Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33.328
Filtrar
1.
Int Breastfeed J ; 16(1): 30, 2021 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-33789708

RESUMEN

BACKGROUND: The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). METHODS: This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil's federal law recommendations. RESULTS: The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment's health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. CONCLUSIONS: In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.


Asunto(s)
Lactancia Materna , Adhesión a Directriz , Higiene , Brasil/epidemiología , Lactancia Materna/efectos adversos , /etiología , Estudios Transversales , Brotes de Enfermedades/prevención & control , Femenino , Adhesión a Directriz/estadística & datos numéricos , Hospitales , Humanos , Servicios de Salud Materna , Pandemias , Embarazo , Encuestas y Cuestionarios
2.
Medicine (Baltimore) ; 100(12): e25151, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761684

RESUMEN

ABSTRACT: In 2014, the American College of Cardiology/American Heart Association (ACC/AHA) released guidelines for ordering pre-operative echocardiograms in patients undergoing non-cardiac surgery. The purpose of this study is to determine if pre-operative echocardiograms ordered prior to fragility hip fracture repair are ordered according to these guidelines, change anesthetic management or affect patient outcomes. In addition, we attempted to evaluate the efficacy of the ACC/AHA guidelines.We conducted a 4-year retrospective chart review of acute fragility hip fractures at a single institution. Charts were reviewed to determine which patients met criteria for a pre-operative echocardiogram. Within this group we then compared patients who received a pre-operative echocardiogram to those who did not. Comparisons were made with regard to time to surgery, changes from standard anesthetic management, major adverse cardiac events, length of hospital stay, and 1-year mortality. We also examined which patients received postoperative echocardiograms and the incidence of adverse cardiac events in this group.Of 402 patients, 87 (22%) had ACC/AHA indications for pre-operative echocardiogram, and 42 (48%) of them received one. The indication to order a pre-operative echocardiogram in stable heart failure or valve disease patients if their last echo was greater than 1 year was only followed 23% of the time. In the pre-operative echocardiogram group, anesthetic management was adjusted more frequently (P = .025), and average time to surgery was greater (P < .001). The incidence of a major adverse cardiac event was 10% in the ACC/AHA echocardiogram indicated group and 3% in the non-indicated echocardiogram group. An equal number of echocardiograms were completed postoperatively as were completed under ACC/AHA pre-operative guidelines. Sixty-seven percent of the postoperative echocardiograms did not have ACC/AHA pre-operative indications.Our data demonstrates that pre-operative echocardiograms for "stable heart failure and valvular disease with greater than 1 year from last echocardiogram" is infrequently performed without significant adverse cardiac outcomes. Pre-operative echocardiography was associated with more anesthetic adjustments and longer time to surgery. Postoperative echocardiograms were done for cardiopulmonary complications. Studies need to examine and refine clinical parameters that would improve the selection of patients who would benefit from pre-operative echocardiograms.


Asunto(s)
Ecocardiografía/normas , Cardiopatías/prevención & control , Fracturas de Cadera/diagnóstico por imagen , Fracturas Osteoporóticas/diagnóstico por imagen , Complicaciones Posoperatorias/prevención & control , Cuidados Preoperatorios/normas , Anciano de 80 o más Años , Femenino , Fijación de Fractura/efectos adversos , Fijación de Fractura/normas , Adhesión a Directriz/estadística & datos numéricos , Cardiopatías/epidemiología , Cardiopatías/etiología , Fracturas de Cadera/cirugía , Humanos , Incidencia , Masculino , Fracturas Osteoporóticas/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Medición de Riesgo
3.
PLoS One ; 16(3): e0248495, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33720979

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a highly contagious viral infection, and it has negative effects on public health. The practice of preventive measures of the disease supports containment processes of the spread of coronavirus. However, the practice of preventive measures is affected by several associated risk factors. OBJECTIVE: This study aimed to investigate the associated factors that limit the youths' practice of preventive measures against COVID-19 in the study area. METHODS: A community-based cross-sectional study was conducted. The study used a quantitative approach for collecting data from 384 youths using a survey method. Not practicing preventive measures was measured to determine whether or not youths applied hygiene practices, kept their distance, restricted their movements, and sought self-help or support in the past two months. Descriptive statistics were used to assess the distribution of study participants, and a binary regression model was executed to examine the association factors with inability to practice preventive measures with a p-value < 0.05 statistically significant. RESULTS: Male youths (Adjusted Odds Ratio (AOR) = 0.06; 95% CI: 0.02, 0.16) were less likely to practice preventive measures. Older youth (AOR = 1.33; 95% CI: 1.13, 1.56), with higher education level (AOR = 1.03; 95% CI: 1.01, 1.06), and who had higher income (AOR = 1.34; 95% CI: 1.02, 1.78) were more likely to practice preventive measures. Further, the belief in the body's immunity to resist the disease (AOR = 0.27; 95% CI: 0.11, 0.67), lack of paying attention to the disease (AOR = 0.07; 95% CI: 0.01, 0.73), ignorance of evidence to the disease (AOR = 0.31; 95% CI: 0.13, 0.74), ease of restriction of movements (AOR = 0.29; 95% CI: 0.12, 0.72), lack of sensitization to actions in the community (AOR = 0.39; 95% CI: 0.16, 0.96), and substance use (AOR = 0.11; 95% CI: 0.05, 0.21) were other factors that were inversely related to practicing preventive measures. CONCLUSIONS: The findings suggested that more intervention efforts, by either communicating to or reaching out all groups, should be employed. All segments of the population should be equipped with the facts that effectively support them practice preventive measures against the disease. Finally, the results suggested that youths should abstain from substance use, keep their distance in their pastime and avoid crowdings.


Asunto(s)
/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Adolescente , /patología , Estudios Transversales , Brotes de Enfermedades , Desinfección , Escolaridad , Etiopía/epidemiología , Femenino , Adhesión a Directriz , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Proyectos Piloto , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/patología , Adulto Joven
4.
Front Public Health ; 9: 627559, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33643992

RESUMEN

Why did COVID-19 hit some countries harder than others? While this question is usually answered based on demographics (e. g., population age), health policy (e.g., quarantine), or economic factors, we argue that cultural variance across countries is just as crucial in understanding how susceptible a society is to the COVID-19 outbreak. To test this hypothesis, we first analyzed data collected across 69 countries and examined the relationship between culture and the impact of COVID. Next, we conducted two studies to validate our findings further and explore the mechanism at hand. As expected, we found that the more individualistic (vs. collectivistic) a country was, the more COVID-19 cases and mortalities it had. We also found that the more individualistic participants were, the higher the chances they would not adhere to epidemic prevention measures. These findings are important in understanding the spread of the pandemic, devising optimal exit strategies from lockdowns, and persuading the population to get the new vaccine against the virus.


Asunto(s)
Cultura , Adhesión a Directriz , Individualidad , Pandemias , Adulto , Comparación Transcultural , Femenino , Humanos , Israel , Masculino , Persona de Mediana Edad , Modelos Teóricos
5.
BMC Public Health ; 21(1): 449, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673833

RESUMEN

INTRODUCTION: The evidence is now unequivocal that people from Black and Minority Ethnic Backgrounds (BAME) living in the UK are disproportionately affected by covid-19. There is growing evidence that the reasons for this difference are multi-factorial and need further exploration. AIM: The aim of this study was to understand better, perceptions of risk and responses to covid-19 of members of the Muslim community living in the North West of England, and to understand the facilitators and barriers to adherence to restrictions and guidance measures. METHOD: A total of 47 participants took part in 25 in-depth qualitative interviews and four focus groups (n=22) that explored perceptions of risk and responses to risk from covid-19. Data were analysed thematically. FINDINGS: Participants were aware of the mechanism of transmission of covid-19 and took steps to mitigate risk of transmission including, observing a range of hygiene practices and following social distancing guidance. Increased risk of covid-19 for BAME populations was explained largely in terms of exposure to the virus due to the types of employment people from BAME populations are employed in. Limitations both within the working environment and more generally in public spaces, was identified as problematic for effective social distancing. The closure of mosques sent out a strong message about the seriousness of the virus and religious teachings reinforced hygiene and social distancing guidelines. CONCLUSION: Across society there are people that adhere to restrictions and guidelines and those that do not. Improving local information provision and communication pathways during times of the pandemic, could aid understanding of risk and promote adherence to social distancing restrictions.


Asunto(s)
Grupo de Ascendencia Continental Africana/psicología , Control de Enfermedades Transmisibles/estadística & datos numéricos , Grupos Étnicos/psicología , Adhesión a Directriz , Islamismo/psicología , Grupos Minoritarios/psicología , Pandemias/prevención & control , Adulto , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Grupos Étnicos/estadística & datos numéricos , Femenino , Grupos Focales , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Investigación Cualitativa , Conducta de Reducción del Riesgo , Reino Unido/epidemiología
6.
BMC Public Health ; 21(1): 466, 2021 03 08.
Artículo en Inglés | MEDLINE | ID: mdl-33685426

RESUMEN

BACKGROUND: The high prevalence and mortality of coronavirus disease 2019 (COVID-19) have made it the most important health and social challenge around the world. However, this disease can be largely prevented by adherence to hygienic principles and protective behaviors. It seems that identifying the processes involved in protective health behaviors can be effective in planning and implementing suitable interventions to encourage the community toward protective behaviors. Therefore, the present study aimed to predict the preventive behaviors of COVID-19 according to the Protection Motivation Theory (PMT). METHODS: This cross-sectional study was conducted over 2 months in Hormozgan Province, Iran. The study population consisted of all citizens above the age of 15 years. An online questionnaire was used to collect the data. The questionnaire link was available to the participants through social networks. The questionnaire consisted of two sections, including the demographic information and the PMT constructs. All statistical calculations and hypothesis testing were performed in SPSS Version 21 and AMOS Version 21. The significance level was considered to be 0.05 for hypothesis testing. RESULTS: A total of 2032 subjects, with the mean age of 34.84 ± 9.8 years (r = 15-98), participated in this study. Most of the participants were 31-40 years old, female (60.4%), married (72%), urban residents (87.3%), and employed (58.8%). The majority of them also had a bachelor's degree or higher (58.8%). Significant positive correlations were observed between the preventive behaviors of COVID-19 and the perceived vulnerability (r = 0.192, P < 0.001), perceived severity (r = 0.092, P < 0.001), response efficacy (r = 0.398, P < 0.001), self-efficacy (r = 0.497, P < 0.001), and protection motivation (r = 0.595, P < 0.001). On the other hand, significant negative correlations were found between the preventive behaviors of COVID-19 and maladaptive behavior rewards (r = - 0.243, P < 0.001) and perceived costs (r = - 0.121, P < 0.001). CONCLUSION: The present findings showed that maladaptive behavior reward and fear negatively predicted the protective behaviors. On the other hand, response efficacy and self-efficacy positively predicted the protective behaviors; the impact of self-efficacy was the strongest. Overall, the information provided in this study can contribute to health policymaking in Iran.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/estadística & datos numéricos , Miedo , Adhesión a Directriz/estadística & datos numéricos , Conductas Relacionadas con la Salud , Motivación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Autoeficacia , Encuestas y Cuestionarios , Adulto Joven
7.
BMC Surg ; 21(1): 132, 2021 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-33726715

RESUMEN

BACKGROUND: To identify whether compliance with Enhanced Recovery After Surgery (ERAS) Society recommendations is associated with length of stay (LOS) in a New Zealand hospital for patients undergoing segmental colectomy in mixed acute and elective general surgery wards. METHODS: Consecutive elective colorectal surgeries (n = 770) between October 2012 and February 2019 were audited. Patients with non-segmental colectomies, multi-organ surgeries, LOS > 14 days, and those who died were excluded. Logistic regression was used to determine the relationship between patient demographics, compliance with ERAS guidelines, and suboptimal LOS (> 4 days). RESULTS: Analysis included 376 patients. Age, surgery prior to 2014, surgical approach, non-colorectal surgical team, operation type, and complications were significantly associated with suboptimal LOS. Non-compliance with ERAS recommendations for laparoscopy [OR 8.9, 95% CI (4.52, 19.67)], removal of indwelling catheters (IDC) [OR 3.14, 95% CI (1.85, 5.51)], use of abdominal drains [OR 4.27, 95% CI (0.99, 18.35)], and removal of PCA [OR 8.71, 95% CI (1.78, 157.27)], were associated with suboptimal LOS (univariable analysis). Multivariable analysis showed that age, surgical team, late removal of IDC, and open approach were independent predictors of suboptimal LOS. CONCLUSIONS: Non-compliance with ERAS guidelines for laparoscopic approach and early removal of IDC was higher among procedures performed by non-colorectal surgery teams, and was also associated with adverse postoperative events and suboptimal LOS. This study demonstrates the importance of the surgical team's expertise in affecting surgical outcomes, and did not find significant independent associations between most individual ERAS guidelines and suboptimal LOS once adjusting for other factors.


Asunto(s)
Colectomía , Relaciones Interprofesionales , Grupo de Atención al Paciente , Rol Profesional , Estudios de Cohortes , Procedimientos Quirúrgicos Electivos , Recuperación Mejorada Después de la Cirugía , Adhesión a Directriz/estadística & datos numéricos , Humanos , Tiempo de Internación/estadística & datos numéricos , Nueva Zelanda , Grupo de Atención al Paciente/organización & administración , Guías de Práctica Clínica como Asunto , Resultado del Tratamiento
8.
PLoS One ; 16(3): e0248282, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33690699

RESUMEN

Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.


Asunto(s)
/psicología , Adhesión a Directriz/tendencias , Personal de Salud/psicología , Adulto , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Estudios Transversales , Femenino , Ghana/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Conocimiento , Masculino , Pandemias/prevención & control , Equipo de Protección Personal/tendencias , Encuestas y Cuestionarios , Virosis/transmisión
9.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-33760428

RESUMEN

PURPOSE: This study aims to examine steps taken by correctional staff to prevent COVID-19 from spreading through correctional facilities and explores strategies used by incarcerated individuals to reduce their own risk of contracting COVID-19 during confinement. DESIGN/METHODOLOGY/APPROACH: Data were drawn from interviews with 327 individuals incarcerated after March 16, 2020, in Midwest1, Midwest2 and Southeast state using a questionnaire developed for this purpose. All study participants were actively involved in a randomized controlled trial of a behavioral health reentry intervention and the human subjects board approved the supplement of this study on COVID-19; interviews were conducted from April 15 to November 19, 2020. FINDINGS: Overall, 9.89% of participants contracted COVID-19. Most (68.50%) individuals learned about COVID-19 from television compared to official correctional facility announcements (32.42%). Participants wore face masks (85.02%), washed hands (84.40%) and practiced physical distancing when possible (66.36%). Participants reported that facilities suspended visitation (89.60%) and volunteers (82.57%), provided face masks (83.18%), sanitized (68.20%), conducted temperature checks (55.35%) and released individuals early (7.34%). SOCIAL IMPLICATIONS: Longitudinal observational study on the implementation and effectiveness of public health guidelines in prisons and jails may identify best practices for containing the infectious disease. Maximizing transparent communications, as well as COVID-19 prevention and mitigation efforts, are critical to achieving universal best practices for virus containment and amplifying public health. ORIGINALITY/VALUE: Data presented indicate the early adoption of many Centers for Disease Control guidelines by individuals and correctional facilities, although broad variation existed. Data support the identification of containment strategies for feasible implementation in a range of correctional spaces.


Asunto(s)
/prevención & control , Adhesión a Directriz , Conocimientos, Actitudes y Práctica en Salud , Entrevistas como Asunto , Prisioneros/psicología , Adulto , Centers for Disease Control and Prevention, U.S. , Femenino , Guías como Asunto , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos , Organización Mundial de la Salud
10.
Ann R Coll Surg Engl ; 103(4): 302-307, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33682433

RESUMEN

INTRODUCTION: The epidemiology of acute paediatric orthopaedic trauma managed surgically across the NHS is poorly described. Compliance against national standards for the management of supracondylar humeral fractures is also unknown at a national level. METHODS: Collaborators in 129 NHS hospitals prospectively collected data on surgically managed acute paediatric orthopaedic trauma cases. Data were collected over a seven-day period and included demographics, injury characteristics, operative details and timing of surgery. A national audit was also undertaken to evaluate compliance with the British Orthopaedic Association Standards for Trauma Guideline 11: Supracondylar Fractures of the Humerus in Children. RESULTS: Data were captured on 770 surgically treated cases. The three most common injuries were forearm fractures of both bones (n = 235), distal radius fractures (n = 194) and supracondylar elbow fractures (n = 89). The mode day of injury was Friday (n = 136) and the mode day of surgery was Saturday (n = 138). 88% of supracondylar fractures received surgery on the day of presentation or the following day. Only 14% of supracondylar fractures were treated surgically after 8pm; 33/89 used 2.0mm Kirschner wires, 38/89 used 1.6mm wires and 2/89 used 1.2mm wires. CONCLUSION: Forearm fractures of both bones, distal radius fractures and supracondylar humeral fractures were the three most common injuries treated surgically. There is wide variation in compliance against national standards in the management of supracondylar humeral fractures with 88% undertaking surgery on the day of or the day following presentation but only 37% using the recommended 2.0mm Kirschner wires.


Asunto(s)
Fijación de Fractura/métodos , Adhesión a Directriz/estadística & datos numéricos , Fracturas del Húmero/epidemiología , Fracturas del Húmero/cirugía , Pautas de la Práctica en Medicina/estadística & datos numéricos , Fracturas del Radio/epidemiología , Fracturas del Radio/cirugía , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Fijación de Fractura/estadística & datos numéricos , Humanos , Incidencia , Masculino , Auditoría Médica , Guías de Práctica Clínica como Asunto , Estudios Prospectivos , Medicina Estatal , Reino Unido/epidemiología
11.
CMAJ Open ; 9(1): E295-E301, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33785477

RESUMEN

BACKGROUND: The quality of case reports, which are often the first reported evidence for a disease, may be negatively affected by a rush to publication early in a pandemic. We aimed to determine the completeness of reporting (COR) for case reports published on coronavirus disease 2019 (COVID-19). METHODS: We conducted a systematic search of the PubMed database for all single-patient case reports of confirmed COVID-19 published from Jan. 1 to Apr. 24, 2020. All included case reports were assessed for adherence to the CARE (Case Report) 31-item checklist, which was used to create a composite COR score. The primary outcome was the mean COR score assessed by 2 independent raters. Secondary outcomes included whether there was a change in overall COR score with certain publication factors (e.g., publication date) and whether there was a linear relation between COR and citation count and between COR scores and social media attention. RESULTS: Our search identified 196 studies that were published in 114 unique journals. We found that the overall mean COR score was 54.4%. No one case report included all of the 31 CARE checklist items. There was no significant correlation between COR with either citation count or social media attention. INTERPRETATION: We found that the overall COR for case reports on COVID-19 was poor. We suggest that journals adopt common case-reporting standards to improve reporting quality.


