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COVID-19 response offers a model to guide research and preventive interventions targeting adolescents, their families, and communities. My 2022 SRA Presidential Address posed: What if the COVID-19 Response Served as a Guidepost for Future Research on Adolescence? Solution versus Problem-Focused Agenda. Several "pandemics" were already underway, emerging from historic and contemporary events that threaten the safety and survival of human lives. The Multi-Transgenerational Life Course Theoretical model was selected to demonstrate pathways through which the transmission of generational exposure to crisis and trauma impact adolescents' developmental trajectories. Recommendations to inform and guide an adolescent research rapid response agenda are proposed minds to advance equity and social justice can become realities.
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The COVID-19 pandemic highlighted the importance of addressing social needs in a crisis context. Some US jurisdictions integrated a social service component into case investigation and contact tracing (CI/CT) programs, including the New York City (NYC) Test & Trace (T2) Program; the Take Care initiative referred NYC residents who tested positive or were exposed to COVID-19 to services to support isolation and quarantine and meet basic needs. More research is needed to determine effective implementation strategies for integrating social needs provision into CI/CT programs. To identify barriers and facilitators to the implementation of the Take Care initiative, we conducted key informant interviews with program staff, community-based organization partners, and cases and contacts as part of a larger evaluation of the T2 program. Interviews were recorded, transcribed, and analyzed using rapid qualitative methods. Key facilitators to implementation included utilizing a case management software system, employing strategies to encourage service uptake, leveraging cross-agency collaborations, and partnering with community-based organizations for resource navigation. Barriers identified included external management of the software system, challenges reaching and engaging the public, administrative complications due to shifting collaborations, and management of CBO partners' structure and hiring. Based on our findings, we provide recommendations to support effective planning and implementation of social needs service provision in a crisis context. Future research should focus on testing promising implementation strategies highlighted in this study and applying them to varied contexts and crisis situations.
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BACKGROUND: Ventilator-associated pneumonia (VAP) may be a particular concern in patients with severe coronavirus disease 2019 (COVID-19). We aimed to determine the prevalence and etiology of VAP in critically ill COVID-19 patients in a Danish intensive care unit (ICU) during the first three waves of the COVID-19 pandemic and to study associations between dexamethasone (DXM) use and development of VAP. METHODS: In an observational single-center study patients were retrospectively screened for VAP including causative pathogens, use of DXM and commonly used antibiotics. Diagnosis of VAP required invasive mechanical ventilation (IMV) >48 h with presence of a new bacterial agent and clinical signs of infection. For analysis, common descriptive statistics were applied. Cox proportional hazards models were used to analyze the association between DXM use and VAP. RESULTS: VAP was detected in 53/119 (44.5%) mechanically ventilated patients across all three COVID-19 waves. Median length of IMV for VAP patients was 24 [15-41] days, and 3 out of 4 were males. VAP was most prevalent (47.0%) during the second wave. Common pathogens included Klebsiella pneumoniae (24.5%), Enterobacter aerogenes (17.0%) and Pseudomonas aeruginosa (13.2%), Staphylococcus aureus (13.2%), and Escherichia coli (13.2%). A change from Gram-negative bacteria only to a combination of Gram-positive and Gram-negative bacteria was observed in the second wave compared to first. Use of DXM was not associated with VAP (adjusted hazard ratio 1.63 95% CI: 0.84-3.17). CONCLUSION: The prevalence of VAP was high across all three COVID-19 waves and showed a different distribution of pathogens between the first and second wave. Use of DXM was not associated with VAP development. Further and larger studies are needed to understand the risk factors associated with VAP in patients with COVID-19.
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During infectious disease epidemics, accurate diagnostic testing is key to rapidly identify and treat cases, and mitigate transmission. When a novel pathogen is involved, building testing capacity and scaling testing services at the local level can present major challenges to healthcare systems, public health agencies, and laboratories. This mixed methods study examined lessons learned from the scale-up of SARS-CoV-2 testing services in New York City (NYC), as a core part of NYC's Test & Trace program. Using quantitative and geospatial analyses, the authors assessed program success at maximizing reach, equity, and timeliness of SARS-CoV-2 diagnostic testing services across NYC neighborhoods. Qualitative analysis of key informant interviews elucidated key decisions, facilitators, and barriers involved in the scale-up of SARS-CoV-2 testing services. A major early facilitator was the ability to establish working relationships with private sector vendors and contractors to rapidly procure and manufacture necessary supplies locally. NYC residents were, on average, less than 25 min away from free SARS-CoV-2 diagnostic testing services by public transport, and services were successfully directed to most neighborhoods with the highest transmission rates, with only one notable exception. A key feature was to direct mobile testing vans and rapid antigen testing services to areas based on real-time neighborhood transmission data. Municipal leaders should prioritize fortifying supply chains, establish cross-sectoral partnerships to support and extend testing services, plan for continuous testing and validation of assays, ensure open communication feedback loops with CBO partners, and maintain infrastructure to support mobile services during infectious disease emergencies.
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AIMS: To explore the impact of the COVID-19 pandemic on nurses' and junior doctors' workload, changes to direct care and the impact of workload on resource allocation. DESIGN: Mixed-method design was used. METHODS: Data were collected from direct observation, hospital administrative database and a survey. Nurses and junior doctors were observed on two COVID-19 wards and one non-COVID-19 ward using a semi-structured observation schedule. Survey data were collected from nurses and junior doctors that had worked on the COVID-19 ward during the pandemic. Patient data were collected from Web Patient Administration System during the period of March-August 2021 and compared to March-August 2022. RESULTS: The results of this study indicated that the workloads of nurses and junior doctors changed on the COVID-19 wards. Nurses on the COVID-19 ward spent less time on administration, communication and documentation compared to nurses working on the non-COVID-19 ward. For junior doctors, less time was being spent on direct care activities and administrative work compared to the non-COVID ward. On the COVID-19 wards, patients were older and had a shorter length of stay compared to the year before. Five themes were identified from the surveys, staffing shortages resulting in higher workloads and the need for overtime, unforeseen time to undertake tasks, lack of support and physical health and patient care compromised. CONCLUSION: The study highlights the need for systemic changes to staffing shortages and elevated workloads to improve the compromised mental and physical health caused during the pandemic and to retain the workforce for future sustainability. IMPLICATIONS: As we collectively reflect on the lessons learned from this unprecedented period, it is imperative to address the challenges experienced proactively, fostering a healthcare environment that prioritises the well-being of its front line heroes and, by extension, the quality of patient care. REPORTING METHOD: STROBE. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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The articles in this special issue of AIDS and Behavior focus on the collision between HIV/AIDS and COVID-19 as intersecting pandemics that profoundly impacted communities globally. This editorial highlights the complex interplay between these two public health crises. The pandemic disrupted access to HIV prevention, testing, and treatment services, potentially jeopardizing decades of progress. Mental health challenges and social vulnerability among people living with HIV (PWH) were exacerbated, with preexisting health disparities amplified, disproportionately affecting marginalized populations. However, despite these challenges, the pandemic also spurred innovation and adaptation in HIV prevention and care, with increased use of telehealth and other modalities. The enduring and actionable lessons learned from the collision of HIV and COVID-19 pandemics can prepare us for the next public health challenge with two calls for action. First, we call for integrated and equitable responses that address the multifaceted challenges faced by individuals and communities affected by HIV in the post-COVID-19 era. Second, we call for a strengthened commitment to building resilient health systems and community-engaged interventions that can withstand future challenges.
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BACKGROUND: Discontinuity between health care delivery systems and community-based organizations is a significant barrier to improving population health. OBJECTIVE: To describe the facilitators and barriers experienced by a health system-community partnership 15 months after implementation. METHODS: Coalition members who led committees within the coalition or had active, sustained participation in coalition activities were invited to participate. Qualitative interviews used a semi-structured interview guide that elicited information on coalition functioning. A content analysis used inductive and deductive codes which were reviewed using a consensus process. Final themes centered on factors that facilitated or impeded the coalition's success in supporting community needs during the COVID-19 pandemic. LESSONS LEARNED: Coalition stakeholder perspectives identified several critical factors: defined governance, a culture of trust that accelerates learning, reliable resources, and a health-care anchor organization committed to shared investment. CONCLUSIONS: Lessons from this endeavor contribute to a deeper understanding of successful practices for health system-community partnerships.
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COVID-19 , Investigación Participativa Basada en la Comunidad , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Investigación Participativa Basada en la Comunidad/organización & administración , SARS-CoV-2 , Atención a la Salud/organización & administración , Relaciones Comunidad-Institución , Pandemias , Investigación CualitativaRESUMEN
Underserved communities have been disproportionately affected by the COVID-19 pandemic. The Project Promoting Engagement and COVID-19 Testing for Health (PEACH) study was designed to understand the attitudes, beliefs, and infrastructure associated with COVID-19 risk, testing, and prevention behaviors in people living with, caring for, or at risk for type 2 diabetes. The purpose of this joint community-academic partnered manuscript is to share lessons learned for maintaining community partnerships through the challenging times of a pandemic. New and existing community partners were invited to share their perceptions about the facilitators and barriers of partnering with academia during the COVID-19 public health crisis. Key facilitators included those partners felt heard and their input valued. And the changing nature and demands in response to the pandemic on the partners' responsibilities were among the key challenges. Successful maintenance of the partnerships required flexibility, creativity, and a willingness to adapt engagement as community partners responded to the needs of their communities.
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COVID-19 , Investigación Participativa Basada en la Comunidad , Relaciones Comunidad-Institución , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Investigación Participativa Basada en la Comunidad/organización & administración , SARS-CoV-2 , Diabetes Mellitus Tipo 2/prevención & control , Pandemias/prevención & controlRESUMEN
BACKGROUND: Due to the COVID-19 pandemic, health professional training programs made substantial changes to shift previously in-person student training opportunities to remote settings. OBJECTIVES: We present lessons learned from changes made to one community-engaged internship program, Bridging the Gaps (BTG)-Pittsburgh, that should prove helpful in future times of crisis. METHODS: BTG-Pittsburgh places inter-disciplinary graduate pairs of students in community-based organizations that serve marginalized populations, to work directly with program participants and develop tangible products aimed to build organizational capacity. Students get additional training on poverty awareness, health literacy, community violence, food justice, trauma-informed self-care, cultural and academic humility, oral health and advocacy. Upon pandemic onset, given increased community need and community partner feedback, BTG-Pittsburgh pivoted quickly, shifting to remote engagement and making critical adjustments to ensure responsiveness to student and community partner needs. Adjustments included: 1) adopting a trauma-informed approach, 2) developing remote mentoring guidance, and 3) doubling site visits to ensure that students and site mentors felt sufficiently supported. CONCLUSIONS: Several program and partnership attributes contributed to our overall program success, including a model of reciprocal benefits, providing supports, flexibility, and long-standing relationships. The university's quick adoption of remote technology and each participating school's commitment to supporting the program model, further enabled effective student-organization-program collaboration. These lessons can inform community-partnered experiential learning programs that may need to incorporate remote components moving forward.
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COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Investigación Participativa Basada en la Comunidad/organización & administración , Pandemias , Educación a Distancia/organización & administración , Internado y Residencia/organización & administraciónRESUMEN
AIM: The objective of this study was to explore how selected sub-national (provincial) primary healthcare units in Ethiopia responded to coronavirus disease 2019 (COVID-19) and what impact these measures had on essential health services. BACKGROUND: National-level responses against the spread of COVID-19 and its consequences are well studied. However, data on capacities and challenges of sub-national health systems in mitigating the impact of COVID-19 on essential health services are limited. In countries with decentralized health systems like Ethiopia, a study of COVID-19 impacts on essential health services could inform government bodies, partners, and providers to strengthen the response against the pandemic and document lessons learned. METHODS: We conducted a qualitative study, using a descriptive phenomenology research design. A total of 59 health leaders across Ethiopia's 10 regions and 2 administrative cities were purposively selected to participate in key informant interviews. Data were collected using a semi-structured interview guide translated into a local language. Interviews were conducted in person or by phone. Coding of transcripts led to the development of categories and themes, which were finalized upon agreement between two investigators. Data were analysed using thematic analysis. FINDINGS: Essential health services declined in the first months of the pandemic, affecting maternal and child health including deliveries, immunization, family planning services, and chronic disease services. Services declined due to patients' and providers' fear of contracting COVID-19, increased cost of transport, and reallocation of financial and human resources to the various activities of the response. Authorities of local governments and the health system responded to the pandemic immediately, capitalizing on multisectoral support and redirecting resources; however, the intensity of the response declined as time progressed. Future investments in health system hardware - health workers, supplies, equipment, and infrastructure as well as carefully designed interventions and coordination are needed to shore up the COVID-19 response.
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COVID-19 , Atención Primaria de Salud , Investigación Cualitativa , Humanos , Etiopía , Personal de Salud/psicología , Femenino , SARS-CoV-2 , Masculino , Adulto , Pandemias , Persona de Mediana EdadRESUMEN
BACKGROUND: Crime has been described as a public health issue in Trinidad and Tobago, a small developing nation. COVID-19 restrictions, aimed at maintaining public health safety by limiting disease spread, may have negatively impacted crime rates due to an alteration of social and economic conditions. This study evaluates the implications of these restrictions on crime dynamics and hence their impacts on overall public health. METHODS: Employing interrupted time series analysis with seasonal autoregressive integrated moving average with exogenous factor (Seasonal Autoregressive Integrated Moving Average with Exogenous Variables) models, monthly data on murders, sexual offences, and motor vehicle larcenies from January 2013 to June 2023 were analysed. RESULTS: The study found a decrease in murders and motor vehicle larcenies with the onset of restrictions, followed by an inverse trend correlating with the easing of measures. Sexual offences showed no significant change in response to the restrictions. CONCLUSIONS: While COVID-19 restrictions initially influenced certain crime rates, the effect varied across crime types. Policy interventions based on lessons learned from the COVID-19 pandemic must be done to strategically reduce and prevent crime without having the negative side effects of the pandemic.
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INTRODUCTION: High-quality evidence is crucial for guiding effective humanitarian responses, yet conducting rigorous research, particularly randomised controlled trials, in humanitarian crises remains challenging. The TISA ("traitement intégré de la sous-nutrition aiguë") trial aimed to evaluate the impact of a Water, Sanitation and Hygiene (WASH) intervention on the standard national treatment of uncomplicated Severe Acute Malnutrition (SAM) in children aged 6-59 months. Implemented in two northern Senegalese regions from December 22, 2021, to February 20, 2023, the trial faced numerous challenges, which this paper explores along with the lessons learned. METHODS: The study utilised trial documentation, including field reports, meeting minutes, training plans, operational monitoring data and funding proposals, to retrace the trial timeline, identify challenges and outline implemented solutions. Contributions from all TISA key staff-current and former, field-based and headquarters-were essential for collecting and interpreting information. Challenges were categorised as internal (within the TISA consortium) or external (broader contextual issues). RESULTS: The TISA trial, executed by a consortium of academic, operational, and community stakeholders, enrolled over 2000 children with uncomplicated SAM across 86 treatment posts in a 28,000 km2 area. The control group received standard outpatient SAM care, while the intervention group also received a WASH kit and hygiene promotion. Initially planned to start in April 2019 for 12 months, the trial faced a 30-month delay and was extended to 27 months due to challenges like the COVID-19 pandemic, national strikes, health system integration issues and weather-related disruptions. Internal challenges included logistics, staffing, data management, funding and aligning diverse stakeholder priorities. DISCUSSION AND CONCLUSION: Despite these obstacles, the trial concluded successfully, underscoring the importance of tailored monitoring, open communication, transparency and community involvement. Producing high-quality evidence in humanitarian contexts demands extensive preparation and strong coordination among local and international researchers, practitioners, communities, decision-makers and funders from the study's inception. TRIAL REGISTRATION: Clinicaltrials.gov NCT04667767 .
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Higiene , Saneamiento , Humanos , Lactante , Preescolar , Senegal , Altruismo , Trastornos de la Nutrición del Niño/prevención & control , Trastornos de la Nutrición del Niño/diagnóstico , Trastornos de la Nutrición del Niño/terapia , Trastornos de la Nutrición del Niño/epidemiología , Resultado del Tratamiento , Femenino , Masculino , Factores de Tiempo , Proyectos de Investigación , COVID-19/epidemiología , Sistemas de SocorroRESUMEN
BACKGROUND: Pregnant patients were a significant population to consider during the pandemic, given the impact of SARS-CoV-2 infection on obstetric outcomes. While COVID testing was a central pillar of infection control, it became apparent that a subset of the population declined to test. At the same time, data emerged about pregnant persons also declining testing. Yet, it was unknown why pregnant patients declined tests and if those reasons were similar or different from those of the general population. We conducted this study to explore pregnant patients' attitudes, access, and utilization of COVID-19 testing to support healthcare for infection prevention management for this unique and medically complex population. METHODS: We conducted a qualitative study of patients who were currently or recently pregnant during the early stages of the pandemic and received outpatient prenatal care at one of the participating study sites. An interview guide was used to conduct in-depth telephone interviews. Coding was performed using NVivo, and analysis was conducted using Grounded Theory. RESULTS: The average age of the participants (N = 37) was 32 (SD 4.21) years. Most were < 35 years of age (57%) and self-described as White (68%). Qualitative analysis identified themes related to barriers to COVID-19 testing access and use during pregnancy, including concerns about test accuracy, exposure to COVID-19 in testing facilities, isolation and separation during labor and delivery, and diminished healthcare quality and patient experience. CONCLUSIONS: The implementation of widespread and universal COVID testing policies did not address the unique needs and challenges of pregnant patients as a medically complex population. It is important to understand the reasons and implications for pregnant patients who declined COVID testing during the current pandemic to inform strategies to prevent infection spread in future public health emergencies.
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Prueba de COVID-19 , COVID-19 , Aceptación de la Atención de Salud , Complicaciones Infecciosas del Embarazo , Atención Prenatal , Investigación Cualitativa , SARS-CoV-2 , Humanos , Femenino , Embarazo , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/psicología , Adulto , Prueba de COVID-19/métodos , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/psicología , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/diagnóstico , Atención Prenatal/métodos , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Mujeres Embarazadas/psicologíaRESUMEN
BACKGROUND: Previous graduate students and postdoctoral associates from the University of Florida Health Cancer Center, in partnership with the University of Florida Student Science Training Program, implemented a cooperative learning curriculum, providing high school students with a broad overview of cancer topics over six weeks over the summer. To address discussions necessitated by the COVID-19 pandemic on student autonomy, we report lessons learned and outcomes of a cancer biology and therapeutic curriculum modified for a collaborative learning environment. METHODS: This pre-post longitudinal observational study conducted in 2023 on a cancer biology and therapeutics course evaluated students' knowledge retention and general awareness and opinions in cancer research. A structured survey was employed for data collection, using learning assessment surveys and the Likert scale ranging from 1 to 10, with 10 being highly likely. RESULTS: Student performance tracked over a 7-year period indicated consistency in performance between years. Post-assessment analysis revealed significant improvements in student benchmark understanding, notably in their ability to define cancer in one sentence (p = 0.0407), identify cancer therapies (p = 0.0040), and recognize cancer hallmarks (p < 0.0001). An increased trend in median response to the likelihood of pursuing cancer research (p = 0.8793) and the possibility of pursuing cancer research (p = 0.4874) were also observed, although not statistically significant. Moreover, feedback from participating students indicated that "the educational activities at the end of class (e.g., escape room, case studies)" and "learning about cancer and getting to work in groups " the curriculum fostered a positive educational learning environment. CONCLUSION: Students generally retained the course material presented and upheld a positive perception of the course. Incorporating opportunities for peer-to-peer learning, especially when introducing or discussing complex issues like cancer, may benefit student autotomy.
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COVID-19 , Curriculum , Neoplasias , Humanos , Estudios Longitudinales , COVID-19/epidemiología , Adolescente , Estudiantes/psicología , Femenino , Masculino , Florida , Evaluación Educacional , SARS-CoV-2RESUMEN
Coronavirus disease 2019 (COVID-19) has affected not only individual lives but also the world and global systems, both natural and human-made. Besides millions of deaths and environmental challenges, the rapid spread of the infection and its very high socioeconomic impact have affected healthcare, economic status and wealth, and mental health across the globe. To better appreciate the pandemic's influence, multidisciplinary and interdisciplinary approaches are needed. In this chapter, world-leading scientists from different backgrounds share collectively their views about the pandemic's footprint and discuss challenges that face the international community.
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COVID-19 , Salud Global , Pandemias , SARS-CoV-2 , COVID-19/epidemiología , Humanos , Pandemias/prevención & controlRESUMEN
The coronavirus disease 2019 (COVID-19) pandemic has unquestionably transformed the field of intensive care medicine. Never have we witnessed millions of patients develop acute respiratory failure in such a short span of time. This led to extensive resource constraints and difficulty in treating patients. However, this also gave rise to several innovations that have spurred the development and progress of intensive care medicine as a specialty. In this chapter, we explore an overview of frailty, the impact of frailty in patients with severe COVID-19 respiratory failure, and the available supports, by summarising the current literature. This chapter also discusses the lessons learnt from each of the sections that can be applied to daily clinical practice. The chapter also proposes insights into future research.
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COVID-19 , Enfermedad Crítica , Fragilidad , SARS-CoV-2 , Humanos , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/terapia , Fragilidad/complicaciones , Fragilidad/epidemiología , Cuidados Críticos/métodos , Anciano , Insuficiencia Respiratoria/terapia , Insuficiencia Respiratoria/virología , Anciano FrágilRESUMEN
Race scholars have discussed how the pandemic has disproportionately burdened marginalized communities and exacerbated pre-existing inequities, particularly for Black Indigenous People of Color (BIPOC) in the United States (U.S.). One glaring social determinant during the time of the COVID-19 is racial discrimination. This chapter will discuss lessons learned regarding the negative impact of discrimination on BIPOC, especially as it pertains to their experiences of trauma. Some of these lessons include (1) the need for clinical psychologist to improve access to treatment through increased research on culturally adaptive interventions, (2) increased research on the effects of race-based trauma on mental health symptomatology, (3) policy and institutional changes that reduce disparities in access to care, and (4) increased education for psychologists around billing procedures for individuals with race-based stress.
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COVID-19 , Disparidades en Atención de Salud , Racismo , Humanos , COVID-19/epidemiología , COVID-19/psicología , Racismo/psicología , Estados Unidos/epidemiología , SARS-CoV-2/patogenicidad , Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Salud Mental , Pandemias , Negro o Afroamericano/psicologíaRESUMEN
This paper presents the structuring dimensions of the CEP-Conep System in order to understand the actions promoted by the National Research Ethics Commission in response to demands for the processing and ethical analysis of research protocols related to COVID-19 in 2020. Based on CEP-Conep System public documents, an assessment of legislation, from 1988 to 2020, and its extension in terms of the number of Committees, users, and protocols, from 2012 to 2020 was presented. The minutes of Conep's Ordinary Meetings (RO), for 2020, of a confidential nature, were analyzed, to verify adaptations to the pandemic. At the end of 2020, the System had 844 Committees, 854,741 users, and 701,791 analyzed protocols. The Commission centralized the analysis of COVID-19 protocols, in January 2020, and promoted three decentralizations, as more knowledge was generated, with vaccine protocols for COVID-19 remaining centralized. The history of the CEP-Conep System provided ballast for the adoption of management, educational and communication measures that accelerated the approval of protocols and made the process transparent. The absence of indicators made it impossible to evaluate the performance in 2020, which was apparently satisfactory.
O artigo apresenta dimensões estruturantes do Sistema CEP-Conep para compreender as ações promovidas pela Comissão Nacional de Ética em Pesquisa nas respostas às demandas de tramitação e análise ética de protocolos de pesquisa relativos à COVID-19 no ano de 2020. Foi elaborado estudo de caso a partir de documentos públicos do Sistema CEP-Conep, para evidenciar seu marco regulatório, de 1988 a 2020, e sua extensão em termos de quantidade de comitês, usuários e protocolos, de 2012 a 2020. Foram examinadas as atas das reuniões ordinárias (RO) da comissão, de 2020, de caráter sigiloso, para caracterizar as adaptações à pandemia. No final de 2020, o sistema contabilizava 844 comitês, 854.741 usuários, e 701.791 protocolos analisados. A comissão centralizou a análise de protocolos de COVID-19, em janeiro de 2020, e promoveu três descentralizações, à medida que mais conhecimento era gerado, permanecendo centralizados os protocolos de vacinas para COVID-19. O histórico do Sistema CEP-Conep proveu lastro para a adoção de medidas de gestão, educativas e de comunicação que aceleraram a apreciação de protocolos e deram transparência ao processo. A ausência de indicadores não permitiu avaliar a performance em 2020, aparentemente satisfatória.
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COVID-19 , Comités de Ética en Investigación , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Brasil/epidemiología , Comités de Ética en Investigación/organización & administración , Ética en Investigación , Investigación BiomédicaRESUMEN
Even though death due to COVID-19 is no longer a public health emergency, less virulent but highly transmissible forms of SARS-CoV-2 continue to spread in many countries leading to outbreaks and rise in hospitalizations in the affected regions. Lessons learned during the pandemic must be put into action to protect the world's population from another catastrophe like COVID-19. Novel approaches that were developed for tracking the spread of SARS-CoV-2 included analysis of wastewater, air samples, and various environmental surfaces. We conducted a study in Kuwait during the peak of COVID-19 pandemic to examine if SARS-CoV-2 could be detected in swabs taken from frequently touched environmental surfaces. We selected 12 Cooperative Society Stores-two from each governorate of Kuwait-for collection of surface samples. The Cooperative Society Stores are widely distributed across the whole country and cater to daily household needs including groceries and other essential items. These stores operated even during the "lockdown" imposed at the height of the pandemic. We collected swabs from high-touch surfaces including the handles of the shopping carts and freezers, the elevators, the keypads of the point-of-service terminals of cash counters, and the automated teller machines. All the surfaces tested showed a variable presence of SARS-CoV-2 by reverse transcriptase quantitative PCR, showing the validity of the proof-of-concept study. Monitoring of the presence of SARS-CoV-2 by surface sampling thus offers a cheap but effective means of environmental surveillance for coronaviruses. We therefore strongly recommend the addition of surface environmental sampling as a strategy for pandemic preparedness everywhere.