Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.127.111
Filtrar
1.
Int. j. clin. health psychol. (Internet) ; 21(1): 198-198, ene.-abr. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-194909

RESUMEN

BACKGROUND/OBJECTIVE: The objective of the study was to elucidate the underlying mechanism through which basic personality dimensions predict indicators of psychological functioning during the COVID-19 pandemic, including subjective well-being and perceived stress. As a personality characteristic highly contextualized in stressful circumstances, resilience was expected to have a mediating role in this relationship. METHOD: A sample of 2,722 Slovene adults, aged from 18 to 82 years filled in the Big Five Inventory, the Connor-Davidson Resilience Scale, the Perceived Stress Scale, and the Mental Health Continuum. A path analysis with the Bootstrap estimation procedure was performed to evaluate the mediating effect of resilience in the relationship between personality and psychological functioning. RESULTS: Resilience fully or partially mediated the relationships between all the Big Five but extraversion with subjective well-being and stress experienced at the beginning of the COVID-19 outburst. Neuroticism was the strongest predictor of less adaptive psychological functioning both directly and through diminished resilience. CONCLUSIONS: Resilience may be a major protective factor required for an adaptive response of an individual in stressful situations such as pandemic and the associated lockdown


ANTECEDENTES/OBJETIVO: El objetivo fue dilucidar el mecanismo subyacente a través del cual las dimensiones básicas de la personalidad predicen indicadores del funcionamiento psicológico durante la pandemia de COVID-19, incluido el bienestar subjetivo y el estrés percibido. Como característica de la personalidad altamente contextualizada en circunstancias estresantes, se esperaba que la resiliencia tuviera un papel mediador en esta relación. MÉTODO: Una muestra de 2.722 adultos eslovenos (18-82 años), completó el Big Five Inventory, la Connor-Davidson Resilience Scale, la Perceived Stress Scale y el Mental Health Continuum. Se realizó un análisis de ruta con el procedimiento de estimación Bootstrap para evaluar el efecto mediador de la resiliencia en la relación entre la personalidad y el funcionamiento psicológico. RESULTADOS: La resiliencia medió total o parcialmente las relaciones entre los Cinco Grandes, y la extraversión con bienestar subjetivo y el estrés experimentado, al comienzo del estallido de COVID-19. El neuroticismo fue el predictor más fuerte de un funcionamiento psicológico menos adaptativo, tanto directamente como a través de la disminución de la capacidad de resiliencia. CONCLUSIONES: La resiliencia puede ser un factor de protección importante y requerido para una respuesta adaptativa de un individuo en situaciones estresantes como la pandemia y el confinamiento asociado


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Resiliencia Psicológica , Personalidad/fisiología , Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Pandemias , Inventario de Personalidad/normas , Psicometría/métodos , Neuroticismo/fisiología
2.
Int. j. clin. health psychol. (Internet) ; 21(1): 196-196, ene.-abr. 2021. graf, tab
Artículo en Inglés | IBECS | ID: ibc-194177

RESUMEN

INTRODUCTION: COVID-19 pandemic, declared on March 11, 2020, constitute an extraordinary health, social and economic global challenge. The impact on people's mental health is expected to be high. This paper sought to systematically review community-based studies on depression conducted during the COVID-19 and estimate the pooled prevalence of depression. METHOD: We searched for cross-sectional, community-based studies listed on PubMed or Web of Science from January 1, 2020 to May 8, 2020 that reported prevalence of depression. A random effect model was used to estimate the pooled proportion of depression. RESULTS: A total of 12 studies were included in the meta-analysis, with prevalence rates of depression ranging from 7.45% to 48.30%. The pooled prevalence of depression was 25% (95% CI: 18%−33%), with significant heterogeneity between studies (I2=99.60%, p<.001). CONCLUSIONS: Compared with a global estimated prevalence of depression of 3.44% in 2017, our pooled prevalence of 25% appears to be 7 times higher, thus suggesting an important impact of the COVID-19 outbreak on people's mental health. Addressing mental health during and after this global health crisis should be placed into the international and national public health agenda to improve citizens' wellbeing


INTRODUCCIÓN: La pandemia de COVID-19, declarada el 11 de marzo de 2020, representa un reto global extraordinario a nivel sanitario, social y económico. Se espera un impacto alto en la salud mental de las personas. Este artículo tiene como objetivo realizar una revisión sistemática de estudios transversales basados en muestras comunitarias que proporcionaban la prevalencia de depresión durante la crisis del COVID-19. MÉTODO: Se realizó una búsqueda de estudios comunitarios publicados en Pubmed y Web of Science desde el 1 de enero del 2020 al 8 de mayo del 2020 y que informaron sobre la prevalencia de depresión. Se usó un modelo de efectos aleatorios para estimar la proporción agrupada de depresión. RESULTADOS: Un total de 12 estudios fueron incluidos en el meta-análisis, con prevalencias de depresión que oscilaban entre 7,45% y 48,30%. La prevalencia agrupada de depresión fue de 25% (95% CI: 18%-33%), con heterogeneidad significativa entre estudios (I2 = 99,60%, p < 0,001). CONCLUSIONES: En comparación con una estimación global de depresión en 2017 del 3,44%, nuestra prevalencia agrupada del 25% es 7 veces mayor, sugiriendo un impacto importante del brote de COVID-19 en la salud mental de las personas. El abordaje de la salud mental durante y después de esta crisis global sanitaria debe ser parte de las agendas de salud pública nacionales e internacionales para mejorar el bienestar de los ciudadanos


Asunto(s)
Humanos , Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Depresión/psicología , Depresión/epidemiología , Pandemias , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Prevalencia
4.
BMC Psychol ; 9(1): 21, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526085

RESUMEN

BACKGROUND: Psychological distress in University settings has grown and became a public health concern. In this context, contemplative practices such as mindfulness have been proposed as a strategy to help students on stress management. METHODS: Forty university students (20 female), aged between 18 to 30 years (mean = 24.15; SD = 3.56), with no previous experience with meditation or yoga were recruited at the Federal University of Rio Grande do Norte and randomized to a mindfulness training (MT) or active control (AC) groups. We analyzed measures of anxiety, affect, stress, as well as state and trait mindfulness in order to evaluate the effects of trait mindfulness and a brief mindfulness intervention in forty healthy young students. Participants were classified as Low (n = 27, females = 13) or High (n = 13, females = 7) Trait Mindfulness by k-means clustering and compared between them using Wilcoxon sum rank test. Furthermore, the sample was randomly allocated to an AC (n = 20, females = 10) or a MT (n = 20, females = 10) group, and mixed analysis of variance was performed to analyze the effect of interventions. The mechanisms and role of trait mindfulness in the intervention was assessed by a moderated mediation analysis. RESULTS: We found that High Trait individuals have lower anxiety trait, anxiety state and perceived stress levels. Only the MT group reduced their anxiety state and perceived stress after the intervention and increased their state mindfulness. Both groups reduced negative affect and cortisol, and no change was found in positive affect. Moderated mediation analysis showed that the training-induced change in state mindfulness mediated the increase in positive affect and the decrease in perceived stress and cortisol, regardless of trait mindfulness. For anxiety state the decrease only occurred in individuals with High Trait Mindfulness. CONCLUSIONS: Together, these results suggest that higher trait mindfulness is associated with low levels of psychological distress and that a brief mindfulness-based intervention seems to be useful to reduce distress measures in university students. TRIAL REGISTRATION: ReBEC, U1111-1194-8661. Registered 28 March 2017-Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-7b8yh8.


Asunto(s)
Atención Plena , Psicoterapia Breve , Estrés Psicológico , Estudiantes , Adolescente , Adulto , Femenino , Humanos , Masculino , Estrés Psicológico/prevención & control , Estrés Psicológico/psicología , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Resultado del Tratamiento , Universidades , Adulto Joven
5.
Int J Med Sci ; 18(5): 1185-1188, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33526979

RESUMEN

Background: Increased stress among medical personnel had been reported in previous virus outbreaks. The novel coronavirus disease (COVID-19) emerged in December 2019, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No qualitative assessment has yet described the physical and mental health conditions of frontline medical personnel in the COVID-19 outbreaks. Methods: Here, 251 frontline medical personnel involved in COVID-19 missions completed electronic questionnaires, consisting of 31 categorical variables related to their physical and mental health status, medical history and environmental conditions. We constructed a correlation amongst these variables through pairwise Kendall rank correlation coefficient test. Then, clusters of highly correlated variables were identified using the leading eigenvector. Finally, we used the network and clusters to clarify the correlations amongst variables. Results: This qualitative study identified the six clusters. Cluster 1 was characterized by skin allergy. Cluster 2 was predominantly associated with anxiety. Cluster 3 consisted mostly of respiratory symptoms. The participants in cluster 4 had medical history. Cluster 5 and cluster 6 were characterized by disinfection and demography, respectively. Finally, we revealed three major findings. First, more than 80% of medical personnel worry about COVID-19-related infection and experience newly appearing anxiety (56.2%), airway or heart symptoms (34.3%) and skin allergies (20.3%). Second, COVID-19-related worry significantly associates with all variables in the anxiety and respiratory symptom clusters. Third, new-onset skin allergies did not associate with either disinfection or anxiety, but did associate with a previous history of allergies. Conclusions: COVID-19-related worry leads to physical and mental health problems amongst medical personnel. Effective responses and interventions could relieve a series of new-onset physical and mental health problems.


Asunto(s)
Brotes de Enfermedades , Personal de Salud/psicología , Adulto , China/epidemiología , Análisis por Conglomerados , Femenino , Estado de Salud , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Adulto Joven
6.
BMC Psychol ; 9(1): 22, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33531071

RESUMEN

BACKGROUND: A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, 'The Resilience Hub', to screen and refer those affected. We present a process evaluation conducted after 1 year. METHODS: Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May's Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. RESULTS: Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. CONCLUSIONS: The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.


Asunto(s)
Terrorismo , Adolescente , Adulto , Niño , Humanos , Terrorismo/psicología , Reino Unido
7.
BMC Psychol ; 9(1): 23, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33531087

RESUMEN

BACKGROUND: The Coping Scales of the Stress and Coping Inventory (SCI; Satow in Stress- und Coping-Inventar (SCI): Test- und Skalendokumentation. Stress and coping inventory. http://www.drsatow.de , 2012) are well-established German self-report scales measuring five coping styles: Positive Thinking, Active Coping, Social Support, Support in Faith, and Alcohol and Cigarette Consumption. The purpose of this study was to translate the scales into English and to psychometrically evaluate this English version of the SCI coping scales with a representative sample of the UK population. METHODS: The coping scales of the SCI were forward-backward translated into English and administered to a representative sample according to age, gender, education, and region for the UK (N = 1006). Internal consistencies, factorial validity, and construct validity were assessed for both the original factor structure of the SCI, as well as a newly identified factor structure. RESULTS: The results for the original factor structure indicated good internal consistency and construct validity. The adaptive coping styles of this version were positively correlated with resilience and negatively with perceived stress. The maladaptive coping strategy, alcohol and cigarette consumption, showed the opposite correlations. The exploratory factor analysis (EFA) of the English version resulted in a five-factor structure, but some items loaded on different factors than in the German version. These new factors were Religious Coping, Social Support, Various Coping, Alcohol and Cigarette Consumption, and Reflective Coping. The novel factors showed similar correlations to resilience and perceived stress as the original factor structure. Only religious coping did not significantly correlate to perceived stress. Confirmatory factor analysis with the original factor structure of the German SCI coping scales revealed poor model fit for the English SCI coping scales. CONCLUSION: The English SCI coping scales consistently and accurately measure five different coping styles. Nevertheless, the original factor structure of the SCI coping scales, when applied to an English-speaking sample, did not fit the data well. The new factor structure established by EFA is only preliminary and needs further validation in future large samples using the English version of the SCI coping scales.


Asunto(s)
Adaptación Psicológica , Estrés Psicológico , Encuestas y Cuestionarios , Análisis Factorial , Humanos , Psicometría , Reproducibilidad de los Resultados , Estrés Psicológico/psicología , Reino Unido
8.
BMJ Open ; 11(1): e041070, 2021 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-33518518

RESUMEN

OBJECTIVES: Having to access life-sustaining treatment during the emerging COVID-19 outbreak has placed patients with cancer at an especially vulnerable position notwithstanding their immunocompromised condition. The present study aimed to elucidate cancer patients' and their caregivers' experiences during this outbreak. DESIGN: Face-to-face semistructured interviews were conducted. SETTING: A tertiary cancer care facility. PARTICIPANTS: 16 patients with cancer and 14 caregivers. Inclusions criteria were: (A) diagnosed with cancer, (B) receiving active treatment or follow-ups, (C) aged 21 years and above and (D) fluent in English or Mandarin. RESULTS: Thematic analysis was conducted. Five themes were identified: heightened sense of threat, impact on healthcare experience, responsibility falls on oneself, striving for normalcy and sense of safety and trust. Heightened threat of COVID-19 was more pronounced in patients and linked to vulnerability and fear, uncertainty and actions of socially irresponsible others. Dominant in their healthcare experience was prioritising cancer and treatment amidst heightened threat and anticipatory worry about treatment disruptions. Both noted on the importance of taking responsibility for one's health, with caregivers reporting a reinforced sense of duty towards patients. They strived to maintain normalcy by viewing COVID-19 as beyond personal control, downplaying and living life as usual. Their resolve was supported by a sense of safety from the actions of authorities, hospitals and trust towards healthcare providers. CONCLUSIONS: Cancer intensifies threat and the emotional impact of COVID-19 and may trigger specific concerns related to treatment. Psychoeducation interventions led by healthcare providers over digital platforms could help address cancer-specific concerns and support patients and caregivers during the pandemic.


Asunto(s)
Cuidadores/psicología , Neoplasias , Distrés Psicológico , /epidemiología , /psicología , Salud de la Familia , Miedo , Femenino , Personal de Salud , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/psicología , Neoplasias/terapia , Rol Profesional , Psicooncología/métodos , Sistemas de Apoyo Psicosocial , Investigación Cualitativa , Singapur/epidemiología , Poblaciones Vulnerables/psicología
9.
BMJ Open ; 11(1): e045794, 2021 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-33518530

RESUMEN

SETTING: The State of Qatar has had one of the highest COVID-19 infection rates globally and has used state-managed quarantine and isolation centres to limit the spread of infection. Quarantine and isolation have been shown to negatively affect the mental health of individuals. Qatar has a unique population, with around 90% of the population being economic migrants and a majority being blue-collar workers and labourers. OBJECTIVES: This study was carried out to evaluate the psychological impact of institutional isolation and quarantine during the COVID-19 pandemic outbreak in Qatar. The study also explored the sociodemographic correlates of this psychological impact. DESIGN, PARTICIPANTS AND INTERVENTION: A cross-sectional study involving 748 consenting individuals in institutional quarantine and isolation in Qatar during the months of June and July 2020 was carried out. Relevant sociodemographic data along with depressive and anxiety symptomatology scores were collected from consenting adults at these facilities. RESULTS: 37.4% (n=270) of respondents reported depressive symptoms and 25.9% (n=189) reported anxiety symptoms. The scores were higher for individuals in isolation facilities and higher for migrants from poor socioeconomic group (p<0.001 for both). Within this group, although worries about infection were widely reported, lack of contact with the family was cited as one of the most important sources of distress. Respondents reported that contact with the family and reliable information were important factors that helped during the duration of isolation and quarantine. CONCLUSIONS: Our study reported significantly elevated scores for depression and anxiety during institutional quarantine, which is in keeping with emerging evidence. However, in contrast to other studies reporting mostly from native populations, this study of a population with an overwhelming majority of immigrants highlights the special mental health needs of this specific group and can inform future healthcare policies.


Asunto(s)
Ansiedad , Control de Enfermedades Transmisibles , Depresión , Distrés Psicológico , Cuarentena/psicología , Adulto , Ansiedad/epidemiología , Ansiedad/etiología , /prevención & control , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/estadística & datos numéricos , Estudios Transversales , Demografía , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Masculino , Salud Mental/estadística & datos numéricos , Evaluación de Necesidades , Qatar/epidemiología , Factores Socioeconómicos , Migrantes/psicología
10.
Pan Afr Med J ; 38: 3, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33520072

RESUMEN

The outbreak of the novel coronavirus disease (COVID-19) has resulted in many cases of morbidity and mortality across the globe, and the lack of the COVID-19 vaccine has contributed greatly to this experience. COVID-19 vaccines have currently been rolled out, and are available in some countries. However, strategies need to be put in place to prevent COVID-19 vaccine hesitancy (VH) especially in Africa; a continent where VH has been previously reported following the introduction of new vaccines. For this cause, we, therefore, recommend optimal community involvement in the structure and modalities for the delivery of the prospective COVID-19 vaccine. Also, feedback mechanisms for the acknowledgement of community efforts in previous health interventions should be improved upon to encourage the acceptance of the prospective COVID-19 vaccine. In addition, improved multi-sectoral collaboration should be initiated and promoted to enhance the acceptance of COVID-19 vaccines through the provision of more resources required to address COVID-19 VH. Furthermore, integration of the COVID-19 vaccine into the routine immunization schedule would strengthen the health system, improve uptake of the COVID-19 vaccine, and improve the health of all persons living on the African continent.


Asunto(s)
/administración & dosificación , Aceptación de la Atención de Salud/psicología , Negativa a la Vacunación/psicología , África , Conducta Cooperativa , Prestación de Atención de Salud/organización & administración , Humanos , Vacunación/psicología
11.
J Occup Health ; 63(1): e12198, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33527667

RESUMEN

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.


Asunto(s)
Evaluación del Impacto en la Salud , Salud Laboral , Actitud del Personal de Salud , Comunicación , Seguridad Computacional , Ejercicio Físico , Familia , Evaluación del Impacto en la Salud/métodos , Estado de Salud , Humanos , Japón , Estilo de Vida , Seguridad , Administración del Tiempo , Trabajo/psicología , Lugar de Trabajo/organización & administración
12.
Medicine (Baltimore) ; 100(4): e24422, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530241

RESUMEN

ABSTRACT: Hypertensive patients commonly co-exist persistent depressive symptoms. However, these issues are not always identified, especially in primary health care, which may worsen the prognosis of hypertension. Therefore, the aim of this study was to determine the prevalence and risk factor of depression, and to develop risk nomogram of depression in hypertensive patients from primary health care Northwest China.We used a stratified multistage random sampling method to obtain 1856 hypertensives subjects aged ≥18 years in Xinjiang between April and October 2019. The subjects were randomly divided into a training set (n = 1299) and a validation set (n = 557). Depression was evaluated by Hospital Anxiety and Depression Scale (HADS), with a cut-off score ≥8. Using the least absolute shrinkage and selection operator (LASSO) regression model, we identified optimized risk factors of depression in the training set, followed by the establishment of prediction nomogram. The discriminative ability, calibration, and clinical usefulness of nomogram were assessed. The results were verified by internal validation in validation set.13.7% hypertensive subjects displayed depression. Seven independent risk factors of depression were identified and entered into the nomogram including age, region, ethnicity, marital status, physical activity, sleep quality, and control of hypertension. The nomogram displayed robust discrimination with an AUC of 0.760 [95% confidence interval (CI): 0.724-0.797)] and 0.761 (95%CI: 0.702-0.819), and good calibration in training set and validation set, respectively. The decision curve analysis and clinical impact curve demonstrated clinical usefulness of predictive nomogram.There is a considerable prevalence of depression in patients with hypertension from primary care of Xinjiang, Northwest China. Our nomogram may help primary care providers assess the risk of depression in patients with hypertension.


Asunto(s)
Depresión/epidemiología , Depresión/etiología , Hipertensión/psicología , Nomogramas , Atención Primaria de Salud/estadística & datos numéricos , Adolescente , Adulto , Calibración , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Factores de Riesgo , Adulto Joven
13.
Curr Urol Rep ; 22(3): 18, 2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33534050

RESUMEN

PURPOSE OF REVIEW: Self-induced genital trauma is rare, and prompt and evidence-based early intervention can improve the urinary and sexual function of these complex patients. This review has surveyed current literature and treatment trends to evaluate the clinical approach to managing genital trauma. RECENT FINDINGS: A literature review was performed regarding self-induced genitalia trauma and trauma management between 2000 and 2019 using MEDLINE® database, the Cochrane Library® Central Search, Web of Science, and Google Scholar. In total, 42 articles were considered relevant and included in this review. Self-induced trauma can be appropriately managed with a multidisciplinary approach. Treatment goals are to preserve urinary, sexual, and reproductive function. Specific evaluation includes mechanism of injury, imaging, and determining the extent of injury and surgical repair, if indicated. Due to the rarity of these injuries and their emergent nature, much of the management is based on retrospective data. Further research is needed to improve long-term functional outcomes in trauma patients.


Asunto(s)
Genitales/lesiones , Conducta Autodestructiva , Sistema Urinario/lesiones , Femenino , Genitales/cirugía , Humanos , Masculino , Conducta Autodestructiva/complicaciones , Conducta Autodestructiva/diagnóstico , Conducta Autodestructiva/psicología , Conducta Autodestructiva/terapia , Sistema Urinario/cirugía
14.
J Foot Ankle Res ; 14(1): 11, 2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33536046

RESUMEN

BACKGROUND: On the 19th of January, 2020, the Chief Medical Officer of Australia issued a statement about a novel coronavirus, or SARS-CoV-2. Since this date, there have been variable jurisdictional responses, including lockdowns, and restrictions on podiatry practice. This study aimed to describe impacts of the SARS-CoV-2 pandemic on the podiatry profession in Australia. METHODS: This was a cross sectional study of Australian podiatrists using demographic data collected between 2017 and 2020, and pandemic-related question responses collected between 30th March and 31st August, 2020. Data were collected online and participants described their work settings, patient funding types, business decisions and impacts, and information sources used to guide practice decisions during this time-period. Inductive thematic analysis was used to analyse open-ended questions about their practice impact of SARS-CoV-2. RESULTS: There were 732 survey responses, with 465 Australian podiatrists or podiatric surgeons providing responses describing pandemic impact. From these responses, 223 (49% of 453) podiatrists reported no supply issues, or having adequate supplies for the foreseeable future with personal protective equipment (PPE) or consumables to support effective infection prevention and control. The most frequent responses about employment, or hours of work, impact were reported in the various categories of "business as usual" (n = 312, 67%). Participants described most frequently using the local state and territory Department of Health websites (n = 347, 75%), and the Australian Podiatry Association (n = 334, 72%) to make decisions about their business. Overarching themes which resounded through open-ended comments was that working through the pandemic was likened to a marathon, and not a sprint. Themes were: (i) commitment to do this, (ii) it's all in the plan, but not everything goes to plan, (iii) my support team must be part of getting through it, (iv) road blocks happen, and (v) nothing is easy, what's next? CONCLUSION: Podiatrists in Australia reported variable pandemic impact on their business decisions, PPE stores, and their valued sources of information. Podiatrists also described their "marathon" journey through the pandemic to date, with quotes describing their challenges and highlights. Describing these experiences should provide key learnings for future workforce challenges, should further restrictions come into place.


Asunto(s)
/prevención & control , Control de Infecciones/tendencias , Médicos/psicología , Podiatría/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Anciano , Australia , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Médicos/estadística & datos numéricos
15.
Epidemiol Psychiatr Sci ; 30: e12, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33543688

RESUMEN

AIMS: Persistent inequalities exist in how individuals from minority ethnic groups access mental health care. A failure to investigate how these inequalities are experienced and what they mean to people with psychosis has privileged professional narratives and hindered our understanding of how they are sustained and what could be done to reduce them. The aim of this study was to investigate the long-term experience of living with psychosis and navigating mental health services within different ethnic groups. METHOD: Our approach was informed by work on narrative analysis and prioritised the meaning that mental health services held for participants. In-depth interviews with 17 black Caribbean, 15 white British and 3 non-British white people with psychosis as part of AESOP-10, a 10-year follow-up of an ethnically diverse cohort of individuals with first-episode psychosis in the UK. Thematic narrative analysis was used to examine experiences at the personal level within and then across the individual accounts. RESULTS: Service users shared many defining experiences and narratives frequently returned to individuals' first contact with mental health services, first hospital admission, the experience of impatient wards, and the meaning of medication and diagnosis in their lives. We found that experiences of powerlessness punctuated the journey through mental health services and this appeared to dominate the accounts of black Caribbean, and to a lesser extent, white British participants. The findings reveal how negative expectations and experiences of mental health services are compounded over time, creating a vicious cycle of disempowerment and mistrust that manifests for many in resistance to - or at the best passive acceptance of - intervention by mental health services. High levels of need, coupled with alienation from services, contributed to negative patterns of service use among black Caribbean participants. White participants recounted substantial, though fewer, experiences of disempowerment and more instances of shared decision making that for some helped protect positive aspects of their lives. CONCLUSIONS: Against a background of entrenched social and economic disempowerment, services were experienced as disempowering by many black Caribbean people, compounding and perpetuating a sense of alienation. Concerted efforts by services to more systematically target social needs and to share power through partnership working may reduce the mistrust that many with psychosis feel when entering services and in turn reduce persistent inequalities across ethnic groups.


Asunto(s)
Grupos Étnicos/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud/etnología , Trastornos Psicóticos/etnología , Adulto , Región del Caribe , Progresión de la Enfermedad , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Navegación de Pacientes , Trastornos Psicóticos/psicología , Trastornos Psicóticos/terapia , Investigación Cualitativa , Clase Social , Reino Unido
16.
R I Med J (2013) ; 104(1): 61-64, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33517603

RESUMEN

OBJECTIVE: To assess the impact of the COVID-19 pandemic and associated lockdowns on public interest in ophthalmology. METHODS: Search interest data for ophthalmic services and conditions were collected from January 1, 2019 to June 21, 2020. Temporal statistical analysis was used to identify significant trends. Weekly data on ophthalmic services and conditions search interest obtained from Google Trends were analyzed with analysis of variance testing and the generalized linear model based on dates. RESULTS: Ophthalmic services searches decreased after the first COVID-19 case in the country (p<0.001); ophthalmic services and conditions search interest also declined after the first COVID-19 case and lockdown orders in each state (p<0.001). Following the first in-state COVID-19 case, search interest in ophthalmic services fell more than for ophthalmic conditions (p=0.0088). Lockdown and COVID-19 had similar effects on ophthalmic services search interest (p=0.2246), but interest in ophthalmic conditions decreased more after lockdown than after the first in-state case (p<0.0001). CONCLUSIONS: Most of the decrease in search interest in ophthalmic services was associated with COVID-19 rather than lockdown orders, suggesting that public interest in ophthalmic care may be more sensitive to changes in the COVID-19 pandemic than lockdown orders.


Asunto(s)
/epidemiología , Oftalmopatías/epidemiología , Conducta en la Búsqueda de Información , Oftalmología , /prevención & control , Oftalmopatías/terapia , Humanos , Sistemas en Línea , Oftalmología/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Cuarentena
17.
Epidemiol Psychiatr Sci ; 30: e10, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33526166

RESUMEN

AIMS: Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. METHODS: We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. RESULTS: The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126-10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520-5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854-2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444-939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). CONCLUSIONS: The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.


Asunto(s)
Servicios de Salud Comunitaria/estadística & datos numéricos , Depresión/terapia , Gastos en Salud/estadística & datos numéricos , Calidad de Vida/psicología , Anciano , Anciano de 80 o más Años , Servicios de Salud Comunitaria/economía , Análisis Costo-Beneficio , Estudios Transversales , Trastorno Depresivo Mayor/terapia , Femenino , Geriatría , Investigación sobre Servicios de Salud , Hong Kong , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente , Apoyo Social
18.
Br J Nurs ; 30(2): 133, 2021 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-33529112

RESUMEN

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the stressful situation of the frontline response to COVID-19, and reflects on a gap between ideal ratios and reality.


Asunto(s)
/enfermería , Personal de Enfermería en Hospital/psicología , Estrés Laboral/epidemiología , /epidemiología , Inglaterra/epidemiología , Hospitales Universitarios , Humanos
19.
Nat Commun ; 12(1): 801, 2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33547324

RESUMEN

Most trials do not release interim summaries on efficacy and toxicity of the experimental treatments being tested, with this information only released to the public after the trial has ended. While early release of clinical trial data to physicians and patients can inform enrollment decision making, it may also affect key operating characteristics of the trial, statistical validity and trial duration. We investigate the public release of early efficacy and toxicity results, during ongoing clinical studies, to better inform patients about their enrollment options. We use simulation models of phase II glioblastoma (GBM) clinical trials in which early efficacy and toxicity estimates are periodically released accordingly to a pre-specified protocol. Patients can use the reported interim efficacy and toxicity information, with the support of physicians, to decide which trial to enroll in. We describe potential effects on various operating characteristics, including the study duration, selection bias and power.


Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias Encefálicas/psicología , Drogas en Investigación/uso terapéutico , Glioblastoma/psicología , Difusión de la Información/métodos , Modelación Específica para el Paciente , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/mortalidad , Neoplasias Encefálicas/patología , Ensayos Clínicos como Asunto , Toma de Decisiones , Glioblastoma/tratamiento farmacológico , Glioblastoma/mortalidad , Glioblastoma/patología , Humanos , Difusión de la Información/ética , Seguridad del Paciente , Selección de Paciente/ética , Análisis de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
20.
J Eur Acad Dermatol Venereol ; 35(2): 281-317, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33547728

RESUMEN

This evidence- and consensus-based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The second part of the guideline provides guidance for specific clinical and comorbid situations such as treating psoriasis vulgaris patient with concomitant psoriatic arthritis, concomitant inflammatory bowel disease, a history of malignancies or a history of depression or suicidal ideation. It further holds recommendations for concomitant diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or patients with a wish for a child in the near future. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.


Asunto(s)
Psoriasis/complicaciones , Psoriasis/terapia , Humanos , Psoriasis/psicología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA