness and uses a range of music styles that easily motivate everyone to get up and move.

Background. Pain is commonly experienced following surgical procedures. Suboptimal management is multifactorial. Objectives. The primary objective was to assess whether patients used a device (Navimed) to self-report pain over and above a normal baseline of observations. Secondary outcome measures included comparison of pain scores and patient use of and feedback on the device. Methods. In a prospective randomized controlled trial, elective gynaecological surgery patients received standard postoperative pain care or standard care plus the Navimed, which allowed them to self-report pain and offered interactive self-help options. Results. 52 female patients, 26 in each of device and standard groups, did not differ in the frequency of nurse-documented pain scores or mean pain scores provided to nurses. The device group additionally reported pain on the device (means 18.50 versus 11.90 pain ratings per day, t ( 32 ) = 2.75 , p < 0.001 ) that was significantly worse than reported to nurses but retrospectively rated significantly less anxiety. 80% of patients found the device useful. Discussion and Conclusion. This study demonstrates that patients used the Navimed to report pain and to help manage it. Further work is required to investigate the difference in pain scores reported and to develop more sophisticated software.

Critical-thinking skills, problem solving, memorization, language acquisition, abstract thinking, analysis, and evaluation are critical dance components that also engage students intellectually (Kaufmann, 2006). [...] the octopus is tired and swims back to its home and goes back to sleep. [...] the students look at each picture and practice forming the same pose as each of the athletes.