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1.
Ann R Coll Surg Engl ; 104(4): 269-273, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34941446

RESUMEN

INTRODUCTION: The first wave of the COVID-19 pandemic led to an unprecedented time for the management of colorectal cancer, with uncertainty as to cancer-specific risks and the circumventing of gold standard oncological strategies. Our study aimed to acquire a snapshot of the practice of multidisciplinary team (MDT) management and variability in response to rapidly emerging guidelines. METHODS: The survey was disseminated to 150 colorectal cancer MDTs across England and Wales taken from the National Bowel Cancer Audit data set between 15 April and 30 June 2020 for completion by colorectal surgeons. RESULTS: Sixty-seven MDTs responded to the survey. Fifty-seven centres reported that they continued to perform colorectal cancer resections during the initial lockdown period. Fifty centres (74.6%) introduced routine preoperative COVID-19 testing and 50 (74.6%) employed full personal protective equipment for elective cases. Laparoscopic resections were continued by 25 centres (42.1%), whereas 28 (48.3%) changed to an open approach. Forty-nine (79.0%) centres reported experiencing patient-led surgical cancellations in 0-25% of their listings. If surgery was delayed significantly then 24 centres (38.7%) employed alternative neoadjuvant therapy, with short-course radiotherapy being their preferred adjunct of choice for rectal cancer. Just over 50% of the MDTs stated that they were uncomfortable or very uncomfortable with their management strategies. CONCLUSIONS: Our study demonstrates variability in the MDT management of colorectal cancer during the initial COVID-19 lockdown, incorporating adaptive patient behaviour and initially limited data on oncological safety profiles leading to challenging decision-making.


Asunto(s)
COVID-19 , Neoplasias del Recto , COVID-19/epidemiología , COVID-19/prevención & control , Prueba de COVID-19 , Control de Enfermedades Transmisibles , Humanos , Pandemias/prevención & control
2.
BMC Surg ; 22(1): 168, 2022 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-35538571

RESUMEN

BACKGROUND: The COVID-19 pandemic caused a global health crisis in 2020. This pandemic also had a negative impact on standard procedures in general surgery. Surgeons were challenged to find the best treatment plans for patients with acute cholecystitis. The aim of this study is to investigate the impact of the COVID-19 pandemic on the outcomes of laparoscopic cholecystectomies performed in a tertiary care hospital in Germany. PATIENTS AND METHODS: We examined perioperative outcomes of patients who underwent laparoscopic cholecystectomy during the pandemic from March 22, 2020 (first national lockdown in Germany) to December 31, 2020. We then compared these to perioperative outcomes from the same time frame of the previous year. RESULTS: A total of 182 patients who underwent laparoscopic cholecystectomy during the above-mentioned periods were enrolled. The pandemic group consisted of 100 and the control group of 82 patients. Subgroup analysis of elderly patients (> 65 years old) revealed significantly higher rates of acute [5 (17.9%) vs. 20 (58.8%); p = 0.001] and gangrenous cholecystitis [0 (0.0%) vs. 7 (20.6%); p = 0.013] in the "pandemic subgroup". Furthermore, significantly more early cholecystectomies were performed in this subgroup [5 (17.9%) vs. 20 (58.8%); p = 0.001]. There were no significant differences between the groups both in the overall and subgroup analysis regarding the operation time, intraoperative blood loss, length of hospitalization, morbidity and mortality. CONCLUSION: Elderly patients showed particularly higher rates of acute and gangrenous cholecystitis during the pandemic. Laparoscopic cholecystectomy can be performed safely in the COVID-19 era without negative impact on perioperative results. Therefore, we would assume that laparoscopic cholecystectomy can be recommended for any patient with acute cholecystitis, including the elderly.


Asunto(s)
COVID-19 , Colecistectomía Laparoscópica , Colecistitis Aguda , Colecistitis , Enfermedad Aguda , Anciano , COVID-19/epidemiología , Colecistectomía Laparoscópica/métodos , Colecistitis/epidemiología , Colecistitis/cirugía , Colecistitis Aguda/epidemiología , Colecistitis Aguda/cirugía , Control de Enfermedades Transmisibles , Alemania/epidemiología , Humanos , Pandemias , Estudios Retrospectivos , Centros de Atención Terciaria , Resultado del Tratamiento
3.
Subst Abus ; 43(1): 1116-1119, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35499400

RESUMEN

Background: The COVID-19 pandemic has been accompanied by increases in cannabis consumption, which might relate to dispensary marketing activities. As part of an ongoing project monitoring cannabis dispensary websites in Northern California and Reno, Nevada, we noticed many websites added announcements and "pop-up" communications in response to lockdowns. This brief report describes the cannabis dispensary website communications related to COVID-19 with the aim to provide insight into emerging marketing messages that may increase cannabis consumption in times of crisis. Methods: Content analysis of COVID-19 announcements present on cannabis dispensary websites in San Francisco/Alameda Counties (n = 32), and the Reno area (n = 15) in April-May 2020 shortly after lockdowns were implemented. Results: COVID-19 announcements were present on 25/32 (78%) of dispensary websites in San Francisco/Alameda and 9/15 (60%) of websites in the Reno area. Almost all COVID-19 announcements (88% San Francisco/Alameda, 89% Reno) announced operational changes such as delivery or curbside pickup services, 72% and 56% respectively announced patron/employee safety measures. Health related messages were present; about half of website announcements referred to government/health authorities, 44% of Reno area announcements used healthcare rhetoric, and some San Francisco/Alameda announcements included suggestions for using cannabis to mitigate infection risk or manage anxiety. Conclusions: Most cannabis dispensaries in the study region implemented COVID-19 pandemic operational changes to maintain product availability, and many positioned their identity with health - either by referring to health authorities, or using health rhetoric, and a minority gave health advice. Cannabis dispensary websites provide a timely snapshot of marketing practices that may contribute to increases in cannabis use during stressful events.


Asunto(s)
COVID-19 , Cannabis , Control de Enfermedades Transmisibles , Humanos , Mercadotecnía , Pandemias/prevención & control
4.
Ann Ital Chir ; 93: 147-151, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503058

RESUMEN

AIM: We analysed our one-year surgical activity in a spoke 'COVID-19 free' centre during the pandemic in South Italy. MATERIAL OF STUDY: From Feb 2020 to Feb 2021 we performed 800 operations (40% in emergency and 60% of major surgery). We applied restrictive measures for the access of patients in our department from 15/2/2020 after several cases of unclear fever. Visitors were not allowed to stay in the ward. RESULTS: In the first period of lockdown, from March to June 2020, in our Region, biomolecular test was indicated only for symptomatic people. We organized the hospitalization with a sealed compartment system (that we defined "boing system") in which the patient stationed in an 'isolation room' for at least 48 hours upon the entry. From July 2020 molecular test were made to all patients before hospitalization. The boing system remains for emergency recovery. DISCUSSION: In the first phase of pandemia we chose to subject patients to serological examination based on the IgM assay to consider them negative. We organized the hospitalization with a sealed compartment system (that we defined "boing system") CONCLUSION: In the first phase of the pandemic the serological examination has shown high specificity in identifying positive patients for COVID 19. In that period we supposed that patients with negative serology could be considered non-contagious Neither patients or staff has been resulted positive to SarS CoV2 test. KEY WORDS: Covid 19, Emercency Surgery, Spoke Center, Pandemia, Serological Tests.


Asunto(s)
COVID-19 , Pandemias , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Humanos , Modelos Organizacionales , SARS-CoV-2
6.
Indian J Ophthalmol ; 70(5): 1767-1772, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35502070

RESUMEN

Purpose: The coronavirus disease (COVID-19) pandemic continues to play havoc in our lives. During the first " lockdown" in 2020, we were keen on assessing the anxiety levels of patients who sought ophthalmic care despite the lockdown. Public health actions, such as social distancing, were necessary to reduce the spread of COVID-19. As a result, most people felt isolated and lonely, thereby causing increased levels of stress and anxiety in them. We aimed to assess the anxiety levels using the Hamilton Anxiety Scale and personality assessment using the 57-point Eysenck's Personality Inventory (EPI) questionnaire among patients visiting a tertiary eye care hospital during the lockdown period. Methods: Consecutive patients attending an ophthalmic tertiary care hospital during the COVID-19 pandemic and lockdown were approached to be a part of this prospective cross-sectional survey. Results: In total, 1,088 responses were analyzed during the 2-month study period with the mean age being 45.7 + 16.9 years. The majority had completed graduation (78%) with 15 years or more of formal education. The purpose of the visit was an emergency consultation in 42% (n = 455), a review appointment in 42% (n = 457), and the remaining (16%, n = 176) came for a routine consultation. The majority of the patients (>90%) did not report experiencing any of the 14 sets of symptoms. A mild level of anxiety was noted in 1,086 (>99%) respondents, whereas only 2 (<1%) respondents showed mild-moderate levels of anxiety. Financial concerns such as affordability of medications (6% vs. 3%, P = 0.05) and fear of losing their job (16% vs. 11%, P = 0.02) were significantly more in those experiencing any anxiety compared to those with no anxiety. Conclusion: Our study revealed that patients visiting a tertiary ophthalmic center during lockdown were graduates, sought eye consultation primarily for emergency or a review, and had no major anxiety symptoms. In those with anxiety, the affordability of medicines and loss of jobs were the main concerns.


Asunto(s)
COVID-19 , Pandemias , Adulto , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Estudios Transversales , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Centros de Atención Terciaria
7.
BMC Pediatr ; 22(1): 254, 2022 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-35524208

RESUMEN

BACKGROUND: The COVID-19 pandemic led to improved hygiene and reduced social encounters. Near elimination of the activity of respiratory syncytial virus and influenza viruses were observed, worldwide. Therefore, we assessed the rates of pediatric outpatient clinic visits and medications prescribed at those visits during the coronavirus disease 2019 (COVID-19) pandemic and pre-COVID-19 period (2016-2019). METHODS: Monthly and annual incidence rates for respiratory and non-respiratory diagnoses and dispensed prescription rates were calculated. Acute gastroenteritis (AGE) visits were analyzed separately since the mode of transmission is influenced by hygiene and social distancing. RESULTS: Overall, 5,588,702 visits were recorded. Respiratory and AGE visits declined by 49.9% and 47.3% comparing the COVID-19 and pre-COVID-19 periods. The respective rate reductions for urinary tract infections, trauma, and skin and soft tissue infections were 18.2%, 19.9%, and 21.8%. Epilepsy visits increased by 8.2%. Overall visits rates declined by 21.6%. Dispensed prescription rates of antibiotics and non-antibiotics respiratory medications declined by 49.3% and 44.4%, respectively. The respective declines for non-respiratory antibiotics and non-antibiotics were 15.1% and 0.2%. Clinic visits and prescription rates reductions were highest in April-May, following the first lockdown in Israel. CONCLUSIONS: COVID-19 pandemic resulted in a substantial reduction in respiratory outpatient clinic visits and dispensed respiratory drugs, with only a mild reduction seen for non-respiratory visits. These trends were probably driven by COVID-19 mitigation measures and by the profound disruption to non-SARS COV-2 respiratory virus activity.


Asunto(s)
COVID-19 , Atención Ambulatoria , Instituciones de Atención Ambulatoria , Antibacterianos/uso terapéutico , COVID-19/epidemiología , Niño , Control de Enfermedades Transmisibles , Humanos , Pandemias , SARS-CoV-2
8.
Sci Rep ; 12(1): 7603, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534601

RESUMEN

Characterizing acute service demand is critical for neurosurgery and other emergency-dominant specialties in order to dynamically distribute resources and ensure timely access to treatment. This is especially important in the post-Covid 19 pandemic period, when healthcare centers are grappling with a record backlog of pending surgical procedures and rising acute referral numbers. Healthcare dashboards are well-placed to analyze this data, making key information about service and clinical outcomes available to staff in an easy-to-understand format. However, they typically provide insights based on inference rather than prediction, limiting their operational utility. We retrospectively analyzed and prospectively forecasted acute neurosurgical referrals, based on 10,033 referrals made to a large volume tertiary neurosciences center in London, U.K., from the start of the Covid-19 pandemic lockdown period until October 2021 through the use of a novel AI-enabled predictive dashboard. As anticipated, weekly referral volumes significantly increased during this period, largely owing to an increase in spinal referrals (p < 0.05). Applying validated time-series forecasting methods, we found that referrals were projected to increase beyond this time-point, with Prophet demonstrating the best test and computational performance. Using a mixed-methods approach, we determined that a dashboard approach was usable, feasible, and acceptable among key stakeholders.


Asunto(s)
COVID-19 , Inteligencia Artificial , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Humanos , Pandemias , Estudios Retrospectivos
9.
Sci Rep ; 12(1): 7572, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534651

RESUMEN

The interrelations between human activity and animal populations are of increasing interest due to the emergence of the novel COVID-19 and the consequent pandemic across the world. Anthropogenic impacts of the pandemic on animals in urban-suburban environments are largely unknown. In this study, the temporal and spatial patterns of urban animal response to the COVID-19 lockdown were assessed using animal-vehicle collisions (AVC) data. We collected AVC data over two 6-month periods in 2019 and 2020 (January to June) from the largest metropolis in southern Poland, which included lockdown months. Furthermore, we used traffic data to understand the impact of lockdown on AVC in the urban area. Our analysis of 1063 AVC incidents revealed that COVID-19 related lockdown decreased AVC rates in suburban areas. However, in the urban area, even though traffic volume had significantly reduced, AVC did not decrease significantly, suggesting that lockdown did not influence the collision rates in the urban area. Our results suggest that there is a need to focus on understanding the effects of changes in traffic volume on both human behaviour and wildlife space use on the resulting impacts on AVC in the urban area.


Asunto(s)
COVID-19 , Animales , Animales Salvajes , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Pandemias , Polonia/epidemiología
10.
Biomed Res Int ; 2022: 8920117, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35535036

RESUMEN

The coronavirus disease (COVID-19) which emerged in Wuhan, China, in December 2019, is widely controlled now in China. However, the global epidemic is still severe. To study and comment on Hubei's approaches for responding to the disease, the paper considered some factors such as suspected cases (part of them are influenza patients or common pneumonia patients, etc.), quarantine, patient classification (three types), clinically diagnosed cases, and lockdown of Wuhan and Hubei. After that, the paper established an SELIHR model based on the surveillance data of Hubei published by the Hubei Health Commission from 10 January 2020 to 30 April 2020 and used the fminsearch optimization method to estimate the optimal parameters of the model. We obtained the basic reproduction number ℛ 0 = 3.1571 from 10 to 22 January. ℛ 0 was calculated as 2.0471 from 23 to 27 January. From 28 January to 30 April, ℛ 0 = 1.5014. Through analysis, it is not hard to find that the patients without classification during the period of confirmed cases will result in the cumulative number of cases in Hubei to increase. In addition, regarding the lockdown measures implemented by Hubei during the epidemic, our simulations also show that if the lockdown time of either Hubei or Wuhan is advanced, it will effectively curb the spread of the epidemic. If the lockdown measures are not taken, the total cumulative number of cases will increase substantially. From the results of the study, it can be concluded that the lockdown, patient classification, and the large-scale case screening are essential to slow the spread of COVID-19, which can provide references for other countries or regions.


Asunto(s)
COVID-19 , Número Básico de Reproducción , COVID-19/epidemiología , China/epidemiología , Control de Enfermedades Transmisibles/métodos , Humanos , Cuarentena , SARS-CoV-2
11.
PLoS One ; 17(5): e0267488, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35536850

RESUMEN

BACKGROUND: The COVID-19 pandemic and countrywide lockdown could negatively impact household food insecurity among low-income households. This study aimed to investigate the prevalence of household food insecurity and its influencing factors among low-income people in Bangladesh during the lockdown of COVID-19. METHODS: This cross-sectional study was conducted through face-to-face interviews from 500 low-income households during the countrywide COVID-19 lockdown. A pretested, structured and validated questionnaire was used to collect socioeconomic characteristics, household income conditions, and food accessibility. Household Food Insecurity Access Scale (HFIAS) and Dietary Diversity Score (DDS) were used to measure food insecurity. Multinomial logistic regression models were estimated to evaluate and predict risk factors that influence food insecurity. RESULTS: The study found that above 67% of households was mild-to-moderate food insecure while 23% experienced severe food insecurity. Significantly, 88%, 97.4%, and 93.4% of the households had anxiety and uncertainty, inadequate quality, and inadequate quantity of food, respectively. The regression analysis revealed the age 36-50 years (RRR: 4.86; 95% CI: 2.31-7.44, RRR: 4.16; 95% CI: 2.25-6.10) and monthly income <58.3 USD (RRR: 3.04; 95% CI: 1.12-5.14, RRR: 3.26; 95% CI: 1.79-4.71) were significantly associated with food insecurity (p <0.001). Likewise, less-income (RRR: 3.87; 95% CI: 1.37-6.46, RRR: 2.99; 95% CI: 1.16-4.83), increase in food prices (RRR: 1.29; 95% CI: 0.32-2.33, RRR: 1.08; 95% CI: 0.05-1.12), and those who did not have same type of earning as before during the COVID-19 lockdown (RRR: 3.41; 95% CI: 1.33-5.62, RRR: 2.60; 95% CI: 0.99-4.24) were potential risk factor for MMFI and FI. CONCLUSION: This study found that households become more susceptible to food insecurity during the COVID-19 pandemic and lockdown period. Based on the findings, we suggest some essential food policies and adequate food assistance to mitigate these negative consequences.


Asunto(s)
COVID-19 , Adulto , Bangladesh/epidemiología , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Estudios Transversales , Inseguridad Alimentaria , Abastecimiento de Alimentos , Humanos , Persona de Mediana Edad , Pandemias , Factores Socioeconómicos
12.
PLoS One ; 17(5): e0268119, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35522614

RESUMEN

Recent research points towards age- and gender-specific transmission of COVID-19 infections and their outcomes. The effect of gender, however, has been overlooked in past modelling approaches of COVID-19 infections. The aim of our study is to explore how gender-specific contact behavior affects gender-specific COVID-19 infections and deaths. We consider a compartment model to establish short-term forecasts of the COVID-19 epidemic over a time period of 75 days. Compartments are subdivided into different age groups and genders, and estimated contact patterns, based on previous studies, are incorporated to account for age- and gender-specific social behaviour. The model is fitted to real data and used for assessing the effect of hypothetical contact scenarios all starting at a daily level of 10 new infections per million population. On day 75 after the end of the lockdown, infection rates are highest among the young and working-age, but they also have increased among the old. Sex ratios reveal higher infection risks among women than men at working ages; the opposite holds true at old age. Death rates in all age groups are twice as high for men as for women. Small changes in contact rates at working and young ages have a considerable effect on infections and mortality at old age, with elderly men being always at higher risk of infection and mortality. Our results underline the high importance of the non-pharmaceutical mitigation measures (NPMM) in low-infection phases of the pandemic to prevent that an increase in contact rates leads to higher mortality among the elderly, even if easing measures take place among the young. At young and middle ages, women's contribution to increasing infections is higher due to their higher number of contacts. Gender differences in contact rates may be one pathway that contributes to the spread of the disease and results in gender-specific infection rates and their mortality outcome. To further explore possible pathways, more data on contact behavior and COVID-19 transmission is needed, which includes gender- and socio-demographic information.


Asunto(s)
COVID-19 , Pandemias , Anciano , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Solución de Problemas
13.
PLoS One ; 17(5): e0268133, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35522676

RESUMEN

The COVID-19 pandemic has magnified the multiple vulnerabilities of people living in urban informal settlements globally. To bring community voices from such settlements to the center of COVID-19 response strategies, we undertook a study in the urban informal settlements of Dharavi, Mumbai, from September 2020-April 2021. In this study, we have examined the awareness, attitudes, reported practices, and some broader experiences of the community in Dharavi with respect to COVID-19. We have used a mixed-methods approach, that included a cross-sectional survey of 468 people, and in-depth interviews and focus group discussions with 49 people living in this area. Data was collected via a mix of phone and face-to-face interviews. We have presented here the descriptive statistics from the survey and the key themes that emerged from our qualitative data. People reported high levels of knowledge about COVID-19, with television (90%), family and friends (56%), and social media (47%) being the main sources of information. The knowledge people had, however, was not free of misconceptions and fear; people were scared of being forcefully quarantined and dying alone during the early days of COVID-19. These fears had negative repercussions in the form of patient-related stigma and hesitancy in seeking healthcare. A year into the pandemic, however, people reported a shift in attitudes from 'extreme fear to low fear' (67% reported perceiving low/no COVID risk in October 2020), contributing to a general laxity in following COVID-appropriate behaviors. Currently, the community is immensely concerned about the revival of livelihoods, that have been adversely impacted due to the lockdown in 2020 as well as the continued 'othering' of Dharavi for being a COVID hotspot. These findings suggest that urban informal settlements like Dharavi need community-level messaging that counters misinformation and denial of the outbreak; local reinforcement of COVID-appropriate behaviours; and long-term social protection measures.


Asunto(s)
COVID-19 , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Estudios Transversales , Miedo , Humanos , Pandemias
14.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(4): 184-190, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35523464

RESUMEN

BACKGROUND AND OBJECTIVE: The SARS-CoV-2 pandemic has caused chaos in all health systems on the planet. It has been difficult to cope with COVID 19, but also to maintain the activity in other specialties. In ophthalmology, the scientific societies recommended providing urgent care, including the intravitreal treatment of patients with active neovascular age-related macular degeneration (AMD), since a delay in treatment implies a potential loss of visual acuity (VA). The main objective of this study was to measure the impact of the coronavirus lockdown on the activity and visual results in patients with neovascular AMD in Area 3 of Madrid. MATERIAL AND METHOD: A retrospective observational study was conducted of all patients with neovascular AMD who attended a consultation and/or received intravitreal treatment in the 3 months before the lockdown. RESULTS: In the 3 months before the lockdown, 144 patients with neovascular AMD were treated, of whom only 51 attended a consultation during the lockdown and, at 6 months after it, only 117 patients had resumed their follow-up. Mean VA before the lockdown was 58.0 ±â€¯23.7 letters and was statistically significantly reduced to 53.0 ±â€¯27.1 letters at 6 months after the lockdown. We also observed a significant decrease in the number of visits during the lockdown, despite the security measures implemented. CONCLUSIONS: Our study shows that patients with neovascular AMD have had a statistically significant decrease in VA due to the lockdown. A VA of almost 58 letters was reduced to 53 at 6 months after the lockdown. The percentage of patients who lost 15 or more letters doubled. We observed a 63.3% loss of temporary follow-up during the lockdown and a 14.58% loss of permanent follow-up at 6 months after the lockdown.


Asunto(s)
COVID-19 , Degeneración Macular Húmeda , Inhibidores de la Angiogénesis/uso terapéutico , Control de Enfermedades Transmisibles , Humanos , Inyecciones Intravítreas , Pandemias , SARS-CoV-2 , Factor A de Crecimiento Endotelial Vascular , Agudeza Visual , Degeneración Macular Húmeda/tratamiento farmacológico
15.
BMC Health Serv Res ; 22(1): 611, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35524211

RESUMEN

BACKGROUND: COVID-19 pandemic may have affected the utilization of maternal and newborn child health services in Nigeria but the extent, directions, contextual factors at all the levels of healthcare service delivery in Nigeria is yet to be fully explored. The objective of the study was to explore the barriers and facilitators of access to MNCH services during the first wave of COVID-19 pandemic in Nigeria. METHODS: A qualitative study was conducted among different stakeholder groups in 18 public health facilities in Nigeria between May and July,2020. In-depth interviews were conducted among 54 study participants (service users, service providers and policymakers) selected from across the three tiers of public health service delivery system in Nigeria (primary health centers, secondary health centers and tertiary health centers). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. RESULTS: Barriers to accessing MNCH services during the first wave of COVID-19-pandemic in Nigeria include fear of contracting COVID-19 infection at health facilities, transportation difficulties, stigmatization of sick persons, lack of personal protective equipment (PPE) /medical commodities, long waiting times at hospitals, shortage of manpower, lack of preparedness by health workers, and prioritization of essential services. Enablers to access include the COVID-19 non-pharmacological measures instituted at the health facilities, community sensitization on healthcare access during the pandemic, and alternative strategies for administering immunization service at the clinics. CONCLUSION: Access to MNCH services were negatively affected by lockdown during the first wave of COVID-19 pandemic in Nigeria particularly due to challenges resulting from restrictions in movements which affected patients/healthcare providers ability to reach the hospitals as well as patients' ability to pay for health care services. Additionally, there was fear of contracting COVID-19 infection at health facilities and the health systems inability to provide enabling conditions for sustained utilization of MNCH services. There is need for government to institute alternative measures to halt the spread of diseases instead of lockdowns so as to ensure unhindered access to MNCH services during future pandemics. This may include immediate sensitization of the general public on modes of transmission of any emergent infectious disease as well as training of health workers on emergency preparedness and alternative service delivery models.


Asunto(s)
COVID-19 , Servicios de Salud del Niño , Servicios de Salud Materna , COVID-19/epidemiología , Niño , Control de Enfermedades Transmisibles , Femenino , Humanos , Recién Nacido , Nigeria/epidemiología , Pandemias , Embarazo
16.
BMC Psychol ; 10(1): 118, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35526076

RESUMEN

BACKGROUND: The COVID-19 pandemic and the resulting restrictions placed upon society have had a profound impact on both physical and mental health, particularly for young people. AIMS: The current study assesses the impact of COVID-19 on student mental health. METHOD: Four hundred and thirty four first year Undergraduate students completed a battery of self-report questionnaires (PHQ-P, GAD-7 and SAS-SV) to assess for depression, anxiety and mobile phone addiction respectively with data being collected over a 2 year period. The data from each year was compared (216 and 218 students respectively). RESULTS: A MANOVA revealed that COVID-19 had a significant impact on self-reported levels of depression, anxiety and smartphone addiction-which all significantly increased from the 2020 to the 2021 group. The percentage of students who had a score which warranted a classification of clinical depression increased from 30 to 44%, and for anxiety increased from 22 to 27%-those students who showed a comorbidity across the two rose from 12 to 21%. Smartphone addiction levels rose from 39 to 50%. Correlational analysis showed a significant relationship between Smartphone usage and depression and anxiety. CONCLUSIONS: This research suggests that COVID-19 has had a major impact upon student mental health, and smartphone addiction. The importance of identifying predictive factors of depression and anxiety is emphasised, and suggestions for intervention are discussed.


Asunto(s)
COVID-19 , Adolescente , Ansiedad/epidemiología , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Depresión/epidemiología , Humanos , Salud Mental , Pandemias , Estudiantes/psicología , Reino Unido/epidemiología
17.
East Mediterr Health J ; 28(4): 258-265, 2022 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-35545906

RESUMEN

Background: COVID-19 is having many impacts on health, economy and social life; some due to the indirect effects of closure of health facilities to curb the spread. Closures were implemented in Pakistan from March 2020, affecting provision of reproductive, maternal, newborn and child health (RMNCH) services. Aims: To appraise the effects of containment and lockdown policies on RMNCH service utilization in order to develop an early response to avoid the catastrophic impact of COVID-19 on RMNCH in Pakistan. Methods: Routine monitoring data were analysed for indicators utilization of RMNCH care. The analysis was based on Period 1 (January-May 2020, first wave of COVID-19); Period 2 (June-September 2020, declining number of cases of COVID-19); and Period 3 (October-December 2020, second wave of COVID-19). We also compared data from May and December 2020 with corresponding months in 2019, to ascertain whether changes were due to COVID-19. Results: Reduced utilization was noted for all RMNCH indicators during Periods 1 and 3. There was a greater decline in service utilization during the first wave, and the highest reduction (~82%) was among children aged < 5 years, who were treated for pneumonia. The number of caesarean sections dropped by 57%, followed by institutional deliveries and first postnatal visit (37% each). Service utilization increased from June to September, but the second wave of COVID-19 led to another decrease. Conclusion: To reinstate routine services, priority actions and key areas include continued provision of family planning services along with uninterrupted immunization campaigns and routine maternal and child services.


Asunto(s)
COVID-19 , Servicios de Salud del Niño , Servicios de Salud Materna , Servicios de Salud Reproductiva , COVID-19/epidemiología , Niño , Salud del Niño , Control de Enfermedades Transmisibles , Femenino , Humanos , Recién Nacido , Salud Materna , Pakistán/epidemiología , Pandemias , Embarazo
18.
PLoS One ; 17(5): e0267555, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503779

RESUMEN

INTRODUCTION: The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and teachers. Our study aims to assess Filipino college students' mental health status and to estimate the effect of the COVID-19 pandemic, the shift to online learning, and social media use on mental health. In addition, facilitators or stressors that modified the mental health status of the college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning will be investigated. METHODS AND ANALYSIS: Mixed-method study design will be used, which will involve: (1) an online survey to 2,100 college students across the Philippines; and (2) randomly selected 20-40 key informant interviews (KIIs). Online self-administered questionnaire (SAQ) including Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE will be used. Moreover, socio-demographic factors, social media usage, shift to online learning factors, family history of mental health and COVID-19, and other factors that could affect mental health will also be included in the SAQ. KIIs will explore factors affecting the student's mental health, behaviors, coping mechanism, current stressors, and other emotional reactions to these stressors. Associations between mental health outcomes and possible risk factors will be estimated using generalized linear models, while a thematic approach will be made for the findings from the KIIs. Results of the study will then be triangulated and summarized. ETHICS AND DISSEMINATION: Our study has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01). The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.


Asunto(s)
COVID-19 , Educación a Distancia , Medios de Comunicación Sociales , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Humanos , Salud Mental , Pandemias , Filipinas/epidemiología , SARS-CoV-2 , Estudiantes/psicología
19.
Front Public Health ; 10: 763490, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35509511

RESUMEN

Aim: Following the outbreak of the COVID-19 epidemic, China adopted community isolation management measures. During the "lockdown" period, urban communities were the most basic prevention and control unit for the epidemic. The effectiveness of community epidemic prevention directly affects the spread of the virus and social stability. Therefore, the aim of this study was to explore the status quo and influencing factors of psychological distress. Methods: For this study, 1,430 community households were randomly selected in key cities affected by the epidemic, and a questionnaire survey was administered during the lockdown period. A structural equation model was used to analyse the influencing factors of community epidemic prevention effects. A total of 1,326 valid questionnaires were collected, with a valid response rate of 92.73%. Results: In this study, the differences in psychological distress among different community types were statistically significant (t = 58.41, P < 0.01). The results showed that epidemic prevention capability played a mediating role. The results of the high-order structural equation model analysis showed that perceived social support (ß = -0.275, P = 0.000) and community social network (ß = -0.296, P < 0.01) were significantly negatively correlated with psychological distress. Conclusions: Community social support indirectly relieves psychological anxiety and improves the effect of epidemic prevention by enhancing residents' ability to prevent epidemics. The community social network help residents reduce the risk of outbreaks and indirectly alleviate psychological distress.


Asunto(s)
COVID-19 , Epidemias , Distrés Psicológico , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles , Humanos , SARS-CoV-2 , Red Social , Apoyo Social
20.
BMJ Open ; 12(5): e060405, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534070

RESUMEN

OBJECTIVES: The aim of this study was to explore the agency of older adults and their strategies to restructure ways of being and belonging in a rapidly and radically changed social environment during the UK's first COVID-19 lockdown in Spring 2020. DESIGN: Qualitative study consisting of semi-structured interviews. Findings were derived from a thematic analysis of interview transcripts. We also established a patient and public involvement and engagement group who advised on study design, interview topic guide and interpretation of findings. SETTING: Interviews were conducted online with older adults in the UK through their platform of choice in Spring 2020 in England, UK. PARTICIPANTS: We conducted 28 interviews (16 women, 12 men) with older adults over the age of 70 years. Our participants were mostly white, middle class adults. RESULTS: From the data, we constructed three strategies that older adults used to employ agency and create spaces of belonging in their social networks despite lockdown restrictions. First, participants created a sense of belonging by being 'good' members of society who were knowledgeable about COVID-19. Second, older adults created new ways to socially engage with the wider community. Finally, older adults actively restructured social networks to preserve a sense of belonging. CONCLUSIONS: Older adults are actively and creatively carving a space of belonging during the societal upheaval in response to the COVID-19 lockdown and public health restrictions. Rather than internalising potential exclusionary messages based on their age, older adults instead used their agency to reimagine and transform spheres of belonging.


Asunto(s)
COVID-19 , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles , Inglaterra/epidemiología , Femenino , Humanos , Masculino , Negociación , Pandemias , Investigación Cualitativa , SARS-CoV-2
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