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1.
CBE Life Sci Educ ; 21(1): ar1, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34978923

RESUMO

The COVID-19 pandemic shut down undergraduate research programs across the United States. A group of 23 colleges, universities, and research institutes hosted remote undergraduate research programs in the life sciences during Summer 2020. Given the unprecedented offering of remote programs, we carried out a study to describe and evaluate them. Using structured templates, we documented how programs were designed and implemented, including who participated. Through focus groups and surveys, we identified programmatic strengths and shortcomings as well as recommendations for improvements from students' perspectives. Strengths included the quality of mentorship, opportunities for learning and professional development, and a feeling of connection with a larger community. Weaknesses included limited cohort building, challenges with insufficient structure, and issues with technology. Although all programs had one or more activities related to diversity, equity, inclusion, and justice, these topics were largely absent from student reports even though programs coincided with a peak in national consciousness about racial inequities and structural racism. Our results provide evidence for designing remote Research Experiences for Undergraduates (REUs) that are experienced favorably by students. Our results also indicate that remote REUs are sufficiently positive to further investigate their affordances and constraints, including the potential to scale up offerings, with minimal concern about disenfranchising students.


Assuntos
COVID-19 , Humanos , Pandemias , SARS-CoV-2 , Estudantes , Estados Unidos
2.
Rev Alerg Mex ; 69 Suppl 1: s1-s14, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34998305

RESUMO

Even though the SARS-CoV-2 pandemic represents a historical challenge, science has had an exponential development, and the current vaccination campaigns are proof of this. Unfortunately, along came misinformation and myths regarding their production and their adverse effects. For this reason, we have considered of utter importance to review anaphylaxis, one of the most feared vaccine adverse events.Anaphylaxis can be defined as a life-threatening acute and systemic allergic reaction, with a wide clinical spectrum, which can be explained by many immunological mechanisms, and whose diagnostic complexity demands the fulfillment of strict criteria. Though infrequent, any vaccine has the potential to trigger anaphylaxis. In the United States, for the new SARS-CoV-2 vaccines, rates from 1:200 000 (Pfizer-BioNTech) to 1:360 000 doses (Moderna) have been estimated. Vaccine adverse events can be mediated by hypersensitivity reactions, either allergic or not. Unlike a typical drug allergy, rarely is the active ingredient responsible for the reaction. Therefore, excipients must be considered during the approach to this problem. Vaccine associated anaphylaxis has to be referred to an allergist so as to guarantee the maximum benefit for the patient and improve the vaccines' security profile.


Assuntos
Anafilaxia , COVID-19 , Vacinas , Anafilaxia/induzido quimicamente , Vacinas contra COVID-19 , Humanos , SARS-CoV-2 , Estados Unidos , Vacinas/efeitos adversos
3.
Cancer Prev Res (Phila) ; 15(1): 1-2, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34992149

RESUMO

The First Lady of the United States, Dr. Jill Biden, visited the Hollings Cancer Center at the Medical University of South Carolina on October 25, 2021. This Commentary remarks on the administration's goal of directing public attention to cancer screening and prevention as part of an overall effort to recover ground lost in the COVID-19 pandemic, particularly in underserved communities.


Assuntos
COVID-19/complicações , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Pessoas Famosas , Neoplasias/diagnóstico , SARS-CoV-2/isolamento & purificação , COVID-19/virologia , Humanos , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Neoplasias/virologia , Estados Unidos
4.
Am J Occup Ther ; 76(1)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35019968

RESUMO

Stroke rehabilitation is expensive, and recent changes to Medicare reimbursement demand more efficient interventions. The use of cost-effectiveness analysis (CEA) can help occupational therapy practitioners, rehabilitation directors, and payers better understand the value of occupational therapy and decide whether or not to implement new treatments. The objective of this article is to illustrate the contribution of CEA to stroke rehabilitation using a hypothetical new intervention as an example. What This Article Adds: This article facilitates an understanding of the importance of CEA to occupational therapy. It also explains how CEA improves consistency with reporting standards for cost-effectiveness studies.


Assuntos
Terapia Ocupacional , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Idoso , Análise Custo-Benefício , Humanos , Medicare , Estados Unidos
5.
Am J Occup Ther ; 76(1)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35019969

RESUMO

IMPORTANCE: Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing health care costs. OBJECTIVE: In this systematic review, we focus on three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: functional status, medication reconciliation, and skin integrity. DATA SOURCES: We conducted a search of the literature published between 2009 and 2019 in CINAHL, Cochrane, MEDLINE, PsycINFO, OTseeker, and Scopus. We also hand searched the systematic reviews and meta-analyses in our search results for articles that met our inclusion criteria. Study Selection and Data Collection: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS: We found 47 articles that address the three outcome areas. Regarding functional status, low strength of evidence is available for cognition and functional mobility interventions to support functional performance, moderate strength of evidence supports interventions for vision, and moderate evidence supports task-oriented and individualized interventions to promote activities of daily living (ADL) outcomes among people with neurological conditions. Strong strength of evidence supports individualized occupational therapy interventions focusing on medication adherence. Low strength of evidence was found for occupational therapy interventions to reduce pressure ulcers and promote skin integrity. Conclusion and Relevance: The evidence supports occupational therapy interventions to improve functional status in ADLs and medication management. Additional research is needed that examines the outcomes of occupational therapy interventions for other areas of function and skin integrity. What This Article Adds: We found evidence to support occupational therapy interventions that align with value-based measures in the three outcome areas of interest. The effectiveness of these interventions highlights the viability of occupational therapy as an essential profession and the worth of occupational therapy to the public, potential clients, and payers.


Assuntos
Terapia Ocupacional , Atividades Cotidianas , Idoso , Estado Funcional , Humanos , Medicare , Reconciliação de Medicamentos , Cuidados Semi-Intensivos , Estados Unidos
6.
Am J Occup Ther ; 76(1)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35019970

RESUMO

This article explains the need for a licensure compact in the occupational therapy profession and describes the joint American Occupational Therapy Association (AOTA) and National Board for Certification in Occupational Therapy (NBCOT®) initiative to develop and implement the compact. Despite uniformity in occupational therapy licensure laws across the states, the ability to obtain and maintain licenses in multiple jurisdictions remains complicated and time consuming. Occupational therapy practitioners will benefit from an improvement to the existing state licensure system that would allow them to obtain a privilege to practice in multiple states through an interstate licensure compact. The licensure compact will be implemented by a commission composed of state regulators from each participating state. In September 2019, AOTA and NBCOT issued a joint statement announcing that the two organizations would be collaborating to support the development of an interstate licensure compact for occupational therapy. This article highlights the need for the Occupational Therapy Licensure Compact, the process used to develop the compact's language, and the state legislative progress made to date. It also outlines the next steps needed to advance Occupational Therapy Licensure Compact legislation as well as efforts needed to operationalize the Occupational Therapy Compact Commission.


Assuntos
Terapia Ocupacional , Certificação , Humanos , Licenciamento , Estados Unidos
7.
BMC Health Serv Res ; 22(1): 59, 2022 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-35022053

RESUMO

BACKGROUND: Veterans increasingly utilize both the Veteran's Health Administration (VA) and non-VA hospitals (dual-users). Dual-users are at increased risk of fragmented care and adverse outcomes and often do not receive necessary follow-up care addressing social determinants of health (SDOH). We developed a Veteran-informed social worker-led Advanced Care Coordination (ACC) program to decrease fragmented care and provide longitudinal care coordination addressing SDOH for dual-users accessing non-VA emergency departments (EDs) in two communities. METHODS: ACC had four core components: 1. Notification from non-VA ED providers of Veterans' ED visit; 2. ACC social worker completed a comprehensive assessment with the Veteran to identify SDOH needs; 3. Clinical intervention addressing SDOH up to 90 days post-ED discharge; and 4. Warm hand-off to Veteran's VA primary care team. Data was documented in our program database. We performed propensity matching between a control group and ACC participants between 4/10/2018 - 4/1/2020 (N- = 161). A joint survival model using Markov Chain Monte Carlo technique was employed for 30-day outcomes. We performed Difference-In-Difference analyses on number of ED visits, admissions, and primary care physician (PCP) visits 120-day pre/post discharge. RESULTS: When compared to a matched control group ACC had significantly lower risk of 30-day ED visits (Hazard Ratio (HR) = 0.61, 95% Confidence Interval (CI) = (0.42, 0.92)) and a higher probability of PCP visits at 13-30 days post-ED visit (HR = 1.5, 95% CI = (1.01, 2.22)). Veterans enrolled in ACC were connected to VA PCP visits (50%), VA benefits (19%), home health care (10%), mental health and substance use treatment (7%), transportation (7%), financial assistance (5%), and homeless resources (2%). CONCLUSION: We developed and implemented a program addressing dual-users' SDOH needs post non-VA ED discharge. Social workers connected dual-users to needed follow-up care and resources which reduced fragmentation and adverse outcomes.


Assuntos
Veteranos , Assistência ao Convalescente , Hospitais de Veteranos , Humanos , Alta do Paciente , Determinantes Sociais da Saúde , Estados Unidos , United States Department of Veterans Affairs
9.
JAMA Netw Open ; 5(1): e2142046, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34982158

RESUMO

Importance: The COVID-19 pandemic has had a distinct spatiotemporal pattern in the United States. Patients with cancer are at higher risk of severe complications from COVID-19, but it is not well known whether COVID-19 outcomes in this patient population were associated with geography. Objective: To quantify spatiotemporal variation in COVID-19 outcomes among patients with cancer. Design, Setting, and Participants: This registry-based retrospective cohort study included patients with a historical diagnosis of invasive malignant neoplasm and laboratory-confirmed SARS-CoV-2 infection between March and November 2020. Data were collected from cancer care delivery centers in the United States. Exposures: Patient residence was categorized into 9 US census divisions. Cancer center characteristics included academic or community classification, rural-urban continuum code (RUCC), and social vulnerability index. Main Outcomes and Measures: The primary outcome was 30-day all-cause mortality. The secondary composite outcome consisted of receipt of mechanical ventilation, intensive care unit admission, and all-cause death. Multilevel mixed-effects models estimated associations of center-level and census division-level exposures with outcomes after adjustment for patient-level risk factors and quantified variation in adjusted outcomes across centers, census divisions, and calendar time. Results: Data for 4749 patients (median [IQR] age, 66 [56-76] years; 2439 [51.4%] female individuals, 1079 [22.7%] non-Hispanic Black individuals, and 690 [14.5%] Hispanic individuals) were reported from 83 centers in the Northeast (1564 patients [32.9%]), Midwest (1638 [34.5%]), South (894 [18.8%]), and West (653 [13.8%]). After adjustment for patient characteristics, including month of COVID-19 diagnosis, estimated 30-day mortality rates ranged from 5.2% to 26.6% across centers. Patients from centers located in metropolitan areas with population less than 250 000 (RUCC 3) had lower odds of 30-day mortality compared with patients from centers in metropolitan areas with population at least 1 million (RUCC 1) (adjusted odds ratio [aOR], 0.31; 95% CI, 0.11-0.84). The type of center was not significantly associated with primary or secondary outcomes. There were no statistically significant differences in outcome rates across the 9 census divisions, but adjusted mortality rates significantly improved over time (eg, September to November vs March to May: aOR, 0.32; 95% CI, 0.17-0.58). Conclusions and Relevance: In this registry-based cohort study, significant differences in COVID-19 outcomes across US census divisions were not observed. However, substantial heterogeneity in COVID-19 outcomes across cancer care delivery centers was found. Attention to implementing standardized guidelines for the care of patients with cancer and COVID-19 could improve outcomes for these vulnerable patients.


Assuntos
COVID-19/epidemiologia , Neoplasias/epidemiologia , Pandemias , População Rural , Vulnerabilidade Social , População Urbana , Idoso , Causas de Morte , Censos , Feminino , Instalações de Saúde , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Razão de Chances , Sistema de Registros , Respiração Artificial , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença , Análise Espacial , Estados Unidos/epidemiologia
11.
BMC Public Health ; 22(1): 54, 2022 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-35000578

RESUMO

BACKGROUND: Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]). METHODS: Age- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy. RESULTS: As of August 2020, 442,677 (range: 18-185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112-1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups. CONCLUSIONS: Our results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.


Assuntos
COVID-19 , Idoso , Brasil , Feminino , Humanos , Expectativa de Vida , Masculino , Mortalidade , Mortalidade Prematura , Pandemias , SARS-CoV-2 , Estados Unidos
12.
Fam Med ; 54(1): 44-46, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35006599

RESUMO

BACKGROUND AND OBJECTIVES: Discussions of scope of practice among family physicians has become a crucial topic amidst the COVID-19 pandemic, coupled with new attention to residency training requirements. Family medicine has seen a gradual narrowing of practice due to a host of issues, including physician choice, expanding scope of practice from physician assistants and nurses, an increased emphasis on patient volume, clinical revenue, and residency training competency requirements. We sought to demonstrate the flexibility of the family medicine workforce as shown through their scopes of practice, and argue that this is indication of their potential for redeployment during emergencies. METHODS: This study computes scopes of practice for 78,416 family physicians who treat Medicare beneficiaries. We used Evaluation and Management (E/M) codes in Medicare's 2017 Part-B public use file to calculate volumes of services done across six sites of service per physician. We aggregated counts and proportions of physicians and the E/M services they provided across sites of practice to characterize scope, and performed a separate analysis on rural physicians. RESULTS: The study found most family physicians practicing at a single site, namely, the ambulatory clinic. However, family physicians in rural areas, where need is greater, exhibit broader scope. This suggests that a significant number of family physicians have capacity for COVID-19 deployment into other settings, such as emergency rooms or hospitals. CONCLUSIONS: Family physicians are a potential resource for emergency redeployment, however the current breadth of scope for most family physicians is not aligned with current residency training requirements and raises questions about the future of family medicine scope of practice.


Assuntos
COVID-19 , Medicina de Família e Comunidade , Idoso , Humanos , Medicare , Pandemias , Médicos de Família , SARS-CoV-2 , Estados Unidos
13.
PLoS One ; 17(1): e0262352, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34986205

RESUMO

INTRODUCTION: COVID-19 infection has been hypothesized to precipitate venous and arterial clotting events more frequently than other illnesses. MATERIALS AND METHODS: We demonstrate this increased risk of blood clots by comparing rates of venous and arterial clotting events in 4400 hospitalized COVID-19 patients in a large multisite clinical network in the United States examined from April through June of 2020, to patients hospitalized for non-COVID illness and influenza during the same time period and in 2019. RESULTS: We demonstrate that COVID-19 increases the risk of venous thrombosis by two-fold compared to the general inpatient population and compared to people with influenza infection. Arterial and venous thrombosis were both common occurrences among patients with COVID-19 infection. Risk factors for thrombosis included male gender, older age, and diabetes. Patients with venous or arterial thrombosis had high rates of admission to the ICU, re-admission to the hospital, and death. CONCLUSION: Given the ongoing scientific discussion about the impact of clotting on COVID-19 disease progression, these results highlight the need to further elucidate the role of anticoagulation in COVID-19 patients, particularly outside the intensive care unit setting. Additionally, concerns regarding clotting and COVID-19 vaccines highlight the importance of addressing the alarmingly high rate of clotting events during actual COVID-19 infection when weighing the risks and benefits of vaccination.


Assuntos
COVID-19/patologia , Trombose/patologia , Idoso , COVID-19/mortalidade , Estudos de Coortes , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , New Jersey , Estudos Retrospectivos , Trombose/mortalidade , Estados Unidos
14.
Am J Occup Ther ; 76(1)2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34990510

RESUMO

IMPORTANCE: Practitioners need to be familiar with, and involved in, managing quality-related adverse events in postacute care. OBJECTIVE: To determine interventions within the scope of occupational therapy that address preventable adverse events in adult postacute inpatient and home health settings. DATA SOURCES: Articles published from January 1995 through 2019 identified through searches of MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Study Selection and Data Collection: Articles were collected, evaluated, and analyzed by two independent reviewers. They were assessed and synthesized with a goal of informing clinical practice. FINDINGS: Twenty-four articles were included in the review. Of the 10 Centers for Medicare & Medicaid Services preventable adverse events, 6 were addressed: diabetes management (n = 2), dysphagia (n = 5), infection control (n = 1), pressure ulcers (n = 6), falls (n = 5), and discharge management (n = 5). There was strong strength of evidence that exercise programs should, when appropriate, be implemented in both inpatient and home health settings to decrease the risk of falls. There was moderate strength of evidence that practitioners could consider implementing a facility wide evidence-based pressure ulcer program; providing multidisciplinary rehabilitation and swallow strengthening exercises for dysphagia; implementing a multidisciplinary, multicomponent falls program; and using a manualized depression intervention in home health to decrease hospital readmission. CONCLUSIONS AND RELEVANCE: The review highlights the importance of preventable adverse events and of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and to control health care costs. What This Article Adds: Many interventions typically performed by occupational therapy practitioners address preventable adverse events. The review highlights the importance of practitioners being aware of this category of impairment or injury.


Assuntos
Terapia Ocupacional , Adulto , Idoso , Humanos , Pacientes Internados , Medicare , Readmissão do Paciente , Cuidados Semi-Intensivos , Estados Unidos
15.
Health Res Policy Syst ; 20(1): 5, 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-34991591

RESUMO

BACKGROUND: Although Good Samaritan laws (GSLs) have been widely adopted throughout the United States, their efficacy in individual states is often unknown. This paper offers an approach for assessing the impact of GSLs and insight for policy-makers and public health officials who wish to know whether they should expect to see outcomes from similar policy interventions. METHODS: Utilizing a system dynamics (SD) modeling approach, the research team conducted a policy evaluation to determine the impact of GSLs on opioid use disorder (OUD) in Connecticut and evaluated the GSL based upon the following health outcomes: (1) emergency department (ED) visits for overdose, (2) behavioral changes of bystanders, and (3) overdose deaths. RESULTS: The simulation model suggests that Connecticut's GSL has not yet affected overdose deaths but has resulted in bystander behavioral changes, such as increased 911 calls for overdose. ED visits have increased as the number of opioid users has increased. CONCLUSIONS: The simulation results indicate that the number of opioid-related deaths will continue to increase and that the GSL alone cannot effectively control the crisis. However, the SD approach that was used will allow policymakers to evaluate the effectiveness of the GSL over time using a simulation framework. This SD model demonstrates great potential by producing simulations that allow policymakers to assess multiple strategies for combating the opioid crisis and select optimal public health interventions.


Assuntos
Overdose de Drogas , Transtornos Relacionados ao Uso de Opioides , Analgésicos Opioides/uso terapêutico , Connecticut , Overdose de Drogas/tratamento farmacológico , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Estados Unidos
16.
Brain Nerve ; 74(1): 33-35, 2022 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-34992168

RESUMO

The COVID-19 pandemic has had a significant impact on neurology residency education and services in the United States. The responsibility of residents was shifted from traditional house staff to frontline providers in the face of the pandemic. As such, a dynamic and rapid transformation was required, involving the development of strong leadership and teamwork skills, while protecting patients and providers from infection and ensuring the quality of education and training. Because of the increased demand from inpatient care and the risk of potential exposure to the virus, a modified rotation schedule was implemented by removing residents from outpatient clinics and minimizing their role in inpatient services. In order to maintain social distances, didactic lectures were conducted only via online platforms, and outpatients were only provided telemedicine. Although the pandemic has taken some of the in-person educational opportunities from residents, innovative changes including video conferences and telemedicine will likely continue to be used as a useful mode of medical training for residents. Herein, the author reports the changes made to the neurology residency program in response to the COVID-19 pandemic, as well as the evolution of leadership roles during this unprecedented time.


Assuntos
COVID-19 , Internato e Residência , Neurologia , Humanos , Pandemias , SARS-CoV-2 , Estados Unidos
17.
Vet Rec ; 190(1): 40, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34994416
18.
Isr J Health Policy Res ; 11(1): 3, 2022 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-34996513

RESUMO

The COVID-19 pandemic has underscored the changing role of scientists, clinicians, ethicists, and educators in advocacy as they rapidly translate their findings to inform practice and policy. Critical efforts have been directed towards understanding child well-being, especially with pandemic-related educational disruptions. While school closures were part of early widespread public health measures to curb the spread of COVID-19, they have not been without consequences for all children, and especially for children from disadvantaged backgrounds. In a recent Isr J Health Policy Res perspective, Paltiel and colleagues demonstrate the integral role of academic activism to promote child well-being during the pandemic by highlighting work of the multidisciplinary academic group on children and coronavirus (MACC). In this commentary, we explore parallels to MACC's work in an international context by describing the efforts of a multidisciplinary team at Johns Hopkins University in Baltimore, Maryland, United States, to aggregate data, conduct analyses, and offer training tools intended to minimize health and educational inequities for children throughout the COVID-19 pandemic. As both MACC and our work collectively demonstrates, multidisciplinary partnerships and public-facing data-driven initiatives are crucial to advocating for children's equitable access to quality health and education. This will likely not be the last pandemic that children experience in their lifetime. As such, efforts should be made to apply the lessons learned during the current pandemic to strengthen multidisciplinary academic-public partnerships which will continue to play a critical role in the future.


Assuntos
COVID-19 , Saúde da Criança , Criança , Política de Saúde , Humanos , Israel , Pandemias , SARS-CoV-2 , Estados Unidos
19.
J Am Dent Assoc ; 153(1): 86-87.e2, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34996534

RESUMO

BACKGROUND: With many states in the United States permitting dentists to administer the COVID-19 vaccine, there is much discussion about their scope of practice in relation to delivering other vaccines. METHODS: Survey questions were developed to assess dentists' awareness about their vaccine administration scope of practice and attitudes and barriers if choosing to incorporate vaccine delivery into their practice scope. The survey was deployed electronically to members of the American Dental Association Clinical Evaluators (ACE) Panel (N = 989) on September 2, 2021, and remained open for 2 weeks. Data were summarized descriptively in Qualtrics and SAS Version 9.4. RESULTS: Of the 330 ACE Panel members who responded to the survey, 42% were not aware of which vaccines their state permits them to deliver. More than one-half (55%) would be willing to administer influenza or COVID-19 vaccines in their practice setting, but at present only 2% of respondents administer vaccines. To overcome vaccine administration barriers, the top 3 resources respondents want access to are the following: training or education, financial support, and access to protocols. Of all the respondents, 91% indicated the dental hygienist should be involved in certain capacities. CONCLUSIONS: Few dentists are administering vaccines, possibly owing to a number of challenges. Dental hygienists may play an integral role in the administration of vaccines in the dental clinic, but few dentists are educating their patients about vaccines. PRACTICAL IMPLICATIONS: Although dentists wishing to administer vaccines in their practice may encounter barriers, support at the state, federal, and organizational levels could help them overcome these challenges.


Assuntos
COVID-19 , Vacinas , American Dental Association , Atitude do Pessoal de Saúde , Vacinas contra COVID-19 , Higienistas Dentários , Odontólogos , Humanos , SARS-CoV-2 , Inquéritos e Questionários , Estados Unidos
20.
BMC Res Notes ; 15(1): 5, 2022 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-35000586

RESUMO

OBJECTIVE: To provide current estimates of the number of patients with prevalent systemic lupus erythematosus (SLE) by major health insurance types in the US and to describe patient characteristics. Four large US health insurance claims databases were analyzed to represent different types of insurance coverage, including private insurance, Medicaid, and Medicare Supplemental. RESULTS: Overall unadjusted SLE prevalence per 100,000 persons in the US ranged from 150.1 (private insurance) to 252.9 (Medicare Supplemental insurance). Extrapolating to the US civilian population in 2016, we estimated roughly 345,000 to 404,000 prevalent SLE patients with private/Medicare insurance and 99,000 prevalent SLE patients with Medicaid insurance. Comorbidities, including renal failure/dialysis were commonly observed across multiple organ systems in SLE patients (8.4-21.1%). We estimated a larger number of prevalent SLE cases in the US civilian population than previous reports and observed extensive disease burden based on a 1-year cross-sectional analysis.


Assuntos
Lúpus Eritematoso Sistêmico , Medicare , Idoso , Estudos Transversais , Humanos , Seguro Saúde , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Prevalência , Estados Unidos/epidemiologia
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