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3.
BMC Public Health ; 24(1): 1524, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844867

RESUMEN

BACKGROUND: Non-pharmaceutical interventions (NPIs) have been widely utilised to control the COVID-19 pandemic. However, it is unclear what the optimal strategies are for implementing NPIs in the context of coronavirus vaccines. This study aims to systematically identify, describe, and evaluate existing ecological studies on the real-world impact of NPIs in containing COVID-19 pandemic following the roll-out of coronavirus vaccines. METHODS: We conducted a comprehensive search of relevant studies from January 1, 2021, to June 4, 2023 in PubMed, Embase, Web of science and MedRxiv. Two authors independently assessed the eligibility of the studies and extracted the data. A risk of bias assessment tool, derived from a bibliometric review of ecological studies, was applied to evaluate the study design, statistical methodology, and the quality of reporting. Data were collected, synthesised and analysed using qualitative and quantitative methods. The results were presented using summary tables and figures, including information on the target countries and regions of the studies, types of NPIs, and the quality of evidence. RESULTS: The review included a total of 17 studies that examined the real-world impact of NPIs in containing the COVID-19 pandemic after the vaccine roll-out. These studies used five composite indicators that combined multiple NPIs, and examined 14 individual NPIs. The studies had an average quality assessment score of 13 (range: 10-16), indicating moderately high quality. NPIs had a larger impact than vaccination in mitigating the spread of COVID-19 during the early stage of the vaccination implementation and in the context of the Omicron variant. Testing policies, workplace closures, and restrictions on gatherings were the most effective NPIs in containing the COVID-19 pandemic, following the roll-out of vaccines. The impact of NPIs varied across different time frames, countries and regions. CONCLUSION: NPIs had a larger contribution to the control of the pandemic as compared to vaccination during the early stage of vaccine implementation and in the context of the omicron variant. The impact of NPIs in containing the COVID-19 pandemic exhibited variability in diverse contexts. Policy- and decision-makers need to focus on the impact of different NPIs in diverse contexts. Further research is needed to understand the policy mechanisms and address potential future challenges.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Pandemias/prevención & control
4.
BMC Public Health ; 24(1): 1531, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38844910

RESUMEN

BACKGROUND: To investigate the changes in the unhealthy eye-related behaviors of junior middle school students during the COVID-19 pandemic and the double reduction policy and its relationship with myopia. METHODS: Data were obtained from the 2019-2022 Tianjin Children and Youth Myopia, Common Diseases and Health Influencing Factors Survey. Latent profile analysis (LPA) and a generalized linear model (GLM) were applied to analyze the effect of eye-related behavior classes on myopia. RESULTS: A total of 2508 junior middle school students were included. The types of eye-related behavior were categorized into the medium-healthy behavior group, heavy academic burden and near-eye behavior group, insufficient lighting group and high-healthy behavior group. Students with heavy academic burdens and near-eye behavior were more likely to develop myopia than were those in the high-healthy group (OR = 1.466, 95% CI = 1.203-1.787; P < 0.001). CONCLUSIONS: The dual reduction policy has a positive effect on improving unhealthy eye-related behaviors, and the prevention and control of myopia through the use of different combinations of eye-related behaviors are heterogeneous among junior middle school students. In the post-COVID-19 period, we should continue to implement a double reduction policy and formulate targeted eye-related behavior strategies to provide an important reference for the prevention and control of myopia among children and adolescents during public health emergencies in the future.


Asunto(s)
COVID-19 , Miopía , Estudiantes , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/psicología , Miopía/epidemiología , Miopía/psicología , Miopía/prevención & control , Masculino , Femenino , Adolescente , Niño , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , China/epidemiología , Conductas Relacionadas con la Salud , Pandemias , Instituciones Académicas , Encuestas y Cuestionarios
5.
BMC Public Health ; 24(1): 1520, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844906

RESUMEN

BACKGROUND: This study addresses the persistent global burden of road traffic fatalities, particularly in middle-income countries like Malaysia, by exploring the impact of the COVID-19 pandemic on Road Traffic Accident (RTA) fatalities in Perak state, Malaysia, with a secondary focus on applying Years of Life Lost (YLL) to understand the implications of these premature deaths. METHODOLOGY: The cross-sectional study retrospectively reviewed certified RTA fatalities from 2018 to 2021, individually counting fatalities in accidents and excluding cases with incomplete death profiles. Data were collected from all Forensic Departments in the government hospitals in Perak. RTA fatalities were confirmed by medical officers/physicians following established procedures during routine procedures. A total of 2517 fatal accident and victim profiles were transcribed into data collection form after reviewing death registration records and post-mortem reports. Inferential analyses were used for comparison between pre- and during COVID-19 pandemic. The standard expected YLL was calculated by comparing the age of death to the external standard life expectancy curve taking into consideration of age and gender in Malaysia. RESULTS: This study included 2207 (87.7%) of the RTA fatalities in Perak State. The analysis revealed a decreasing trend in RTA deaths from 2018 to 2021, with a remarkable Annual Percent Change (APC) of -25.1% in 2020 compared to the pre-pandemic year in 2019 and remained stable with lower APC in 2021. Comparison between pre-pandemic (2018-2019) and pandemic years (2020-2021) revealed a difference in the fatality distribution with a median age rise during the pandemic (37.7 (IQR: 22.96, 58.08) vs. 41.0 (IQR: 25.08, 61.00), p = 0.002). Vehicle profiles remained consistent, yet changes were observed in the involvement of various road users, where more motorcycle riders and pedestrian were killed during pandemic (p = 0.049). During pandemic, there was a decline in vehicle collisions, but slight increase of the non-collision accidents and incidents involving pedestrians/animals (p = 0.015). A shift in accident from noon till midnight were also notable during the pandemic (p = 0.028). YLL revealed differences by age and gender, indicating a higher YLL for females aged 30-34 during the pandemic. CONCLUSION: The decline in RTA fatalities during COVID-19 pandemic underscores the influence of pandemic-induced restrictions and reduced traffic. However, demographic shifts, increased accident severity due to risky behaviors and gender-specific impacts on YLL, stress the necessity for improved safety interventions amidst evolving dynamics.


Asunto(s)
Accidentes de Tránsito , COVID-19 , Mortalidad Prematura , Humanos , Malasia/epidemiología , COVID-19/mortalidad , COVID-19/epidemiología , Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/estadística & datos numéricos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Estudios Transversales , Mortalidad Prematura/tendencias , Adolescente , Estudios Retrospectivos , Anciano , Adulto Joven , Niño , Esperanza de Vida/tendencias , Preescolar , Lactante , Anciano de 80 o más Años , Pandemias , Recién Nacido
6.
BMC Med Educ ; 24(1): 637, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844924

RESUMEN

BACKGROUND: Online education has emerged as a crucial tool for imparting knowledge and skills to students in the twenty-first century, especially in developing nations like India, which previously relied heavily on traditional teaching methods. METHODS: This study delved into the perceptions and challenges experienced by students and teachers in the context of online education during the COVID-19 pandemic. Data were collected from a sample of 491 dental students and 132 teachers utilizing a cross-sectional research design and an online-validated survey questionnaire. RESULTS: The study's findings revealed significant insights. Internet accessibility emerged as a major impediment for students, with online instruction proving more effective for theoretical subjects compared to practical ones. Although most teachers expressed comfort with online teaching, they highlighted the absence of classroom interaction as a significant challenge. CONCLUSION: This study comprehensively examines the perspectives of both students and teachers regarding online education during the pandemic. The results carry substantial implications for the academic community, underscoring the need to address internet access issues and explore ways to enhance engagement and interaction in online learning environments.


Asunto(s)
COVID-19 , Educación en Odontología , Educación a Distancia , Estudiantes de Odontología , Humanos , COVID-19/epidemiología , India/epidemiología , Estudios Transversales , Estudiantes de Odontología/psicología , Estudiantes de Odontología/estadística & datos numéricos , Masculino , Femenino , Educación en Odontología/métodos , Adulto , SARS-CoV-2 , Encuestas y Cuestionarios , Pandemias , Docentes de Odontología , Adulto Joven
7.
BMC Med Educ ; 24(1): 631, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38844926

RESUMEN

BACKGROUND: The onset of the COVID-19 pandemic catalysed a monumental shift in the field of continuing professional development (CPD). Prior to this, the majority of CPD group-learning activities were offered in-person. However, the pandemic forced the field to quickly pivot towards more novel methods of learning and teaching in view of social distancing regulations. The purpose of this study was to obtain the perspectives of CPD leaders on the impact of the pandemic to elucidate trends, innovations, and potential future directions in the field. METHODS: Semi-structured interviews were conducted between April-September 2022 with 23 CPD leaders from Canada and the USA. Interviews were audio-recorded, transcribed, and de-identified. A thematic analysis approach was used to analyse the data and generate themes. RESULTS: Participants characterised COVID-19 as compelling widespread change in the field of CPD. From the interviews, researchers generated six themes pertaining to the impact of the pandemic on CPD: (1) necessity is the mother of innovation, (2) the paradox of flexibility and accessibility, (3) we're not going to unring the bell, (4) reimagining design and delivery, (5) creating an evaluative culture, and (6) a lifeline in times of turmoil. CONCLUSION: This qualitative study discusses the impact of the pandemic on the field of CPD and leaders' vision for the future. Despite innumerable challenges, the pandemic created opportunities to reform design and delivery. Our findings indicate a necessity to maintain an innovative culture to best support learners, to improve the healthcare system, and to prepare for future emergencies.


Asunto(s)
COVID-19 , Educación Médica Continua , Investigación Cualitativa , Humanos , COVID-19/epidemiología , Canadá , Estados Unidos , Pandemias , SARS-CoV-2 , Femenino , Entrevistas como Asunto , Masculino , Liderazgo , Desarrollo de Personal
8.
Clin Psychol Psychother ; 31(3): e3015, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38850261

RESUMEN

OBJECTIVE: Telepresence may play a fundamental role in establishing authentic interactions and relationships in online psychological interventions and can be measured by the Telepresence in Videoconference Scale (TVS), which was validated only with patients to date. This post hoc study aimed to validate the Italian version of the TVS with mental health professionals. METHOD: The Italian TVS was included in an online survey, whose primary aim was to assess the experiences of Italian psychologists and psychotherapists with online interventions during the first wave of the COVID-19 pandemic and was filled in by 296 participants (83.4% females, mean age = 42 years old). RESULTS: Exploratory factor analysis supported the original factor structure only partially because the scale 'Absorption' (i.e., the feeling of losing track of time), as it was formulated, did not measure telepresence. Correlations were also explored between the TVS scales and some survey items pertaining to intimacy and emotional closeness to patients, comfort and positive as well as negative experiences with online interventions. CONCLUSION: The TVS may be a useful tool to measure physical and social telepresence in online interventions, both in patients and in professionals.


Asunto(s)
COVID-19 , Psicoterapeutas , Comunicación por Videoconferencia , Humanos , COVID-19/psicología , Femenino , Masculino , Adulto , Italia , Psicoterapeutas/psicología , Telemedicina , Encuestas y Cuestionarios , Persona de Mediana Edad , SARS-CoV-2 , Reproducibilidad de los Resultados , Psicometría , Pandemias , Psicoterapia/métodos , Psicología/métodos
9.
S Afr Fam Pract (2004) ; 66(1): e1-e8, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38832387

RESUMEN

BACKGROUND:  The coronavirus disease 2019 (COVID-19) caused global disruptions in healthcare service delivery. The prevention of mother-to-child transmission (PMTCT) of human immunodeficiency viruses (HIV) services were also interrupted, threatening the attainment of Sustainable Development Goal 3. This article describes the PMTCT service interruptions experienced during the COVID-19 pandemic in Tshwane healthcare facilities. METHODS:  A descriptive phenomenological design was used to explore and describe the experiences of healthcare providers offering PMTCT services during COVID-19 in the Tshwane district, Gauteng province. Purposive sampling was used to recruit participants. Data were collected through in-depth interviews with 16 participants, and Colaizzi's data analysis steps were followed in analysing the findings. RESULTS:  Participants reported interruptions in PMTCT service delivery during the pandemic. Non-adherence to scheduled visits resulted in patients defaulting or not adhering to treatment regimens, high viral loads and mother-infant pairs' loss to follow-up. Other features of service disruption included late antenatal bookings, low client flow and delays in conducting deoxyribonucleic acid-polymerase chain reaction (DNA-PCR) testing in HIV-exposed babies. In addition, staff shortages occurred because of re-assignments to COVID-19-related activities. Study participants were psychologically affected by the fear of contracting COVID-19 and worked in a frustrating and stressful environment. CONCLUSION:  Improved community-based follow-up services are critical to enhance PMTCT service outcomes and prevent infant HIV infections.Contribution: The findings may influence policymakers in developing strategies to curb HIV infections among mothers and children during pandemics.


Asunto(s)
COVID-19 , Infecciones por VIH , Transmisión Vertical de Enfermedad Infecciosa , SARS-CoV-2 , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/transmisión , Femenino , Infecciones por VIH/transmisión , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Embarazo , Sudáfrica/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto , Pandemias/prevención & control , Recién Nacido
10.
PLoS One ; 19(6): e0303079, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38833458

RESUMEN

How did mental healthcare utilization change during the COVID-19 pandemic period among individuals with pre-existing mental disorder? Understanding utilization patterns of these at-risk individuals and identifying those most likely to exhibit increased utilization could improve patient stratification and efficient delivery of mental health services. This study leveraged large-scale electronic health record (EHR) data to describe mental healthcare utilization patterns among individuals with pre-existing mental disorder before and during the COVID-19 pandemic and identify correlates of high mental healthcare utilization. Using EHR data from a large healthcare system in Massachusetts, we identified three "pre-existing mental disorder" groups (PMD) based on having a documented mental disorder diagnosis within the 6 months prior to the March 2020 lockdown, related to: (1) stress-related disorders (e.g., depression, anxiety) (N = 115,849), (2) serious mental illness (e.g., schizophrenia, bipolar disorders) (N = 11,530), or (3) compulsive behavior disorders (e.g., eating disorder, OCD) (N = 5,893). We also identified a "historical comparison" group (HC) for each PMD (N = 113,604, 11,758, and 5,387, respectively) from the previous year (2019). We assessed the monthly number of mental healthcare visits from March 13 to December 31 for PMDs in 2020 and HCs in 2019. Phenome-wide association analyses (PheWAS) were used to identify clinical correlates of high mental healthcare utilization. We found the overall number of mental healthcare visits per patient during the pandemic period in 2020 was 10-12% higher than in 2019. The majority of increased visits was driven by a subset of high mental healthcare utilizers (top decile). PheWAS results indicated that correlates of high utilization (prior mental disorders, chronic pain, insomnia, viral hepatitis C, etc.) were largely similar before and during the pandemic, though several conditions (e.g., back pain) were associated with high utilization only during the pandemic. Limitations included that we were not able to examine other risk factors previously shown to influence mental health during the pandemic (e.g., social support, discrimination) due to lack of social determinants of health information in EHR data. Mental healthcare utilization among patients with pre-existing mental disorder increased overall during the pandemic, likely due to expanded access to telemedicine. Given that clinical correlates of high mental healthcare utilization in a major hospital system were largely similar before and during the COVID-19 pandemic, resource stratification based on known risk factor profiles may aid hospitals in responding to heightened mental healthcare needs during a pandemic.


Asunto(s)
COVID-19 , Trastornos Mentales , Servicios de Salud Mental , Aceptación de la Atención de Salud , Humanos , COVID-19/epidemiología , COVID-19/psicología , Masculino , Femenino , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Adulto , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos , Servicios de Salud Mental/estadística & datos numéricos , Pandemias , Registros Electrónicos de Salud , Anciano , SARS-CoV-2 , Massachusetts/epidemiología , Adulto Joven , Adolescente
11.
Sci Rep ; 14(1): 12866, 2024 06 04.
Artículo en Inglés | MEDLINE | ID: mdl-38834635

RESUMEN

While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana's longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises.


Asunto(s)
COVID-19 , Multimorbilidad , Médicos , Investigación Cualitativa , Humanos , COVID-19/epidemiología , COVID-19/psicología , India/epidemiología , Estudios Longitudinales , Masculino , Femenino , Médicos/psicología , Pandemias , Adulto , Persona de Mediana Edad , SARS-CoV-2 , Telemedicina
12.
BMC Public Health ; 24(1): 1496, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38835010

RESUMEN

BACKGROUND: The COVID-19 pandemic has been the most widespread and threatening health crisis experienced by the Korean society. Faced with an unprecedented threat to survival, society has been gripped by social fear and anger, questioning the culpability of this pandemic. This study explored the correlation between social cognitions and negative emotions and their changes in response to the severe events stemming from the COVID-19 pandemic in South Korea. METHODS: The analysis was based on a cognitive-emotional model that links fear and anger to the social causes that trigger them and used discursive content from comments posted on YouTube's COVID-19-related videos. A total of 182,915 comments from 1,200 videos were collected between January and December 2020. We performed data analyses and visualizations using R, Netminer 4.0, and Gephi software and calculated Pearson's correlation coefficients between emotions. RESULTS: YouTube videos were analyzed for keywords indicating cognitive assessments of major events related to COVID-19 and keywords indicating negative emotions. Eight topics were identified through topic modeling: causes and risks, perceptions of China, media and information, infection prevention rules, economic activity, school and infection, political leaders, and religion, politics, and infection. The correlation coefficient between fear and anger was 0.462 (p < .001), indicating a moderate linear relationship between the two emotions. Fear was the highest from January to March in the first year of the COVID-19 outbreak, while anger occurred before and after the outbreak, with fluctuations in both emotions during this period. CONCLUSIONS: This study confirmed that social cognitions and negative emotions are intertwined in response to major events related to the COVID-19 pandemic, with each emotion varying individually rather than being ambiguously mixed. These findings could aid in developing social cognition-emotion-based public health strategies through education and communication during future pandemic outbreaks.


Asunto(s)
Ira , COVID-19 , Miedo , Medios de Comunicación Sociales , Humanos , COVID-19/epidemiología , COVID-19/psicología , República de Corea/epidemiología , Medios de Comunicación Sociales/estadística & datos numéricos , Miedo/psicología , Brotes de Enfermedades , Grabación en Video , SARS-CoV-2 , Pandemias
13.
Korean J Med Educ ; 36(2): 137-143, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38835307

RESUMEN

PURPOSE: This study aimed to analyze the research trends of the Korean Journal of Medical Education (KJME) since it became an English-language journal. METHODS: A total of 274 articles published in KJME from 2016 to 2023 were analyzed. All article types were included in the analysis. NetMiner ver. 4.0 (Cyram Inc., Korea) was used for the main keyword and topic modeling analysis. RESULTS: Of the 274 articles, 170 (62%) and 104 (38%) were by domestic and international authors, respectively. The main keywords with high frequency were "students," "learning," "experience," "pandemic," and "perception." Three topics were derived using topic matching analysis: "residents' perception and attitude of the pandemic," "assessment of learning and achievement," and "learning experiences in the pandemic." CONCLUSION: Since the shift to English-language journals, medical education research has witnessed an increase in the number of articles published by international authors. Research on postgraduate education has increased. Research topics are relevant to situations such as the coronavirus disease 2019 pandemic. These findings can help researchers select research topics and encourage them to submit their research to the journal.


Asunto(s)
Educación Médica , Publicaciones Periódicas como Asunto , Humanos , República de Corea , COVID-19/epidemiología , Investigación , Pandemias , SARS-CoV-2 , Bibliometría
14.
Korean J Med Educ ; 36(2): 157-174, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38835309

RESUMEN

PURPOSE: This study examines various aspects related to medical professionalism in medical students during coronavirus disease 2019 (COVID-19) pandemic, focusing on their medical professionalism attributes, KPA (knowledge, practices, and attitudes) toward COVID-19 and attitudes toward provision of care in pandemic. We assessed whether these aspects related to medical professionalism were varied by their demographics and mental health level. METHODS: Six questionnaires related to medical professionalism were distributed online to medical students in six grades at a single medical school. A one-way analysis of variance was used to examine differences in scores related to medical professionalism based on their demographics, for examples, gender, grade, residence, religion, as well as their mental health levels. Pearson correlation analysis was used to examine correlations between each variable. RESULTS: Female students scored higher on medical professionalism attributes and attitudes toward duty-to-care than male students. Medical professionalism attribute scores were higher with higher relationship satisfaction and resilience levels but lower with higher anxiety levels. Furthermore, these scores were significantly associated with attitudes toward COVID-19 preparedness. However, COVID-19 knowledge and practice scores were negatively associated with attitudes toward COVID-19 preparedness and careers after graduation. Meanwhile, students who took the leave of absence related to 2020 doctors' strike had significantly lower scores on attitudes toward COVID-19 preparedness and duty to care than those who did not. CONCLUSION: Our findings suggest that mental health of medical students is strongly related to their various aspects related to medical professionalism, especially their attitudes toward COVID-19 preparedness. Good mental health was positively linked to medical professionalism attributes and attitudes toward COVID-19 preparedness. However, knowledge and practice of COVID-19 were negatively associated with willingness to participate in the pandemic response. Additionally, the experience of the 2020 leave of absence impacted the attitudes of medical students toward COVID-19 preparedness (p=0.015) and their duty to care (p=0.012) negatively.


Asunto(s)
Actitud del Personal de Salud , COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Salud Mental , Profesionalismo , SARS-CoV-2 , Estudiantes de Medicina , Humanos , COVID-19/epidemiología , COVID-19/psicología , Estudiantes de Medicina/psicología , Femenino , Masculino , Encuestas y Cuestionarios , Pandemias , Adulto , Adulto Joven , República de Corea
16.
Front Endocrinol (Lausanne) ; 15: 1304436, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38836223

RESUMEN

Introduction: The Coronavirus Disease - 2019 (COVID-19) pandemic significantly impacted healthcare service provision and put diabetic patients at increased risk of adverse health outcomes. We aimed to assess the impact of the COVID-19 pandemic on the incidence and demographic shift of major lower-limb amputation in diabetic patients. Methods: We performed a retrospective analysis of diabetic patient records undergoing major lower-limb amputation between 01/03/2019 and 01/03/2021 at the Royal Sussex County Hospital, the regional arterial hub for Sussex. Primary outcomes were amputation incidence rates and patient demographics compared between the prepandemic and pandemic cohorts. Results: The incidence rate ratio of major lower-limb amputations shows a drop in amputations during the pandemic compared to pre-pandemic (IRR 0.82; 95% CI 0.57-1.18). Data suggests a shift in the social deprivation background of patients receiving amputations to disproportionately affect those in the more deprived 50% of the population (p=0.038). Younger patients received more amputations during the pandemic compared to prepandemic levels (p=0.001). Conclusion: Results suggest that during the COVID-19 pandemic there was a paradoxical reduction in amputations compared to prepandemic levels. However, changes to the demographic makeup of patient's receiving amputations are alarming as younger, and more deprived patients have been disproportionately affected by the pandemic.


Asunto(s)
Amputación Quirúrgica , COVID-19 , Humanos , COVID-19/epidemiología , Amputación Quirúrgica/estadística & datos numéricos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Privación Social , Pie Diabético/cirugía , Pie Diabético/epidemiología , Incidencia , Pandemias , SARS-CoV-2 , Anciano de 80 o más Años
17.
Nurs Open ; 11(6): e2205, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38837908

RESUMEN

AIM: To explore cognitions in nurses' professional value and career development amid the COVID-19 pandemic and to analyse influencing factors. DESIGN: A qualitative descriptive study design was employed. METHODS: Thirty practising nurses from three general hospitals in Chengdu, China, were purposively recruited. Face-to-face semi-structured interviews were conducted. The content analysis was used for data analysis. RESULTS: After the outbreak of the COVID-19 pandemic, there were obvious cognitive changes in nurses' professional value, including improvement in the cognition of professional value, awareness of the broadening of the field of acting professional value, and realization of increasingly high requirements in careers. Approval and gratitude of patients, social recognition and attention, self-awareness of nurses were main influencing factors. For cognitive changes in career development, nurses became more motivated to develop their careers, had a clearer understanding of career development environment, and acquired a clearer understanding of what was needed to advance careers. Hospital support, social respect, family support, and team atmosphere were key influencing factors. CONCLUSIONS: The contributions made by nurses in the prevention and control of the COVID-19 pandemic have prompted positive changes in their cognition of professional value and career development. To promote nurses' positive understanding and approach to career development, measures should be taken by hospitals. Further, social respect, family support and team cooperation can enhance nurses' enthusiasm for career development.


Asunto(s)
COVID-19 , Investigación Cualitativa , Humanos , COVID-19/psicología , Femenino , Adulto , China/epidemiología , Masculino , Personal de Enfermería en Hospital/psicología , SARS-CoV-2 , Movilidad Laboral , Pandemias , Cognición , Enfermeras y Enfermeros/psicología , Actitud del Personal de Salud , Persona de Mediana Edad
18.
Sci Adv ; 10(23): eadn0671, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38838157

RESUMEN

Government responses to COVID-19 are among the most globally impactful events of the 21st century. The extent to which responses-such as school closures-were associated with changes in COVID-19 outcomes remains unsettled. Multiverse analyses offer a systematic approach to testing a large range of models. We used daily data on 16 government responses in 181 countries in 2020-2021, and 4 outcomes-cases, infections, COVID-19 deaths, and all-cause excess deaths-to construct 99,736 analytic models. Among those, 42% suggest outcomes improved following more stringent responses ("helpful"). No subanalysis (e.g. limited to cases as outcome) demonstrated a preponderance of helpful or unhelpful associations. Among the 14 associations with P values < 1 × 10-30, 5 were helpful and 9 unhelpful. In summary, we find no patterns in the overall set of models that suggests a clear relationship between COVID-19 government responses and outcomes. Strong claims about government responses' impacts on COVID-19 may lack empirical support.


Asunto(s)
COVID-19 , Gobierno , SARS-CoV-2 , COVID-19/epidemiología , COVID-19/mortalidad , COVID-19/virología , Humanos , Modelos Teóricos , Pandemias
19.
Int J Public Health ; 69: 1606626, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841538

RESUMEN

Objectives: This study aimed to describe the impact of COVID-19 on maternal and child health service utilization in the Eastern part of Ethiopia. Methods: Comparative analysis was used to examine 2 years of maternal and child health service utilization. Data were extracted from client registers. A traditional Expert Modeler and one-way Analysis of Variance were used to compare service utilization before and during the COVID-19 pandemic. Results: A total of 34,576 client records were reviewed, of which 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during the COVID-19 pandemic, respectively. The total client visit has shown a 2% percentage point increase. However, postnatal care and child immunization services showed a decrease. Moreover, there was a significant difference between service visits before and during COVID-19 (f = 4.6, p < 0.04). Conclusion: Mothers and children have missed or unattended facility appointments due to protective impositions or fear of getting infected with COVID-19, which might suggest a higher proportion of MCH issues were not addressed during the pandemic. The health system should therefore improve its resilience and strengthen its access at the lowest health care inlets.


Asunto(s)
COVID-19 , Aceptación de la Atención de Salud , Humanos , COVID-19/epidemiología , Etiopía/epidemiología , Femenino , Niño , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , SARS-CoV-2 , Preescolar , Lactante , Servicios de Salud del Niño/estadística & datos numéricos , Servicios de Salud Materno-Infantil/estadística & datos numéricos , Embarazo , Servicios de Salud Materna/estadística & datos numéricos , Masculino , Pandemias
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