Asunto(s)
/epidemiología , Lista de Verificación/normas , Edición/normas , Informe de Investigación/normas , Bibliografía de Medicina , Bibliometría , /virología , Manejo de Datos , Estudios Epidemiológicos , Ética , Adhesión a Directriz , Humanos , Evaluación de Resultado en la Atención de Salud , Informe de Investigación/tendencias , /aislamiento & purificación , Medios de Comunicación Sociales/estadística & datos numéricos
12.
BMC Public Health ; 21(1): 522, 2021 03 17.
Artículo en Inglés | MEDLINE | ID: mdl-33731056

RESUMEN

BACKGROUND: SARS-CoV-2 lacks sentience and can only be spread through human behaviour. Government instructions to the general public include: (a) limiting time spent outside the home, (b) staying more than 1 m away from people outside the household at all times, and (c) maintaining hand hygiene. Current evidence suggests high rates of adherence to such instructions, but interventions to sustain adherence to government instructions in the long term can only be developed if we know why people do or do not adhere to them. The aims were to assess levels of public adherence to government instructions to reduce transmission of SARS-CoV-2, but more importantly to gauge why people were or were not adhering to instructions. METHODS: Cross-sectional survey of 2252 adults who were representative of the UK population. Data were analysed descriptively, and using one-sample t-tests, within-participants ANOVA and multiple linear regression. RESULTS: The sample reported mostly adhering to UK government instructions to reduce SARS-CoV-2 transmission, with 5% or fewer people reporting active resistance to instructions. People generally reported high levels of capability, opportunity and motivation to follow the instructions, but perceived relatively few physical and social opportunities. Multiple linear regression analyses showed that better adherence was associated with older age, being a woman, having a white ethnic background, and with perceiving greater levels of capabilities, opportunities and motivations. CONCLUSIONS: Interventions targeted at people with black, Asian and minority ethnic backgrounds, men and younger people that focus on increasing capabilities, providing greater opportunities and boosting motivations are needed to support continued adherence to government instructions to reduce SARS-CoV-2 transmission. Further research is required to track changes in people's capabilities, opportunities, motivations and behaviours in response to the ongoing emergency, any changes in government instructions, and to adapt the present procedures to other emergency situations.


Asunto(s)
/prevención & control , Adhesión a Directriz , Motivación , Adulto , Factores de Edad , Anciano , Estudios Transversales , Femenino , Guías como Asunto , Humanos , Masculino , Persona de Mediana Edad , Factores Raciales , Factores Sexuales , Clase Social , Reino Unido/epidemiología
13.
Sci Rep ; 11(1): 6569, 2021 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-33753851

RESUMEN

Does cognitive motivation influence how people gather and interpret information about COVID-19 and their adherence to measures? To address these questions, we conducted a longitudinal survey among European and American respondents. Wave 1 (N = 501) was conducted on March 27, 2020 and Wave 2 (N = 326) on July 1, 2020. We assessed COVID-19 knowledge, endorsement of COVID-19 conspiracy theories, media use, Need for Cognition (NC), Need for Cognitive Closure (NCC), and self-reported adherence to governmental measures taken. Results showed that nearly three-quarters of our respondents actively searched for information about COVID-19. Most at least once a day. Information seeking behaviour was not influenced by cognitive motivation (i.e., NC and NCC). However, cognitive motivation was related to (1) knowledge about COVID-19, (2) conspiracy rejection, and (3) change in knowledge over time. Respondents with more knowledge on COVID-19 also indicated to adhere more often to measures taken by their government. Self-reported adherence to measures was not influenced by cognitive motivation. Implications of these findings will be discussed.


Asunto(s)
/patología , Conocimiento , Adolescente , Adulto , Anciano , Conducta , Cognición , Femenino , Adhesión a Directriz , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Autoinforme , Encuestas y Cuestionarios , Adulto Joven
14.
Medicine (Baltimore) ; 100(11): e24836, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725954

RESUMEN

ABSTRACT: Anesthesiologists and surgeons have demonstrated a lack of familiarity with professional guidelines when providing care for surgical patients with a do-not-resuscitate (DNR) order. This substantially infringes on patient's self-autonomy; therefore, leading to substandard care particularly for palliative surgical procedures. The interventional nature of surgical procedures may create a different mentality of surgical "buy-in," that may unintentionally prioritize survivability over maintaining patient self-autonomy. While previous literature has demonstrated gains in communication skills with simulation training, no specific educational curriculum has been proposed to specifically address perioperative code status discussions. We designed a simulated standardized patient actor (SPA) encounter at the beginning of post-graduate year (PGY) 2, corresponding to the initiation of anesthesiology specific training, allowing residents to focus on the perioperative discussion in relation to the SPA's DNR order.Forty four anesthesiology residents volunteered to participate in the study. PGY-2 group (n = 17) completed an immediate post-intervention assessment, while PGY-3 group (n = 13) completed the assessment approximately 1 year after the educational initiative to ascertain retention. PGY-4 residents (n = 14) did not undergo any specific educational intervention on the topic, but were given the same assessment. The assessment consisted of an anonymized survey that examined familiarity with professional guidelines and hospital policies in relation to perioperative DNR orders. Subsequently, survey responses were compared between classes.Study participants that had not participated in the educational intervention reported a lack of prior formalized instruction on caring for intraoperative DNR patients. Second and third year residents outperformed senior residents in being aware of the professional guidelines that detail perioperative code status decision-making (47%, 62% vs 21%, P = .004). PGY-3 residents outperformed PGY-4 residents in correctly identifying a commonly held misconception that institutional policies allow for automatic perioperative DNR suspensions (85% vs 43%; P = .02). Residents from the PGY-3 class, who were 1 year removed the educational intervention while gaining 1 additional year of clinical anesthesiology training, consistently outperformed more senior residents who never received the intervention.Our training model for code-status training with anesthesiology residents showed significant gains. The best results were achieved when combining clinical experience with focused educational training.


Asunto(s)
Competencia Clínica/estadística & datos numéricos , Atención Perioperativa/psicología , Medicina Perioperatoria/educación , Órdenes de Resucitación/psicología , Estudiantes de Medicina/psicología , Adulto , Anestesiología/educación , Femenino , Adhesión a Directriz/estadística & datos numéricos , Humanos , Internado y Residencia/estadística & datos numéricos , Conocimiento , Masculino , Simulación de Paciente , Autonomía Personal , Aprendizaje Basado en Problemas , Encuestas y Cuestionarios
15.
N Z Med J ; 134(1531): 36-54, 2021 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-33767486

RESUMEN

AIM: A number of evidence-based medications are recommended following an acute coronary syndrome (ACS), including statins, antithrombotics (antiplatelet and/or anticoagulants), a beta-blocker and an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACE-I/ARB). This study aimed to describe the dispensing of the cardioprotective medications in the first year following an ACS hospitalisation in New Zealand and how this varies according to age, sex and type of coronary intervention. METHOD: National hospitalisation data was used to identify all New Zealand residents aged 35-79 years who were discharged from hospital in the years 2013/14 with a primary discharge diagnosis of ACS. Using anonymous linkage to national pharmaceutical dispensing and mortality datasets, the dispensing of each group of medications was examined in survivors of quarters one, two and four of the first year post discharge. RESULTS: There were 14,496 patients; mean age was 63.4 years and 68.8% were male. Dispensing of medications in survivors steadily fell across quarters one, two and four: 90.8%, 82.1% and 78.8% of patients were dispensed statins; 90.6%, 79.8% and 78.1% were dispensed aspirin; 82.7%, 72.6% and 70.0% were dispensed beta-blockers; 69.6%, 62.7% and 61.3% were dispensed ACE-I/ARB; 67.7%, 53.6% and 40.4% were dispensed a P2Y12 inhibitor; and 68.6%, 53.0% and 40.7% were dispensed a combination of two or more antithrombotics. CONCLUSION: Cardioprotective medication dispensing was lower than would have been the case if the current ACS guidelines were followed. The greatest decrease in dispensing occurred between quarter one and quarter two, which highlights a potentially important period for targeted interventions to improve adherence.


Asunto(s)
Síndrome Coronario Agudo/tratamiento farmacológico , Cardiotónicos/uso terapéutico , Adhesión a Directriz/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Prevención Secundaria , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Angiografía Coronaria/estadística & datos numéricos , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Factores Sexuales , Adulto Joven
16.
Antimicrob Resist Infect Control ; 10(1): 61, 2021 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-33781341

RESUMEN

OBJECTIVE: The appropriate use of facemasks, recommended or mandated by authorities, is critical to prevent the spread of COVID-19 in the community. We aim to evaluate frequency and quality of facemask use in general populations. METHODS: A multi-site observational study was carried out from June to July 2020 in the west of France. An observer was positioned at a predetermined place, facing a landmark, and all individual passing between the observer and the landmark were included. The observer collected information on facemask use (type, quality of positioning), location and demographic characteristics. RESULTS: A total of 3354 observations were recorded. A facemask was worn by 56.4% (n = 1892) of individuals, including surgical facemasks (56.8%, n = 1075) and cloth masks (43.2%, n = 817). The facemask was correctly positioned in 75.2% (n = 1422) of cases. The factors independently associated with wearing a facemask were being indoors (adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI] 2.28-3.19), being in a mandatory area (aOR, 6.92; 95% CI 5-9.7), female gender (aOR, 1.75; 95% CI 1.54-2.04), age 41-65 years (aOR, 1.7; 95% CI 1.43-2.02) and age > 65 years (aOR, 2.28; 95% CI 1.83-2.85). The factors independently associated with correct mask position were rural location (aOR, 1.38; 95% CI 1.07-1.79), being in an indoor area (aOR, 1.85; 95% CI 1.49-2.3), use of clothmask (aOR, 1.53; 95% CI 1.23-1.91), and age > 40 years (aOR, 1.75 95%CI 1.37-2.23). CONCLUSIONS: During the initial phase of the COVID-19 pandemic, the frequency and quality of facemask wearing remained low in the community setting. Young people in general, and men in particular, represent the priority targets for information campaigns. Simplifying the rules to require universal mandatory facemasking seemed to be the best approach for health authorities.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/instrumentación , Adhesión a Directriz/estadística & datos numéricos , Conductas Relacionadas con la Salud , Máscaras , Adulto , Anciano , Control de Enfermedades Transmisibles/métodos , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Adulto Joven
17.
BMC Surg ; 21(1): 152, 2021 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-33743667

RESUMEN

BACKGROUND: Inguinal hernia surgery is a frequent procedure among general surgeons in Costa Rica, but the management and technique are not uniform. The International Guideline for Groin Hernia management was published in 2018 to standardize the inguinal hernia surgery, but the diffusion of the guidelines and its adherence have been extremely varied. PURPOSE: Collect and analyze the current reality regarding groin hernia management in Costa Rica. Secondly evaluate the diffusion and development comparing it to the guideline's recommendations. METHOD: Questionnaire of 42 single and multiple answer questions according to the topics of the International Guideline directed to general surgeons. Diffusion of the inquiry through surgical and hernia association chats and email. Timeframe June-December 2019. RESULTS: 64 surveys were collected, which is a representative number of the general surgeons national college. The most frequent procedure between these was the abdominal wall surgery. Every surgeon did more than 52 groin hernia surgeries in one year, most of them outpatients. The epidural anesthesia was used the most and Lichtenstein's technique was the most frequently used (64%). 68% of the surgeons know how to perform a minimally invasive inguinal hernia surgery but with variable volumes. 38% of participants considered themselves experts in groin hernia management and 52% did not know the 2018 International Guideline. The recommendations of such guideline are followed only partially. CONCLUSIONS: The 2018 Hernia Surge International Guidelines have low diffusion among Costa Rican surgeons. The laparoscopic approach is widely accepted but there are no studies to assess the results and the quality. There should be protocols and studies adapted to Costa Rica's national situation.


Asunto(s)
Ingle/cirugía , Adhesión a Directriz/estadística & datos numéricos , Hernia Inguinal/cirugía , Herniorrafia/métodos , Laparoscopía/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/estadística & datos numéricos , Cirujanos , Adulto , Anestesia Local/estadística & datos numéricos , Costa Rica/epidemiología , Femenino , Herniorrafia/normas , Humanos , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , Encuestas y Cuestionarios
18.
Proc Natl Acad Sci U S A ; 118(12)2021 03 23.
Artículo en Inglés | MEDLINE | ID: mdl-33658331

RESUMEN

We evaluate the impacts of implementing and lifting nonpharmaceutical interventions (NPIs) in US counties on the daily growth rate of COVID-19 cases and compliance, measured through the percentage of devices staying home, and evaluate whether introducing and lifting NPIs protecting selective populations is an effective strategy. We use difference-in-differences methods, leveraging on daily county-level data and exploit the staggered introduction and lifting of policies across counties over time. We also assess heterogenous impacts due to counties' population characteristics, namely ethnicity and household income. Results show that introducing NPIs led to a reduction in cases through the percentage of devices staying home. When counties lifted NPIs, they benefited from reduced mobility outside of the home during the lockdown, but only for a short period. In the long term, counties experienced diminished health and mobility gains accrued from previously implemented policies. Notably, we find heterogenous impacts due to population characteristics implying that measures can mitigate the disproportionate burden of COVID-19 on marginalized populations and find that selectively targeting populations may not be effective.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/métodos , /economía , Control de Enfermedades Transmisibles/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Política de Salud/economía , Política de Salud/tendencias , Humanos , Pandemias , Factores Socioeconómicos , Estados Unidos/epidemiología
19.
PLoS One ; 16(3): e0248929, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33740025

RESUMEN

PURPOSE: Primary objective of this study was to identify potential difficulties and/or discomfort when using a facemask. Moreover, to explore the impact of spectacles, contact lenses and visual acuity on the compliance to the facemask directive. METHODS: This is a prospective study that was conducted at the Department of Ophthalmology, University Hospital of Alexandroupolis, Greece between June 2020 and August 2020. Greek speaking citizens with permanent residency in Greece above 18 years old were included. A custom questionnaire (DeMask-20) was constructed and validated, which pertained to the perceived difficulty and discomfort when using a facemask. It contained 20 items grouped in 8 subscales (driving, near vision, distance vision, ocular discomfort, role limitation, collaboration, dependency on others, emotional stress). Perceived difficulty and discomfort when using a facemask, compliance and correlations of compliance with DeMask-20 scores, demographics, spectacle and/or contact lens use, and visual acuity were evaluated. RESULTS: The number of factors was determined through factor analysis. Cronbach's alpha ranged from 0.716 for the "Role limitation" subscale to 0.938 for "Ocular discomfort" subscale. 1,214 participants (402 men, 812 women, mean age 36.79±12.50 years) completed the DeMask-20 instrument. Mean DeMask-20 score of all study participants was 3.79±0.71. Significant differences in DeMask-20 score were detected in gender (p = 0.009), spectacle use (p = 0.034), contact lens use (p = 0.049), and binocular distance visual acuity (bDVA) (p = 0.001). Mean compliance of all participants was 4.05±0.96. Men, people <50 years and spectacle wearers showed significantly worse compliance (p<0.05). Moreover, professional workers and professional drivers demonstrated significantly better compliance (p = 0.008 and p = 0.047). Significant correlation was detected between compliance and DeMask-20 score (p<0.001, R2 = 0.471). Significant correlations were detected with driving, near vision, distance vision, collaboration, role limitation, emotional stress (p<0.05, R2: 0.386-0.493). CONCLUSIONS: Factor analysis suggested that the DeMask-20 instrument demonstrates adequate validity, while Cronbach's alpha indicated sufficient internal consistency of all subscales. This study provided the necessary methods that could evaluate compliance trends and the efficacy of healthcare interventions against COVID-19. Our outcomes suggest that young males who use spectacles should be targeted by Greek Healthcare authorities in order to improve compliance rates.


Asunto(s)
/prevención & control , Adhesión a Directriz , Máscaras , Adulto , Factores de Edad , Conducción de Automóvil , Lentes de Contacto , Anteojos , Femenino , Grecia , Humanos , Masculino , Estudios Prospectivos , Medios de Comunicación Sociales , Encuestas y Cuestionarios , Agudeza Visual , Adulto Joven
20.
J Acoust Soc Am ; 149(3): 1838, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33765773

RESUMEN

Sweden stands out among the other European countries by the degree of restrictive measures taken towards handling the 2019 coronavirus outbreak, associated with the CoViD-19 pandemic. While several governments have imposed a nationwide total or partial lockdown to slow down the spread of the virus, the Swedish government has opted for a recommendation-based approach together with a few imposed restrictions. In a previous contribution by the authors, the impact of the Swedish strategy was observed through the monitored variation of the city noise levels during a period associated with the so-called "first wave" of the pandemic in Stockholm. A very strong impact of these recommendations was shown on the evolution of the noise levels in central Stockholm. This highlighted the potential of acoustic sensor networks both for enforcement of regulation and monitoring of the effectiveness of their implementation. The present contribution presents a follow-up to this urban noise monitoring in central Stockholm, Sweden, for the period leading to the so-called "second wave" of the pandemic in Europe. Both the evolution of adherence to the recommendations and the impact of the recurrence of cases combined with reinforced recommendations are observed through the evolution of the measured noise levels. While the measurements show a gradual lower level of compliance, in particular, past the summer break, these also show again a rapid response to the reinforced recommendations issued by the authorities in mid-fall of 2020. These observations thus confirm the potential associated with detailed urban noise monitoring, for instance here acting as a proxy to evaluating the response to recommendations or restrictions in times of crisis.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles , Monitoreo del Ambiente/métodos , Ruido , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/normas , Adhesión a Directriz , Humanos , Pandemias , Suecia
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...