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1.
J Emerg Manag ; 18(3): 191-203, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32441036

RESUMO

OBJECTIVE: Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season. DESIGN: We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season. SETTING: Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season. PARTICIPANTS: Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data reported by 11 NYCH+H hospitals during the 2017-2018 influenza season. MAIN OUTCOME MEASURES: Operational challenges and lessons from frontline hospitals responding to severe seasonal influenza. RESULTS: Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration. CONCLUSION: Seasonal influenza poses dynamic operational stresses across health systems and cities, poten-tially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and personnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.


Assuntos
Coleta de Dados , Assistência à Saúde/organização & administração , Planejamento em Desastres/organização & administração , Planejamento em Saúde/organização & administração , Influenza Humana/epidemiologia , Cidades , Número de Leitos em Hospital , Humanos , Influenza Humana/prevenção & controle , Cidade de Nova Iorque , Estudos Retrospectivos , Estações do Ano
2.
J Emerg Manag ; 18(3): 247-260, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32441041

RESUMO

INTRODUCTION: Thirty-three separate local emergency medical services (EMS) authority agencies serve the 58 counties in California. Each local emergency medical services agency dictates widely different treatment and trans-port protocols for its paramedics. Although previous research has established the problem of geographic EMS dis-parities, nothing definitively explains their cause. METHODS: We analyze California's most recently available EMS performance-measure data to determine if there is still disparity in EMS patient care and patient outcomes in California. If there is a disparity, we determine whether the differences are accounted for by socioeconomic factors, geographical differences, or population size, by combin-ing California EMS data with other state and county level data. If none of these factors are significantly correlated, this supports the hypothesis that something different, such as system structure, could be a potential cause of Califor-nia's EMS disparities. As a secondary analysis, we attempt to replicate these types of analyses at national and inter-national levels, which could potentially permit a structural comparison as well. RESULTS: There is still disparity in EMS patient care and patient outcomes in California. Regression analyses did not identify a single factor to explain the disparity in performance measures. Most notably, the regression found that basic socioeconomic factors and geographical differences frequently speculated as common drivers for disparity of services, including median income, population density, and availability of specialty care facilities, did not account for the disparity in services. CONCLUSIONS: Unfortunately, the striking lack of performance-measure data-a data desert-for EMS throughout the United States meant that the secondary analyses were inconclusive. Based on these results, we propose three recommendations:(1) most importantly, the lack of data must be addressed. Data collection should be standardized and mandatory for all EMS providers. (2) Treatment protocols for the state should be standardized and based on the latest evidence-based research. Providers should be required to offer the same level of care, to all geographic re-gions. (3) It may be beneficial to consider restructuring the California EMS system. While the research is limited due to imperfect information, consolidated systems seem to perform better. An existing framework for this already exists.


Assuntos
Serviços Médicos de Emergência/organização & administração , Disparidades em Assistência à Saúde , Características de Residência , California , Coleta de Dados , Sistemas de Informação Geográfica , Humanos , Estados Unidos
3.
Sci Total Environ ; 732: 139204, 2020 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-32438190

RESUMO

The development of biodiversity-friendly agricultural landscapes is of major importance to meet the sustainable development challenges of our time. The emergence of unmanned aerial vehicles (UAVs), i.e. drones, has opened a new set of research and management opportunities to achieve this goal. On the one hand, this review summarizes UAV applications in agricultural landscapes, focusing on biodiversity conservation and agricultural land monitoring, based on a systematic review of the literature that resulted in 550 studies. Additionally, the review proposes how to integrate UAV research in these fields and point to new potential applications that may contribute to biodiversity-friendly agricultural landscapes. UAV-based imagery can be used to identify and monitor plants, floral resources and animals, facilitating the detection of quality habitats with high prediction power. Through vegetation indices derived from their sensors, UAVs can estimate biomass, monitor crop plant health and stress, detect pest or pathogen infestations, monitor soil fertility and target patches of high weed or invasive plant pressure, allowing precise management practices and reduced agrochemical input. Thereby, UAVs are helping to design biodiversity-friendly agricultural landscapes and to mitigate yield-biodiversity trade-offs. In conclusion, UAV applications have become a major means of biodiversity conservation and biodiversity-friendly management in agriculture, while latest developments, such as the miniaturization and decreasing costs of hyperspectral sensors, promise many new applications for the future.


Assuntos
Agricultura , Biodiversidade , Animais , Coleta de Dados , Plantas , Solo
4.
Rev Esp Salud Publica ; 942020 May 29.
Artigo em Espanhol | MEDLINE | ID: mdl-32468999

RESUMO

OBJECTIVE: Sedentarism rates are increasing at school age, and it is necessary to know how it affects both rural and urban contexts. The present study aimed to identify whether the place of residence, rural or urban, influenced the level of physical activity that schoolchildren had in Primary Education and in Secondary Education. METHODS: A longitudinal study was carried out using the Physical Activity Questionnaire for Children (PAQ-C) for data collection. The sample consisted of 542 students (272 boys and 270 girls), aged between 11 and 13 years, who were interviewed at two different times: during the sixth year of primary education, and later in the first year of secondary education. A descriptive analysis of the items and final score of the PAQ-C in the rural and urban environment were carried out in both educational periods and an ANCOVA analysis of the final score; The association between the level of physical activity and the variables used was studied through corrected typified residuals and Cramer's V. The effect size was calculated. RESULTS: The results obtained confirmed that there are significant differences in the course variable (f=63,757; p<0.001; η2sup>=0.056) but not in the type of locality (p>0.05), nor in the locality x course interaction. (p>0.05) when the sex variable was controlled (f=27,325; p<0.001; η2=0.025). CONCLUSIONS: The transition to Secondary Education implies the increase of a sedentary lifestyle, both in rural and urban areas.


Assuntos
Exercício Físico , Adolescente , Criança , Coleta de Dados , Feminino , Humanos , Estudos Longitudinais , Masculino , População Rural , Instituições Acadêmicas , Espanha , Estudantes , População Urbana
6.
Acta Med Port ; 33(4): 229-236, 2020 Apr 01.
Artigo em Português | MEDLINE | ID: mdl-32238236

RESUMO

INTRODUCTION: Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman's role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life. MATERIAL AND METHODS: In order to characterise the country's situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Causas de Morte , Estudos Transversais , Características Culturais , Coleta de Dados , Bases de Dados Factuais/normas , Características da Família , Feminino , Inquéritos Epidemiológicos , Habitação/normas , Humanos , Expectativa de Vida , Masculino , Saúde Pública , São Tomé e Príncipe , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
7.
Neurocrit Care ; 32(3): 667-671, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32346843

RESUMO

The magnitude of the COVID-19 pandemic will result in substantial neurological disease, whether through direct infection (rare), para-infectious complications (less rare), or critical illness more generally (common). Here, we raise the importance of stringent diagnosis and data collection regarding neurological complications of COVID-19; we urge caution in the over-diagnosis of neurological disease where it does not exist, but equally strongly encourage the concerted surveillance for such conditions. Additional to the direct neurological complications of COVID-19 infection, neurological patients are at risk of harm from both structural limitations (such as number of intensive care beds), and a hesitancy to treat with certain necessary medications given risk of nosocomial COVID-19 infection. We therefore also outline the specific management of patients with neuroinflammatory diseases in the context of the pandemic. This article describes the implications of COVID-19 on neurological disease and advertises the Neurocritical Care Society's international data collection collaborative that seeks to align data elements.


Assuntos
Infecções por Coronavirus/fisiopatologia , Doenças do Sistema Nervoso/fisiopatologia , Pneumonia Viral/fisiopatologia , Betacoronavirus , Disfunção Cognitiva/etiologia , Infecções por Coronavirus/complicações , Cuidados Críticos , Estado Terminal , Infecção Hospitalar/prevenção & controle , Coleta de Dados , Encefalomielite Aguda Disseminada/etiologia , Síndrome de Guillain-Barré/etiologia , Humanos , Imunossupressores/efeitos adversos , Controle de Infecções , Cooperação Internacional , Mielite Transversa/etiologia , Doenças do Sistema Nervoso/tratamento farmacológico , Doenças do Sistema Nervoso/etiologia , Pandemias , Pneumonia Viral/complicações
8.
J Med Internet Res ; 22(4): e19016, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32287039

RESUMO

BACKGROUND: The recent coronavirus disease (COVID-19) pandemic is taking a toll on the world's health care infrastructure as well as the social, economic, and psychological well-being of humanity. Individuals, organizations, and governments are using social media to communicate with each other on a number of issues relating to the COVID-19 pandemic. Not much is known about the topics being shared on social media platforms relating to COVID-19. Analyzing such information can help policy makers and health care organizations assess the needs of their stakeholders and address them appropriately. OBJECTIVE: This study aims to identify the main topics posted by Twitter users related to the COVID-19 pandemic. METHODS: Leveraging a set of tools (Twitter's search application programming interface (API), Tweepy Python library, and PostgreSQL database) and using a set of predefined search terms ("corona," "2019-nCov," and "COVID-19"), we extracted the text and metadata (number of likes and retweets, and user profile information including the number of followers) of public English language tweets from February 2, 2020, to March 15, 2020. We analyzed the collected tweets using word frequencies of single (unigrams) and double words (bigrams). We leveraged latent Dirichlet allocation for topic modeling to identify topics discussed in the tweets. We also performed sentiment analysis and extracted the mean number of retweets, likes, and followers for each topic and calculated the interaction rate per topic. RESULTS: Out of approximately 2.8 million tweets included, 167,073 unique tweets from 160,829 unique users met the inclusion criteria. Our analysis identified 12 topics, which were grouped into four main themes: origin of the virus; its sources; its impact on people, countries, and the economy; and ways of mitigating the risk of infection. The mean sentiment was positive for 10 topics and negative for 2 topics (deaths caused by COVID-19 and increased racism). The mean for tweet topics of account followers ranged from 2722 (increased racism) to 13,413 (economic losses). The highest mean of likes for the tweets was 15.4 (economic loss), while the lowest was 3.94 (travel bans and warnings). CONCLUSIONS: Public health crisis response activities on the ground and online are becoming increasingly simultaneous and intertwined. Social media provides an opportunity to directly communicate health information to the public. Health systems should work on building national and international disease detection and surveillance systems through monitoring social media. There is also a need for a more proactive and agile public health presence on social media to combat the spread of fake news.


Assuntos
Infecções por Coronavirus/epidemiologia , Mineração de Dados , Comunicação em Saúde , Pneumonia Viral/epidemiologia , Mídias Sociais , Betacoronavirus , Coronavirus , Coleta de Dados , Saúde Global , Humanos , Pandemias , Saúde Pública
9.
Recenti Prog Med ; 111(4): 198-201, 2020 04.
Artigo em Italiano | MEDLINE | ID: mdl-32319439

RESUMO

Chronicity and comorbidity influence the risk of CoViD-19 infection and the course of the disease. Epidemiological data and studies performed show different rates of chronic diseases and multimorbidity among patients affected by CoViD-19 in the various countries and areas, but they consistently stress their impact on CoViD-19 infection. In order to protect chronic and frail patients, the Italian Medicines Agency has taken measures to extend the therapeutic plans and monitoring registers; hopefully, therapeutic plans for antidiabetics, drugs for respiratory diseases and oral anticoagulant drugs will be abolished since they do not offer any additional advantage in terms of appropriateness and traceability of outcomes. The MaCroScopio project (Observatory on Chronic Diseases), regarding the CoViD-19 emergency, has started a new research path to foster the integration of the administrative data flows with the CoViD-19 Registers for planning and research purposes in the context of chronicity, as well as to evaluate the economic and organizational impact of the pandemic.


Assuntos
Doença Crônica , Infecções por Coronavirus/complicações , Conhecimentos, Atitudes e Prática em Saúde , Pneumonia Viral/complicações , Anticoagulantes/uso terapêutico , Betacoronavirus , Comorbidade , Infecções por Coronavirus/epidemiologia , Coleta de Dados , Humanos , Hipoglicemiantes/uso terapêutico , Pandemias , Planejamento de Assistência ao Paciente , Pneumonia Viral/epidemiologia , Doenças Respiratórias , Fatores de Risco , Populações Vulneráveis
12.
Am J Infect Control ; 48(6): 592-598, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32334904

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) is spreading rapidly, bringing pressure and challenges to nursing staff. OBJECTIVE: To explore the psychology of nurses caring for COVID-19 patients. METHODS: Using a phenomenological approach, we enrolled 20 nurses who provided care for COVID-19 patients in the First Affiliated Hospital of Henan University of Science and Technology from January 20, to February 10, 2020. The interviews were conducted face-to-face or by telephone and were analysed by Colaizzi's 7-step method. RESULTS: The psychological experience of nurses caring for COVID-19 patients can be summarized into 4 themes. First, negative emotions present in early stage consisting of fatigue, discomfort, and helplessness was caused by high-intensity work, fear and anxiety, and concern for patients and family members. Second, self-coping styles included psychological and life adjustment, altruistic acts, team support, and rational cognition. Third, we found growth under pressure, which included increased affection and gratefulness, development of professional responsibility, and self-reflection. Finally, we showed that positive emotions occurred simultaneously with negative emotions. CONCLUSIONS: During an epidemic outbreak, positive and negative emotions of the front-line nurses interweaved and coexisted. In the early stage, negative emotions were dominant and positive emotions appeared gradually. Self-coping styles and psychological growth played an important role in maintaining mental health of nurses.


Assuntos
Cuidadores/psicologia , Infecções por Coronavirus/terapia , Enfermeiras e Enfermeiros/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Pneumonia Viral/terapia , Adaptação Psicológica , Adulto , Ansiedade/psicologia , Betacoronavirus , Coleta de Dados , Emoções , Fadiga/psicologia , Medo/psicologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Pandemias , Pesquisa Qualitativa
19.
Am J Bioeth ; 20(3): 63-65, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32116161
20.
Stud Health Technol Inform ; 268: 31-43, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32141877

RESUMO

Health behaviour change programs that utilise IT-based delivery have great potential to improve health. Whilst more static Web 1.0 technologies have been somewhat effective, they often failed to promote longer-term user engagement required for greater health promotion impact. With Web 2.0 technologies, however, there is potential for greater engagement and retention, through allowing individuals to determine how information is generated, modified, and shared collaboratively. The WALK 2.0 study utilised a Web 2.0-based platform to engage participants in health behaviour change aimed at increasing physical activity levels. The program included two trials: (1) a three-arm randomised controlled trial (RCT) that compared the effectiveness of Web 2.0, Web 1.0, and paper-based logbook interventions; and (2) a real-world randomised ecological trial (RET) that compared a Web 2.0 and Web 1.0 intervention. The aim of this paper is not to focus on the research trial results per se, but rather the success factors and challenges in both the RCT and RET. Both the RCT and RET demonstrated successful outcomes, with greater improvements in physical activity for the Web 2.0 groups. A range of challenges, however, were identified in designing, implementing, and evaluating such interventions. These include IT-based intervention development within a research context, the ability to establish a self-sustaining online community, the rapid pace of change in web-based technology and implications for trial design, the selection of best outcome measures for ecological trials, and managing engagement, non-usage and study attrition in real-world trials. Future research and developments in this area must look to broader research designs that allow for the ever-changing IT-user landscape and behaviour, and greater reliance on development and testing in real-world settings.


Assuntos
Exercício Físico , Comportamentos Relacionados com a Saúde , Coleta de Dados , Promoção da Saúde , Humanos , Mídias Sociais
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