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1.
Paidéia (Ribeirão Preto, Online) ; 32: e3209, 2022. tab
Статья | WHO COVID, LILACS - Страны Америки - | ID: covidwho-1833843

Реферат

Abstract The COVID-19 pandemic has intensely affected the quality of life and labor conditions of healthcare workers (HCWs). This study sought to understand the experiences of 16 professionals in medicine, nursing and physical therapy who work on the "frontline" of the new Coronavirus. A phenomenological design was used. Results were organized into four axes: (a) the impact of the arrival of the pandemic; (b) participants' progressive exhaustion; (c) fear and coping; and (d) rethinking life and death. Experiences of anguish, anxiety, depression, and physical and psychological health problems stand out. It was possible to observe that the lack of national coordination, in addition to unscientific political positions, were felt as an aggravating factor for work demands, and that impotence in the face of the disease implicated in rethinking the meaning of life and death. According to the JD-R model, the need to expand resources and emotional support so HCWs can properly manage psychosocial risk factors at work is evident.


Resumo A pandemia vem afetando intensamente a qualidade de vida e condições laborais dos trabalhadores da saúde (TS). Este estudo teve por objetivo compreender as vivências de 16 profissionais da medicina, enfermagem e fisioterapia que atuam na "linha de frente" do novo coronavírus. Empregou-se desenho fenomenológico. Os resultados foram organizados em quatro eixos: (a) o impacto da chegada; (b) desgaste progressivo; (c) medo e enfrentamento e (d) repensando a morte e a vida. Destacam-se vivências de angústia, ansiedade, depressão, agravos à saúde física e psicológica. Foi possível observar que a falta de coordenação nacional somada a posicionamentos políticos anticientíficos foi sentida como agravante das demandas laborais e que a impotência diante da doença implicou repensar o sentido da vida e da morte. Com base no modelo JD-R, fica evidente a necessidade de ampliar recursos e suporte emocional aos TS a fim de administrar adequadamente os Fatores Psicossociais de Risco no Trabalho.


Resumen La pandemia ha afectado intensamente la calidad de vida y condiciones laborales de los trabajadores de la salud (TS). Este estudio buscó conocer experiencias de 16 profesionales de medicina, enfermería y fisioterapia que trabajan en la "primera línea" del nuevo coronavirus. Se utilizó diseño fenomenológico. Los resultados se organizaron en: (a) el impacto de la llegada; (b) desgaste progresivo; (c) miedo y confrontación; y (d) repensar la muerte y la vida. Se destacan experiencias de angustia, ansiedad, depresión, problemas de salud física y psicológica. Se observó que la falta de coordinación nacional, sumada a posiciones políticas acientíficas, fue un agravante de demandas laborales y que la impotencia frente a la enfermedad implicaba repensar el sentido de la vida y la muerte. Desde el modelo JD-R, es evidente la necesidad de ampliar recursos y apoyo emocional a los TS para gestionar adecuadamente los Factores de Riesgo Psicosocial en el Trabajo.

2.
Paidéia (Ribeirão Preto, Online) ; 32: e3208, 2022. tab
Статья в английский | WHO COVID, LILACS - Страны Америки - | ID: covidwho-1833842

Реферат

Abstract The National Policies of Humanization and Permanent Health Education (PHE) have shown advances and setbacks in their historical process. Some concepts from the theoretical framework of institutional analysis can contribute in these themes, such as the concept of analyzer. This article discusses the analyzers identified in an intervention research with professionals who work as supporters of humanization and/or articulators of PHE in municipalities of the state of São Paulo. The theoretical-methodological framework is the institutional analysis, socio-clinical line, focusing on the work of the analyzers. The intervention groups were composed of 30 participants. We highlight three analyzers: (1) the COVID-19 historical analyzer; (2) the time analyzer; (3) the silence analyzer. These analyzers evidence tensions such as: the peripheral place of primary care, discomfort in the face of "not knowing" and/or lethargy in the face of imposed non-doing, and the paradox of creating and interrupting both care actions and support for the teams.


Resumo As Políticas Nacionais de Humanização e Educação Permanente em Saúde têm mostrado em seu processo histórico avanços e retrocessos. Alguns conceitos do referencial teórico da análise institucional podem contribuir nesses temas, como o conceito de analisador. O objetivo do presente estudo foi discutir os analisadores identificados em uma pesquisa-intervenção, com profissionais que exercem a função de apoiadores de humanização e/ou de articuladores de educação permanente em saúde em municípios paulistas. O quadro teórico-metodológico é a análise institucional, linha sócio-clínica, sendo destacado, o trabalho dos analisadores. Participaram 30 pessoas dos grupos de intervenção. Destacamos três analisadores: (1) o analisador histórico Covid-19; (2) o analisador tempo; (3) o analisador silêncio. Esses analisadores iluminaram tensões como: o lugar periférico da atenção básica, o desconforto frente ao "não saber" e/ou a letargia ante o não-fazer imposto e o paradoxo de criar e interromper tanto ações de cuidado, como de suporte às equipes.


Resumen Las Políticas Nacionales de Humanización y Educación Permanente en Salud han mostrado avances y retrocesos en su proceso histórico. Algunos conceptos del marco teórico del análisis institucional pueden contribuir a estos temas, como el concepto de analizador. El objetivo de este artículo fue discutir los analizadores identificados en una investigación-intervención, con profesionales que actúan como apoyadores de la humanización y/o articuladores de la educación permanente en salud en municipios de São Paulo. El marco teórico-metodológico fue el del análisis institucional, línea socioclínica, destacándose el trabajo de los analizadores. Participaron 30 personas en los grupos de intervención. Se destacan tres analizadores: (1) el analizador histórico Covid-19; (2) el analizador de tiempo; (3) el analizador de silencio. Estos analizadores iluminan tensiones como: el lugar periférico de la atención primaria, el malestar ante el "no saber" y/o el letargo ante el no hacer impuesto y la paradoja de crear e interrumpir tanto las acciones asistenciales como de apoyo a los equipos.


Тема - темы
Humans , Primary Health Care , Unified Health System , Education, Continuing , Humanization of Assistance , COVID-19 , Health Services Research
3.
JMIR Form Res ; 5(1): e24662, 2021 Jan 26.
Статья | MEDLINE | ID: covidwho-1834122

Реферат

BACKGROUND: Anxiety is an extremely prevalent condition, and yet, it has received notably less attention than depression and other mental health conditions from a research, clinical, and public health perspective. The COVID-19 pandemic has only exacerbated growing concerns about the burden of anxiety due to the confluence of physical health risks, economic stressors, social isolation, and general disruption of daily activities. OBJECTIVE: This study examines differences in anxiety outcomes by care modality (coaching, teletherapy and telepsychiatry, and combined care) within an on-demand mental health system. We also explore the association between levels of engagement within each care modality and odds of improvement in symptoms of anxiety. METHODS: We conducted a retrospective observational study of individuals who accessed Ginger, an on-demand mental health system. Data were collected from 1611 Ginger members between January 1, 2018, and December 31, 2019. We used logistic regression to assess the association between care modality and improvement in anxiety symptoms. Within each modality, we assessed the association between level of engagement and improvement. RESULTS: Of 1611 Ginger members, 761 (47.0%) experienced a decrease in anxiety symptoms, as measured by a change from a positive to a negative 2-item Generalized Anxiety Disorder (GAD-2) screen. Among members who still screened positive at follow-up (865/1611, 53%), a total of 192 members (11.9%) experienced a clinically significant score reduction in the full GAD-7 (ie, a score reduction of >5 points), even though their GAD-2 scores were still positive. All modalities showed increased odds of improvement compared to those who were not engaged with coaching or clinical services ("app-only"). Higher GAD-7 intake scores were also associated with decreased odds of improvement. CONCLUSIONS: This study found increased odds of anxiety improvement for all care modalities compared to those who did not engage in care, with larger effect sizes for higher utilization within all care modalities. Additionally, there is a promising observation that those engaged in combined care (teletherapy and text-based coaching) had the greatest odds of anxiety improvement. Future directions include more detailed classifications of utilization patterns and an exploration of explanations and solutions for lower-utilization members.

4.
Risk Manag Healthc Policy ; 14: 4799-4807, 2021.
Статья в английский | MEDLINE | ID: covidwho-1834054

Реферат

PURPOSE: The key preventive measures adopted to minimise the spread of the coronavirus disease (COVID-19) had significant health, economic and physical impacts mostly in developing countries. This study evaluated the health, economic and physical impacts of COVID-19 lockdown measures among sub-Saharan African (SSA) population and associated demographic variations. METHODS: A total of 1970 respondents took part in this web-based cross-sectional survey during the mandatory lockdown period in most SSA. The dependent variables were health (COVID-19 infection, hospitalisation), socioeconomic (lost job, closed down business) and physical impacts (separated from family) of COVID-19. Univariate and bivariate logistic regression analyses were used to explore the factors associated with each of the dependent variables by the four sub-regions (Southern, Western, Central and East Africa). RESULTS: The respondents were aged 34.1 ± 11.5 years (range: 18-75 years) and mostly men (1099, 55%). 25.9% (n = 511) reported an impact of COVID-19 pandemic with significant regional variations (p < 0.0005, higher proportion were East 36.2% and Southern Africans 30.3%) but no gender (p = 0.334) and age group variations (p > 0.05). Among Central African respondents, more men than women lost their businesses (45.7% versus 14.3%, p = 0.002) and contracted COVID-19 infections (40.0% versus 18.2%, p = 0.024) during the study period. Multivariable analysis revealed that respondents from East (adjusted odds ratio [AOR] 1.95, 95% confidence interval [CI]: 1.42-2.69), Southern (AOR 1.46, 95% CI: 1.09-1.96) and Central Africa (AOR 1.47, 95% CI: 1.06-2.03) reported significantly higher impact of COVID-19. Those who reported family separation during the lockdown were more likely to be older participants (39-48 years, AOR 2.48, 95% CI: 1.11-5.57). CONCLUSION: One in four SSA respondents, mostly East and Southern Africans, were adversely affected by the COVID-19 pandemic during the lockdown. Interventions in high-risk populations are needed to reduce the health, socioeconomic and gender disparities in the impacts of COVID-19.

5.
Risk Manag Healthc Policy ; 14: 4853-4865, 2021.
Статья в английский | MEDLINE | ID: covidwho-1834051

Реферат

BACKGROUND AND AIMS: There has been a rising concern regarding the relationship of iron levels, vitamin D, and consumption of multivitamins on pain perception and sleep quality. The purpose of this study is to shed light on these connections in hopes of enhancing quality of sleep. METHODS: A cross-sectional analysis was used, and data collection was based on close-ended online questionnaire created on Survey Monkey. The survey included an operator designed questionnaire, questions from both the Brief Pain Inventory and Sleep Quality questionnaires. The targeted population was participants who were medically fit, non-pregnant Saudi citizens aged between 25 and 55 years. RESULTS: Prior to the COVID-19 crisis, data were collected during the months of February and March 2020, with a grand total of 3127 participants, out of which 2774 responses were included. The outcome of the research revealed that diminished levels of vitamin D, and iron had a negative impact on sleep quality. In turn, poor sleep quality had a significant pain response. CONCLUSION: This study reveals the detrimental role of vitamins on sleep, and their concurrent domino effect on pain.

6.
J Inflamm Res ; 14: 6293-6303, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833962

Реферат

BACKGROUND: The clinical spectrum of COVID-19 is extremely variable. Thus, it is likely that the heterogeneity in the genetic make-up of the host may contribute to disease severity. Toll-like receptor (TLR)-4 plays a vital role in the innate immune response to SARS-CoV-2 infection. The susceptibility of humans to severe COVID-19 concerning TLR-4 single nucleotide polymorphisms (SNPs) has not been well examined. OBJECTIVE: The goal of this research was to investigate the association between TLR-4 (Asp299Gly and Thr399Ile) SNPs and COVID-19 severity and progression as well as the cytokine storm in Egyptian patients. METHODS: We genotyped 300 adult COVID-19 Egyptian patients for TLR-4 (Asp299Gly and Thr399Ile) SNPs using PCR-restriction fragment length polymorphism (PCR-RFLP). We also measured interleukin (IL)-6 levels by enzyme-linked immunosorbent assay (ELISA) as an indicator of the cytokine storm. RESULTS: The minor 299Gly (G) and 399Ile (T) alleles were associated with a significant (P < 0.001) positive risk of severe COVID-19 (OR = 3.14; 95% CI = 2.02-4.88 and OR = 2.75; 95% CI = 1.66-4.57), their frequency in the severe group were 71.8% (84/150) and 70.7% (58/150), respectively. We detected significant differences between TLR-4 (Asp299Gly, Thr399Ile) genotypes with regard to serum levels of IL-6. Levels of IL-6 increased significantly with the presence of the mutant 299Gly (G) and 399Ile (T) alleles to reach the highest levels in the Gly299Gly (GG) and the Ile399Ile (TT) genotypes (170 pg/mL (145-208.25) and 112 pg/mL (24-284.75), respectively). CONCLUSION: The TLR-4 (Asp299Gly and Thr399Ile) minor alleles 299Gly (G) and 399Ile (T) are associated with COVID-19 severity, mortality, and the cytokine storm.

7.
Ann Am Thorac Soc ; 19(5): 861-863, 2022 May.
Статья в английский | MEDLINE | ID: covidwho-1833700
8.
PLoS One ; 16(4): e0251060, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833536

Реферат

During the COVID-19 lockdown in the US, many businesses were shut down temporarily. Essential businesses, most prominently grocery stores, remained open to ensure access to food and household essentials. Grocery shopping presents increased potential for COVID-19 infection because customers and store employees are in proximity to each other. This study investigated shoppers' perceptions of COVID-19 infection risks and put them in context by comparing grocery shopping to other activities outside home, and examined whether a proactive preventive action by grocery stores influence shoppers' perceived risk of COVID-19 infection. Our data were obtained via an anonymous online survey distributed between April 2 and 10, 2020 to grocery shoppers in New York State (the most affected by the pandemic at the time of the study) and Washington State (the first affected by the pandemic). We found significant factors associated with high levels of risk perception on grocery shoppers. We identified some effective preventive actions that grocery stores implement to alleviate anxiety and risk perception. We found that people are generally more concerned about in-store grocery shopping relative to other out-of-home activities. Findings suggest that a strict policy requiring grocery store employees to use facemasks and gloves greatly reduced shoppers' perceived risk rating of infection of themselves by 37.5% and store employees by 51.2%. Preventive actions by customers and businesses are critical to reducing the unwitting transmission of COVID-19 as state governments prepare to reopen the economy and relax restrictions on activities outside home.


Тема - темы
COVID-19/psychology , Consumer Behavior/statistics & numerical data , Perception/ethics , Consumer Behavior/economics , Family Characteristics , Food , Food Supply/statistics & numerical data , Health Risk Behaviors , Humans , New York , Perception/physiology , Risk Assessment/methods , SARS-CoV-2/pathogenicity , Supermarkets , Surveys and Questionnaires , United States/epidemiology , Washington
9.
PLoS One ; 16(4): e0250853, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833535

Реферат

BACKGROUND: Infection by SARS-CoV-2 in domestic animals has been related to close contact with humans diagnosed with COVID-19. Objectives: To assess the exposure, infection, and persistence by SARS-CoV-2 of dogs and cats living in the same households of humans that tested positive for SARS-CoV-2, and to investigate clinical and laboratory alterations associated with animal infection. METHODS: Animals living with COVID-19 patients were longitudinally followed and had nasopharyngeal/oropharyngeal and rectal swabs collected and tested for SARS-CoV-2. Additionally, blood samples were collected for laboratory analysis, and plaque reduction neutralization test (PRNT90) to investigate specific SARS-CoV-2 antibodies. RESULTS: Between May and October 2020, 39 pets (29 dogs and 10 cats) of 21 patients were investigated. Nine dogs (31%) and four cats (40%) from 10 (47.6%) households were infected with or seropositive for SARS-CoV-2. Animals tested positive from 11 to 51 days after the human index COVID-19 case onset of symptoms. Three dogs tested positive twice within 14, 30, and 31 days apart. SARS-CoV-2 neutralizing antibodies were detected in one dog (3.4%) and two cats (20%). In this study, six out of thirteen animals either infected with or seropositive for SARS-CoV-2 have developed mild but reversible signs of the disease. Using logistic regression analysis, neutering, and sharing bed with the ill owner were associated with pet infection. CONCLUSIONS: The presence and persistence of SARS-CoV-2 infection have been identified in dogs and cats from households with human COVID-19 cases in Rio de Janeiro, Brazil. People with COVID-19 should avoid close contact with their pets during the time of their illness.


Тема - темы
COVID-19/epidemiology , COVID-19/veterinary , Pets/virology , Animals , Animals, Domestic/virology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Brazil/epidemiology , Cat Diseases , Cats , Dog Diseases , Dogs , Longitudinal Studies , Prevalence , SARS-CoV-2/pathogenicity
10.
PLoS One ; 16(4): e0250815, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833533

Реферат

BACKGROUND: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic. STUDY DESIGN AND METHODS: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data. RESULTS: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher AngⅡ level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (AngⅡ) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%). CONCLUSION: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.


Тема - темы
COVID-19/complications , Heart Injuries/epidemiology , Hypertension/epidemiology , Adult , Aged , Aged, 80 and over , COVID-19/metabolism , COVID-19/physiopathology , Comorbidity , Disease Progression , Female , Heart Injuries/virology , Hospitalization , Humans , Hypertension/physiopathology , Hypertension/virology , Male , Medical Records , Middle Aged , Pandemics , Renin-Angiotensin System , SARS-CoV-2/pathogenicity
11.
PLoS One ; 16(4): e0250780, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833531

Реферат

The spike protein receptor-binding domain (RBD) of SARS-CoV-2 is the molecular target for many vaccines and antibody-based prophylactics aimed at bringing COVID-19 under control. Such a narrow molecular focus raises the specter of viral immune evasion as a potential failure mode for these biomedical interventions. With the emergence of new strains of SARS-CoV-2 with altered transmissibility and immune evasion potential, a critical question is this: how easily can the virus escape neutralizing antibodies (nAbs) targeting the spike RBD? To answer this question, we combined an analysis of the RBD structure-function with an evolutionary modeling framework. Our structure-function analysis revealed that epitopes for RBD-targeting nAbs overlap one another substantially and can be evaded by escape mutants with ACE2 affinities comparable to the wild type, that are observed in sequence surveillance data and infect cells in vitro. This suggests that the fitness cost of nAb-evading mutations is low. We then used evolutionary modeling to predict the frequency of immune escape before and after the widespread presence of nAbs due to vaccines, passive immunization or natural immunity. Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection. Predicted resistance timelines are comparable to those of the decay kinetics of nAbs raised against vaccinal or natural antigens, raising a second potential mechanism for loss of immunity in the population. Strategies for viral elimination should therefore be diversified across molecular targets and therapeutic modalities.


Тема - темы
COVID-19/genetics , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Binding Sites/genetics , COVID-19/metabolism , Epitopes/immunology , Evolution, Molecular , Humans , Immune Evasion/immunology , Models, Molecular , Neutralization Tests/methods , Peptidyl-Dipeptidase A/metabolism , Protein Binding/genetics , Protein Domains/genetics , Receptors, Virus/metabolism , SARS-CoV-2/pathogenicity , Spike Glycoprotein, Coronavirus/metabolism , Structure-Activity Relationship
12.
PLoS One ; 16(4): e0250651, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833527

Реферат

In recent times, many alarm bells have begun to sound: the metaphorical presentation of the COVID-19 emergency as a war might be dangerous, because it could affect the way people conceptualize the pandemic and react to it, leading citizens to endorse authoritarianism and limitations to civil liberties. The idea that conceptual metaphors actually influence reasoning has been corroborated by Thibodeau and Boroditsky, who showed that, when crime is metaphorically presented as a beast, readers become more enforcement-oriented than when crime is metaphorically framed as a virus. Recently, Steen, Reijnierse and Burgers replied that this metaphorical framing effect does not seem to occur and suggested that the question should be rephrased about the conditions under which metaphors do or do not influence reasoning. In this paper, we investigate whether presenting the COVID-19 pandemic as a war affects people's reasoning about the pandemic. Data collected suggest that the metaphorical framing effect does not occur by default. Rather, socio-political individual variables such as speakers' political orientation and source of information favor the acceptance of metaphor congruent entailments: right-wing participants and participants relying on independent sources of information are those more conditioned by the COVID-19 war metaphor, thus more inclined to prefer bellicose options.


Тема - темы
COVID-19/psychology , Social Behavior , Thinking/physiology , Adult , Armed Conflicts/psychology , Female , Humans , Italy , Language , Male , Metaphor , Pandemics/prevention & control , Problem Solving , SARS-CoV-2/pathogenicity
13.
PLoS One ; 16(4): e0250319, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833525

Реферат

Projections of the stage of the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic and local, regional and national public health policies to limit coronavirus spread as well as "reopen" cities and states, are best informed by serum neutralizing antibody titers measured by reproducible, high throughput, and statically credible antibody (Ab) assays. To date, a myriad of Ab tests, both available and FDA authorized for emergency, has led to confusion rather than insight per se. The present study reports the results of a rapid, point-in-time 1,000-person cohort study using serial blood donors in the New York City metropolitan area (NYC) using multiple serological tests, including enzyme-linked immunosorbent assays (ELISAs) and high throughput serological assays (HTSAs). These were then tested and associated with assays for neutralizing Ab (NAb). Of the 1,000 NYC blood donor samples in late June and early July 2020, 12.1% and 10.9% were seropositive using the Ortho Total Ig and the Abbott IgG HTSA assays, respectively. These serological assays correlated with neutralization activity specific to SARS-CoV-2. The data reported herein suggest that seroconversion in this population occurred in approximately 1 in 8 blood donors from the beginning of the pandemic in NYC (considered March 1, 2020). These findings deviate with an earlier seroprevalence study in NYC showing 13.7% positivity. Collectively however, these data demonstrate that a low number of individuals have serologic evidence of infection during this "first wave" and suggest that the notion of "herd immunity" at rates of ~60% or higher are not near. Furthermore, the data presented herein show that the nature of the Ab-based immunity is not invariably associated with the development of NAb. While the blood donor population may not mimic precisely the NYC population as a whole, rapid assessment of seroprevalence in this cohort and serial reassessment could aid public health decision making.


Тема - темы
COVID-19/epidemiology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Neutralizing/blood , Antibodies, Viral/immunology , Blood Donors , COVID-19/immunology , Cohort Studies , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Immunoglobulin G/blood , Male , Middle Aged , New York City/epidemiology , SARS-CoV-2/pathogenicity , Sensitivity and Specificity , Seroconversion/physiology , Seroepidemiologic Studies , Serologic Tests/methods , Spike Glycoprotein, Coronavirus/immunology
14.
Bone Jt Open ; 2(4): 271-277, 2021 Apr.
Статья в английский | MEDLINE | ID: covidwho-1833469

Реферат

AIMS: Open reduction in developmental dysplasia of the hip (DDH) is regularly performed despite screening programmes, due to failure of treatment or late presentation. A protocol for open reduction of DDH has been refined through collaboration between surgical, anaesthetic, and nursing teams to allow same day discharge. The objective of this study was to determine the safety and feasibility of performing open reduction of DDH as a day case. METHODS: A prospectively collected departmental database was visited. All consecutive surgical cases of DDH between June 2015 and March 2020 were collected. Closed reductions, bilateral cases, cases requiring corrective osteotomy, and children with comorbidities were excluded. Data collected included demographics, safety outcome measures (blood loss, complications, readmission, reduction confirmation), and feasibility for discharge according to the Face Legs Activity Cry Consolidability (FLACC) pain scale. A satisfaction questionnaire was filled by the carers. Descriptive statistics were used for analysis. RESULTS: Out of 168 consecutive DDH cases, 16 patients fit the inclusion criteria (age range 10 to 26 months, 13 female). Intraoperative blood loss ranged from "minimal" to 120 ml, and there were no complications or readmissions. The FLACC score was 0 for all patients. The carers satisfaction questionnaire expressed high satisfaction from the experience with adequate information and support provided. CONCLUSION: Open reduction in DDH, without corrective osteotomy, is safe and feasible to be managed as a day case procedure. It requires a clear treatment pathway, analgesia, sufficient counselling, and communication with carers. It is even more important during the COVID-19 pandemic when reduced length of hospital stay is likely to be safer for both patient and their parents. Cite this article: Bone Joint Open 2021;2(4):271-277.

15.
Egypt J Intern Med ; 33(1): 37, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833420

Реферат

BACKGROUND: In this pandemic of COVID-19, the highest amount of infective material, biomedical waste is generated in hospitals and it is frequently handled by the healthcare workers irrespective of cadres. Hence the awareness of healthcare workers in regards with biomedical waste (BMW) management is crucial in this pandemic. This study is therefore conducted to assess the knowledge, attitude and practices in BMW management among health care workers in our institution. RESULTS: A total of 280 subjects consisting of doctors, nursing staff and group D workers were included in the study after obtaining informed consent. The knowledge among healthcare workers was satisfactory, but comparatively group D workers were lagging behind. Overall they all have a good attitude towards BMW management but practices on BMW management needs improvement mostly among group D workers. CONCLUSIONS: There have to be regular training programmes on biomedical waste management and its hazards for all the healthcare workers including group D workers. Along with educational intervention, strict implementation of biomedical waste management guidelines with its monitoring at all levels is also very much essential.

16.
Int J Educ Technol High Educ ; 18(1): 59, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833377

Реферат

The COVID-19 pandemic required an abrupt shift from face-to-face to online instruction for many students in higher education in the United States. Prior research has raised some concerns about both equitable access to online courses, and the quality of instruction in online courses compared to face-to-face courses. This survey study included a retrospective pretest approach to comparing students experiences before and after the transition to online instruction. The sample of 1731 students ranged across all available topics of study and all class standings from first-year students to doctoral students at a R1: Doctoral Universities-Very High Research Activity university according to the Carnegie classifications. Quality of instruction was addressed through the three principles of Universal Design for Learning. Students reported that most areas of quality of instruction were poorer after the transition, with having Engagement dropping by the largest effect size. However, Representation showed a small effect of improvement following the transition. Students who preferred online instruction reported less loss of instructional quality. Similarly, students eligible for disability services also reported less loss of instructional quality. Doctoral students reported significantly poorer access on multiple measures compared to all four years of undergraduate students' standings. Results are discussed in terms of patterns, exceptions, effect sizes, and recommendations for future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41239-021-00296-5.

17.
J Eat Disord ; 9(1): 150, 2021 Nov 12.
Статья в английский | MEDLINE | ID: covidwho-1833358

Реферат

BACKGROUND: A question frequently raised in the field is whether evidence-based interventions have adequate translational capacity for delivery in real-world settings where patients are presumed to be more complex, clinicians less specialized, and multidisciplinary teams less coordinated. The dual purpose of this article is to (a) outline a model for implementing evidence-driven, outpatient treatments for eating disorders in a non-academic clinical setting, and (b) report indicators of feasibility and quality of care. MAIN BODY: Since our inception (2015), we have completed nearly 1000 phone intakes, with first-quarter 2021 data suggesting an increase in the context of COVID-19. Our caseload for the practice currently consists of approximately 200 active patients ranging from 6 to 66 years of age. While the center serves a transdiagnostic and trans-developmental eating disorder population, modal concerns for which we receive inquiries are Anorexia Nervosa and Avoidant Restrictive Food Intake Disorder, with the most common age range for prospective patients spanning childhood through late adolescence/emerging adulthood; correspondingly, the modal intervention employed is Family-based treatment. Our team for each case consists, at a minimum, of a primary internal therapist and a physician external to the center. SHORT CONCLUSION: We will describe our processes of recruiting, training and coordinating team members, of ensuring ongoing fidelity to evidence-based interventions, and of training the next generation of clinicians. Future research will focus on a formal assessment of patient outcomes, with comparison to benchmark outcomes from randomized controlled trials.


A question frequently raised in the eating disorders field is whether treatments that were developed and tested in research environments can achieve the same results in real-world clinical settings, where patients' diagnoses are presumed to be more complex, clinicians less specialized, and multi-professional care teams less coordinated. The purpose of this article is to outline a model for implementing evidence-driven, outpatient treatments for eating disorders in non-academic clinical settings, specifically private practices and specialty programs. We describe the philosophy, infrastructure, training processes, personnel, and procedures utilized to optimize care delivery and to create accountability for both scientifically-adherent practice and positive patient outcomes. We also outline ways to be producers­not just consumers­of research in the private sector, and to train the next generation of scientifically-informed eating disorder specialists, all with the goal to bridge the research-practice divide.

18.
BMC Cancer ; 21(1): 1148, 2021 Oct 26.
Статья в английский | MEDLINE | ID: covidwho-1833290

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BACKGROUND: Studies have shown that the skeletal muscle index at the third lumbar vertebra (L3 SMI) had reasonable specificity and sensitivity in nutritional assessment and prognostic prediction in digestive system cancers, but its performance in lung cancer needs further investigation. METHODS: A retrospective study was performed on 110 patients with advanced lung cancer. The L3 SMI, the Patient-Generated Subjective Global Assessment score (PG-SGA score), body mass index (BMI), and serological indicators were analyzed. According to PG-SGA scores, patients were divided into severe malnutrition (≥9 points), mild to moderate malnutrition (≥3 points and ≤ 8 points), and no malnutrition (≤2 points) groups. Pearson correlation and logistic regression analysis were adopted to find factors related to malnutrition, and a forest plot was drawn. The receiver operating characteristic (ROC) curve was performed to compare the diagnostic values of malnutrition among factors, which were expressed by the area under curve (AUC). RESULTS: 1. The age of patients in the severe malnutrition group, the mild to moderate malnutrition group, and the no malnutrition group significantly differed, with mean ages of 63.46 ± 10.01 years, 60.42 ± 8.76 years, and 55.03 ± 10.40 years, respectively (OR = 1.062, 95%CI: 1.008 ~ 1.118, P = 0.024; OR = 1.100, 95%CI: 1.034 ~ 1.170, P = 0.002). Furthermore, the neutrophil to lymphocyte ratio (NLR) of the severe malnutrition group was significantly higher than that of the no malnutrition group, with statistical significance. The difference between the mild to moderate malnutrition group and the no malnutrition group were not statistically significant, with NLR of 4.07 ± 3.34 and 2.47 ± 0.92, respectively (OR = 1.657,95%CI: 1.036 ~ 2.649, P = 0.035). The L3 SMI of patients in the severe malnutrition and mild to moderate malnutrition groups were significantly lower than that of the patients in the no malnutrition group, with statistical significance. The L3 SMI of patients in the severe malnutrition group, mild to moderate malnutrition group, and no malnutrition group were 27.40 ± 4.25 cm2/m2, 38.19 ± 6.17 cm2/m2, and 47.96 ± 5.02 cm2/m2, respectively (OR = 0.600, 95%CI: 0.462 ~ 0.777, P < 0.001; OR = 0.431, 95%CI: 0.320 ~ 0.581, P < 0.001). 2. The Pearson correlation analysis showed that the PG-SGA score positively correlated with age (r = 0.296, P < 0.05) but negatively correlated with L3 SMI (r = - 0.857, P < 0.05). The L3 SMI was also negatively correlated with age (r = - 0.240, P < 0.05). 3. The multivariate analysis showed that the L3 SMI was an independent risk factor for malnutrition (OR = 0.446, 95%CI: 0.258 ~ 0.773, P = 0.004; OR = 0.289, 95%CI: 0.159 ~ 0.524, P < 0.001). CONCLUSION: 1. The differences in the L3 SMI was statistically significant among advanced lung cancer patients with different nutritional statuses. 2. In the nutritional assessment of patients with lung cancer, the L3 SMI was consistent with the PG-SGA. 3. The L3 SMI is an independent predictor of malnutrition in patients with advanced lung cancer.


Тема - темы
Lung Neoplasms/complications , Malnutrition/etiology , Muscle, Skeletal/physiology , Vertebral Body/physiology , Female , Humans , Male , Malnutrition/physiopathology , Middle Aged , Nutrition Assessment , Prognosis , Retrospective Studies , Risk Factors
19.
Eur Respir J ; 59(3)2022 Mar.
Статья в английский | MEDLINE | ID: covidwho-1833273

Реферат

BACKGROUND: Individual case series and cohort studies have reported conflicting results in people with asthma on the vulnerability to and risk of mortality from coronavirus disease 2019 (COVID-19). RESEARCH QUESTION: Are people with asthma at a higher risk of being infected or hospitalised or poorer clinical outcomes from COVID-19? METHODS: A systematic review and meta-analysis based on five main databases including the World Health Organization COVID-19 database between 1 December 2019 and 11 July 2021 on studies with a control (non-asthma) group was conducted. Prevalence and risk ratios were pooled using Sidik-Jonkman random-effects meta-analyses. FINDINGS: 51 studies with an 8.08% (95% CI 6.87-9.30%) pooled prevalence of people with asthma among COVID-19 positive cases. The risk ratios were 0.83 (95% CI 0.73-0.95, p=0.01) for acquiring COVID-19; 1.18 (95% CI 0.98-1.42, p=0.08) for hospitalisation; 1.21 (95% CI 0.97-1.51, p=0.09) for intensive care unit (ICU) admission; 1.06 (95% CI 0.82-1.36, p=0.65) for ventilator use; and 0.94 (95% CI 0.76-1.17, p=0.58) for mortality for people with asthma. Subgroup analyses by continent revealed a significant difference in risk of acquiring COVID-19, ICU admission, ventilator use and death between the continents. INTERPRETATION: The risk of being infected with severe acute respiratory syndrome coronavirus 2 was reduced compared to the non-asthma group. No statistically significant differences in hospitalisation, ICU admission and ventilator use were found between groups. Subgroup analyses showed significant differences in outcomes from COVID-19 between America, Europe and Asia. Additional studies are required to confirm this risk profile, particularly in Africa and South America, where few studies originate.


Тема - темы
Asthma , COVID-19 , Asthma/epidemiology , Hospitalization , Humans , Intensive Care Units , SARS-CoV-2
20.
Glob Qual Nurs Res ; 8: 23333936211051705, 2021.
Статья в английский | MEDLINE | ID: covidwho-1833234

Реферат

People with developmental disabilities (DD) are devastatingly impacted by COVID-19, yet no studies have explored the experiences of developmental disability nurses during the pandemic. In April 2020, as part of a multiple method study, we used manifest content analysis to evaluate nurses' 287 open-ended responses to our online survey question: "What is the experience of being a developmental disability nurse while encountering challenges to meeting basic care needs during the early COVID-19 pandemic?" We identified four themes: living with fear and stress, helping others to understand and cope, navigating a changing landscape, and being left out. Findings reinforce the need for accessible health information for people with developmental disability, guidelines relevant to developmental disability nursing settings, emotional support for developmental disability nurses, and education of health care professionals about the contribution of the developmental disability nurse in supporting the holistic well-being of people with DD.

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