RESUMO
OBJECTIVE: This systematic review and meta-analysis aimed to investigate the objective, functional recovery of patients more than 3 months after acute COVID-19 infection. METHODS: Comprehensive database searches of EMBASE, PubMed/MEDLINE, Cochrane COVID-19 Study Register, CINAHL, and Google Scholar in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were carried out until October 19, 2022. Data were extracted and agreed in duplicate. Data were narratively synthesized, and a series of meta-analyses were performed using the random-effects inverse variance method. RESULTS: One-hundred six papers covering 20,063 patients who were either hospitalized or not hospitalized with acute COVID-19 who were followed-up between 3 to 24 months were included. Percentage predicted 6-minute walk distance at 3 months to <5 months was 84.3% (95% CI = 79.2-89.3; n = 21; I2 = 98.3%) and 92.5% (95% CI = 89.8-95.3; n = 9; I2 = 94.5%) at ≥11 months. Cardiopulmonary exercise testing revealed percentage predicted peak oxygen consumption rate ($peak\dot{\mathrm{V}}{\mathrm{o}}_2$) at 3 months to <5 months was 77.3% (95% CI = 71.0-83.7; n = 6; I2 = 92.3%) and 95.4% (95% CI = 87.1-103.6; n = 2; I2 = 77.3%) at ≥11 months. Mean handgrip strength was greatest at ≥11 months at 31.16 kg (95% CI = 19.89-42.43; n = 2; I2 = 98.3%) of all time points. All analyses showed marked heterogeneity. CONCLUSION: Patients have reduced physical function more than 3 months after COVID-19 infection. Better physical function in multiple physical domains is found after a longer recovery time. IMPACT: Physical function as measured by the 6-minute walk test, hand grip strength, and cardiopulmonary exercise testing is reduced at 3 months after COVID-19 infection and can remain over 11 months of follow-up. This protracted recovery following acute COVID-19 infection supports the need to assess physical function at any clinical follow-up, and further research into rehabilitation programs and intervention for patients who have not recovered.
RESUMO
Task prioritisation (TP), the ability to arrange assigned responsibilities in order of importance, has been identified by doctors as the most important non-technical skill when working out of hours. This review aimed to identify the factors influencing task prioritisation in a workplace setting. The following databases were searched for relevant studies: BNI, CINAHL, EMBASE, MEDLINE and PsycINFO as well as the reference lists of relevant articles, review papers and Google Scholar. Data were extracted from the studies using a standard proforma. Twenty relevant papers were identified from management, aviation and healthcare fields. Task prioritisation ability differed across individuals and was associated with personality and experience. Tasks were prioritised based on length, urgency, importance and reward. With practice people become more efficient at task prioritisation. Practical applications include education, personalised task management software and intrusive notifications. Additional research is needed to assess the effects of such interventions in a healthcare setting.
RESUMO
OBJECTIVE: To investigate the assessment and treatment of physical health in patients with personality disorder and compare this to the care received in schizophrenia. METHOD: We collected data from a random sample of 246 patients with personality disorder on monitoring and intervention for seven key aspects of physical health. We compared the results with those from a random sample with schizophrenia. RESULTS: In our sample, 160 (65%) people had the diagnosis of emotionally unstable personality disorder. In total, 104 (42.3%) people with personality disorder were being prescribed antipsychotic medication; 23 (9.3%) participants had all seven aspects of physical health recorded. Alcohol was most frequently recorded (76%); BMI (38.6%), blood glucose (25.2%) and blood cholesterol (20.7%) were less likely to be recorded. Interventions were not given to all those requiring them. Compared to people with schizophrenia, a lower proportion had evidence of assessment of smoking, illicit drug use, blood glucose and blood lipid levels. Smoking cessation advice was more likely to be offered to people with schizophrenia (difference = 29.4%, 95% CI = 12.5 to 44.7). CONCLUSION: Physical health is under-assessed and under-treated in patients with personality disorder. Medical staff must do more to help tackle increased morbidity among this group.
