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2.
Eur J Anaesthesiol ; 38(12): 1284-1292, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1537590

RESUMO

BACKGROUND: During the surge in coronavirus disease 2019 (COVID-19) infections in early 2020, many medical organisations began developing strategies for implementing teleconsultation to maintain medical services during lockdown and to limit physical contact. Therefore, we developed a teleconsultation preoperative evaluation platform to replace on-site preoperative meetings. OBJECTIVE: This study assessed the feasibility of a teleconsultation for preoperative evaluation and procedure-associated adverse events. DESIGN: Implementation study. SETTING: A tertiary care university hospital in Germany from April 2020 to October 2020. PATIENTS: One hundred and eleven patients scheduled for elective surgery. INTERVENTION: Patients were assigned to receive teleconsultation for preoperative evaluation and to complete a subsequent survey. MAIN OUTCOME MEASURES: Primary endpoints were medical and technical feasibility, user satisfaction and time savings. RESULTS: For 100 out of 111 patients, telepreoperative consultations allowed for adequate perioperative risk assessment, patient education and also for effective collection of legal signatures. For six patients (5.4%), consultations could not be started because of technical issues, whereas for five patients (4.8%), clearance for surgery could not be granted because of medical reasons. A clear majority of anaesthetists (93.7%) rated the telepreoperative evaluations as equivalent to on-site meetings. The majority of the patients considered teleconsultation for preoperative evaluation as convenient as an on-site meeting (98.2%) and would choose a teleconsultation again (97.9%). Median travel time saved by patients was 60 min (Q1 40, Q3 80). We registered one adverse event: we detected atrial fibrillation in one patient only immediately prior to surgery. CONCLUSION: Telepreoperative evaluations are medically and technically feasible, yielding high satisfaction rates on both sides. However, regarding patient safety, not every patient is equally well suited. Overall, implementation of teleconsultation for preoperative evaluation into clinical routine could help maintain medical care during the COVID-19 pandemic. TRIAL REGISTRATION: NCT04518514, ClinicalTrials.gov.


Assuntos
COVID-19 , Consulta Remota , Controle de Doenças Transmissíveis , Estudos de Viabilidade , Humanos , Pandemias , SARS-CoV-2
4.
Work ; 70(2): 347-354, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1538353

RESUMO

BACKGROUND: Due to the COVID-19 pandemic in Iran, the number of patients admitted to hospitals and the workload of nurses has increased. High workload can reduce efficiency and quality of life. In the meantime the percived social support may had a moderating role. OBJECTIVE: The aim of the study was to investigate the effect of workload and perceived social support on quality of life in nurses who work in COVID-19 inpatient wards. METHODS: This was a cross-sectional descriptive-analytic study. 336 nurses who worked in inpatient wards with COVID-19 patients were randomly selected and studied. NASA-TLX Workload Questionnaire, WHO Quality of Life Questionnaire and Multidimensional Social Support Perception Scale were used to data collection. Structural equation modelling in PLS software was used to modelling. RESULTS: The results showed that the average score of workload, perceived social support and quality of life were 80.87±20.17, 56.23±11.46 and 55.87±13.74, respectively. A significant inverse relationship was observed between workload and quality of life (P < 0.05). Also, perceived social support had a moderator effect on relationship between workload and quality of life (P < 0.05). CONCLUSIONS: High workload can upset the balance between work and life that leads to decrease the quality of life. Perceived social support as a moderator can reduce the negative impact of workload on quality of life. In the COVID-19 pandemic where nurses' workload have increased, by increasing the perceived social support can manage the negative effect of workload.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Estudos Transversais , Humanos , Pandemias , Qualidade de Vida , SARS-CoV-2 , Apoio Social , Inquéritos e Questionários , Carga de Trabalho
5.
Work ; 70(2): 355-363, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1538352

RESUMO

BACKGROUND: Coronavirus disease (COVID-19) is caused by SARS-COV2, a highly transmissible and pathogenic viral infection, and was identified in December 2019 in Wuhan, China. Three months later, it became a severe pandemic. OBJECTIVE: To identify scientific evidence on the use of face shields by health professionals during the COVID-19 pandemic period. METHOD: An integrative literature review of articles obtained from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases was undertaken. For the search, controlled, non-controlled descriptors and specific keywords: "face shield," "fluid resistance procedure," "respiratory infections," "healthcare workers," "COVID-19," "aerosols," and "personal protection infection" were used. RESULTS: The sample comprised seven studies. The available evidence has shown that face shields do not have a defined standard for their production-their effectiveness depends on the quality of the visor, structure, and fixation system. They must be used as adjuvants to other personal protective equipment (PPE), and their isolated use is not recommended due to the fragilities of peripheral face sealing, especially during the COVID-19 pandemic period. CONCLUSION: Due to the shortage of this equipment, domestic face shields can be indicated if they meet production requirements, based on scientific evidence for their efficient use.


Assuntos
COVID-19 , Pandemias , Pessoal de Saúde , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , RNA Viral , SARS-CoV-2
6.
Work ; 70(2): 365-376, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1538351

RESUMO

BACKGROUND: Dentistry is one of the highest risk occupations that face COVID-19, especially in countries that are severely affected by the pandemic, such as Indonesia. OBJECTIVE: The purpose of the study was to determine factors influencing job satisfaction among dentists during the new normal of COVID-19 pandemic in Indonesia by utilizing the Structural Equation Modeling (SEM) approach. METHODS: A total of 310 Indonesian dentists voluntary completed an online questionnaire, which contained 58 questions. Several latent variables such as perceived severity of COVID-19, staff cooperation and management commitment, personal protective equipment, job stress, working hours, income, and overall job satisfaction were analyzed simultaneously. RESULTS: SEM revealed perceived severity of COVID-19 had significant effects on job stress (ß:0.394, p = 0.025) and the utilization of personal protective equipment (ß:0.757, p = 0.001). Subsequently, job stress (ß:-0.286, p = 0.001), working hours (ß:0.278, p = 0.018), income (ß:0.273, p = 0.003), personal protective equipment (ß:0.145, p = 0.038), and staff cooperation & management commitment (ß:0.091, p = 0.002) were found to have significant effects on overall job satisfaction. In addition, management & staff cooperation was found to have a significant association with job stress reduction (ß:-0.319, p = 0.003) which subsequently led to higher satisfaction. CONCLUSIONS: The current study is one of the first that analyzed job satisfaction among dentists in Indonesia during the global COVID-19 pandemic. The integrated latent variables can be applied and extended to evaluate job satisfaction among dentists during the COVID-19 pandemic in other countries. Finally, this study contributed as a theoretical foundation for policymakers to enhance the job satisfaction of dentists during the COVID-19 pandemic.


Assuntos
COVID-19 , Pandemias , Odontólogos , Humanos , Indonésia/epidemiologia , Satisfação no Emprego , Análise de Classes Latentes , SARS-CoV-2 , Inquéritos e Questionários
7.
J Med Ethics ; 47(8): 547-548, 2021 08.
Artigo em Inglês | MEDLINE | ID: covidwho-1537986

RESUMO

Rapid, large-scale uptake of new vaccines against COVID-19 will be crucial to decrease infections and end the pandemic. In a recent article in this journal, Julian Savulescu argued in favour of monetary incentives to convince more people to be vaccinated once the vaccine becomes available. To evaluate the potential of his suggestion, we conducted an experiment investigating the impact of payments and the communication of individual and prosocial benefits of high vaccination rates on vaccination intentions. Our results revealed that none of these interventions or their combinations increased willingness to be vaccinated shortly after a vaccine becomes available. Consequently, decision makers should be cautious about introducing monetary incentives and instead focus on interventions that increase confidence in vaccine safety first, as this has shown to be an especially important factor regarding the demand for the new COVID-19 vaccines.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/economia , COVID-19 , Motivação , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Vacinação/economia , Vacinação/psicologia , COVID-19/prevenção & controle , Feminino , Educação em Saúde , Humanos , Masculino , Pandemias , SARS-CoV-2
8.
Adv Exp Med Biol ; 1318: 263-291, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1536207

RESUMO

We herein seek to expound on up-to-the-minute information regarding cardiovascular disease in the era of coronavirus disease 2019 (COVID-19) by highlighting acute myocardial injury caused by COVID-19 and probing into its pathophysiology, clinical signs, diagnostic tests, and treatment modalities. We aim to share the latest research findings vis-à-vis cardiovascular disease patients with confirmed or suspected COVID-19 on the association between hypertension and this infectious disease along with the relevant recommendations; describe the mechanism of coronary artery disease in such patients together with the necessary measures in the setting of non-ST-segment elevation acute coronary syndrome, ST-segment elevation myocardial infarction, and chronic coronary syndrome; discuss tachy- and bradyarrhythmias in the COVID-19 setting alongside their treatments; elucidate coagulopathies, venous thromboembolism, and its prophylactic measures in the context of this infection; set out the cardiopulmonary resuscitation protocol as well as the pertinent safety concerns during the current pandemic; and, finally, explicate drug-drug interactions between COVID-19 and cardiovascular medication in hypertension, acute coronary syndrome, heart failure, venous thromboembolism, and arrhythmias.


Assuntos
COVID-19 , Doenças Cardiovasculares , Infarto do Miocárdio com Supradesnível do Segmento ST , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Humanos , Pandemias , SARS-CoV-2
9.
Epidemiol Infect ; 148: e168, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: covidwho-1537262

RESUMO

This study aimed to identify clinical features for prognosing mortality risk using machine-learning methods in patients with coronavirus disease 2019 (COVID-19). A retrospective study of the inpatients with COVID-19 admitted from 15 January to 15 March 2020 in Wuhan is reported. The data of symptoms, comorbidity, demographic, vital sign, CT scans results and laboratory test results on admission were collected. Machine-learning methods (Random Forest and XGboost) were used to rank clinical features for mortality risk. Multivariate logistic regression models were applied to identify clinical features with statistical significance. The predictors of mortality were lactate dehydrogenase (LDH), C-reactive protein (CRP) and age based on 500 bootstrapped samples. A multivariate logistic regression model was formed to predict mortality 292 in-sample patients with area under the receiver operating characteristics (AUROC) of 0.9521, which was better than CURB-65 (AUROC of 0.8501) and the machine-learning-based model (AUROC of 0.4530). An out-sample data set of 13 patients was further tested to show our model (AUROC of 0.6061) was also better than CURB-65 (AUROC of 0.4608) and the machine-learning-based model (AUROC of 0.2292). LDH, CRP and age can be used to identify severe patients with COVID-19 on hospital admission.


Assuntos
Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Modelos Logísticos , Aprendizado de Máquina , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Adolescente , Adulto , Idoso , COVID-19 , China/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Prognóstico , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco/métodos , Adulto Jovem
10.
J Am Coll Radiol ; 17(8): 1011-1013, 2020 08.
Artigo em Inglês | MEDLINE | ID: covidwho-1536620

RESUMO

BACKGROUND: Quarantine and stay-at-home orders are strategies that many countries used during the acute pandemic period of coronavirus disease 2019 (COVID-19) to prevent disease dissemination, health system overload, and mortality. However, there are concerns that patients did not seek necessary health care because of these mandates. PURPOSE: To evaluate the differences in the clinical presentation of acute appendicitis and CT findings related to these cases between the COVID-19 acute pandemic period and nonpandemic period. MATERIALS AND METHODS: A retrospective observational study was performed to compare the acute pandemic period (March 23, 2020, to May 4, 2020) versus the same period the year before (March 23, 2019, to May 4, 2019). The proportion of appendicitis diagnosed by CT and level of severity of the disease were reviewed in each case. Univariate and bivariate analyses were performed to identify significant differences between the two groups. RESULTS: A total of 196 abdominal CT scans performed due to suspected acute appendicitis were evaluated: 55 from the acute pandemic period and 141 from the nonpandemic period. The proportion of acute appendicitis diagnosed by abdominal CT was higher in the acute pandemic period versus the nonpandemic period: 45.5% versus 29.8% (P = .038). The severity of the diagnosed appendicitis was higher during the acute pandemic period: 92% versus 57.1% (P = .003). CONCLUSION: During the acute COVID-19 pandemic period, fewer patients presented with acute appendicitis to the emergency room, and those who did presented at a more severe stage of the disease.


Assuntos
Apendicite/diagnóstico por imagem , Apendicite/epidemiologia , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Análise de Variância , COVID-19 , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Análise Multivariada , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Quarentena/estatística & dados numéricos , Estudos Retrospectivos , Medição de Risco , Tomografia Computadorizada por Raios X/métodos , Estados Unidos
11.
Can J Anaesth ; 67(9): 1217-1248, 2020 09.
Artigo em Inglês | MEDLINE | ID: covidwho-1536371

RESUMO

PURPOSE: We conducted two World Health Organization-commissioned reviews to inform use of high-flow nasal cannula (HFNC) in patients with coronavirus disease (COVID-19). We synthesized the evidence regarding efficacy and safety (review 1), as well as risks of droplet dispersion, aerosol generation, and associated transmission (review 2) of viral products. SOURCE: Literature searches were performed in Ovid MEDLINE, Embase, Web of Science, Chinese databases, and medRxiv. Review 1: we synthesized results from randomized-controlled trials (RCTs) comparing HFNC to conventional oxygen therapy (COT) in critically ill patients with acute hypoxemic respiratory failure. Review 2: we narratively summarized findings from studies evaluating droplet dispersion, aerosol generation, or infection transmission associated with HFNC. For both reviews, paired reviewers independently conducted screening, data extraction, and risk of bias assessment. We evaluated certainty of evidence using GRADE methodology. PRINCIPAL FINDINGS: No eligible studies included COVID-19 patients. Review 1: 12 RCTs (n = 1,989 patients) provided low-certainty evidence that HFNC may reduce invasive ventilation (relative risk [RR], 0.85; 95% confidence interval [CI], 0.74 to 0.99) and escalation of oxygen therapy (RR, 0.71; 95% CI, 0.51 to 0.98) in patients with respiratory failure. Results provided no support for differences in mortality (moderate certainty), or in-hospital or intensive care length of stay (moderate and low certainty, respectively). Review 2: four studies evaluating droplet dispersion and three evaluating aerosol generation and dispersion provided very low certainty evidence. Two simulation studies and a crossover study showed mixed findings regarding the effect of HFNC on droplet dispersion. Although two simulation studies reported no associated increase in aerosol dispersion, one reported that higher flow rates were associated with increased regions of aerosol density. CONCLUSIONS: High-flow nasal cannula may reduce the need for invasive ventilation and escalation of therapy compared with COT in COVID-19 patients with acute hypoxemic respiratory failure. This benefit must be balanced against the unknown risk of airborne transmission.


Assuntos
Infecções por Coronavirus/terapia , Oxigenoterapia/métodos , Pneumonia Viral/terapia , Insuficiência Respiratória/terapia , Aerossóis , COVID-19 , Cânula , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Humanos , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/virologia
12.
MedUNAB ; 24(1): 9-12, 23-04-2021.
Artigo em Espanhol | LILACS (Américas) | ID: covidwho-1536097

RESUMO

Sr. Editor. Hasta la fecha se han documentado 7,439,220 de contagio por coronavirus (COVID-19) con una cifra de muertes de 961,400, de los cuales aproximadamente 7,000 hacen parte del personal de salud. En Colombia, las cifras por COVID-19 llegan a 758,398 con una mortalidad de 3,1%, lo que equivale a 24,039 muertes. Esto ha significado una gran carga mental para el personal de salud, conduciendo a un incremento en el número de suicidios por parte de este personal. Colombia no es ajena a la situación, tiene un reporte de 43,157 casos de los cuales 7,651 se dieron en médicos, 11,171 en auxiliares de enfermería, 4,611 en enfermeras profesionales. En cuanto a la mortalidad, hasta la fecha de revisión del 3 de febrero del 2021 había una cifra de 216 fallecidos de los cuales 71 eran médicos, 38 eran auxiliares de enfermería y trece enfermeras profesionales (1). DOI: https://doi.org/10.29375/01237047.3997


Until today, 7,439,220 infections have been documented by coronavirus (COVID-19) with a death toll of 961,400, of which approximately 7,000 make part of the health personnel. In Colombia, the figures for COVID-19 reaches 758,398 with a mortality of 3.1%, which is equivalent to 24,039 deaths. This has meant a great mental burden for health personnel, driving an increase in the number of suicides by this staff. Colombia is no stranger to the situation, it has a report from 43,157 cases of which 7,651 occurred in physicians, 11,171 in nursing assistants, 4,611 in nurses Professionals. Regarding mortality, to date revision of February 3, 2021 there was a figure of 216 deceased of which 71 were doctors, 38 were nursing assistants and thirteen professional nurses (1). DOI: https://doi.org/10.29375/01237047.3997


Até hoje, 7.439.220 infecções foram documentadas por coronavírus (COVID-19) com um número de mortes de 961.400, das quais aproximadamente 7.000 fazem parte do pessoal de saúde. Na Colômbia, os dados do COVID-19 chegam a 758.398 com mortalidade de 3,1%, o que equivale a 24.039 óbitos. Isso tem significado uma grande carga mental para o pessoal de saúde, levando a um aumento no número de suicídios dessa equipe. A Colômbia conhece bem a situação, tem um relatório de 43.157 casos, dos quais 7.651 ocorreram em médicos, 11.171 em auxiliares de enfermagem, 4.611 em profissionais de enfermagem. Em relação à mortalidade, até a data da revisão de 3 de fevereiro de 2021 havia 216 mortos, sendo 71 médicos, 38 auxiliares de enfermagem e treze profissionais de enfermagem (1). DOI: https://doi.org/10.29375/01237047.3997


Assuntos
Esgotamento Psicológico , Saúde Mental , Infecções por Coronavirus , Pandemias
13.
J Sports Med Phys Fitness ; 61(8): 1052-1060, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: covidwho-1535057

RESUMO

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is the virus causing Coronavirus disease 2019 (COVID-19). Since the World Health Organization declared the outbreak of pandemic on March 11, 2020, cases have been increasing around the World with more than 3-million deaths recorded and a daily number of COVID-19 cases 20 times higher than when the Olympics were postponed, at the time of writing. Governments adopted various lockdown measures forcing isolation for many weeks/months depending on the evolution of the disease in each country. The rapid transmission of the disease forced the Tokyo 2020 Olympics to be postponed for one year. Travel restrictions, quarantine requirements and isolation have been the norm for many athletes in preparation for the Olympic Games. Also, due to the measures put in place to reduce the spread of the disease, sporting facilities have been closed and competitions cancelled forcing athletes and their staff to find alternative solutions to maintain performance and continue preparing for the Olympics. This unique challenge is affecting the whole World, and while vaccination programs start to be deployed, in a few months the world will see the first Olympic Games' edition during a pandemic. The aim of this special paper was to consider the various challenges posed by the COVID pandemic and to provide information for coaching support staff to improve the preparation for Tokyo Olympics as well as consider the possible performance implications of this unique Olympic edition.


Assuntos
COVID-19 , Pandemias , Atletas , Controle de Doenças Transmissíveis , Humanos , SARS-CoV-2
14.
Biochem Med (Zagreb) ; 31(3): 030901, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: covidwho-1534570

RESUMO

Introduction: The data on the coronavirus disease (COVID-19) in solid-organ transplant recipients (SOTRs) in Croatia is unknown. The aim of this study was to analyze the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Croatian SOTRs. Materials and methods: From 7 September to 27 November 2020 (beginning of the second COVID-19 pandemic wave), a cross-sectional screening for COVID-19 was performed in the adult outpatient liver (LTRs; N = 280) and kidney transplant recipients (KTRs; N = 232). Serum samples were initially tested for SARS-CoV-2 IgG antibodies using a commercial enzyme-linked immunosorbent assay (ELISA; Vircell Microbiologists, Granada, Spain). All positive samples were confirmed using a virus neutralization test (VNT). Data on risk exposure and COVID-19 related symptoms were collected using a questionnaire. Results: The transplanted cohort's seroprevalence detected by ELISA and VNT was 20.1% and 3.1%, respectively. Neutralizing (NT) antibodies developed in 15.6% of anti-SARS-CoV-2 ELISA IgG positive SOTRs. The difference in seropositivity rates between LTRs and KTRs was not statistically significant (ELISA 21.1% vs. 19.0%, P = 0.554; VNT 3.6% vs. 2.6%, P = 0.082). Overall VNT positivity rates were higher in patients who reported participation in large community events (5.9% vs. 1.0%; P = 0.027) as well as in patients who reported COVID-19 related symptoms in the past six months. In addition, symptomatic VNT positive patients showed significantly higher (P = 0.031) NT antibody titers (median 128, interquartile range (IQR) = 32-128) compared to asymptomatic patients (median 16, IQR = 16-48). Conclusions: This study showed that 15.6% of anti-SARS-CoV-2 ELISA positive Croatian SOTRs developed NT antibodies indicating protective immunity. Further studies are needed to determine the dynamic of NT antibodies and COVID-19 immunity duration in immunocompromised populations such as LTRs and KTRs.


Assuntos
COVID-19 , Transplante de Órgãos , Adulto , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2 , Estudos Soroepidemiológicos
16.
Pediatrics ; 148(1)2021 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1533449

RESUMO

BACKGROUND AND OBJECTIVES: Depression is common, and suicide rates are increasing. Adolescent depression screening might miss those with unidentified suicide risk. Our primary objective in this study was to compare the magnitude of positive screen results across different approaches. METHODS: From June 2019 to October 2020, 803 mostly Medicaid-enrolled adolescents aged ≥12 years with no recent history of depression or self-harm were screened with the Patient Health Questionnaire-9 Modified for Adolescents (PHQ-9A) and the Ask Suicide-Screening Questions (ASQ) across 12 primary care practices. Two PHQ-9A screening strategies were evaluated: screening for any type of depression or other mental illness (positive on any item) or screening for major depressive disorder (MDD) (total score ≥10). RESULTS: Overall, 56.4% of patients screened positive for any type of depression, 24.7% screened positive for MDD, and 21.1% screened positive for suicide risk. Regardless of PHQ-9A screening strategy, the ASQ identified additional subjects (eg, 2.2% additional cases compared with screening for any type of depression or other mental illness and 8.3% additional cases compared with screening positive for MDD). Of those with ≥6 month follow-up, 22.9% screened positive for any type of depression (n = 205), 35.6% screened positive for MDD (n = 90), and 42.7% with a positive ASQ result (n = 75) had a depression or self-harm diagnosis or an antidepressant prescription. CONCLUSIONS: Suicide risk screening identifies cases not identified by depression screening. In this study, we underscore opportunities and challenges in primary care related to the high prevalence of depression and suicide risk. Research is needed regarding optimal screening strategies and to help clinicians manage the expected number of screening-identified adolescents.


Assuntos
Depressão/epidemiologia , Programas de Rastreamento/métodos , Atenção Primária à Saúde/métodos , Suicídio/estatística & dados numéricos , Adolescente , Antidepressivos/uso terapêutico , COVID-19/epidemiologia , COVID-19/psicologia , Criança , Depressão/diagnóstico , Depressão/tratamento farmacológico , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Solidão , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Pandemias , Fatores de Risco , SARS-CoV-2 , Isolamento Social , Suicídio/prevenção & controle , Adulto Jovem
17.
Isr J Health Policy Res ; 10(1): 40, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: covidwho-1533279

RESUMO

BACKGROUND AND PURPOSE: Marked reductions in imaging exams have been documented during the COVID-19 pandemic. The study aimed to examine the effect of the two waves of COVID-19 on magnetic resonance imaging (MRI) utilization at the national and regional level. MATERIALS AND METHODS: A retrospective-archive study was conducted in Israel, comparing March-December 2020 with March-December 2018 and 2019. Data on MRI utilization were obtained from the national MRI registry, while data on confirmed COVID-19 cases, by place of residence, were obtained from the Israeli Ministry of Health open COVID-19 database. RESULTS: The number and rate of MRI examinations decreased during the first COVID-19 wave, with the steepest drop in April 2020: 47.5% relative decrease compared to April 2019, and 42.2% compared to 2018. This was followed by a compensatory increase between the waves and a return to almost pre-pandemic levels of use, with just a modest decrease, during the second, more intense COVID wave, compared with the previous year. Existing differences between regions increased during the pandemic. The rate ratio of MRI exams between Tel-Aviv and the Northern periphery increased from 2.89 in April 2019 to 3.94 in April 2020. Jerusalem metropolitan region, with the largest burden of COVID disease, demonstrated only a modest decrease (1%) in MRI utilization during the first 10 months of the pandemic. CONCLUSIONS: At the national level, time trends in reduced MRI utilization followed the first wave of COVID-19, and were accompanied by increased regional disparities. These changes were not explained by differences in the burden of COVID-19 disease but might be explained by unequal distribution of MRI scanners among regions. Reduced utilization was not evident during the second wave, nor at the beginning of the third wave, despite higher COVID-19 case load, demonstrating adaptation to the new normal. Patterns of MRI utilization might help policy-makers and healthcare managers predict the behavior of imaging as well as other sectors, such as elective surgical procedures, during an ongoing pandemic. This forecast might help to manage the lasting effects of the pandemic, including extended waiting times, in the months and years following its remission. In preparation for future national emergencies, timely and detailed data on MRI utilization can serve as a "sensor" for a wide array of diagnostic and interventional medical activities, providing policy-makers with an updated snapshot to guide their response at the regional and national levels.


Assuntos
COVID-19/epidemiologia , Imageamento por Ressonância Magnética/estatística & dados numéricos , Pandemias , Utilização de Procedimentos e Técnicas/tendências , Humanos , Israel/epidemiologia , Estudos Retrospectivos
18.
Hum Resour Health ; 19(1): 112, 2021 09 16.
Artigo em Inglês | MEDLINE | ID: covidwho-1533262

RESUMO

BACKGROUND: Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses' globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom. MAIN BODY: Nurses' health is influenced by the broader social, economic, and political system and the redistribution of power relations that creates new policies regarding the labour market and the welfare state. The vulnerability faced by nurses is heightened by gender inequalities, in addition to social class, ethnicity/race (and caste), age and migrant status, that are inequality axes that explain why nurses' workers, and often their families, are exposed to multiple risks and/or poorer health. Before the COVID-19 pandemic, informalization of nurses' employment and working conditions were unfair and harmed their health. During COVID-19 pandemic, there is evidence that the employment and working conditions of nurses are associated to poor physical and mental health. CONCLUSION: The protection of nurses' health is paramount. International and national enforceable standards are needed, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work-life balance. More knowledge is needed to understand the pathways and mechanisms on how precariousness might affect nurses' health and monitor the progress towards nurses' health equity.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Emprego , Disparidades nos Níveis de Saúde , Humanos , Pandemias , SARS-CoV-2
19.
BMC Psychiatry ; 21(1): 560, 2021 11 11.
Artigo em Inglês | MEDLINE | ID: covidwho-1533249

RESUMO

BACKGROUND: In addition to having a negative impact on the physical and emotional health of the population, the global Covid-19 pandemic has necessitated psychotherapists moving their practice to online environments. This service evaluation examines the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) Therapy delivered via the internet. METHODS: A real-world service evaluation was conducted from a self-selecting group of EMDR therapists that subscribe to either a JISCMail discussion list or either the UK or All Ireland National EMDR Associations. Author designed questionnaires were used to gather information on the efficacy of EMDR delivered online as well as client and therapist characteristics. RESULTS: Thirty-three therapists provided efficacy data on a total of 93 patients. Statistically significant and clinically meaningful reductions were found in all four-psychometrics used both in adult and children and young people populations. Client outcome was not related to therapist experience. CONCLUSIONS: EMDR delivered via the internet can be an effective treatment for clients experiencing mental health issues.


Assuntos
COVID-19 , Dessensibilização e Reprocessamento através dos Movimentos Oculares , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Criança , Movimentos Oculares , Humanos , Pandemias , SARS-CoV-2 , Resultado do Tratamento
20.
BMC Emerg Med ; 21(1): 102, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: covidwho-1533244

RESUMO

BACKGROUND: The COVID-19 pandemic has had profound effects on the utilization of health care services, including Emergency Medical Services (EMS). Social distancing measures taken to prevent the spread of the disease have greatly affected the functioning of societies and reduced or halted many activities with a risk of injury. The aim of this study was to report the effects of lockdown measures on trauma-related EMS calls in the Finnish capital area. METHODS: We conducted a retrospective cohort study of all EMS calls in the Helsinki University Hospital (HUH) catchment area between 1 January and 31 July 2020. Calls were identified from the HUH EMS database. Calls were grouped into pre-lockdown, lockdown, and post-lockdown periods according to the restrictions set by the Finnish government and compared to the mean number of calls for the corresponding periods in 2018 and 2019. Statistical comparisons were performed using Mann-Whitney U-test for weekly numbers and percentages. RESULTS: During the study period there was a total of 70,705 EMS calls, of which 14,998 (21.2%) were related to trauma; 67,973 patients (median age 61.6 years; IQR 35.3-78.6) were met by EMS. There was no significant change in the weekly number of total or trauma-related EMS calls during the pre-lockdown period. During the lockdown period, the number of weekly total EMS calls was reduced by 12.2% (p = 0.001) and the number of trauma-related calls was reduced by 23.3% (p = 0.004). The weekly number of injured patients met by EMS while intoxicated with alcohol was reduced by 41.8% (p = 0.002). During the post-lockdown period, the number of total and trauma-related calls and the number of injured patients intoxicated by alcohol returned to previous years' levels. CONCLUSIONS: The COVID-19 pandemic and social distancing measures reduced the number of trauma-related EMS calls. Lockdown measures had an especially significant effect on the number of injured patients intoxicated by alcohol met by the EMS. TRIAL REGISTRATION: Not applicable.


Assuntos
COVID-19 , Serviços Médicos de Emergência , Ferimentos e Lesões/epidemiologia , Controle de Doenças Transmissíveis , Serviços Médicos de Emergência/estatística & dados numéricos , Finlândia/epidemiologia , Humanos , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos
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