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1.
BMC Public Health ; 20(1): 1351, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887592

RESUMO

BACKGROUND: COVID-19 restrictions such as the closure of schools and parks, and the cancellation of youth sports and activity classes around the United States may prevent children from achieving recommended levels of physical activity (PA). This study examined the effects of the COVID-19 pandemic on PA and sedentary behavior (SB) in U.S. children. METHOD: Parents and legal guardians of U.S. children (ages 5-13) were recruited through convenience sampling and completed an online survey between April 25-May 16, 2020. Measures included an assessment of their child's previous day PA and SB by indicating time spent in 11 common types of PA and 12 common types of SB for children. Parents also reported perceived changes in levels of PA and SB between the pre-COVID-19 (February 2020) and early-COVID-19 (April-May 2020) periods. Additionally, parents reported locations (e.g., home/garage, parks/trails, gyms/fitness centers) where their children had performed PA and their children's use of remote/streaming services for PA. RESULTS: From parent reports, children (N = 211) (53% female, 13% Hispanic, Mage = 8.73 [SD = 2.58] years) represented 35 states and the District of Columbia. The most common physical activities during the early-COVID-19 period were free play/unstructured activity (e.g., running around, tag) (90% of children) and going for a walk (55% of children). Children engaged in about 90 min of school-related sitting and over 8 h of leisure-related sitting a day. Parents of older children (ages 9-13) vs. younger children (ages 5-8) perceived greater decreases in PA and greater increases in SB from the pre- to early-COVID-19 periods. Children were more likely to perform PA at home indoors or on neighborhood streets during the early- vs. pre-COVID-19 periods. About a third of children used remote/streaming services for activity classes and lessons during the early-COVID-19 period. CONCLUSION: Short-term changes in PA and SB in reaction to COVID-19 may become permanently entrenched, leading to increased risk of obesity, diabetes, and cardiovascular disease in children. Programmatic and policy strategies should be geared towards promoting PA and reducing SB over the next 12 months.


Assuntos
Infecções por Coronavirus/epidemiologia , Exercício Físico , Pandemias , Pneumonia Viral/epidemiologia , Comportamento Sedentário , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos/epidemiologia
2.
Soins ; 65(845): 27-29, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32862961

RESUMO

From the 1980s, the dissociation of sexuality and reproduction has led to questioning on the "evidence" of the female-male categories. The United States were the first to take governmental initiatives to offset the under-representation of women, particularly in the field of research. They were followed, twenty years later, by the European Community. However, inequalities between women and men persist today. It seems obvious that only proactive measures can help to improve this situation.


Assuntos
Disparidades nos Níveis de Saúde , Pesquisa/história , Feminino , História do Século XX , Humanos , Masculino , Fatores Sexuais , Estados Unidos
3.
J Grad Med Educ ; 12(4): 507-511, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32879697

RESUMO

Background: The start of a new academic year in graduate medical education will mark a transition for postgraduate year 1 (PGY-1) residents from medical school into residency. The relocation of individuals has significant implications given the COVID-19 pandemic and variability of the outbreak across the United States, but little is known about the extent of the geographic relocation taking place. Objective: We reported historical trends of PGY-1 residents staying in-state and those starting residency from out-of-state to quantify the geographic movement of individuals beginning residency training each year. Methods: We analyzed historical data collected by the Accreditation Council for Graduate Medical Education in academic years 2016-2017, 2017-2018, and 2018-2019, comparing the locations of medical school and residency programs for PGY-1 residents to determine the number of matriculants from in-state medical schools and out-of-state medical schools. International medical school graduates (IMGs) were shown separately in the analysis and then combined with out-of-state matriculants. US citizens who trained abroad were counted among IMGs. Results: The total number of PGY-1s increased by 10.3% during the 3-year time period, from 29 338 to 32 348. When combined, IMGs and USMGs transitioning from one state or country to another state accounted for approximately 72% of PGY-1s each year. Approximately 63% of USMGs matriculated to a residency program in a new state, and IMGs made up 24.6% to 23.1% of PGY-1s over the 3-year period. Conclusions: Each year brings a substantial amount of movement among PGY-1s that highlights the need for policies and procedures specific to the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Internato e Residência , Pandemias , Pneumonia Viral , Área de Atuação Profissional , Betacoronavirus , Infecções por Coronavirus/virologia , Educação Médica , Educação de Graduação em Medicina , Médicos Graduados Estrangeiros , Humanos , Pneumonia Viral/virologia , Estados Unidos , Local de Trabalho
7.
J Int Med Res ; 48(8): 300060520938943, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32865095

RESUMO

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) began in December 2019 and continues to spread worldwide. Rapid and accurate identification of suspected cases is critical in slowing spread of the virus that causes the disease. We aimed to highlight discrepancies in the various criteria used by international agencies and highly impacted individual countries around the world. METHODS: We reviewed the criteria for identifying a suspected case of COVID-19 used by two international public health agencies and 10 countries across Asia, Europe, and North America. The criteria included information on the clinical causes of illness and epidemiological risk factors. Non-English language guidelines were translated into English by a co-author who is fluent in that particular language. RESULTS: Although most criteria are modifications of World Health Organization recommendations, the specific clinical features and epidemiological risks for triggering evaluation of patients with suspected COVID-19 differed widely among countries. The rationale for these differences may be related to each country's resources, politics, experience with previous outbreaks or pandemics, health insurance system, COVID-19 outbreak severity, and other undetermined factors. CONCLUSION: We found no consensus regarding the best diagnostic criteria for identifying a suspected case of COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Regulamento Sanitário Internacional , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde Pública/legislação & jurisprudência , Ásia/epidemiologia , Betacoronavirus , Centers for Disease Control and Prevention, U.S. , Europa (Continente)/epidemiologia , Humanos , Cooperação Internacional , América do Norte/epidemiologia , Pandemias , Estados Unidos , Organização Mundial da Saúde
10.
Braz Dent J ; 31(4): 392-398, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32901715

RESUMO

This study aimed to analyze the videos available on YouTube related to dentistry and the novel coronavirus (COVID-19), as there is no such analysis in the existing literature. The terms "dental" and "COVID-19" were searched on YouTube on May 9, 2020. The top 116 English-language videos with at least 300 views were analyzed by two observers. Data was saved for each video, including target audience, source, country of origin, content, number of views, time watched, average views, duration, like/dislike ratio, and usefulness. Total video information and quality index (VIQI) scores were calculated, consisting of flow, information, accuracy, quality, and precision indices. Non-parametric tests were used for analysis. The analyzed videos were viewed 375,000 times and totaled 20 h of content. Most videos were uploaded by dentists (45.7%), originated from the United States (79.3%), and contained information targeted towards patients (48.3%). Nearly half of the videos (47.4%) were moderately useful. For the usefulness of the videos, statistically significant differences were found for all indices as well as total VIQI scores. A comparison of the indices according to the relevance of the videos showed statistically significant differences in the videos' information and precision indices and total VIQI scores. The results of this study showed that dentistry YouTube videos related to COVID-19 had high view numbers; however, the videos were generally moderate in quality and usefulness.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Mídias Sociais , Betacoronavirus , Odontologia , Humanos , Estados Unidos , Gravação em Vídeo
11.
Rev Saude Publica ; 54: 89, 2020 Sep 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901754

RESUMO

OBJECTIVE: To analyze the nutritional composition of ultra-processed foods consumed by children that attend basic health units. METHODS: This is a cross-sectional study with a representative probabilistic sample of 536 children aged between 6 and 59 months treated at a health unit in the city of Rio de Janeiro. Nutritional information was extracted from labels of the ultra-processed foods referred to in a 24-hour recall. The 351 foods mentioned were divided into 22 groups and 38 subgroups according to the type of product, and they were characterized according to the averages of the values for energy, total fats, saturated fats, trans fats and sodium in 100 grams of the product, in addition to presence, number, and type of "other sweeteners". The nutritional Profile Model of the Pan American Health Organization was applied for each food and for the average of nutrient content obtained for each group to examine the occurrence of critical nutrients excess. RESULTS: Ultra-processed foods contained high energy value and high levels of total fats, saturated fats, trans fats, and sodium. Out of the total of ultra-processed foods, 66% presented excess of at least one critical nutrient, with emphasis on requeijões and ultra-processed cheeses, instant noodles, and industrialized and sausage-like meats, which presented 100% of foods with excess of total fats, saturated fats and sodium. Out of the 21 groups, the following exceeded the limit established by the Pan American Health Organization: for total fats, 10 groups; for saturated fats, 11; for trans fats, 3; and sodium, 13. Requeijões and ultra-processed cheeses; industrialized and sausage-like meats; and biscuits exceeded this limit in all parameters. Out of the set of ultra-processed foods analyzed, 13.4% contained "other sweeteners" (eight different types). CONCLUSIONS: The ultra-processed foods analyzed presented unbalanced nutritional profile, and two thirds presented excess of at least one critical nutrient. Educational actions and regulatory measures are necessary to better inform the population and to discourage its consumption.


Assuntos
Ingestão de Energia , Fast Foods , Comportamento Alimentar , Valor Nutritivo , Brasil , Criança , Pré-Escolar , Estudos Transversais , Manipulação de Alimentos , Humanos , Lactente , Estados Unidos
17.
S Afr Med J ; 110(6): 445-446, 2020 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-32880545

RESUMO

Less than 3 months after the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern, and within a month of the WHO declaring COVID19 a global pandemic, COVID-19 infections and fatalities have grown exponentially, globally. Now, more than ever, the world needs responsible political leadership, evidence-based decision-making, and co-ordinated global health action.


Assuntos
Infecções por Coronavirus/epidemiologia , Saúde Global , Pneumonia Viral/epidemiologia , Política , Saúde Pública , Humanos , Liderança , Pandemias , África do Sul/epidemiologia , Estados Unidos/epidemiologia , Organização Mundial da Saúde/organização & administração
18.
JAMA Netw Open ; 3(9): e2019722, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32880651

RESUMO

Importance: Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with coronavirus disease 2019 (COVID-19) incidence is unknown. Objective: To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results. Design, Setting, and Participants: This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020. Exposures: Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased). Main Outcomes and Measures: The outcome was a positive COVID-19 polymerase chain reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators. Results: A total of 489 patients (mean [SD] age, 49.2 [18.4] years; 366 [75%] women; and 331 [68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing. Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants (25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%) tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group. Conclusions and Relevance: In this single-center, retrospective cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Deficiência de Vitamina D , Vitamina D/uso terapêutico , Betacoronavirus/isolamento & purificação , Calcifediol/sangue , Calcitriol/sangue , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/terapia , Vitaminas/uso terapêutico
19.
MMWR Morb Mortal Wkly Rep ; 69(35): 1210-1215, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32881845

RESUMO

Hydroxychloroquine and chloroquine, primarily used to treat autoimmune diseases and to prevent and treat malaria, received national attention in early March 2020, as potential treatment and prophylaxis for coronavirus disease 2019 (COVID-19) (1). On March 20, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for chloroquine phosphate and hydroxychloroquine sulfate in the Strategic National Stockpile to be used by licensed health care providers to treat patients hospitalized with COVID-19 when the providers determine the potential benefit outweighs the potential risk to the patient.* Following reports of cardiac and other adverse events in patients receiving hydroxychloroquine for COVID-19 (2), on April 24, 2020, FDA issued a caution against its use† and on June 15, rescinded its EUA for hydroxychloroquine from the Strategic National Stockpile.§ Following the FDA's issuance of caution and EUA rescindment, on May 12 and June 16, the federal COVID-19 Treatment Guidelines Panel issued recommendations against the use of hydroxychloroquine or chloroquine to treat COVID-19; the panel also noted that at that time no medication could be recommended for COVID-19 pre- or postexposure prophylaxis outside the setting of a clinical trial (3). However, public discussion concerning the effectiveness of these drugs on outcomes of COVID-19 (4,5), and clinical trials of hydroxychloroquine for prophylaxis of COVID-19 continue.¶ In response to recent reports of notable increases in prescriptions for hydroxychloroquine or chloroquine (6), CDC analyzed outpatient retail pharmacy transaction data to identify potential differences in prescriptions dispensed by provider type during January-June 2020 compared with the same period in 2019. Before 2020, primary care providers and specialists who routinely prescribed hydroxychloroquine, such as rheumatologists and dermatologists, accounted for approximately 97% of new prescriptions. New prescriptions by specialists who did not typically prescribe these medications (defined as specialties accounting for ≤2% of new prescriptions before 2020) increased from 1,143 prescriptions in February 2020 to 75,569 in March 2020, an 80-fold increase from March 2019. Although dispensing trends are returning to prepandemic levels, continued adherence to current clinical guidelines for the indicated use of these medications will ensure their availability and benefit to patients for whom their use is indicated (3,4), because current data on treatment and pre- or postexposure prophylaxis for COVID-19 indicate that the potential benefits of these drugs do not appear to outweigh their risks.


Assuntos
Cloroquina/uso terapêutico , Hidroxicloroquina/uso terapêutico , Padrões de Prática Médica/estatística & dados numéricos , Especialização/estatística & dados numéricos , Infecções por Coronavirus/tratamento farmacológico , Feminino , Humanos , Masculino , Resultado do Tratamento , Estados Unidos
20.
MMWR Morb Mortal Wkly Rep ; 69(35): 1204-1209, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32881848

RESUMO

Adolescents and young adults represent approximately 13% of the U.S. workforce (1). Compared with adult workers, young workers (aged 15-24 years) experience higher rates of job-related injury (2,3). To describe injuries among young workers and inform research and prevention activities, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed national data for 2012-2018 from the occupational supplement to the National Electronic Injury Surveillance System* (NEISS-Work) and for 2018 from the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII).† During the 7-year period, an estimated 3.2 million (95% confidence interval [CI] = 2.6-3.7) nonfatal, job-related injuries to young workers were treated in hospital emergency departments (EDs). From 2012 to 2018, annual rates of work-related injuries§ treated in the ED (ED-treated injuries) declined overall across all age groups but ranged from 1.2 to 2.3 times higher for workers aged 15-24 years compared with those for adults aged 25-44 years. Workers aged 18-19 years had the highest rate of ED-treated injuries. In 2018, among all age groups, workers in service occupations¶ had the highest percentage of injuries requiring at least 1 day away from work. Among workers aged 15-17 years, those in the leisure and hospitality industry had the highest percentage of work-related injuries requiring at least 1 day away from work. Occupational injuries can have long-term impacts on health (4). The disproportionate risk of injury among young workers highlights the need for sustained, targeted public health efforts to prepare this population with essential workplace safety and health competencies before they enter the workforce and to provide high-quality safety training and close supervision on the job. NIOSH and its partners developed a free curriculum to teach adolescents workplace safety and health competencies, which includes identification of workplace hazards and methods for addressing them, how to understand their rights and responsibilities as workers, and how to voice concerns about work safety issues (5).


Assuntos
Traumatismos Ocupacionais/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia , Adulto Jovem
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