The https:// ensures that you are connecting to the Impact of COVID-19 pandemic on mental health in the general population: a systematic review. This study reports worsened sleep in patients at CARD; previous research found patients with ADHD and ASD to report high rates of delays in bedtime, decreased sleep duration and increased sleep disorders (18). Front Neurol. For patients seen in multiple clinics or multiple times, the first survey answers were analyzed. There was a 0.998 cumulative decrease in reports of worsening behavior with each increase in age by month (Table2). Festivals and Other Multi-Day Large Gatherings: COVID-19 Planning Toolkit for Health Departments. The statistical model correctly classified 88.3% of the sample, 2 (14, N=1644)=24.8, p=0.037). Pandemic intake questionnaires were accompanied by text (Supplementary Appendix A) which explained to parents that providers would use the data to inform their care at their upcoming visit, and that de-identified information collected could be analyzed. Providers reported that this process helped identify additional patient concerns specifically with social interactions and school services. Frequently Asked Questions. The Neurology clinic sees patients diagnosed with brain injury, leukodystrophies, Rett syndrome, stroke and epilepsy. The impact of the novel coronavirus disease 2019 on therapy service delivery for children with disabilities. Kennedy Krieger has one of the only clinics in the country that treats children and young adults dealing with what's known as "long COVID," when some suffer from symptoms long after the initial infection. For testing inquiries or results, please contact your health care provider. The Center of Disease Control determined that patients with neurological conditions are high-risk and more susceptible to severe complications, when infected with COVID-19 (4). Uttar Pradesh. OASAS HOPEline: New York State's 24/7 problem gambling and chemical dependency hotline. Clinic type was a significant predictor; guardians of CARD patients (22%) were 2.2 times more likely to report worsening sleep compared to CDL patients (12%). For General Inquiries. We successfully implemented a pre-visit Pandemic Intake questionnaire to quickly and systematically inform provider awareness of COVID-19 related patient concerns; the majority of program directors reported that this information helped them provide optimal care. Virtual learning, increase stress, and altered routines impacted the sleep and appetite patterns of children during the pandemic (17). The statistical model was significant and correctly categorized 96% of patients, 2 (14, N=1,644)=43.7, p<0.001). TOP. Comparison of more medically and less medically complicated clinics by pandemic questionnaire item. Comparison of more medically and less medically complicated clinics by pandemic questionnaire item. Have had close contact with someone with confirmed COVID-19 or COVID-19 symptoms. Clinicians viewed the completed questionnaire before or during the visit and addressed COVID-related concerns during the appointment. Kennedy Krieger Institute offers COVID-19 testing at its schools, Video Series: Off the Record with Sloane Brown, Off the Record with Sloane Brown: Jack Mitchell, Mitchell-Wiedefeld Funeral Home, YOUR CALIFORNIA PRIVACY RIGHTS/PRIVACY POLICY, Elliott Schreur | Md. Our focus is on the safety and health of all who come to Kennedy Krieger. (2020) 95(9):e1257e66. During the pandemic, results identified several major areas of impact, including patient populations at increased risk for behavioral changes, sleep and/or disruptions of medical care. Our inpatient hospital continues to serve patients and is working hard to ensure the continued safety of our patients, families and staff members. For questions related to the COVID-19 pandemic 1-833-431-2053 Monday, Wednesday, and Friday: 9 a.m. to 5 p.m. . In the medically more complicated clinics (Table3), patients were more likely to be treated with several medications simultaneously, have been hospitalized for seizures, surgeries, and other medical issues, and were more likely to be dependent on medical equipment such as wheelchairs, ventilators, and pumps. Impact of the COVID-19 pandemic on the well-being of children with neurodevelopmental disabilities and their parents, Scoping review of prevalence of neurologic comorbidities in patients hospitalized for COVID-19. Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic. A 24x7 control room has also been established for any query related . The Kennedy Krieger Institute approaches neurodevelopmental disorders through a multi-professional treatment lens, allowing for expansive integration of changes and improvements in the quality of care. Copyright 2021 Scripps Media, Inc. All rights reserved. The mean age was 9.5 years (range 021.6 years); 1,119 (68.1%) were males and 524 (31.9%) were female. Please send an email to KYcovid19@ky.gov Clean frequently touched surfaces and objects daily. Children ages 5-11 are not currently eligible for . What is coefficient alpha? Disruptions in their home and school routines, and restrictions accessing crucial healthcare services has had a significant impact. Covid . Get your seasonal flu vaccine. 7 Articles, This article is part of the Research Topic, https://doi.org/10.3389/fresc.2022.934558, https://www.frontiersin.org/articles/10.3389/fresc.2022.934558/full#supplementary-material, Creative Commons Attribution License (CC BY). Why does COVID-19 affect patients with spinal cord injury milder? DOH launched the DOH COVID-19 emergency hotlines 02-894-COVID (02-894-26843) and 1555 in partnership with the National Emergency Hotline of the Department of Interior and Local Government (DILG), and PLDT and its wireless subsidiary Smart Communications Inc. Callers can ask questions if they suspect they are . Guardians of patients from more medically complicated clinics were significantly more likely to report perceived increased risk of contracting COVID-19, and the inability to access surgeries and therapies. Table 4. Please check the specific event notice in this section of the Web site to confirm the status of the meeting or event in which you are interested or registered to attend. 3 Arundel Pediatrics, Arnold, MD, United States. Reports for difficulty in accessing surgeries decreased over time. Pandemic intake questionnaires were accompanied by text (Supplementary Appendix A) which explained to parents that providers would use the data to inform their care at their upcoming visit, and that de-identified information collected could be analyzed. View more interviews in the video archive. SWS, sturge weber syndrome; CARD, center for autism and related disorders; other, metabolism, epigenetics, sickle cell clinic. The clinics noted as medically more complicated include: Neurogenetics, Neurology, Spinal Cord Injury, Sturge-Weber syndrome, Epigenetics, Metabolism and the Sickle Cell clinic. No formal analysis to attempt to demonstrate these differences was done. (2021) 27(8):87480. Contact Us. Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. Returning the questionnaire was voluntary and not required for the visit. Analysis included responses from 1643 guardians of pediatric patients (mean age 9.5 years, range 021.6 years). Responses were analyzed in relation to sex, age, race/ethnicity and clinic. 111 online will not give you a diagnosis, but we will direct you to the best place to get help for your symptoms. The statistical model correctly classified 95% of the sample, 2 (14, N=1,627)=28.2, p=0.013). Herman C, Mayer K, Sarwal A. Scoping review of prevalence of neurologic comorbidities in patients hospitalized for COVID-19. This project included 10 clinical programs, led by seven clinician program leaders, including the Center for Development and Learning (CDL), the Center for Autism and Related Disorders (CARD), Tourette's syndrome clinic, Neurogenetics, Neurology, Metabolism clinic, Epigenetics, Sturge-Weber syndrome clinic, Sickle Cell disease clinic, and the Center for Spinal Cord Injury. If you are planning an onsite or virtual conference, please contact ConferenceReservations@KennedyKrieger.org as soon as possible to start the process of requesting a new event. By: Daily Record Staff The statistical model correctly classified 88.3% of the sample, 2 (14, N=1644)=24.8, p=0.037). The clinic offers a sensory friendly environment with minimal sights and sounds and a team of professionals on site to help calm fears of vaccination. doi: 10.1089/tmj.2020.0525, 8. Get the Latest from the CDC. Help job seekers learn about the company by being objective and to the point. This toolkit aims to help health departments prevent the spread of COVID-19 at multi-day events that are expected to draw large numbers of people. Aggression, hypersensitivity and behavioral problems are issues in patients with autism spectrum disorder. Sze S, Pan D, Nevill CR, Gray LJ, Martin CA, Nazareth J, et al. PV drafted the manuscript. Track your flight by Flight Number or by Departure and Arrival Airports Clinic type, age and race were significant predictors; sex was not. If you need to speak to someone about NHS Test and Trace (including testing for COVID-19 and test results), booking or amending a vaccination appointment, or the NHS COVID Pass, please call 119. You can contact us by: Telephone: 0300 311 22 33. West Bengal. J Appl Psychol. Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. This project included 10 clinical programs, led by seven clinician program leaders, including the Center for Development and Learning (CDL), the Center for Autism and Related Disorders (CARD), Tourette's syndrome clinic, Neurogenetics, Neurology, Metabolism clinic, Epigenetics, Sturge-Weber syndrome clinic, Sickle Cell disease clinic, and the Center for Spinal Cord Injury. This study suggests that patients from the Sturge-Weber clinic and patients that were Black had higher reports of worsening appetite. Twenty percent (n=322) reported a worsening in their child's mood during the pandemic; (model correctly classified 80.2% of the sample, 2 (14, N=1627)=43.2, p<0.001). Written informed consent from the participants legal guardian/next of kin was not required to participate in this study in accordance with the national legislation and the institutional requirements. 0381-2315879. Careers, Unable to load your collection due to an error. Figure 2. Providers addressed this concern by making referrals to other clinics. Measures implemented by program directors to address COVID-19 concerns brought up in the pandemic intake questionnaire. National coronavirus helpline. Odds ratios of significant predictors of pandemic intake Questionnaire responses. This poses an issue for patients struggling to access telehealth services (6), specifically patients from underserved populations (7). If you would like to request an accommodation for a person with a disability related to the Center's COVID Safety Plan, please contact the Office of Accessibility in advance of your visit at 202-416-8727 or access@kennedy-center.org . Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. A case-control study: results from two observational cohorts. This work was supported by funding provided by the Orokawa Foundation. MDH COVID-19 Public Hotline. Some people don't finish that. 13. Share by Facebook. 8884219457 (8884C19HLP) Under the federal Families First Coronavirus Response Act (FFCRA), the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA), and the Coronavirus Aid, Relief, and . A significant main effect for time (early vs. later pandemic) was only observed in the ability to access surgeries over time (p=0.027); more respondents reported difficulty accessing surgeries between May and August (39.4%) than between September and December (13.6%). (2020) 13(3):100942. doi: 10.1016/j.dhjo.2020.100942, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. The inability of these patients to understand complex situations presents challenges with mood and behavior (5). Most people can manage COVID-19 at home with support from their GP. The late senator's son discussed his skepticism about the safety and efficacy of COVID-19 vaccines, called Dr. Fauci "an abject failure," and shared the vaccine advice he'd give his mother. Clinic type was a significant predictor; age, sex, and race were not. Background: The COVID-19 pandemic uniquely affects patients with neurologic and developmental disabilities at the Kennedy Krieger Institute. It is now doing 1,200 TeleHealth sessions a day. Uncover why Kennedy Krieger is the best company for you. Questions asked guardians to identify a worsening, improvement, or no change in quality of life due to the COVID-19 pandemic. Why does COVID-19 affect patients with spinal cord injury milder? Turk MA, Landes SD, Formica MK, Goss KD. Comorbidities are risk factors for hospitalization and serious COVID-19 illness in children and adults with sickle cell disease. The clinics noted as medically more complicated include: Neurogenetics, Neurology, Spinal Cord Injury, Sturge-Weber syndrome, Epigenetics, Metabolism and the Sickle Cell clinic. The implementation the Pandemic Intake survey facilitated the exchange of information and ideas, to benefit both patients and providers, and can be adapted to be used as a model for future pandemics at similar institutions. (2021) 11(3):e045343. Share by Email. The Kennedy Krieger Institute is planning an expansion of its pediatric long Covid-19 clinic thanks to an influx of federal funding. A total of 3,153 questionnaires were returned with a 33.6% response rate (N=1,643; see Table1). They face significant disruptions to home and school routines, that can cause further declines in health outcomes, and limitations in accessing necessary healthcare and educational services (2, 3), which can further exacerbate their neurodevelopmental impairments. . Robert F. Kennedy Jr. has risen to become a major figure in the vaccine resistance movement. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. The CARD program director reported making more referrals to the crisis center and care coordination to increase resources and address these behavioral changes (17). How 111 online works. The Kennedy Krieger Institute provides outpatient medical services and care for children and adolescents with disorders involving the brain, spinal cord and musculoskeletal systems. Sections. Patients with neurodevelopmental disorders are less able to tolerate mask wearing or observe social distancing requirements, exacerbating the risk of becoming infected with COVID-19 and the stress upon them and their families. National Coronavirus Helpline (NCH) Phone: 1800 020 080. October 12, 2021 / 11:03 PM 5.7% reported that this was due to asthma/other lung disease and 0.7 reported that was due to heart disease. Due to the pandemic, many of these services transitioned to telerehabilitation (15). These cookies do not store any personal information. By: Daily Record Staff May 5, 2021. 2023 CBS Broadcasting Inc. All Rights Reserved. BALTIMORE Johns Hopkins Medicine and the Kennedy Krieger Institute have partnered together to host a drive-thru COVID-19 vaccination clinic. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Those from more medically complicated clinics were more likely to report inability to obtain therapies (32% vs. 18%; p<0.001) and inability to obtain surgeries (9% vs. 3%; p<0.001). How is COVID-19 affecting the mental health of children with special educational needs and disabilities and their families? Twenty percent (n=322) reported a worsening in their child's mood during the pandemic; (model correctly classified 80.2% of the sample, 2 (14, N=1627)=43.2, p<0.001). The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. *denotes statistical significance in table3. Providers addressed this concern by making referrals to other clinics. PV drafted the manuscript. AC, ML, TZ, PV, HB, CM, BC, EL, MR, DM, and PL contributed to conception and design of the study. (2020) 29:100630. doi: 10.1016/j.eclinm.2020.100630, 15. Providers also worked to make more in-person (50%) and virtual therapies available (50%), and provided clinical equipment for patients without access (50%) (Figure2). To assess the utility of the Pandemic Intake questionnaire, a provider feedback survey was developed and sent to the seven program directors. We successfully implemented a pre-visit Pandemic Intake questionnaire to quickly and systematically inform provider awareness of COVID-19 related patient concerns; the majority of program directors reported that this information helped them provide optimal care. Franciosi EB, Tan AJ, Kassamali B, Leonard N, Zhou G, Krueger S, et al. Results of provider feedback survey. These patients are at increased risk for impaired motor function, cognition, and social interaction, making them more susceptible to COVID-19 related complications (1). The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fresc.2022.934558/full#supplementary-material, National Library of Medicine Five out of six found the Pandemic Intake questionnaire helpful in their care of their patients. the contents by NLM or the National Institutes of Health. Chloe is now getting treatment from doctors at Kennedy Krieger, at one of the . . Live agents are available: Monday - Friday 8am to 5pm EST If you have an urgent medical need, please reach out to your healthcare provider. Blood Adv. The contact numbers are as follows: Eastern Cape: 043 707 6300 or 043 707 6335. It is mandatory to procure user consent prior to running these cookies on your website. Inaccessibility to services like physical, occupational, and speech therapies can result in a decline in patient health (6). Changes made to their clinic evaluations in response to the feedback were noted. Department of Labor. Attestation to vaccination and symptom screening should be included in registration. Bruni O, Breda M, Ferri R, Melegari MG. Changes in sleep patterns and disorders in children and adolescents with attention deficit hyperactivity disorders and autism spectrum disorders during the COVID-19 lockdown. Clinicians viewed the completed questionnaire before or during the visit and addressed COVID-related concerns during the appointment. Sci. Clinic type was a significant predictor, but sex, age, and race were not (80.5% correctly classified, 2 (14, N=1,638)=158.6, p<0.001). Continue to practice everyday preventive actions now: Kennedy Krieger Institute scheduled events happening at Kennedy Krieger, or in other locations, may be impacted by changes to the public health environment. Based on parent surveys, researchers believe thatone-third of parents will not send their children back to school for in-person instructionduring the ongoing pandemic. Get fully vaccinated between December 15, 2021, and March 31, 2022. Perhaps due to their increased risk of co-morbidities (1), parents of patients with neurodevelopmental disorders frequently reported concerns for increased risk of contracting COVID-19. Kennedy Krieger has one of the only clinics in the country that treats children and young adults dealing with what's known as "long COVID," when some suffer from symptoms long after the initial . The central helpline number: 011-23978046. The scale had low internal item inter-correlation, i.e., less than 0.70 (Cronbach's alpha =0.491), suggesting that the questionnaire items were sampling from a variety of clinical areas rather than assessing a single, unitary clinical domain (8, 9). Guardians of patients seen at the SWS center (9%) were 2.4 times more likely to report worsened appetite then CDL patients (5%). CARD, CDL and the Tourette's clinic were noted as less medically complicated. The statistical model correctly categorized 80.4% of the sample, 2 (14, N=1644)=121.5, p<0.001). 2022 Vedmurthy, Murray, Chen, Asiedu, Baranano, Bay, Belcher, Burton, Conlon, Fine, Gill, Harris, Hart, Inches, Johnson, Lance, Lipkin, Menon, McIntyre, Rajaprakash, Recio, Singer, Smegal, Smith-Hicks, Vernon, Wilms Floet, Wong, Yelin, Leppert, Zabel and Comi. (2020) 95(2):7784. Coronavirus (COVID-19) enquiries. Our rehabilitation clinic is for children and adolescents under age 21 who have recovered from the virus but need additional support to regain lost neurological and physical function as a result of the illness. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. This questionnaire was created on the institute's Qualtrics account and distributed via web-link to patients prior to their in-person or telehealth clinic visits. Bethesda, MD 20894, Web Policies The studies involving human participants were reviewed and approved by Johns Hopkins Institutional Review Board. Mucalo L, Brandow AM, Dasgupta M, Mason SF, Simpson PM, Singh A, et al. Kennedy Krieger Institutewill begintesting consented students forCOVID-19in Mayat all four of its schoolsas part ofastudy that will helptodeterminethebeststrategiesforthe safe return to in-person learning forstudents with disabilities. The Kennedy Krieger Institute provides outpatient medical services and care for children and adolescents with disorders involving the brain, spinal cord and musculoskeletal systems. Latest coronavirus stories from WJZ Fortunately, Kennedy Krieger was already doing telehealth with military families for three years. This study has important limitations. The Kennedy Krieger Institute approaches neurodevelopmental disorders through a multi-professional treatment lens, allowing for expansive integration of changes and improvements in the quality of care. doi: 10.1182/bloodadvances.2021004288. Before The COVID-Safety Venue Information provided is subject to change. Rametta SC, Fridinger SE, Gonzalez AK, Xian J, Galer PD, Kaufman M, et al. Regarding appetite, 4.98% (n=81) reported their child experienced worsened appetite. Twenty percent (n=333) of guardians reported increased difficulty accessing therapies for their children during the pandemic. For Help and Hope call 1-877-8-HOPENY or text HOPENY. This de-identified database was stored on a secure Institute shared drive, and analyzed within IBM SPSS 27. The inability of these patients to understand complex situations presents challenges with mood and behavior (5). Be prepared for lots of very detailed clinical scenarios to solve and a written portion that it SUPER long but you onlly get 15-20 minutes for. Black and African American patients (8%) were 1.9 times more likely to report worsened appetite than White respondents (4%). The clinic helps patients through physical therapy and connects them with neurologists and physiologists to help them get better. One of those clinics is located in Maryland at the Kennedy Krieger Institute in east Baltimore. SHARE. Give Light and the People Will Find Their Own Way. Three hundred and thirty-seven respondents (20.6%) agreed (yes) or were unsure if their child was at increased risk of contracting COVID-19. 3323412600. Upvote. It is designed for people with disabilities who are 12 years of age and older, as well as their families and caregivers. We are continuously monitor and respond to the changing public health environment. At the same time, the pandemic has disproportionatelyaffectedindividuals with disabilities, in part becausemanyrely on daily structure and in-person support for learning and social growth. Free text boxes were included to allow the taker to expand on their concerns. Guardians of patients in more medically complicated clinics reported perceived increased risk of COVID-19 (p<0.001) and inability to obtain therapies (p<0.001) and surgeries (p<0.001). The complex, inter-related factors, unique to patients with neurodevelopmental disorders influence the impact of the COVID-19 pandemic. However, these other data were not from children with neurodevelopmental disorders. Black and African American patients (8%) were 1.9 times more likely to report worsened appetite than White respondents (4%). Guardians of Black and African American (17%) and Asian (13%) children were 0.6670.486 times less likely to report worsening in behavior, compared to parents of White children (23%). There was no difference in perceived increased risk of contracting COVID-19 across race, age and sex; this data contradicts previously reported information where Black and Asian individuals were at higher risk (14). Patients from CARD had higher reports of worsening behavior. Rehabilit. We also use third-party cookies that help us analyze and understand how you use this website. Hancock issued the original stay-at-home order for Denver a little after 2 p.m. Monday. If you have COVID-19 you should try to stay at home. Asbury K, Fox L, Deniz E, Code A, Toseeb U. Binary logistic regression identified significant predictors of guardian response; the statistical model included sex, age, race, and clinic type as covariates. Fifteen percent seen in the Center for Development and Learning reported an increased perceived risk for their children (i.e., yes or unsure); those from more medically complicated programs, i.e., Spine (59%), Other (58%), Sturge-Weber Syndrome (49%), Neurology (44%), and Neurogenetics (35%) clinics were 3.298.77 times more likely to report a perceived increased risk of contracting COVID-19 (Table2). The impact of telehealth implementation on underserved populations and no-show rates by medical specialty during the COVID-19 pandemic. 5.7% reported that this was due to asthma/other lung disease and 0.7 reported that was due to heart disease. Regarding appetite, 4.98% (n=81) reported their child experienced worsened appetite. This was a cross-sectional study; further work is needed to understand implementation over time during the pandemic. The United States Center for Disease Control and Prevention (CDC) has more information at a federal level about COVID-19 and our current pandemic. 1800 020 080. Murphy A, Pinkerton LM, Bruckner E, Risser HJ. This approach, and Pandemic Intake Questionnaire, may prove useful as the COVID-19 pandemic situation evolves, and for future pandemics, both at the Kennedy Krieger Institute and at other similar medical facilities. Aggression, hypersensitivity and behavioral problems are issues in patients with autism spectrum disorder. The impact of telehealth implementation on underserved populations and no-show rates by medical specialty during the COVID-19 pandemic, Evolving healthcare delivery in neurology during the coronavirus disease 2019 (COVID-19) pandemic, What is coefficient alpha? In partnership with the Maryland State Department of Education andlocalschoolsystems, Kennedy Krieger School Programs serve nearly 500 public school students with disabilities from more than half of the school districts in Maryland. Waiting for a 111 callback? In the medically more complicated clinics (Table3), patients were more likely to be treated with several medications simultaneously, have been hospitalized for seizures, surgeries, and other medical issues, and were more likely to be dependent on medical equipment such as wheelchairs, ventilators, and pumps. For the past three years, we have adjusted COVID-19 protocols, policies and guidance at Johns Hopkins Medicine (JHM) to protect the health and safety of our patients, colleagues and community members, especially those most at risk for severe infection. 2 Departments of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, MD, United States. The statistical model was significant and correctly categorized 96% of patients, 2 (14, N=1,644)=43.7, p<0.001). Providers increased availability of in-person and virtual therapies and visits and made referrals for additional care to address this. Necessary cookies are absolutely essential for the website to function properly. They face significant disruptions to home and school routines, that can cause further declines in health outcomes, and limitations in accessing necessary healthcare and educational services (2, 3), which can further exacerbate their neurodevelopmental impairments. and transmitted securely. If you have any symptoms of "long COVID" or suspect anything, doctors at Kennedy Kreiger recommend reaching out to your child's pediatrician to see if they can start to help out your child and figure out if they might be experiencing "long COVID. There was a 1.006 cumulative increase in reports of worsened appetite with increase in age by month (Table2). Respondents from the Tourette's (8%), Spinal Cord (12%), and Sturge Weber syndrome (17%) clinic were 3.867.37 time more likely to report difficulty in accessing surgeries compared to respondents from CDL (3%) (Table2). This material may not be published, broadcast, rewritten, or redistributed.
