Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 890.103
Filtrar
1.
Sr Care Pharm ; 36(1): 4-5, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33384028

RESUMEN

The demographics of the Veterans in our care are everchanging, we are currently seeing a major shift in our geriatric Veteran population. World War II (WWII) ended in 1945, meaning that the youngest WWII Veterans are no more than 93 years old. There are currently close to 300,000 WWII Veterans and this number is expected to drop to <50,000 by 2024. Conversely, there are currently nearly 1 million Veterans of the Korean Conflict (1950-1953) and nearly 6 million Vietnam Era (1964-1975) Veterans. As the Vietnam Era Veterans age, we are seeing a surge in the number of Veterans aged 75 and older. There are currently less than 4.6 million Veterans in this age group and that number is expected to exceed 5 million by 2023.


Asunto(s)
Veteranos , Anciano , Anciano de 80 o más Años , Humanos , Guerra de Corea , Estados Unidos , Vietnam , Segunda Guerra Mundial
2.
Sr Care Pharm ; 36(1): 42-48, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33384033

RESUMEN

PURPOSE: The purpose of this quality improvement project was to increase pharmacist involvement in the outpatient hospice transition process to improve care of veterans, prevent medication errors, and to ensure medications are provided to the patient via the appropriate pharmacy.METHODS: This project began with implementation of a pilot process for the pharmacist to complete medication reconciliation for each patient admitted to non-Veterans Affairs (VA) hospice care from the Omaha VA Medical Center. The second step of this project was completion of a retrospective chart review of the interventions made. Statistical analysis was completed via descriptive statistics.RESULTS: A total of 21 patients were eligible for this study. The mean age was 78 years. The average total number of medications per veteran before and after medication reconciliation for VA meds were 13 and 4 and for non-VA meds were 4 and 6, respectively. The average total cost savings for one fill of all medications changed to non-VA was estimated to be $40.08. The pharmacist noted on average 12.6 medication discrepancies during medication reconciliation per veteran. Just less than half of the clinical recommendations made by the pharmacist were accepted by the providers.CONCLUSIONS: All veterans admitted to non-VA hospice care had at least one medication discrepancy noted by the pharmacist during medication reconciliation. A majority of the veterans had at least one VA medication changed to non-VA since hospice was now prescribing and providing. The cost savings on average appear to outweigh the time spent on medication reconciliation by the pharmacist.


Asunto(s)
Cuidados Paliativos al Final de la Vida , Conciliación de Medicamentos , Veteranos , Anciano , Humanos , Farmacéuticos , Estudios Retrospectivos , Estados Unidos
3.
Sr Care Pharm ; 36(1): 63, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33384036

RESUMEN

The author discusses benefits available to US Veterans starting with the Department of Veterans Affairs and going into state funding and long-term care benefits.


Asunto(s)
Veteranos , Hospitales de Veteranos , Humanos , Amor , Estados Unidos , United States Department of Veterans Affairs
4.
Nihon Yakurigaku Zasshi ; 156(1): 37-46, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-33390479

RESUMEN

Gilteritinib fumarate (Xospata® tablets 40 mg) is a novel, highly selective, oral FMS-like tyrosine kinase 3 (FLT3) inhibitor used for the treatment of patients with relapsed or refractory FLT3-mutated acute myeloid leukemia (AML), and it was approved in Japan in September 2018. Preclinical studies demonstrated that gilteritinib inhibited FLT3 and showed antiproliferative activity against Ba/F3 cells expressing mutated FLT3. In addition, gilteritinib inhibited tumor growth, induced tumor regression, and prolonged survival in mice xenografted with MV4-11 cells endogenously expressing FLT3-internal tandem duplication. In clinical trials conducted in the United States, Europe, and Japan, plasma concentrations after administration of gilteritinib 20 to 450 mg/day were generally dose proportional, and gilteritinib was well tolerated. Multiple clinical trials, including a global Phase III study, in patients with relapsed or refractory FLT3-mutated AML treated with gilteritinib demonstrated higher response rates of complete remission or complete remission with partial hematologic recovery and longer overall survival compared with patients treated with salvage chemotherapy. Some clinical trials are ongoing in patients with FLT3-mutated AML at various treatment stages, such as induction therapy, maintenance therapy, and treatment after hematopoietic stem cell transplantation. In conclusion, in vitro, in vivo, and clinical data indicate that gilteritinib fumarate is an effective treatment option in adult patients with relapsed or refractory FLT3-mutated AML in Japan.


Asunto(s)
Leucemia Mieloide Aguda , Tirosina Quinasa 3 Similar a fms , Adulto , Compuestos de Anilina , Animales , Humanos , Japón , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia Mieloide Aguda/genética , Ratones , Mutación , Pirazinas , Comprimidos , Estados Unidos , Tirosina Quinasa 3 Similar a fms/genética
5.
Curr Opin Pediatr ; 33(1): 129-135, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33394741

RESUMEN

PURPOSE OF REVIEW: The novel severe respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has caused a world-wide pandemic with devastating effects. Fortunately, most children display only mild-to-moderate symptoms, but there are a subset that will have severe symptoms warranting treatment. This review evaluates the current evidence for antiviral and anti-inflammatory treatment of acute SARS-COV-2 infections, including coronavirus disease 2019 in pediatrics. RECENT FINDINGS: Treatment recommendations continue to evolve with emerging results from clinical trials. Initial therapies were tailored to repurposed medications, and have now transitioned toward more specific antiviral therapy. In addition to specific antiviral therapy, there is also support to modulate the immune system and reduce inflammatory damage seen in coronavirus disease 2019. Much of the data result from adult studies with subsequent extrapolation to pediatrics. SUMMARY: Recommended therapy will continue to adapt as results return from clinical trials. A continued commitment from the National Institutes of Health and research community to assist in determining optimal therapies for pediatric patients is essential. Until then, most recommendations will likely be informed from the results seen in adult populations.


Asunto(s)
/tratamiento farmacológico , Pediatría , Adulto , Antiinflamatorios/uso terapéutico , Antivirales/uso terapéutico , Niño , Humanos , Estados Unidos
6.
N C Med J ; 82(1): 29-35, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33397751

RESUMEN

BACKGROUND In the early months of the COVID-19 pandemic, health care decision-makers in North Carolina needed information about the available health workforce in order to conduct workforce surge planning and to anticipate concerns about professional or geographic workforce shortages.METHOD Descriptive and cartographic analyses were conducted using licensure data held by the North Carolina Health Professions Data System to assess the supply of respiratory therapists, nurses, and critical care physicians in North Carolina. Licensure data were merged with population data and numbers of intensive care unit (ICU) beds drawn from the Centers for Medicare and Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS).RESULTS The pandemic highlighted how critical data infrastructure is to public health infrastructure. Respiratory therapists and acute care, emergency, and critical care nurses were diffused broadly throughout the state, with higher concentrations in urban areas. Critical care physicians were primarily based in areas with academic health centers.LIMITATIONS Data were unavailable to capture the rapid changes in supply due to clinicians reentering or exiting the workforce. County-level analyses did not reflect individual, facility-level supply, which was needed to plan organizational responses.CONCLUSIONS Health care decision-makers in North Carolina were able to access information about the supply of clinicians critical to caring for COVID-19 patients due to the state's long-standing investments in health workforce data infrastructure. Ability to respond was made easier due to strong working relationships between the University of North Carolina at Chapel Hill Cecil G. Sheps Center for Health Services Research, the North Carolina Area Health Education Centers Program, the health professional licensure boards, and state government health care agencies.


Asunto(s)
Fuerza Laboral en Salud , Anciano , Humanos , Medicare , North Carolina , Pandemias , Estados Unidos
7.
MMWR Morb Mortal Wkly Rep ; 70(1): 14-19, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33411699

RESUMEN

During early August 2020, county-level incidence of coronavirus disease 2019 (COVID-19) generally decreased across the United States, compared with incidence earlier in the summer (1); however, among young adults aged 18-22 years, incidence increased (2). Increases in incidence among adults aged ≥60 years, who might be more susceptible to severe COVID-19-related illness, have followed increases in younger adults (aged 20-39 years) by an average of 8.7 days (3). Institutions of higher education (colleges and universities) have been identified as settings where incidence among young adults increased during August (4,5). Understanding the extent to which these settings have affected county-level COVID-19 incidence can inform ongoing college and university operations and future planning. To evaluate the effect of large colleges or universities and school instructional format* (remote or in-person) on COVID-19 incidence, start dates and instructional formats for the fall 2020 semester were identified for all not-for-profit large U.S. colleges and universities (≥20,000 total enrolled students). Among counties with large colleges and universities (university counties) included in the analysis, remote-instruction university counties (22) experienced a 17.9% decline in mean COVID-19 incidence during the 21 days before through 21 days after the start of classes (from 17.9 to 14.7 cases per 100,000), and in-person instruction university counties (79) experienced a 56.2% increase in COVID-19 incidence, from 15.3 to 23.9 cases per 100,000. Counties without large colleges and universities (nonuniversity counties) (3,009) experienced a 5.9% decline in COVID-19 incidence, from 15.3 to 14.4 cases per 100,000. Similar findings were observed for percentage of positive test results and hotspot status (i.e., increasing among in-person-instruction university counties). In-person instruction at colleges and universities was associated with increased county-level COVID-19 incidence and percentage test positivity. Implementation of increased mitigation efforts at colleges and universities could minimize on-campus COVID-19 transmission.


Asunto(s)
/epidemiología , Universidades/organización & administración , Adolescente , Adulto , /transmisión , Humanos , Incidencia , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
8.
MMWR Morb Mortal Wkly Rep ; 70(1): 1-6, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33411702

RESUMEN

Approximately 15.5 million cancer survivors were alive in the United States in 2016 with expected growth to 26.1 million by 2040 (1). Cancer survivors are living longer because of advances in early detection and treatment, but face psychosocial, cognitive, financial, and physical challenges (1,2). Physical challenges include cardiovascular complications, partly because cancer and cardiovascular disease (CVD) share some cumulative risk factors including tobacco use, physical inactivity, obesity, poor diet, hypertension, diabetes, and dyslipidemia (3). In addition, many cancer treatments damage the heart, and some cancer types increase risk for developing CVD (4). The recognition and management of heart disease in cancer survivors has given rise to the discipline of cardio-oncology, which focuses on the cardiovascular health of this population (5). CVD risk has been previously estimated using prediction models, and studies suggest that physician-patient communication using predicted heart age rather than predicted 10-year risk has led to a more accurate perception of excess heart age, encouraged actions to adopt a healthy lifestyle, and improved modifiable CVD risk factors (6,7). Using the nonlaboratory-based Framingham Risk Score (FRS) to estimate 10-year risk for developing CVD, predicted heart age is estimated from the 10-year risk of CVD (predicted by age, sex, diabetes status, smoking status, systolic blood pressure, hypertension treatment status, and body mass index); it is the age of an otherwise healthy person with the same predicted risk, with all other risk factors included in the prediction model at the normal level (systolic blood pressure of 125 mmHg, no hypertension treatment, body mass index of 22.5, nonsmoker, and nondiabetic) (6). Using data from the Behavioral Risk Factor Surveillance System (BRFSS), this study estimates predicted heart age, excess heart age (difference between predicted heart age and actual age), and racial/ethnic and sociodemographic disparities in predicted heart age among U.S. adult cancer survivors and noncancer participants aged 30-74 years using previously published methods (7). A total of 22,759 men and 46,294 women were cancer survivors with a mean age of 48.7 and 48.3 years, respectively. The predicted heart age and excess heart age among cancer survivors were 57.2 and 8.5 years, respectively, for men and 54.8 and 6.5 years, respectively, for women, and varied by age, race/ethnicity, education and income. The use of predicted heart age by physicians to encourage cancer survivors to improve modifiable risk factors and make heart healthy choices, such as tobacco cessation, regular physical activity, and a healthy diet to maintain a healthy weight, can engage survivors in informed cancer care planning after diagnosis.


Asunto(s)
Supervivientes de Cáncer/estadística & datos numéricos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Adulto , Anciano , Consejo Dirigido , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Relaciones Médico-Paciente , Factores de Riesgo , Estados Unidos/epidemiología
9.
J Nurses Prof Dev ; 37(1): 66-68, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33395166

RESUMEN

With the rapid escalation of COVID-19 educational needs within hospitals, it was imperative for content experts of the infection prevention departments to lean on the expertise of nursing professional development specialists. This article provides a brief overview of how a clinical education and professional development department was deployed to assist and support the COVID-19 response efforts.


Asunto(s)
/prevención & control , Conducta Cooperativa , Control de Infecciones/organización & administración , Personal de Enfermería en Hospital/educación , Desarrollo de Personal/organización & administración , /epidemiología , Humanos , Estados Unidos/epidemiología
10.
MMWR Morb Mortal Wkly Rep ; 70(2): 29-35, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444294

RESUMEN

Screening for breast cancer, cervical cancer, and colorectal cancer (CRC) reduces mortality from these cancers.* However, screening test receipt has been below national targets with disparities observed in certain populations (1,2). National Health Interview Survey (NHIS) data from 2018 were analyzed to estimate percentages of adults up to date with U.S. Preventive Services Task Force (USPSTF) screening recommendations. Screening test receipt remained below national Healthy People 2020 (HP2020) targets, although CRC test receipt neared the target. Disparities were evident, with particularly low test receipt among persons who were uninsured or did not have usual sources of care. Continued monitoring helps assess progress toward targets and could inform efforts to promote screening and reduce barriers for underserved populations.


Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Adulto , Anciano , Neoplasias de la Mama/diagnóstico , Neoplasias Colorrectales/diagnóstico , Femenino , Encuestas de Atención de la Salud , Disparidades en Atención de Salud , Programas Gente Sana , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Neoplasias del Cuello Uterino/diagnóstico , Adulto Joven
11.
MMWR Morb Mortal Wkly Rep ; 70(2): 36-39, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444295

RESUMEN

CDC continually evaluates its Emergency Management Program (EMP) activities, including Incident Management System (IMS) activations, use of EMP functions (referred to as EMP utilizations), and exercises, to ensure that the agency is ready to respond to infectious disease outbreaks, disasters (human-made or natural), and security events. Such evaluation not only documents baseline preparedness and response activities during a selected analytical period, but also highlights significant EMP actions that can guide and inform future emergency operations. To characterize EMP activities that occurred during January 1, 2013-December 31, 2018, CDC conducted a retrospective analysis of operational activity logs. The results showed 253 domestic (U.S. states and territories) and international EMP activities, including 12 IMS activations, 147 EMP utilizations, and 94 exercises. Infectious diseases were the most common threat among both IMS activations (58%) and EMP utilizations (52%). CDC responded to the 2014 Ebola epidemic and the 2016 Zika outbreak; each response lasted approximately 2 years and required extended collaboration with domestic and international partners. Understanding the trends in EMP activities, including knowing the most common threats, aids CDC in allocating resources and focusing preparedness efforts. In 2013, CDC became the first federal agency to receive full agency-wide accreditation by the Emergency Management Accreditation Program (EMAP) in recognition of CDC's commitment to preparedness and its ability to respond to domestic and global public health threats. CDC received EMAP reaccreditation in December 2018 (1,2).


Asunto(s)
Centers for Disease Control and Prevention, U.S. , Servicios Médicos de Urgencia/organización & administración , Cooperación Internacional , Humanos , Estados Unidos
12.
MMWR Morb Mortal Wkly Rep ; 70(2): 46-51, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444297

RESUMEN

As of January 3, 2021, a total of 20,346,372 cases of coronavirus disease 2019 (COVID-19) and 349,246 associated deaths have been reported in the United States. Long-term sequalae of COVID-19 over the course of a lifetime currently are unknown; however, persistent symptoms and serious complications are being reported among COVID-19 survivors, including persons who initially experience a mild acute illness.* On December 11, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for Pfizer-BioNTech COVID-19 vaccine to prevent COVID-19, administered as 2 doses separated by 21 days. On December 12, 2020, the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use of Pfizer-BioNTech COVID-19 vaccine (1); initial doses were recommended for health care personnel and long-term care facility residents (2). As of December 23, 2020, a reported 1,893,360 first doses of Pfizer-BioNTech COVID-19 vaccine had been administered in the United States, and reports of 4,393 (0.2%) adverse events after receipt of Pfizer BioNTech COVID-19 vaccine had been submitted to the Vaccine Adverse Event Reporting System (VAERS). Among these, 175 case reports were identified for further review as possible cases of severe allergic reaction, including anaphylaxis. Anaphylaxis is a life-threatening allergic reaction that does occur rarely after vaccination, with onset typically within minutes to hours (3). Twenty-one cases were determined to be anaphylaxis (a rate of 11.1 per million doses administered), including 17 in persons with a documented history of allergies or allergic reactions, seven of whom had a history of anaphylaxis. The median interval from vaccine receipt to symptom onset was 13 minutes (range = 2-150 minutes). Among 20 persons with follow-up information available, all had recovered or been discharged home. Of the remaining case reports that were determined not to be anaphylaxis, 86 were judged to be nonanaphylaxis allergic reactions, and 61 were considered nonallergic adverse events. Seven case reports were still under investigation. This report summarizes the clinical and epidemiologic characteristics of case reports of allergic reactions, including anaphylaxis and nonanaphylaxis allergic reactions, after receipt of the first dose of Pfizer-BioNTech COVID-19 vaccine during December 14-23, 2020, in the United States. CDC has issued updated interim clinical considerations for use of mRNA COVID-19 vaccines currently authorized in the United States (4) and interim considerations for preparing for the potential management of anaphylaxis (5). In addition to screening for contraindications and precautions before administering COVID-19 vaccines, vaccine locations should have the necessary supplies available to manage anaphylaxis, should implement postvaccination observation periods, and should immediately treat persons experiencing anaphylaxis signs and symptoms with intramuscular injection of epinephrine (4,5).


Asunto(s)
Anafilaxia/etiología , Hipersensibilidad/etiología , Adolescente , Adulto , Sistemas de Registro de Reacción Adversa a Medicamentos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Adulto Joven
13.
MMWR Morb Mortal Wkly Rep ; 70(2): 52-55, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33444301

RESUMEN

During the beginning of the coronavirus disease 2019 (COVID-19) pandemic, nursing homes were identified as congregate settings at high risk for outbreaks of COVID-19 (1,2). Their residents also are at higher risk than the general population for morbidity and mortality associated with infection with SARS-CoV-2, the virus that causes COVID-19, in light of the association of severe outcomes with older age and certain underlying medical conditions (1,3). CDC's National Healthcare Safety Network (NHSN) launched nationwide, facility-level COVID-19 nursing home surveillance on April 26, 2020. A federal mandate issued by the Centers for Medicare & Medicaid Services (CMS), required nursing homes to commence enrollment and routine reporting of COVID-19 cases among residents and staff members by May 25, 2020. This report uses the NHSN nursing home COVID-19 data reported during May 25-November 22, 2020, to describe COVID-19 rates among nursing home residents and staff members and compares these with rates in surrounding communities by corresponding U.S. Department of Health and Human Services (HHS) region.* COVID-19 cases among nursing home residents increased during June and July 2020, reaching 11.5 cases per 1,000 resident-weeks (calculated as the total number of occupied beds on the day that weekly data were reported) (week of July 26). By mid-September, rates had declined to 6.3 per 1,000 resident-weeks (week of September 13) before increasing again, reaching 23.2 cases per 1,000 resident-weeks by late November (week of November 22). COVID-19 cases among nursing home staff members also increased during June and July (week of July 26 = 10.9 cases per 1,000 resident-weeks) before declining during August-September (week of September 13 = 6.3 per 1,000 resident-weeks); rates increased by late November (week of November 22 = 21.3 cases per 1,000 resident-weeks). Rates of COVID-19 in the surrounding communities followed similar trends. Increases in community rates might be associated with increases in nursing home COVID-19 incidence, and nursing home mitigation strategies need to include a comprehensive plan to monitor local SARS-CoV-2 transmission and minimize high-risk exposures within facilities.


Asunto(s)
/epidemiología , Personal de Salud/estadística & datos numéricos , Casas de Salud/estadística & datos numéricos , Anciano , Humanos , Incidencia , Estados Unidos/epidemiología
14.
Commun Biol ; 4(1): 60, 2021 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-33402722

RESUMEN

The basic reproduction number, R0, determines the rate of spread of a communicable disease and therefore gives fundamental information needed to plan public health interventions. Using mortality records, we estimated the rate of spread of COVID-19 among 160 counties and county-aggregates in the USA at the start of the epidemic. We show that most of the high among-county variance is explained by four factors (R2 = 0.70): the timing of outbreak, population size, population density, and spatial location. For predictions of future spread, population density and spatial location are important, and for the latter we show that SARS-CoV-2 strains containing the G614 mutation to the spike gene are associated with higher rates of spread. Finally, the high predictability of R0 allows extending estimates to all 3109 counties in the conterminous 48 states. The high variation of R0 argues for public health policies enacted at the county level for controlling COVID-19.


Asunto(s)
/epidemiología , Brotes de Enfermedades , Modelos Estadísticos , /virología , Análisis Factorial , Geografía Médica , Humanos , Densidad de Población , Vigilancia de la Población , Estados Unidos/epidemiología
15.
PLoS One ; 16(1): e0245327, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33411812

RESUMEN

BACKGROUND: University students are increasingly recognized as a vulnerable population, suffering from higher levels of anxiety, depression, substance abuse, and disordered eating compared to the general population. Therefore, when the nature of their educational experience radically changes-such as sheltering in place during the COVID-19 pandemic-the burden on the mental health of this vulnerable population is amplified. The objectives of this study are to 1) identify the array of psychological impacts COVID-19 has on students, 2) develop profiles to characterize students' anticipated levels of psychological impact during the pandemic, and 3) evaluate potential sociodemographic, lifestyle-related, and awareness of people infected with COVID-19 risk factors that could make students more likely to experience these impacts. METHODS: Cross-sectional data were collected through web-based questionnaires from seven U.S. universities. Representative and convenience sampling was used to invite students to complete the questionnaires in mid-March to early-May 2020, when most coronavirus-related sheltering in place orders were in effect. We received 2,534 completed responses, of which 61% were from women, 79% from non-Hispanic Whites, and 20% from graduate students. RESULTS: Exploratory factor analysis on close-ended responses resulted in two latent constructs, which we used to identify profiles of students with latent profile analysis, including high (45% of sample), moderate (40%), and low (14%) levels of psychological impact. Bivariate associations showed students who were women, were non-Hispanic Asian, in fair/poor health, of below-average relative family income, or who knew someone infected with COVID-19 experienced higher levels of psychological impact. Students who were non-Hispanic White, above-average social class, spent at least two hours outside, or less than eight hours on electronic screens were likely to experience lower levels of psychological impact. Multivariate modeling (mixed-effects logistic regression) showed that being a woman, having fair/poor general health status, being 18 to 24 years old, spending 8 or more hours on screens daily, and knowing someone infected predicted higher levels of psychological impact when risk factors were considered simultaneously. CONCLUSION: Inadequate efforts to recognize and address college students' mental health challenges, especially during a pandemic, could have long-term consequences on their health and education.


Asunto(s)
/psicología , Salud Mental , Estudiantes/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estados Unidos/epidemiología , Universidades , Adulto Joven
16.
PLoS One ; 16(1): e0244974, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33412567

RESUMEN

Antisocial behaviors cause harm, directly or indirectly, to others' welfare. The novel coronavirus pandemic has increased the urgency of understanding a specific form of antisociality: behaviors that increase risk of disease transmission. Because disease transmission-linked behaviors tend to be interpreted and responded to differently than other antisocial behaviors, it is unclear whether general indices of antisociality predict contamination-relevant behaviors. In a pre-registered study using an online U.S. sample, we found that individuals reporting high levels of antisociality engage in fewer social distancing measures: they report leaving their homes more frequently (p = .024) and standing closer to others while outside (p < .001). These relationships were observed after controlling for sociodemographic variables, illness risk, and use of protective equipment. Independently, higher education and leaving home for work were also associated with reduced distancing behavior. Antisociality was not significantly associated with level of worry about the coronavirus. These findings suggest that more antisocial individuals may pose health risks to themselves and their community during the COVID-19 pandemic.


Asunto(s)
/prevención & control , Adulto , /epidemiología , Control de Enfermedades Transmisibles , Política de Salud , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos/epidemiología
17.
Artículo en Inglés | MEDLINE | ID: mdl-33431724

RESUMEN

Search and find methods*) such as cluster tracing1)-6) or large-scale PCR testing**) of those who exhibit no symptoms or only mild symptoms of COVID-19 is shown by data analysis to be a powerful means to suppress the spread of COVID-19 instead of, or in addition to, lockdown of the entire population. Here we investigate this issue by analyzing the data from some cities and countries and we establish that search and find method is as powerful as lockdown of a city or a country. Moreover, in contrast to lockdown, it neither causes inconvenience to citizens nor does it disrupt the economy. Generally speaking, it is advisable that both social distancing and increased test numbers be employed to suppress spread of the virus. The product of the total test number with the rate of positive cases is the crucial index.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/métodos , África/epidemiología , Infecciones Asintomáticas/epidemiología , Brasil/epidemiología , /transmisión , China/epidemiología , Control de Enfermedades Transmisibles/estadística & datos numéricos , Política de Salud , Humanos , Inmunidad Colectiva , Japón/epidemiología , Los Angeles/epidemiología , Modelos Biológicos , Modelos Estadísticos , New York/epidemiología , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Cuarentena , Sensibilidad y Especificidad , Suecia/epidemiología , Tokio/epidemiología , Estados Unidos/epidemiología
18.
Kidney Int ; 99(1): 26-28, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33390231

RESUMEN

Undocumented immigrant patients with kidney disease in the United States are rightfully gaining increased access to scheduled hemodialysis treatments. For health care systems that have transitioned from emergency to more consistent treatments, the impact of this care on patients' livelihood remains unknown. Cervantes and colleagues provide evidence to better understand patients' experiences following transitions to scheduled hemodialysis treatments. These data are invaluable to formulate future implementation strategies that prioritize patients' values and health equity.


Asunto(s)
Inmigrantes Indocumentados , Servicio de Urgencia en Hospital , Accesibilidad a los Servicios de Salud , Humanos , Medición de Resultados Informados por el Paciente , Diálisis Renal/efectos adversos , Estados Unidos
19.
Pediatr Emerg Care ; 37(1): 48-53, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33394945

RESUMEN

OBJECTIVE: We aim to describe the current coronavirus disease 2019 (COVID-19) preparedness efforts among a diverse set of pediatric emergency departments (PEDs) within the United States. METHODS: We conducted a prospective multicenter survey of PED medical director(s) from selected children's hospitals recruited through a long established national research network. The questionnaire was developed by physicians with expertise in pediatric emergency medicine, disaster readiness, human factors, and survey development. Thirty-five children's hospitals were identified for recruitment through an established national research network. RESULTS: We report on survey responses from 25 (71%) of 35 PEDs, of which 64% were located within academic children's hospitals. All PEDs witnessed decreases in non-COVID-19 patients, 60% had COVID-19-dedicated units, and 32% changed their unit pediatric patient age to include adult patients. All PEDs implemented changes to their staffing model, with the most common change impacting their physician staffing (80%) and triaging model (76%). All PEDs conducted training for appropriate donning and doffing of personal protective equipment (PPE), and 62% reported shortages in PPE. The majority implemented changes in the airway management protocols (84%) and cardiac arrest management in COVID patients (76%). The most common training modalities were video/teleconference (84%) and simulation-based training (72%). The most common learning objectives were team dynamics (60%), and PPE and individual procedural skills (56%). CONCLUSIONS: This national survey provides insight into PED preparedness efforts, training innovations, and practice changes implemented during the start of COVID-19 pandemic. Pediatric emergency departments implemented broad strategies including modifications to staffing, workflow, and clinical practice while using video/teleconference and simulation as preferred training modalities. Further research is needed to advance the level of preparedness and support deep learning about which preparedness actions were effective for future pandemics.


Asunto(s)
/epidemiología , Planificación en Desastres , Servicio de Urgencia en Hospital/organización & administración , Encuestas de Atención de la Salud , Pandemias , Personal de Hospital/educación , Niño , Estudios Transversales , Planificación en Desastres/estadística & datos numéricos , Educación a Distancia , Servicio de Urgencia en Hospital/estadística & datos numéricos , Hospitales Pediátricos/estadística & datos numéricos , Humanos , Equipo de Protección Personal , Estudios Prospectivos , Entrenamiento Simulado , Telecomunicaciones , Triaje , Estados Unidos
20.
Int J Equity Health ; 20(1): 3, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33397390

RESUMEN

Despite being the wealthiest and one of the most technologically advanced countries in the world, the United States has the greatest number of Covid-19 cases and deaths. What accounts for this failure? The dismantling of the country's public health infrastructure has crippled contact tracing and exacerbated inequality as a disproportionate number of poor people and people of color have fallen ill with Covid-19. Inadequate regulation of the private for-profit sector has adversely affected the efficiency and quality of testing for the virus, and the prescription of costly drugs whose benefit and safety in treating infected patients have not been established. More stringent regulation of the commercial sector has led to the development of efficacious vaccines in a remarkably short time. Still, questions remain about the vaccines' effectiveness in the real world, and their safety.


Asunto(s)
/epidemiología , Pandemias , Trazado de Contacto , Predicción , Disparidades en el Estado de Salud , Humanos , Pandemias/prevención & control , Salud Pública/legislación & jurisprudencia , Administración en Salud Pública , Estados Unidos/epidemiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA