Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.540
Filtrar
2.
JAMA Netw Open ; 3(9): e2015470, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32876682

RESUMEN

Importance: Home health care is one of the fastest growing postacute services in the US and is increasingly important in the era of coronavirus disease 2019 and payment reform, yet it is unknown whether patients who need home health care are receiving it. Objective: To examine how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Design, Setting, and Participants: This cross-sectional study used Medicare data regarding the postacute home health care setting from October 1, 2015, through September 30, 2016. The participants were Medicare fee-for-service and Medicare Advantage beneficiaries who were discharged alive from a hospital with a referral to home health care (2 379 506 discharges). Statistical analysis was performed from July 2019 to June 2020. Exposures: Hospital referral to home health care. Main Outcomes and Measures: Primary outcomes included whether discharges received their first home health care visit within 14 days of hospital discharge and the number of days between hospital discharge and the first home health visit. Differences in the likelihood of receiving home health care across patient, zip code, and hospital characteristics were also examined. Results: Among 2 379 506 discharges from the hospital with a home health care referral, 1 358 697 patients (57.1%) were female, 468 762 (19.7%) were non-White, and 466 383 (19.6%) were dually enrolled in Medicare and Medicaid; patients had a mean (SD) age of 73.9 (11.9) years and 4.1 (2.1) Elixhauser comorbidities. Only 1 284 300 patients (54.0%) discharged from the hospital with a home health referral received home health care services within 14 days of discharge. Of the remaining 1 095 206 patients (46.0%) discharged, 37.7% (896 660 discharges) never received any home health care, while 8.3% (198 546 discharges) were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White (48.0% [95% CI, 47.8%-48.1%] of Black and 46.1% [95% CI, 45.7%-46.5%] of Hispanic discharges received home health within 14 days compared with 55.3% [95% CI, 55.2%-55.4%] of White discharges). In addition, disadvantaged patients waited longer for their first home health care visit. For example, patients living in high-unemployment zip codes waited a mean of 2.0 days (95% CI, 2.0-2.0 days), whereas those living in low-unemployment zip codes waited 1.8 days (95% CI, 1.8-1.8 days). Conclusions and Relevance: Disparities in the use of home health care remain an issue in the US. As home health care is increasingly presented as a safer alternative to institutional postacute care during coronavirus disease 2019, and payment reforms continue to pressure hospitals to discharge patients home, ensuring the availability of safe and equitable care will be crucial to maintaining high-quality care.


Asunto(s)
Cuidados Posteriores/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud/etnología , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Derivación y Consulta , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Planes de Aranceles por Servicios , Femenino , Disparidades en Atención de Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Medicaid/estadística & datos numéricos , Medicare , Medicare Part C , Alta del Paciente , Pobreza/estadística & datos numéricos , Características de la Residencia/estadística & datos numéricos , Desempleo/estadística & datos numéricos , Estados Unidos
3.
Proc Natl Acad Sci U S A ; 117(36): 21854-21856, 2020 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-32839337

RESUMEN

The COVID-19 pandemic is causing a catastrophic increase in US mortality. How does the scale of this pandemic compare to another US catastrophe: racial inequality? Using demographic models, I estimate how many excess White deaths would raise US White mortality to the best-ever (lowest) US Black level under alternative, plausible assumptions about the age patterning of excess mortality in 2020. I find that 400,000 excess White deaths would be needed to equal the best mortality ever recorded among Blacks. For White mortality in 2020 to reach levels that Blacks experience outside of pandemics, current COVID-19 mortality levels would need to increase by a factor of nearly 6. Moreover, White life expectancy in 2020 will remain higher than Black life expectancy has ever been unless nearly 700,000 excess White deaths occur. Even amid COVID-19, US White mortality is likely to be less than what US Blacks have experienced every year. I argue that, if Black disadvantage operates every year on the scale of Whites' experience of COVID-19, then so too should the tools we deploy to fight it. Our imagination should not be limited by how accustomed the United States is to profound racial inequality.


