Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38
Filtrar
1.
International Journal of Practice-Based Learning in Health and Social Care ; 10(1):36-47, 2022.
Artigo em Inglês | Scopus | ID: covidwho-2145809

RESUMO

Clinical placements are fundamental to entry-level physiotherapy education and provide an opportunity for students to translate theory into practice within authentic clinical environments. Student success during clinical placement is a core requirement of physiotherapy programs and a critical component of the pathway to graduation, registration, and then employment. The registration of a physiotherapist confirms that as a student, they have met the profession's rigorous accreditation requirements. COVID-19 has significantly disrupted physiotherapy clinical placements across Australia, with many placements postponed or cancelled in the early public health response. These placement disruptions may preclude students from demonstrating mandatory pre-registration accreditation requirements, ultimately reducing the number of eligible new-graduate physiotherapists. Creating sustainable clinical placements whilst upholding the professional standard of entry level graduates during the pandemic, calls for innovative solutions to monitor student placement experiences. A Clinical Portfolio was implemented to improve monitoring processes and enable dynamic responses to potentially altered student learning experiences as COVID-19 public health measures evolved. In doing so, the aim of this study was to evaluate the impact of COVID-19 on physiotherapy student placements between May and June 2020 through examining client case-mix, demographics and learning model documented in each student's Clinical Portfolio. These data sets allowed for comparison of learning model and case-mix during the pandemic with previous literature monitoring typical physiotherapy clinical placement experience, and providing support for ensuring the registration of the cohort impacted. © 2022 Andrea Hams & Taryn Jones. This Open Access article is distributed under the terms of the Creative Commons Attribution Attribution-Non-Commercial No Derivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is unaltered.

2.
J Hosp Infect ; 131: 23-33, 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: covidwho-2117484

RESUMO

BACKGROUND: Hospital transmission of SARS-CoV-2 has proved difficult to control, with healthcare-associated infections troublesome throughout. AIM: To understand factors contributing to hospital transmission of infections, which is necessary for containing spread. METHODS: An outbreak of 56 staff and patient cases of COVID-19 over a 31-day period in a tertiary referral unit is presented, with at least a further 29 cases identified outside of the unit and the hospital by whole genome sequencing (WGS). FINDINGS: Transmission is documented from staff to staff, staff to patients, and patients to staff, showing disruption of a tertiary referral service, despite implementation of nationally recommended control measures, superior ventilation, and use of personal protective equipment. There was extensive spread from the index case, despite this patient spending only 10 h bed bound on the ward in strict cubicle isolation and with an initial single target low level (CT = 32) polymerase chain reaction test. CONCLUSION: This investigation highlights how effectively and rapidly SARS-CoV-2 can spread in certain circumstances. It raises questions about infection control measures in place at the time and calls into question the premise that transmissibility can be reliably detected by using lower sensitivity rapid antigen lateral flow tests. We also highlight the value of early intervention in reducing impact as well as the value of WGS in understanding outbreaks.

3.
The Journal of hospital infection ; 2022.
Artigo em Inglês | EuropePMC | ID: covidwho-2057526

RESUMO

We present an outbreak of 56 staff and patient cases of COVID-19 over a 31 day period in a tertiary referral unit, with at least a further 29 cases identified outside of the unit and the hospital by whole genome sequencing (WGS). We document transmission from staff-to-staff, staff-to-patients and patients-to-staff and show disruption of a tertiary referral service, despite implementation of nationally recommended control measures, superior ventilation and use of PPE. We demonstrate extensive spread from the index case, despite them spending only 10 hours bed bound on the ward in strict cubicle isolation and with an initial single target low level (CT=32) PCR test. This investigation highlights critical issues including how effectively and explosively SARS-CoV-2 can spread in certain circumstances. It raises questions about infection control measures in place at the time and calls into question the premise that transmissibility can be reliably detected using lower sensitivity rapid antigen lateral flow tests. We also highlight the value of early intervention in reducing impact as well as the value of WGS in understanding outbreaks.

4.
Innovation in Aging ; 5:278-278, 2021.
Artigo em Inglês | Web of Science | ID: covidwho-2011854
5.
BMJ Global Health ; 7:A29-A30, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1968273

RESUMO

Objective The impact of the COVID-19 pandemic on the English National Health Service (NHS) has been profound. Those who commission health services face questions and pressures around addressing growing waiting lists and ensuring patients receive appropriate and timely treatment. In 2019, NHS England launched the Evidence-Based Interventions (EBI) programme, a national initiative that intends to reduce provision of medical and surgical interventions found to have insufficient evidence of effectiveness - either in general, or in select patient groups. The EBI programme originally produced treatment policy recommendations for 17 interventions across several surgical specialties. Reducing provision of treatments already embedded in practice has been historically challenging for health services worldwide. Our ongoing NIHR-funded mixed methods study seeks to evaluate the impact and acceptability of the EBI programme. As part of this work, a key objective is to investigate national policy-makers' experiences of implementing the EBI programme during the COVID-19 pandemic, and its role in the COVID recovery programme. Methods Semi-structured interviews with informants working within English Clinical Commissioning Groups (CCGs) and at a national level. Data are being analysed thematically, using the constant comparison approach. Data collection and analysis are ongoing, with 10 interviews having been undertaken with informants from 6 geographically spread CCGs. Results Emerging findings indicate that although the pandemic impacted how informants were able to implement evidencebased treatment policies, these were perceived to be potentially useful in supporting healthcare providers to manage waiting lists in a clinically appropriate manner. Discussion This research will provide early empirical insights into informants' experiences of priority setting during and in the wake of COVID-19. Early findings suggest that historically challenging priority setting processes may be easier to implement, from informants' perspectives, under the auspices of waiting list management following the pandemic. More developed findings and implications will be reported at the conference.

6.
Journal of the Academy of Consultation-Liaison Psychiatry ; 63:S61, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1966671

RESUMO

Background: Post-intensive care syndrome (PICS) affects up to half of ICU patients and comprises neuromuscular, cognitive, and psychiatric impairments that persist up to years after discharge (Inoue, 2019). PICS is often overlooked and under-diagnosed (Rawal, 2017), without clear evidence-based strategies for management. Data supporting interventions for symptoms of anxiety, depression, and post-traumatic stress after discharge is limited (Needham, 2012). Developing high-quality, evidence-based interventions for PICS would address this critical need. Methods: Shortly before discharge, patients are recruited from our neurological ICU who have been intubated for at least 24 hours and score 24–32 on the Impact of Event Scale - Revised (which indicates likely PTSD symptoms without a true diagnosis). Baseline Beck Depression Index and Telephone Interview for Cognitive Status questionnaires are also administered to each patient. Participants are then randomly assigned either to a virtual reality exposure therapy intervention or to a control group that receives no therapeutic intervention. VRET patients are given an online 360° video of an ICU room from the perspective of an intubated patient, complete with sounds and simulated clinical scenarios (rounds, intubation, suctioning, etc.). Intervention patients have unlimited access to the videos for six months, beginning one month after discharge. Follow-up IES-R, BDI, and TICS are administered at 1, 3, and 6 months to both groups. Results/Discussion: Our IRB approved this study in March 2021. Enrollment has begun with 3–5 feasibility patients, to be followed by 30 randomized patients starting in November. Our poster features a case discussion on our first patient's experiences with VRET. Given the novelty of remote VRET for post-ICU PTSD symptoms, our results will be an important contribution with the potential to change practice. Conclusion: This will be the first remote intervention for neuropsychiatric symptoms of PICS, and has far-reaching implications for inpatient and outpatient CL psychiatrists — particularly at a time when patients have grown increasingly accustomed to virtual interventions, and when ICU survivors have multiplied due to COVID-19. Should our VRET prove successful, it will open the eyes of intensivists and CL psychiatrists to a whole realm of remote, efficient, and accessible virtual reality therapies for patients who have undergone acute care. This will improve long-term outcomes, particularly for patients who may have difficulty seeing an outpatient psychiatrist or taking medications consistently. Finally, our study will help to raise awareness of the psychiatric sequelae of acute illness, and so enhance inpatient collaboration between psychiatry and many other specialties. References: 1. Inoue S et al. Post-intensive care syndrome: its pathophysiology, prevention, and future directions. Acute Med Surg. 2019;(3):233-246. 2. Needham DM et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med. 2012;40(2):502-9. 3. Rawal G et al. Post-intensive Care Syndrome: an Overview. J Transl Int Med. 2017;5(2):90-92.

7.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Artigo em Inglês | English Web of Science | ID: covidwho-1880174
8.
JNCI Cancer Spectr ; 6(3)2022 05 02.
Artigo em Inglês | MEDLINE | ID: covidwho-1878801

RESUMO

BACKGROUND: TMPRSS2, a cell surface protease regulated by androgens and commonly upregulated in prostate cancer (PCa), is a necessary component for SARS-CoV-2 viral entry into respiratory epithelial cells. Previous reports suggested a lower risk of SARS-CoV-2 among PCa patients on androgen deprivation therapy (ADT). However, the impact of ADT on severe COVID-19 illness is poorly understood. METHODS: We performed a multicenter study across 7 US medical centers and evaluated patients with PCa and SARS-CoV-2 detected by polymerase-chain-reaction between March 1, 2020, and May 31, 2020. PCa patients were considered on ADT if they had received appropriate ADT treatment within 6 months of COVID-19 diagnosis. We used multivariable logistic and Cox proportional-hazard regression models for analysis. All statistical tests were 2-sided. RESULTS: We identified 465 PCa patients (median age = 71 years) with a median follow-up of 60 days. Age, body mass index, cardiovascular comorbidity, and PCa clinical disease state adjusted overall survival (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 0.68 to 1.98, P = .59), hospitalization status (HR = 0.96, 95% CI = 0.52 to 1.77, P = .90), supplemental oxygenation (HR 1.14, 95% CI = 0.66 to 1.99, P = .64), and use of mechanical ventilation (HR = 0.81, 95% CI = 0.25 to 2.66, P = .73) were similar between ADT and non-ADT cohorts. Similarly, the addition of androgen receptor-directed therapy within 30 days of COVID-19 diagnosis to ADT vs ADT alone did not statistically significantly affect overall survival (androgen receptor-directed therapy: HR = 1.27, 95% CI = 0.69 to 2.32, P = .44). CONCLUSIONS: In this retrospective cohort of PCa patients, the use of ADT was not demonstrated to influence severe COVID-19 outcomes, as defined by hospitalization, supplemental oxygen use, or death. Age 70 years and older was statistically significantly associated with a higher risk of developing severe COVID-19 disease.


Assuntos
COVID-19 , Neoplasias da Próstata , Idoso , Antagonistas de Androgênios/uso terapêutico , Androgênios/uso terapêutico , COVID-19/tratamento farmacológico , Teste para COVID-19 , Humanos , Masculino , Neoplasias da Próstata/tratamento farmacológico , Receptores Androgênicos/uso terapêutico , Estudos Retrospectivos , SARS-CoV-2
9.
Frontiers in Education ; 7:10, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-1869366

RESUMO

Monitoring student attendance and engagement is common practice during undergraduate courses at university. Attendance data typically show a strong positive relationship with student performance and regular monitoring is an important tool to identify students who may require additional academic provisions, wellbeing support and pastoral care, for example. However, most of the previous studies and our framework for monitoring attendance and engagement is based on traditional on-campus, in-person delivery. Accelerated by the COVID-19 pandemic, our transition to online teaching delivery requires us to re-evaluate what constitutes attendance and engagement in a purely online setting and what are the most accurate ways of monitoring. Here, I show how statistics derived from student interaction with a virtual learning environment, Canvas, can be used as a monitoring tool. I show how basic statistics such as the number and frequency of page views are not adequate and do not correlate with student performance. A more in-depth analysis of video viewing duration, rather than simple page clicks/views is required, and weakly correlates with student performance. Lastly, I provide a discussion of the potential pitfalls and advantages of collecting such data and provide a perspective on some of the associated challenges.

10.
Journal of Aggression Conflict and Peace Research ; : 17, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-1816412

RESUMO

Purpose Restorative practice programs in the USA and Western elementary and secondary schools have been the focus of intensive, large scale field research that reports positive impacts on school climate, pro-social student behavior and aggressive behavior. This paper aims to contribute to a gap in the research by reporting a case study of transformation of an urban middle school in a multi-year implementation of restorative practices. Design/methodology/approach This paper reports how Creative Response to Conflict (CRC) supported the transformation of Middle School 217, in Queens, NY, from a school with one of the highest suspension rates in New York City to a model restorative school. CRC's model, which incorporates the themes of cooperation, communication, affirmation, conflict resolution, mediation, problem-solving, bias awareness, bullying prevention and intervention, social-emotional learning and restorative practices, helped shift the perspective and practice of the entire school community from punitive to restorative. Findings Implementation of a full school advisory program using restorative circles for all meetings and classes and development of a 100% respect program committing all school community members to dignified and respectful treatment aided the transformation. Key to MS 217's success was the collaboration of multiple non-profit organizations for provision of peer mediation training, after-school follow-up work, staff coaching and preventative cyberbullying training through the Social Media-tors! Program. Research limitations/implications Challenges to the restorative practices implementation are reviewed with attention to the implementation online during COVID-19. Originality/value Next steps in the program post-COVID are articulated as a best practice model for other schools interested in adopting MS 217's commitment, creativity and community-building to become a model restorative school.

11.
Open Forum Infectious Diseases ; 8(SUPPL 1):S114-S115, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1746758

RESUMO

Background. Human-to-feline and airborne transmission among cats of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been described, though documented feline-to-human transmission has not been reported. In October 2020, all 3 Malayan tigers at a Tennessee AZA accredited zoo were diagnosed with symptomatic SARS-CoV-2 infection. We investigated to determine source and prevent further transmission. Methods. Tiger nasal swab specimens were tested at the National Veterinary Services Laboratories (NVSL). An environmental assessment at the zoo was completed. We interviewed 18 staff who interacted with the tigers during the 2 weeks before animal symptom onset. Confirmed human cases were defined as persons testing positive for SARS-CoV-2 by RT-PCR during September 28-October 29, with tiger interaction during their 14-day incubation period. Interviewed staff had repeat SARSCoV-2 RT-PCR and serum IgG testing on October 29. Tigers and staff testing positive had specimens sent to CDC for genomic sequencing. Tiger sequences were compared phylogenetically with 30 geographically associated human cases collected within 2 weeks of the outbreak and > 200 background sequences from TN. Results. NVSL confirmed SARS-CoV-2 infection in all 3 tigers. Environmental assessment identified fencing between humans and animals allowing airflow and an open outdoor exhibit observation point above the habitat. Confirmed cases were identified in a tiger keeper and veterinary assistant;both developed symptoms after exposure to symptomatic tigers and one sample was genotyped. Staff did not report known contact with ill visitors. All staff were negative for SARS-CoV-2 IgG. The tigers and most temporally and geographically associated cases had genetic sequences in clade 20G and B.1.2. Tiger sequences were 3-6 single nucleotide polymorphisms different from the positive tiger keeper (Figure). Figure. Whole-genome phylogenetic analysis. Whole-genome phylogenetic analysis from a portion of clade 20G showing divergence estimates from SARS-CoV-2 Wuhan-Hu-1 reference genome with sequences from humans living in Tennessee and Malayan tigers sampled during the outbreak investigation in October 2020. Sequence analysis showed 3-6 single nucleotide polymorphisms (SNPs) differences between one human tiger keeper and all three tiger sequences. Differences are indicated by one-step edges (lines) between colored dots (individual SARS-CoV-2 sequenced infections). Numbers indicate unique sequences. Note not all analyzed sequences are shown in this figure. Conclusion. Using a One Health approach, we concluded the index tiger was likely infected via transmission from an ill visitor at an exhibit observation point or unidentified asymptomatic staff. Infection spread to the other 2 tigers and tigerto-human transmission to 2 staff is possible thereafter. The zoo was advised on infection control practices for humans and animals, and no additional cases were identified.

12.
Open Forum Infectious Diseases ; 8(SUPPL 1):S167-S168, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1746741

RESUMO

Background. The COVID-19 pandemic placed a strain on inpatient clinical and hospital programs due to increased patient volume and rapidly evolving data on best COVID-19 management strategies. However, the impact of the pandemic on ASPs has not been well described. Methods. We performed a cross-sectional electronic survey of stewardship pharmacy and physician leaders in 37 hospitals within the Duke Antimicrobial Stewardship Outreach Network (DASON) (community) and Duke/UNC Health systems (academic) in April-May 2021. The survey included 60 questions related to staffing changes, use of COVID-targeted therapies, related restrictions, and medication shortages. Results. Twenty-seven facilities responded (response rate of 73%). Pharmacy personnel was reduced in 17 (63%) facilities by an average of 16%. Impacted pharmacy personnel included the stewardship lead in 15/17 (88.2%) hospitals. Converting to remote work was rare and only reported in academic institutions (n=2, 7.4%). ASP personnel were reassigned to non-stewardship duties in 12 (44%) hospitals with only half returning to routine ASP work as of May 2021. Respondents estimated that 62% of routine ASP activities were diverted during the time of the pandemic. Non-traditional, pandemic-related ASP activities included managing multiple drug shortages, of which ventilator support medications (91%) were most common affecting patient care at 52% of facilities. Steroid and hydroxychloroquine shortages were less frequent (44% and 22%, respectively). Despite staff reductions, pharmacists often served as primary contact for remdesivir approvals either using a criteria-based checklist at dispensing or as part of a dedicated phone approval team (Figure). Most (77%) hospitals used a criteria-based pharmacist review strategy after remdesivir FDA approval. Restriction processes for other COVID-19 therapies such as tocilizumab, hydroxychloroquine, and ivermectin were reported in 64% of hospitals. Proportion of facilities implementing specific remdesivir allocation strategies from the time of the first US Food and Drug Administration (FDA) Emergency Use Authorization (EUA) through FDA approval Conclusion. Pandemic response diverted routine ASP work and has not yet returned to baseline. Despite the reduction in pharmacy personnel due to the pandemic, the ASP pharmacy lead took on a novel and critical stewardship role throughout the pandemic exemplified by their involvement in novel treatment allocation for COVID patients.

13.
Open Forum Infectious Diseases ; 8(SUPPL 1):S348, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1746503

RESUMO

Background. COVID-19 continues to threaten public health, particularly in Native American (NA) communities, which experienced some of the highest rates of COVID-19 infection and mortality in the US. Although the risk factors and clinical characteristics of COVID-19 are well documented in the general population, there has been little research on NA patients. Methods. We present descriptive data based on chart reviews of COVID-19 patients hospitalized between April 1 and July 31, 2020 at the Whiteriver Service Unit (WRSU), an Indian Health Service site on the Fort Apache Reservation. Results. Of the 2,262 COVID-19 cases during the observation period, 490 (22%) were hospitalized and 35 (1.6%) died within 28 days. Compared to previous reports, hospitalized patients at WRSU were younger (median age 54), more likely to be female (55% female), and more likely to have comorbidities (92% at least 1, median 2). Patients under 50 (n=200) often had a history of alcohol abuse (51%) or polysubstance abuse (20%). One third of hospitalized patients (34%) were monitored at home and referred for treatment through a high-risk outreach program. Patients were admitted much earlier at WRSU than in other locations, with a median interval of 4 days from symptom onset to hospitalization compared to 7 days reported elsewhere, but over half were still transferred to higher care. Although WRSU patients had higher rates of comorbidities, the 28-day hospital mortality rate from COVID-19 was nearly half of what has been previously reported (35/490, 7% vs 15-20% reported elsewhere, p < 0.001). This trend persisted after controlling for age. Multivariate logistic regression showed that increasing age, male sex, and high BMI were significantly associated with higher risk of death from COVID-19 (overall model p < 0.001). Characteristics and outcomes of hospitalized COVID-19 patients at WRSU Conclusion. Hospitalized patients at WRSU tended to be younger but with more comorbidities than previous studies. This may reflect the fact that NAs tend to acquire comorbidities at younger ages than the general population. This may also reflect the high rates of substance abuse in younger patients, which could be an additional risk factor for severe COVID-19. We believe that the low mortality rates at WRSU are a result of our outreach program, which likely decreased the interval between symptom onset and medical treatment.

14.
Vietnam tourism: policies and practices ; : 119-135 41 ref, 2022.
Artigo em Inglês | CAB Abstracts | ID: covidwho-1721793

RESUMO

This chapter examines the symbiosis of heritage conservation and tourism development at a UNESCO (United Nations Educational, Scientific and Cultural Organization) cultural heritage site, one of the most popular touristic sites in Vietnam. Bui, Le and Jones present findings derived from a longitudinal study over 5 years spanning before and during the COVID-19 pandemic (from 2016 to 2020). Although Hoi An has dramatically benefited from mass tourism, the excessive increase in visitor numbers and concentration in the core heritage zone of the city has negatively impacted the economic wealth of the residents of the ancient town. COVID-19 halted the development of tourism, which attracts attention to the overdependence of the city on tourism, and offers an opportunity for administrators to rethink and revise Hoi An's existing tourism policies.

15.
Journal of Humanistic Mathematics ; 12(1):148-171, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-1717179

RESUMO

In summer 2020, we invited the 6761 undergraduate students who took a Spring 2020 math course at the University of Arizona to participate in a survey, with 13% responding. We asked about their experience with the emergency transition to remote learning and measured their math anxiety before and after the transition using the well-established Abbreviated Math Anxiety Scale (AMAS). "Unmotivated, depressed, anxious" are the words one undergraduate used to describe their emergency transition to remote learning. Our results indicate that limited access to quality technology and inadequate communication with an instructor were the two greatest predictors for an increase in math anxiety after the emergency transition to remote learning. These results may encourage instructors to foster community with their students, especially during emergency remote learning.

16.
2021 ASEE Virtual Annual Conference, ASEE 2021 ; 2021.
Artigo em Inglês | Scopus | ID: covidwho-1695988

RESUMO

Senior Capstone Design is a culminating course of the undergraduate engineering curriculum which gives students the opportunity to work in teams on designing a solution to real-world problems submitted and mentored by industrial and research project sponsors. In Biological and Agricultural Engineering disciplines, these projects can involve tasks such as field data collection, laboratory experiments or fabrication of prototypes that require access to specific laboratories and equipment. In the Spring 2020, Universities across the US shut down to prevent the spread of COVID-19 and transitioned to remote or virtual courses. The objective of this study was to investigate the impact of the transition to remote and virtual courses on senior design or capstone courses in Biological and Agricultural Engineering to find lessons learned and help plan for future disruption in these courses. Four Senior Design Capstone Course instructors from different Biological and Agricultural Engineering departments were interviewed to gather their perspectives and experiences regarding changes in instruction;student projects' management and outcomes;as well as students' learning and performance in the course. The shift to remote learning triggered frustration on both students and instructors' sides. They also faced unprecedented challenges with technology and access. Instructors acknowledged student resilience and adaptability to the situation. The creative flexibility that instructors applied to course delivery, project deliverables and assessment is a key tool that allowed them to maintain the real-world experiential nature of BAE capstone programs. © American Society for Engineering Education, 2021

17.
Journal of Tourism Futures ; 7(3):322-336, 2021.
Artigo em Inglês | CAB Abstracts | ID: covidwho-1633711

RESUMO

Purpose: Different countries have responded to the pandemic with distinct domestic and international travel restrictions. The purpose of this paper is to investigate the stringency of the coronavirus disease 2019 (COVID-19) countermeasures in Japan against their G20 cohorts. Primary data were monitored at a ski resort in Kyushu regarding the social acceptance of initial COVID-19 countermeasures, ranging from hygiene and local "lockdowns" to border control measures. Design/methodology/approach: The stringency of the COVID-19 countermeasures was examined using data from the Oxford COVID-19 Government Response Tracker (OxCGRT) and triangulated with the early stage social acceptance of survey respondents in Aso Kuju National Park in February 2020 that consisted of 165 valid Japanese language questionnaires. Findings: An one-way analysis of variance (ANOVA) identified significant differences in social acceptance for countermeasures, with more-concerned respondents agreeing more strongly with "low-tech" health protocols, such as washing hands (M = 3.7) or wearing a mask (3.4). More concerned visitors were significantly more likely to modify their travel plans (2.9) or cancel their trip altogether (2.7). Male day trippers were less likely to be concerned by the COVID-19 pandemic. Originality/value: This paper's originality is derived from a triangulation of the stringency of Japan's initial COVID-19 countermeasures via a combination of comparison with G20 cohorts and social acceptance of domestic snowboarders and skiers. Moreover, by shining a light on the trade-off between public health and human rights, the paper provides a current review of the ethical dimension of a travel restriction debate that is often overlooked in the ongoing pandemic.

18.
American Journal of Health Education ; 53(1):11-15, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-1633157

RESUMO

Background: Successful management of diseases, especially COVID-19, a disease by a novel virus, is often contingent upon health literacy (HL), as it directly impacts understanding preventative mandates, testing, and treatment modalities. Many vulnerable populations have preexisting conditions and lack of insurance or access to health care. Such disparities coupled with low HL, mistrust, and fear of medical communities increase their vulnerability to COVID-19, contributing to disparate outcomes. Additionally, ardent social media consumers received, believed and shared misinformation rapidly via social media. Purpose: Since health literacy and population training are vital to improving health outcomes, HL must be an outcome of health education. Results: This commentary suggests ways to make HL an outcome of health education efforts by using factual memes. Discussion: In addressing disparate outcomes, health education specialists must create culturally sensitive, low-literacy, multilingual guides and decision aids with large font, inclusive images, and socially acceptable lingo. Translation to Health Education Practice: Memes have comedic and catchy nature, are easily understood and rapidly shared, and can deliver accurate information while increasing HL among vulnerable groups who use social media.

20.
Open forum infectious diseases ; 8(Suppl 1):S348-S348, 2021.
Artigo em Inglês | EuropePMC | ID: covidwho-1602097

RESUMO

Background COVID-19 continues to threaten public health, particularly in Native American (NA) communities, which experienced some of the highest rates of COVID-19 infection and mortality in the US. Although the risk factors and clinical characteristics of COVID-19 are well documented in the general population, there has been little research on NA patients. Methods We present descriptive data based on chart reviews of COVID-19 patients hospitalized between April 1 and July 31, 2020 at the Whiteriver Service Unit (WRSU), an Indian Health Service site on the Fort Apache Reservation. Results Of the 2,262 COVID-19 cases during the observation period, 490 (22%) were hospitalized and 35 (1.6%) died within 28 days. Compared to previous reports, hospitalized patients at WRSU were younger (median age 54), more likely to be female (55% female), and more likely to have comorbidities (92% at least 1, median 2). Patients under 50 (n=200) often had a history of alcohol abuse (51%) or polysubstance abuse (20%). One third of hospitalized patients (34%) were monitored at home and referred for treatment through a high-risk outreach program. Patients were admitted much earlier at WRSU than in other locations, with a median interval of 4 days from symptom onset to hospitalization compared to 7 days reported elsewhere, but over half were still transferred to higher care. Although WRSU patients had higher rates of comorbidities, the 28-day hospital mortality rate from COVID-19 was nearly half of what has been previously reported (35/490, 7% vs 15-20% reported elsewhere, p < 0.001). This trend persisted after controlling for age. Multivariate logistic regression showed that increasing age, male sex, and high BMI were significantly associated with higher risk of death from COVID-19 (overall model p < 0.001). Characteristics and outcomes of hospitalized COVID-19 patients at WRSU Conclusion Hospitalized patients at WRSU tended to be younger but with more comorbidities than previous studies. This may reflect the fact that NAs tend to acquire comorbidities at younger ages than the general population. This may also reflect the high rates of substance abuse in younger patients, which could be an additional risk factor for severe COVID-19. We believe that the low mortality rates at WRSU are a result of our outreach program, which likely decreased the interval between symptom onset and medical treatment. Disclosures All Authors: No reported disclosures

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA