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1.
J Ment Health Policy Econ ; 23(2): 55-60, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32621725

RESUMO

BACKGROUND: The approach to care for persons with an acute illness is different from that for a person with a chronic disease. Whilst the goal of treatment for an acute illness is to cure the disease, a chronic condition has no cure as such, and hence management requires a team approach that is aimed at achieving goals that are jointly set by service users and providers. Severe and persistent mental illness (SPMI) is a chronic disease. However, in many mental health services, the approach to care for persons with SPMI is similar to those who have an acute mental illness. AIM: The aims of this paper are twofold: (i) to make an argument for recovery oriented services to focus on meeting clients' needs rather than on symptom reduction, (ii) to propose a model of service provision where clinical mental health services form a part rather than the mainstay of care for people with SPMI. RESULTS: Using examples from Australia's Partner's in Recovery initiative and other recovery literature, we start by describing how SPMI should be treated as a chronic disease that focuses on recovery. We then highlight how mental health services continue to monitor outcomes based on clinical rather than personal recovery. Next, we diagrammatically illustrate how needs can be aligned with the recovery process and illustrate how care coordination can be the hub of service delivery in a hub and spoke model. We conclude with comments on workforce requirements and costs of a needs-based recovery oriented service. DISCUSSION: In a needs based model, the role of the specialist mental health service will move from being at the centre of care to being one of the components of care and the role of the care coordinator will become central. Although, there are as yet no randomised controlled trials to show that meeting needs of persons with SPMI will significantly contribute to their recovery, preliminary studies show that it is possible. IMPLICATIONS FOR HEALTHCARE PROVISION AND USE: The role of the care coordinator becomes the hub of service provision collaborating with agencies such as family practices, specialist mental health services, legal, housing, employment, education, and community services. IMPLICATIONS FOR HEALTH POLICIES: A shift from the current model of care to a needs based approach requires a revolutionary change in the way we do business and will have to be the largest shake up of the mental health service system since deinstitutionalisation. IMPLICATIONS FOR FURTHER RESEARCH: It is a long journey from the status quo to a needs based approach. The first step would be to gather more evidence on the usefulness of addressing people's needs in achieving recovery.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/organização & administração , Equipe de Assistência ao Paciente , Austrália , Doença Crônica , Comportamento Cooperativo , Habitação , Humanos , Transtornos Mentais/psicologia
2.
Environ Monit Assess ; 192(8): 544, 2020 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-32715319

RESUMO

Poorly ventilated environments such as residences can accumulate radon gas to levels that are harmful to humans and thus produce a public health risk. To assess the risk from natural radiation due to indoor radon exposure, 222Rn measurements, using an alpha RAD7 detector, were conducted in Timóteo, Minas Gerais state, southeastern Brazil. Indoor radon concentrations, along with meteorological parameters, were measured every 2 h during both wet and dry seasons in 2017 and 2018. The mean concentration of indoor radon varied between 18.0 and 412.8 Bq m-3, which corresponded to an effective annual dose of 1.2 and 7.6 mSv y-1. Average radon concentrations were significantly higher during the winter dry season, and there was a strong positive correlation with humidity in both wet and dry season. Furthermore, concentrations showed an inverse correlation with atmospheric pressure, wind speed, air temperature, and solar radiation. The radon levels are generally above the limits recommended by international standards, meaning that mitigation measures are needed to improve air quality to reduce human exposure and risk. Finally, through the statistical analysis, it was possible to determine the differences and similarities between the sampling points concerning the geology of the place and the geographical location.


Assuntos
Poluentes Radioativos do Ar/análise , Poluição do Ar em Ambientes Fechados/análise , Monitoramento de Radiação , Radônio/análise , Brasil , Habitação , Humanos , Estações do Ano
4.
Encephale ; 46(3S): S53-S59, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32475692

RESUMO

OBJECTIVES: Explore the evolution of sleep during the SARS-CoV-2 quarantine period and define associated factors. METHODS: An online survey of patients in quarantine. Questions targeted the conditions of quarantine, sleep related behaviours and exposure to factors known to affect sleep and circadian rhythms (light exposure and sport). RESULTS: In all, 1777 participants were included: 77% women and 72% aged 25-54 years. Quarantine conditions were most frequently in couples with children (36%) and in a house with a garden (51%). Forty-seven percent of participants reported a decrease in sleep quality during quarantine. Factors associated with a reduction in sleep quality by logistic regression were sleep reduction (OR 15.52 P<0.001), going to bed later (OR 1.72 P<0.001), getting up earlier (2.18 P=0.01), an increase in sleep-wake irregularity (OR 2.29 P<0.001), reduced exposure to daylight (OR 1.46 P=0.01) and increased screen use in the evenings (OR 1.33 P=0.04). CONCLUSION: Sleep quality tended to reduce during quarantine and this was associated with changes in sleep behaviours and light exposure, especially in the evening. In order to optimise sleep during quarantine, regular sleep and wake times, at least 1hour exposure to daylight and a reduction of screen use in the evenings are suggested.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Inquéritos Epidemiológicos , Pandemias , Pneumonia Viral , Quarentena , Transtornos do Sono-Vigília/etiologia , Sono , Isolamento Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Dissonias/tratamento farmacológico , Dissonias/epidemiologia , Dissonias/etiologia , Exercício Físico , Família , Feminino , França/epidemiologia , Hábitos , Habitação , Humanos , Luz , Masculino , Pessoa de Meia-Idade , Sistemas On-Line , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Sono/fisiologia , Sono/efeitos da radiação , Medicamentos Indutores do Sono , Privação do Sono , Transtornos do Sono do Ritmo Circadiano/tratamento farmacológico , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Transtornos do Sono do Ritmo Circadiano/etiologia , Latência do Sono , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/epidemiologia , Isolamento Social/psicologia , Adulto Jovem
5.
Encephale ; 46(3S): S85-S92, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32522407

RESUMO

OBJECTIVES: During the COVID-19 pandemic, the French government has decided a general lockdown. This unprecedented situation has raised concerns about children's and adolescent's mental health. Children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) may find this context of restrained activity particularly tricky. The objectives of our study are to gather information about the well-being and global life conditions of children and adolescents with ADHD during the COVID-19 outbreak in France. METHODS: We designed a survey including both open-ended questions and questionnaire items for parents of children and adolescents with ADHD. Parents responded to the following open-ended questions: 1) "How is your child doing since the lockdown?" 2) "How is life at home since the lockdown?" 3) "If you had a remote service provision with a mental health professional (e.g. by telephone or video technology), please share your thoughts and any suggestions with us" 4) "Please share any other items that you think are important about ADHD symptoms of your child and the lockdown situation". This survey was posted on social media on the 6th of April and disseminated by French ADHD-parent and patient organizations. The present article reports the descriptive, qualitative and textometrical analyses of the survey. RESULTS: Between day 20 and 30 of lockdown, 538 parents responded to the survey, and we included 533 responses in the final analysis. The vast majority of responders were women 95 % (95 % CI 93,50; 97,18) with children whose mean age was 10,5 (95 % CI 7.58; 13.44). Since the lockdown, 34.71 % (95 % CI 30.70; 38.94) of children experienced a worsening in well-being, 34.33 % (95 % CI 30.34; 38.56) showed no significant changes and 30.96 % (95 % CI 27.09; 35.10) were doing better according to their parents. The thematic analysis showed that an improvement of their children's anxiety was one of the main topics addressed by parents. This improvement related to less school-related strain and flexible schedules that respected their children's rhythm. Improved self-esteem was another topic that parents linked with a lesser exposure of their children to negative feed-back. Parents repeatedly reported both inattention and hyperactivity/impulsivity. However, optimal lockdown life conditions seemed to compensate for the impact of ADHD symptoms (e.g. sufficient space at home, presence of a garden). Some parents reported worsening of general well-being in their children, and this manifested as oppositional/defiant attitudes and emotional outbursts. Parents also cited sleep problems and anxiety in this context. As regards everyday life during lock-down, at-home schooling was another major topic-parents described that their children struggled to complete school-related tasks and that teachers seemed to have forgotten about academic accommodations. The lockdown situation seems to have raised parents' awareness of the role of inattention and ADHD symptoms in their children's learning difficulties. Due to potential selection biases, the results of our survey may not be generalizable to all children and adolescents with ADHD. The main strengths of this rapid survey-based study lies in the reactivity of the participants and the quality and diversity of their responses to the open-ended questions. CONCLUSIONS: According to their parents, most children and adolescents with ADHD experience stability or improvement of their well-being. An improvement in school-related anxiety and the flexible adjustment to the children's' rhythms as well as parents' increased awareness of the difficulties their children experience are among the key topics in parents' descriptions.


Assuntos
Adaptação Psicológica , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Psicologia do Adolescente , Psicologia da Criança , Isolamento Social/psicologia , Adolescente , Atitude , Tédio , Criança , Educação , Relações Familiares , Feminino , França , Habitação , Humanos , Atividades de Lazer , Masculino , Relações Pais-Filho , Pais/psicologia , Autoimagem , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários
6.
J Med Internet Res ; 22(7): e19514, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32568727

RESUMO

BACKGROUND: Most patients with coronavirus disease (COVID-19) who show mild symptoms are sent home by physicians to recover. However, the condition of some of these patients becomes severe or critical as the disease progresses. OBJECTIVE: The aim of this study was to evaluate a telemedicine model that was developed to address the challenges of treating patients with progressive COVID-19 who are home-quarantined and shortages in the medical workforce. METHODS: A telemedicine system was developed to continuously monitor the progression of home-quarantined patients with COVID-19. The system was built based on a popular social media smartphone app called WeChat; the app was used to establish two-way communication between a multidisciplinary team consisting of 7 medical workers and 188 home-quarantined individuals (including 74 confirmed patients with COVID-19). The system helped patients self-assess their conditions and update the multidisciplinary team through a telemedicine form stored on a cloud service, based on which the multidisciplinary team made treatment decisions. We evaluated this telemedicine system via a single-center retrospective study conducted at Tongji Hospital in Wuhan, China, in January 2020. RESULTS: Among 188 individuals using the telemedicine system, 114 (60.6%) were not infected with COVID-19 and were dismissed. Of the 74 confirmed patients with COVID-19, 26 (35%) recovered during the study period and voluntarily stopped using the system. The remaining 48/76 confirmed patients with COVID-19 (63%) used the system until the end of the study, including 6 patients whose conditions progressed to severe or critical. These 6 patients were admitted to hospital and were stabilized (one received extracorporeal membrane oxygenation support for 17 days). All 74 patients with COVID-19 eventually recovered. Through a comparison of the monitored symptoms between hospitalized and nonhospitalized patients, we found prolonged persistence and deterioration of fever, dyspnea, lack of strength, and muscle soreness to be diagnostic of need for hospitalization. CONCLUSIONS: By continuously monitoring the changes in several key symptoms, the telemedicine system reduces the risks of delayed hospitalization due to disease progression for patients with COVID-19 quarantined at home. The system uses a set of scales for quarantine management assessment that enables patients to self-assess their conditions. The results are useful for medical staff to identify disease progression and, hence, make appropriate and timely treatment decisions. The system requires few staff to manage a large cohort of patients. In addition, the system can solicit help from recovered but self-quarantined medical workers to alleviate shortages in the medical workforce and free healthy medical workers to fight COVID-19 on the front line. Thus, it optimizes the usage of local medical resources and prevents cross-infections among medical workers and patients.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Progressão da Doença , Habitação , Monitorização Fisiológica , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Quarentena , Telemedicina/métodos , Adulto , Idoso , Betacoronavirus , Infecções por Coronavirus/fisiopatologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Admissão do Paciente , Médicos/estatística & dados numéricos , Pneumonia Viral/fisiopatologia , Quarentena/métodos , Estudos Retrospectivos
7.
Med Leg J ; 88(2): 57-64, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32515258

RESUMO

This is a personal view from London as the Covid-19 pandemic continues to spread here and the situation changes from day to day. As such it can only be a snapshot caught in time; it is not a diary of events. The Coronavirus Act 2020 gives Government enormous powers and was passed by Parliament in one day of debate immediately before it closed early for the Easter break. In March, the government imposed a "lockdown: the closure of all" but "essential" businesses and people other than essential workers must work from home but are allowed out for exercise and food shopping but must maintain 2 m apart, the "social distancing rule". The aim is to suppress the spread of the virus, reduce the death toll and "protect the National Health Service (NHS)" which needed time to empty wards and expand its intensive care unit (ICU) capability to deal with an expected influx of thousands of very sick patients. I discuss whether this strategy is working, how and why it has rapidly been altered to respond to criticism. Why was the Government so slow to seek the help of private laboratories to assist with testing? Why was the personal protective equipment (PPE) guidance altered only after criticism? I look at the impact of the lockdown on the UK economy, the changes to practice of medicine and speeding of scientific research. Cooperating with the lockdown has its price; is it harming the health and mental health of children, people living in households with potentially abusive partners or parents and those who are disabled or financially desperate? Is the cure worse than the disease? The Economy is being devastated by the lockdown and each day of lockdown it is worse. Is litigation being seeded even now by the pandemic? Notwithstanding unprecedented Government financial help many businesses are on the edge of collapse, people will lose their jobs and pensioners income. The winners include pharmacies, supermarkets, online food retailers, Amazon, online apps, providers of video games, services, streaming and scientific research laboratories, manufacturers of testing kits, ventilators, hand sanitisers, coffins, undertakers, etc. The British public is cooperating with lockdown but are we less productive at home? Parents with babies and children often child minders, school, grandparents or paid help which is not now available. Will current reliance on video-conferencing and video calls permanently change the way we work and will we need smaller city offices? Will we travel less? Will medical and legal practice and civil and criminal trials be generally carried out remotely? Will social distancing with self-isolation and job losses and business failures fuel depression? Is Covid-19 comparable to past epidemics like the Plague and Spanish flu?


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Ansiedade/epidemiologia , Comércio/legislação & jurisprudência , Controle de Doenças Transmissíveis , Infecções por Coronavirus/transmissão , Direito Penal , Depressão/epidemiologia , Economia , Previsões , Liberdade , Regulamentação Governamental , Habitação/economia , Humanos , Internet , Londres/epidemiologia , Corpo Clínico Hospitalar/provisão & distribução , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Pandemias , Pânico , Autonomia Pessoal , Pneumonia Viral/transmissão , Administração em Saúde Pública , Quarentena , Instituições Acadêmicas , Políticas de Controle Social , Isolamento Social , Telemedicina , Viagem , Triagem
8.
Chemosphere ; 257: 127119, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32497835

RESUMO

Radon-based radiation from natural soil building materials is an important factor likely influencing residents' health as a contributing source of natural radiation. This survey aims to quantify the nuclide-specific α-radiation of isotopes 222Rn and 220Rn in common types of houses in a region of northern Vietnam, Dong Van karst plateau, to preliminarily (i) evaluate the total annual effective dose rates and (ii) assess the relative risk of cancer induction from indoor α-radiation for inhabitants. The average 222Rn concentrations in all house types were lower than 100 Bq m-3, but 220Rn abundances were far higher than 222Rn, even up to >1000 Bq m-3 in air close to a wall of unfired-soil bricks. The estimated total annual effective dose rates from indoor 222Rn and 220Rn and their progenies to residents with daily exposure of 13 h in the various types of houses range from 3.1 to 4.3 mSv a-1 for houses constructed with modified materials, but up to higher than 6 mSv a-1 in houses with raw building materials. The average risk of developing lung cancer as a consequence of a lifetime exposure to indoor α-radiation in affected homes ranges from 3.9% to 14.6%. 220Rn and its metallic progenies contribute more than 80% of the total average lung cancer risk from total radon, being responsible for a range of 2.7-14.6% of the risk of developing lung cancer.


Assuntos
Poluentes Radioativos do Ar/análise , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Monitoramento de Radiação , Radônio/análise , Poluição do Ar em Ambientes Fechados/análise , Radiação de Fundo , Materiais de Construção , Habitação/estatística & dados numéricos , Humanos , Solo , Vietnã
12.
Sci Total Environ ; 724: 138092, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32408432

RESUMO

The burden of lung cancer associated with residential radon in existing housing can be reduced by interventions to screen and mitigate existing housing having radon levels above a mitigation threshold. The objective of this study is to estimate the cost effectiveness of radon interventions for screening and mitigation of existing housing for the 2016 population in Canada and to assess the structural uncertainty associated with the choice of model used in the cost-utility analysis. The incremental cost utility ratios are estimated using both a Markov cohort model and a discrete event simulation model. A societal perspective, a lifetime horizon and a discount rate of 1.5% are adopted. At a radon mitigation threshold of 200 (100) Bq/m3, the discounted ICERs for current rates of screening and mitigation of existing housing are 72,569 (68,758) $/QALY using a Markov cohort model and 84,828 (76,917) $/QALY using discrete event simulation. It appears that minimal structural uncertainty is associated with the choice of model used for this cost-utility analysis, and the cost effectiveness would improve at increased rates of radon testing and mitigation. The mitigation of radon in existing housing is estimated to be a practical policy option for reducing the associated lung cancer burden in Canada.


Assuntos
Poluição do Ar em Ambientes Fechados , Neoplasias Pulmonares , Radônio/análise , Canadá , Análise Custo-Benefício , Habitação , Humanos , Incerteza
13.
BMC Infect Dis ; 20(1): 386, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32471376

RESUMO

BACKGROUND: Hepatitis C virus (HCV) is highly prevalent among homeless persons, yet barriers continue to impede HCV testing and treatment in this population. We studied the experiences of homeless individuals related to accessing HCV care to inform the design of a shelter-based HCV prevention and treatment program. METHODS: Homeless shelter clients (10 women and 10 men) of a large shelter in San Francisco participated in gender segregated focus groups. Focus groups followed a semi-structured interview format, which assessed individual, program/system, and societal-level barriers and facilitators to universal HCV testing and linkage to HCV care. Focus group interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS: We identified key barriers to HCV testing and treatment at the individual level (limited knowledge and misconceptions about HCV infection, mistrust of health care providers, co-morbid conditions of substance use, psychiatric and chronic medical conditions), system level (limited advocacy for HCV services by shelter staff), and social level (stigma of homelessness). Individual, system, and social facilitators to HCV care described by participants included internal motivation, financial incentives, prior experiences with rapid HCV testing, and availability of affordable direct acting antiviral (DAA) treatment, respectively. CONCLUSIONS: Interrelated individual- and social-level factors were the predominant barriers affecting homeless persons' decisions to engage in HCV prevention and treatment. Integrated models of care for homeless persons at risk for or living with HCV address many of these factors, and should include interventions to improve patient knowledge of HCV and the availability of effective treatments.


Assuntos
Implementação de Plano de Saúde , Hepacivirus/imunologia , Hepatite C/epidemiologia , Hepatite C/psicologia , Pessoas em Situação de Rua , Adulto , Idoso , Antivirais/uso terapêutico , Feminino , Pessoal de Saúde , Hepatite C/complicações , Hepatite C/prevenção & controle , Anticorpos Anti-Hepatite C/sangue , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , São Francisco/epidemiologia , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/complicações
14.
PLoS One ; 15(5): e0231615, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469883

RESUMO

Businesses in the smart home sector are actively promoting the benefits of smart home technologies for consumers, such as convenience, economy and home security. To better understand meanings of and trust in the smart home, we carried out a nationally representative survey of UK consumers designed to measure adoption and acceptability, focusing on awareness, ownership, experience, trust, satisfaction and intention to use. We analysed the results using theories of meanings and acceptability of technologies including semiotics, social construction of technology (SCOT) and sociotechnical affordance. Our findings suggest that the meaning and value proposition of the smart home have not yet achieved closure for consumers, but is already foregrounding risks to privacy and security amongst the other meaning-making possibilities it could afford. Anxiety about the likelihood of a security incident emerges as a prominent factor influencing adoption of smart home technology. This factor negatively impacts adoption. These findings underline how businesses and policymakers will need to work together to act on the sociotechnical affordances of smart home technology in order to increase consumers' trust. This intervention is necessary if barriers to adoption and acceptability of the smart home are to be addressed now and in the future.


Assuntos
Segurança Computacional , Habitação , Sistemas de Informação/normas , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Instituições Residenciais/normas , Confiança , Adolescente , Adulto , Idoso , Confidencialidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Medição de Risco , Inquéritos e Questionários , Telemedicina , Reino Unido , Adulto Jovem
15.
Health Educ Behav ; 47(4): 519-524, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32408770

RESUMO

In this Perspective, we build on social justice and emancipatory traditions within the field of health education, and the field's long-standing commitment to building knowledge and shared power to promote health equity, to examine lessons and opportunities for health education emerging from the COVID-19 pandemic. Examining patterns that emerged as the pandemic unfolded in Metropolitan Detroit, with disproportionate impacts on African American and low-income communities, we consider conditions that contributed to excess exposure, mortality, and reduced access to critical health protective resources. Using a life course framework, we consider enduring impacts of the pandemic for health equity. Finally, we suggest several strategic actions in three focal areas-environment, occupation, and housing-that can be taken by health educators working in partnership with community members, researchers, and decision makers, using, for example, a community-based participatory research approach, to reduce adverse impacts of COVID-19 and promote long-term equity in health.


Assuntos
Infecções por Coronavirus/etnologia , Educação em Saúde/organização & administração , Equidade em Saúde/organização & administração , Pneumonia Viral/etnologia , Determinantes Sociais da Saúde/etnologia , Betacoronavirus , Meio Ambiente , Habitação/organização & administração , Humanos , Michigan/epidemiologia , Pandemias , Fatores Socioeconômicos
16.
MMWR Morb Mortal Wkly Rep ; 69(17): 523-526, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32352954

RESUMO

On March 30, 2020, Public Health - Seattle and King County (PHSKC) was notified of a confirmed case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and day center (shelter A). Residents from two other homeless shelters (B and C) used shelter A's day center services. Testing for SARS-CoV-2, the virus that causes COVID-19, was offered to available residents and staff members at the three shelters during March 30-April 1, 2020. Among the 181 persons tested, 19 (10.5%) had positive test results (15 residents and four staff members). On April 1, PHSKC and CDC collaborated to conduct site assessments and symptom screening, isolate ill residents and staff members, reinforce infection prevention and control practices, provide face masks, and advise on sheltering-in-place. Repeat testing was offered April 7-8 to all residents and staff members who were not tested initially or who had negative test results. Among the 118 persons tested in the second round of testing, 18 (15.3%) had positive test results (16 residents and two staff members). In addition to the 31 residents and six staff members identified through testing at the shelters, two additional cases in residents were identified during separate symptom screening events, and four were identified after two residents and two staff members independently sought health care. In total, COVID-19 was diagnosed in 35 of 195 (18%) residents and eight of 38 (21%) staff members who received testing at the shelter or were evaluated elsewhere. COVID-19 can spread quickly in homeless shelters; rapid interventions including testing and isolation to identify cases and minimize transmission are necessary. CDC recommends that homeless service providers implement appropriate infection control practices, apply physical distancing measures including ensuring resident's heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents (1).


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Pessoas em Situação de Rua/estatística & dados numéricos , Habitação/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Washington/epidemiologia
17.
MMWR Morb Mortal Wkly Rep ; 69(17): 521-522, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32352957

RESUMO

In the United States, approximately 1.4 million persons access emergency shelter or transitional housing each year (1). These settings can pose risks for communicable disease spread. In late March and early April 2020, public health teams responded to clusters (two or more cases in the preceding 2 weeks) of coronavirus disease 2019 (COVID-19) in residents and staff members from five homeless shelters in Boston, Massachusetts (one shelter); San Francisco, California (one); and Seattle, Washington (three). The investigations were performed in coordination with academic partners, health care providers, and homeless service providers. Investigations included reverse transcription-polymerase chain reaction testing at commercial and public health laboratories for SARS-CoV-2, the virus that causes COVID-19, over approximately 1-2 weeks for residents and staff members at the five shelters. During the same period, the team in Seattle, Washington, also tested residents and staff members at 12 shelters where a single case in each had been identified. In Atlanta, Georgia, a team proactively tested residents and staff members at two shelters with no known COVID-19 cases in the preceding 2 weeks. In each city, the objective was to test all shelter residents and staff members at each assessed facility, irrespective of symptoms. Persons who tested positive were transported to hospitals or predesignated community isolation areas.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pessoas em Situação de Rua/estatística & dados numéricos , Habitação/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Boston/epidemiologia , Cidades , Georgia/epidemiologia , Humanos , Pandemias , Prevalência , São Francisco/epidemiologia , Washington/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-32466326

RESUMO

After the outbreak of COVID-19 (especially in the stage of tourism recovery), the bed and breakfast (B&B) tourism industry faced big challenges in improving its health strategies. B&Bs are very important for the tourism industry in China and many other countries. However, few studies have studied the impact of B&Bs, under COVID-19, on tourism in China. Our paper is among one of the first studies to investigate the impact of COVID-19 on tourist satisfaction with B&Bs in China. The work/travel restrictions started from 20 January 2020, and work/after travel resumed from 20 February 2020 in Zhejiang, China. Data were collected from 588 tourists (who experienced B&Bs in Zhejiang, China) from a WeChat online survey, from 1 March to 15 March 2020. The current study attempted to fill the gap by studying the changing tourist satisfaction levels with B&Bs before/after COVID-19. Moreover, some suggestions are given to the B&B industry for tourism resumption after COVID-19 by an importance-performance analysis (IPA).


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Satisfação Pessoal , Pneumonia Viral , Viagem , Desjejum , China , Habitação , Humanos , Inquéritos e Questionários
19.
Soins Pediatr Pueric ; 41(313): 26-28, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32446553

RESUMO

The house is a symbol strongly invested by the children we receive in transcultural devices. Its structure echoes both the psychological and physical structure of the child but also that of family ties. The clinical situation of a family from Tunisia makes it possible to describe the system of the Métissages group and the symbol of the "mother house", both through drawings and games.


Assuntos
Habitação , Psicologia da Criança , Criança , Humanos , Tunísia
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