Asunto(s)
Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/mortalidad , Neumonía Viral/etnología , Neumonía Viral/mortalidad , Afroamericanos/estadística & datos numéricos , Betacoronavirus , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Humanos , Esperanza de Vida/etnología , Esperanza de Vida/tendencias , Mortalidad/etnología , Mortalidad/tendencias , Pandemias , Factores Socioeconómicos , Estados Unidos/epidemiología
4.
J Natl Black Nurses Assoc ; 31(1): 1-12, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32853490

RESUMEN

The purpose of this article is to provide an understanding about the mechanisms that contribute to the proliferation of COVID-19 morbidity and mortality among high-risk populations, and especially African-Americans. African-Americans are succumbing to novel SARS-CoV-2 (COVID-19) at an alarming rate. Current data indicate that while African-Americans represent less than 13.4% of the United States' population, they account for one-third of more than 4.77 million persons with verified COVID-19 infections. Currently, more than 50,258 African-Americans have succumbed to the disease. African-Americans are disproportionately impacted by COVID-19 to an extent unobserved in other racial/ethnic subgroups. In addition, this article describes the physiological event inflammation-mediation storming (cytokine storming). Social determinants of health such as income, education, and employment are hypothesized to impact cogent health care delivery for African-Americans. Included in this article are data on clinical outcomes that highlight the role of pre-existing (health disparities) conditions like diabetes, hypertension, cardiovascular disease, obesity, and lung disease, as barriers to optimal outcomes among African-Americans who are hospitalized with COVID-19. Also explored in this article is causation for vascular complications. A further aim of this article is to provide insight into cause and effect rationales for COVID-19 and health disparities, from both biosocial and health inequality perspectives. Linkages between these selected health disparities and COVID-19 are examined to determine possible deteriorating effects of COVID-19. Finally, techniques are offered to render culturally competent care to African-Americans diagnosed with COVID-19 who present concomitantly with health disparities.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/mortalidad , Disparidades en el Estado de Salud , Neumonía Viral/etnología , Neumonía Viral/mortalidad , Humanos , Pandemias , Determinantes Sociales de la Salud/etnología , Estados Unidos/epidemiología
6.
Palliat Med ; 34(9): 1241-1248, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32736485

RESUMEN

BACKGROUND: Palliative care services face challenges in adapting and responding to the COVID-19 pandemic. Understanding how palliative care needs and outcomes have changed during the pandemic compared to before the pandemic is crucial to inform service planning and research initiatives. AIM: To evaluate the impact of COVID-19 on symptoms, clinical characteristics, and outcomes for patients referred to a hospital-based palliative care service in a district general hospital in London, UK. DESIGN: A retrospective service evaluation. Data were extracted from the electronic patient records. SETTING/PARTICIPANTS: The first 60 inpatients with confirmed COVID-19 infection, referred to the hospital palliative care service between 1 March 2020 and 23 April 2020, and another 60 inpatients, referred to the hospital palliative care service between 11 March 2019 and 23 April 2019, were included from a district general hospital in East London, UK. RESULTS: Patients with COVID-19 have lower comorbidity scores, poorer performance status, and a shorter time from referral to death compared to patients without COVID-19. Breathlessness, drowsiness, agitation, and fever are the most prevalent symptoms during COVID-19 compared to pain and drowsiness pre-COVID-19. Time from admission to referral to palliative care is longer for Black, Asian and minority ethnic patients, especially during COVID-19. CONCLUSION: Early referral to palliative care is essential in COVID-19, especially for Black, Asian and minority ethnic groups. There is urgent need to research why Black, Asian and minority ethnic patients are referred late; how palliative care services have changed; and possible solutions to setting up responsive, flexible, and integrated services.


Asunto(s)
Infecciones por Coronavirus/enfermería , Cuidados Paliativos/estadística & datos numéricos , Neumonía Viral/enfermería , Derivación y Consulta/estadística & datos numéricos , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Betacoronavirus , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , Londres , Masculino , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Estudios Retrospectivos , Factores de Tiempo
7.
Public Health Rep ; 135(5): 685-690, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32762633

RESUMEN

OBJECTIVES: Racial/ethnic disparities in HIV diagnosis rates remain despite the availability of effective treatment and prevention tools in the United States. In 2019, President Trump announced the "Ending the HIV Epidemic: A Plan for America" (EHE) initiative to reduce new HIV infections in the United States at least 75% by 2025 and at least 90% by 2030. The objective of this study was to show the potential effect of the EHE initiative on racial/ethnic disparities in HIV diagnosis rates at the national level. METHODS: We used 2017 HIV diagnoses data from the Centers for Disease Control and Prevention National HIV Surveillance System. We developed a counterfactual scenario to determine changes in racial/ethnic disparities if the 2017 HIV diagnosis rates were reduced by 75% in the geographic regions targeted by the EHE initiative. We used 4 measures to calculate results: rate ratio, population-attributable proportion (PAP), Gini coefficient, and Index of Disparity. RESULTS: The relative measures of racial/ethnic disparity decreased by 9%-21% in the EHE scenario compared with the 2017 HIV diagnoses data. The largest decrease was in the Hispanic/Latino:white rate ratio (-20.6%) and in the black:white rate ratio (-18.2%). The PAP measure decreased by 11.5%. The absolute versions of the Index of Disparity (unweighted and weighted) were approximately 50% lower in the EHE scenario than in the 2017 HIV diagnoses data. CONCLUSIONS: EHE efforts could reduce but will not eliminate racial/ethnic disparities in HIV diagnosis rates. Efforts to address racial/ethnic disparities should continue, and innovative approaches, specifically those that focus on social and structural factors, should be developed and implemented for populations that are disproportionately affected by HIV in the United States.


Asunto(s)
Epidemias/prevención & control , Epidemias/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Disparidades en el Estado de Salud , Salud Pública/legislación & jurisprudencia , Salud Pública/estadística & datos numéricos , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Grupos de Población Continentales/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
8.
J Natl Black Nurses Assoc ; 31(1): 26-31, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32853493

RESUMEN

Chronic stress and depressive symptoms in midlife southern rural African-American women were examined because little is known about the intersections among them in this population. The research used Vitaliano's model of chronic stress to guide a secondary analysis of a convenience sample 206 (N = 206) midlife (40-65 years) African-American women from a southern rural community in Florida. Data were obtained from a larger study that focused on menopausal health and well-being among women. It also included brief comments from the women during focus group meetings, indicating that they experienced stress and were feeling "down." Statistical data showed that although the women reported relatively low levels of chronic stress and depressive symptoms, associations with certain personal vulnerabilities and social resources emerged as significant. The results from this secondary analysis will help to inform healthcare professionals about the role of personal vulnerability and social resources.


Asunto(s)
Afroamericanos/psicología , Depresión/etnología , Estrés Psicológico/etnología , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Femenino , Florida , Grupos Focales , Humanos , Menopausia , Persona de Mediana Edad , Población Rural/estadística & datos numéricos
9.
J Natl Black Nurses Assoc ; 31(1): 46-51, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32853496

RESUMEN

African-Americans are disproportionately affected by hypertension with lower rates of blood pressure control in comparison to the general population (Brennan et al., 2010). Low-sodium dietary intake is one of the most important lifestyle changes that can help control hypertension (Zhang et al., 2013). This qualitative study aimed to explore and describe the perceptions and experiences of low-sodium dietary practices among African-American women with hypertension. The study used a single-category focus group design. The findings suggest that African-American women are attempting to follow a low-sodium diet; however, they are influenced by personal and environmental factors and lack a clear understanding of what a low-sodium diet entails. Therefore, nurses must understand the factors that influence African-American women's ability to follow a low-sodium diet so that effective interventions can be implemented to improve adherence in this population.


Asunto(s)
Afroamericanos/psicología , Dieta Hiposódica/etnología , Dieta Hiposódica/psicología , Hipertensión/dietoterapia , Hipertensión/etnología , Afroamericanos/estadística & datos numéricos , Dieta Hiposódica/enfermería , Femenino , Grupos Focales , Disparidades en el Estado de Salud , Humanos , Hipertensión/enfermería , Investigación Cualitativa , Cumplimiento y Adherencia al Tratamiento/etnología
10.
J Natl Black Nurses Assoc ; 31(1): 60-63, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32853498

RESUMEN

African-Americans with hypertension continue to demonstrate poor blood pressure (BP) control and have markedly lower rates of hypertension self-management compared to non-African-Americans. Innovative and practical solutions such as mHealth technology are promising and can be leveraged to promote self-management of hypertension. Substantial evidence has demonstrated the importance of community support in improving patients' management of chronic illnesses. Unfortunately, such programs do not offer technology-based interventions (TBI) as a delivery method. Thus, this paper describes the design and rationale of an ongoing pilot study that incorporates TBI using a community-based participatory approach.


Asunto(s)
Afroamericanos/educación , Educación del Paciente como Asunto , Obesidad Pediátrica/etnología , Obesidad Pediátrica/prevención & control , Afroamericanos/estadística & datos numéricos , Niño , Investigación sobre Servicios de Salud , Humanos , Proyectos Piloto , Atención Primaria de Salud/métodos , Mejoramiento de la Calidad , Población Rural/estadística & datos numéricos
12.
BMJ Open ; 10(8): e039849, 2020 08 11.
Artículo en Inglés | MEDLINE | ID: mdl-32784264

RESUMEN

INTRODUCTION: Data on race and ethnic disparities for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. We analysed sociodemographic factors associated with higher likelihood of SARS-CoV-2 infection and explore mediating pathways for race and ethnic disparities in the SARS-CoV-2 pandemic. METHODS: This is a cross-sectional analysis of the COVID-19 Surveillance and Outcomes Registry, which captures data for a large healthcare system, comprising one central tertiary care hospital, seven large community hospitals and an expansive ambulatory/emergency care network in the Greater Houston area. Nasopharyngeal samples for individuals inclusive of all ages, races, ethnicities and sex were tested for SARS-CoV-2. We analysed sociodemographic (age, sex, race, ethnicity, household income, residence population density) and comorbidity (Charlson Comorbidity Index, hypertension, diabetes, obesity) factors. Multivariable logistic regression models were fitted to provide adjusted OR (aOR) and 95% CI for likelihood of a positive SARS-CoV-2 test. Structural equation modelling (SEM) framework was used to explore three mediation pathways (low income, high population density, high comorbidity burden) for the association between non-Hispanic black (NHB) race, Hispanic ethnicity and SARS-CoV-2 infection. RESULTS: Among 20 228 tested individuals, 1551 (7.7%) tested positive. The overall mean (SD) age was 51.1 (19.0) years, 62% were females, 22% were black and 18% were Hispanic. NHB and Hispanic ethnicity were associated with lower socioeconomic status and higher population density residence. In the fully adjusted model, NHB (vs non-Hispanic white; aOR, 2.23, CI 1.90 to 2.60) and Hispanic ethnicity (vs non-Hispanic; aOR, 1.95, CI 1.72 to 2.20) had a higher likelihood of infection. Older individuals and males were also at higher risk of infection. The SEM framework demonstrated a significant indirect effect of NHB and Hispanic ethnicity on SARS-CoV-2 infection mediated via a pathway including residence in densely populated zip code. CONCLUSIONS: There is strong evidence of race and ethnic disparities in the SARS-CoV-2 pandemic that are potentially mediated through unique social determinants of health.


Asunto(s)
Infecciones por Coronavirus/etnología , Disparidades en el Estado de Salud , Pandemias , Neumonía Viral/etnología , Factores Raciales , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Betacoronavirus , Comorbilidad , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Densidad de Población , Vigilancia de la Población , Sistema de Registros , Factores Socioeconómicos , Texas/epidemiología
13.
AIDS ; 34(12): 1781-1787, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-32604138

RESUMEN

BACKGROUND: Many people living with HIV (PLWH) have comorbidities which are risk factors for severe coronavirus disease 2019 (COVID-19) or have exposures that may lead to acquisition of severe acute respiratory distress syndrome coronavirus 2. There are few studies, however, on the demographics, comorbidities, clinical presentation, or outcomes of COVID-19 in people with HIV. OBJECTIVE: To evaluate risk factors, clinical manifestations, and outcomes in a large cohort of PLWH with COVID-19. METHODS: We systematically identified all PLWH who were diagnosed with COVID-19 at a large hospital from 3 March to 26 April 2020 during an outbreak in Massachusetts. We analyzed each of the cases to extract information including demographics, medical comorbidities, clinical presentation, and illness course after COVID-19 diagnosis. RESULTS: We describe a cohort of 36 PLWH with confirmed COVID-19 and another 11 patients with probable COVID-19. Almost 85% of PLWH with confirmed COVID-19 had a comorbidity associated with severe disease, including obesity, cardiovascular disease, or hypertension. Approximately 77% of PLWH with COVID-19 were non-Hispanic Black or Latinx whereas only 40% of the PLWH in our clinic were Black or Latinx. Nearly half of PLWH with COVID-19 had exposure to congregate settings. In addition to people with confirmed COVID-19, we identified another 11 individuals with probable COVID-19, almost all of whom had negative PCR testing. CONCLUSION: In the largest cohort to date of PLWH and confirmed COVID-19, almost all had a comorbidity associated with severe disease, highlighting the importance of non-HIV risk factors in this population. The racial disparities and frequent link to congregate settings in PLWH and COVID-19 need to be explored urgently.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por VIH/epidemiología , Neumonía Viral/epidemiología , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Betacoronavirus , Estudios de Cohortes , Comorbilidad , Infecciones por Coronavirus/etnología , Costo de Enfermedad , Femenino , Infecciones por VIH/etnología , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Massachusetts/epidemiología , Persona de Mediana Edad , Pandemias , Neumonía Viral/etnología , Factores de Riesgo
14.
J Med Internet Res ; 22(7): e20001, 2020 07 10.
Artículo en Inglés | MEDLINE | ID: mdl-32614778

RESUMEN

BACKGROUND: Existing health disparities based on race and ethnicity in the United States are contributing to disparities in morbidity and mortality during the coronavirus disease (COVID-19) pandemic. We conducted an online survey of American adults to assess similarities and differences by race and ethnicity with respect to COVID-19 symptoms, estimates of the extent of the pandemic, knowledge of control measures, and stigma. OBJECTIVE: The aim of this study was to describe similarities and differences in COVID-19 symptoms, knowledge, and beliefs by race and ethnicity among adults in the United States. METHODS: We conducted a cross-sectional survey from March 27, 2020 through April 1, 2020. Participants were recruited on social media platforms and completed the survey on a secure web-based survey platform. We used chi-square tests to compare characteristics related to COVID-19 by race and ethnicity. Statistical tests were corrected using the Holm Bonferroni correction to account for multiple comparisons. RESULTS: A total of 1435 participants completed the survey; 52 (3.6%) were Asian, 158 (11.0%) were non-Hispanic Black, 548 (38.2%) were Hispanic, 587 (40.9%) were non-Hispanic White, and 90 (6.3%) identified as other or multiple races. Only one symptom (sore throat) was found to be different based on race and ethnicity (P=.003); this symptom was less frequently reported by Asian (3/52, 5.8%), non-Hispanic Black (9/158, 5.7%), and other/multiple race (8/90, 8.9%) participants compared to those who were Hispanic (99/548, 18.1%) or non-Hispanic White (95/587, 16.2%). Non-Hispanic White and Asian participants were more likely to estimate that the number of current cases was at least 100,000 (P=.004) and were more likely to answer all 14 COVID-19 knowledge scale questions correctly (Asian participants, 13/52, 25.0%; non-Hispanic White participants, 180/587, 30.7%) compared to Hispanic (108/548, 19.7%) and non-Hispanic Black (25/158, 15.8%) participants. CONCLUSIONS: We observed differences with respect to knowledge of appropriate methods to prevent infection by the novel coronavirus that causes COVID-19. Deficits in knowledge of proper control methods may further exacerbate existing race/ethnicity disparities. Additional research is needed to identify trusted sources of information in Hispanic and non-Hispanic Black communities and create effective messaging to disseminate correct COVID-19 prevention and treatment information.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Grupos Étnicos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud/etnología , Neumonía Viral/epidemiología , Encuestas y Cuestionarios , Adulto , Afroamericanos/estadística & datos numéricos , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Betacoronavirus , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Medios de Comunicación Sociales , Estados Unidos/epidemiología , Adulto Joven
17.
Issues Ment Health Nurs ; 41(8): 662-664, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32610022

RESUMEN

Generations of nurses to come, now called heroes in the media, will have challenges in providing care for persons during this global pandemic. COVID-19 has impacted all demographics, regardless of race, gender, or socioeconomic class globally. African Americans have experienced a disproportionate number of deaths related to COVID-19 in the New Orleans and surrounding Metropolitan areas. According to the Louisiana Department of Health (2020), fifty-seven percent (57.40%) of the deaths in Louisiana related to COVID-19 have been African American (Black) and fifty-five percent (55.2%) have been males as of May 11, 2020. Social determinants of health are the conditions in which people age and the conditions they are born, grow, age and work. These conditions include neighborhoods, schools, and places of employment. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels (World Health Organization, 2020). Years later the same community that comprised "pre-and post-Katrina" are now facing this pandemic.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Femenino , Humanos , Louisiana/epidemiología , Masculino , Pandemias , Factores Socioeconómicos
19.
Sci Immunol ; 5(49)2020 07 29.
Artículo en Inglés | MEDLINE | ID: mdl-32727884

RESUMEN

Limited data are available for pregnant women affected by SARS-CoV-2. Serological tests are critically important for determining SARS-CoV-2 exposures within both individuals and populations. We validated a SARS-CoV-2 spike receptor binding domain serological test using 834 pre-pandemic samples and 31 samples from COVID-19 recovered donors. We then completed SARS-CoV-2 serological testing of 1,293 parturient women at two centers in Philadelphia from April 4 to June 3, 2020. We found 80/1,293 (6.2%) of parturient women possessed IgG and/or IgM SARS-CoV-2-specific antibodies. We found race/ethnicity differences in seroprevalence rates, with higher rates in Black/non-Hispanic and Hispanic/Latino women. Of the 72 seropositive women who also received nasopharyngeal polymerase chain reaction testing during pregnancy, 46 (64%) were positive. Continued serologic surveillance among pregnant women may inform perinatal clinical practices and can potentially be used to estimate exposure to SARS-CoV-2 within the community.


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Disparidades en el Estado de Salud , Neumonía Viral/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto , Afroamericanos/estadística & datos numéricos , Anticuerpos Antivirales/inmunología , Betacoronavirus/inmunología , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Estudios de Cohortes , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Pandemias , Philadelphia/epidemiología , Neumonía Viral/sangre , Neumonía Viral/inmunología , Neumonía Viral/virología , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/inmunología , Complicaciones Infecciosas del Embarazo/virología , Dominios Proteicos/inmunología , Estudios Seroepidemiológicos , Glicoproteína de la Espiga del Coronavirus/inmunología , Adulto Joven
20.
J Nurs Adm ; 50(7-8): 414-418, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32701646

RESUMEN

United States demographics are changing, but that change is yet to be recognized in the makeup of the nursing workforce. The underrepresentation of minorities in nursing is a longstanding problem, resulting in missed opportunities for culturally sensitive care that can foster optimal patient care outcomes. This report describes qualitative analysis of leadership opportunities emerging from a collaborative leadership development program between an urban baccalaureate nursing program and a large healthcare system in the northeast United States. The investigative team used qualitative methods to analyze the experiences of 19 participating African American (AA) RN graduates. Findings demonstrated that, for program participants, active engagement in personal and professional nursing leadership activities was enhanced. The academic-practice leadership program was an effective tool for enculturating AA nurses into the practice environment and into eventual leadership in nursing and healthcare.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Liderazgo , Personal de Enfermería/psicología , Desarrollo de Programa , Desarrollo de Personal , Adulto , Afroamericanos/psicología , Competencia Clínica , Diversidad Cultural , Prestación de Atención de Salud , Bachillerato en Enfermería , Femenino , Grupos Focales , Humanos , Masculino , Mentores , New England
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA