Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.909
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-33167478

RESUMO

The outbreak of the COVID-19 pandemic has caused changes in the provision of psychotherapy around the world. The common format of delivering in-person psychotherapy is replaced by psychotherapy via the Internet to a great extent. This study examined how well Austrian psychotherapists feel informed about the use of the Internet in psychotherapy, where additional information needs exist, and which software is used. A link to an online survey was sent to all psychotherapists providing a valid email address in the official list of licensed psychotherapists at the start of the COVID-19 lockdown in Austria. A total of 1547 people took part in the survey. The results show that psychotherapy via the Internet was primarily offered via Skype and Zoom during the COVID-19 pandemic and that the majority of the therapists felt well-informed about psychotherapy via the Internet; however, several therapists stated that they wish to have further information on data protection and security. Overall, the study shows that Austrian psychotherapists coped well with the rapid change from the provision of psychotherapy through personal contact to psychotherapy via the Internet. Security and data protection aspects of therapy via the Internet should be addressed in training and further education of psychotherapists. As this study was conducted online, it might have caused some respondent bias towards a higher participation of psychotherapists with higher preference for new technologies.


Assuntos
Intervenção Baseada em Internet , Psicoterapia/educação , Psicoterapia/tendências , Telemedicina/tendências , Áustria , Betacoronavirus , Infecções por Coronavirus , Educação Continuada , Humanos , Pandemias , Pneumonia Viral
2.
Wien Med Wochenschr ; 170(15-16): 392-402, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33026541

RESUMO

Excessive iodine intake should be avoided in certain thyroid disorders, such as Graves' disease, Hashimoto's thyroiditis and thyroid goiter with autonomous nodules. Regarding alimentary iodine intake broad information can be found in the literature or the internet. Cure and rehabilitation therapy is used in many clinical settings, such as chronic degenerative disorders of the musculoskeletal system, rehabilitation after trauma, after treatment of malignant tumors and many others. Iodine intake with iodine-rich thermal water during cure and rehabilitation is possible and the extent depends in particular on the route of application and the duration of treatment. Information on this topic can be hardly found in the literature. This article analyses iodine-rich cure and rehabilitation treatment with iodine-rich thermal water from the point of view of the thyroid gland. The positive and possible negative effects of treatment with iodine-rich thermal water on thyroid function are elucidated. Apart from an insight into the physiology and pathophysiology of iodine metabolism, the extent of iodine intake during cure and rehabilitation treatment is presented depending on the route of application and the clinical implications for certain thyroid disorders are discussed. An overview of cure and rehabilitation centers in Austria and neighboring countries is given. In addition, an algorithm for the clinical selection of patients unsuitable for high iodine intake and who should thus avoid an iodine-rich cure or rehabilitation treatment is presented in order to assist clinicians in optimally selecting patients for cure or rehabilitation treatment with iodine-rich thermal water.


Assuntos
Bócio , Hipertireoidismo , Iodo , Doenças da Glândula Tireoide , Áustria , Humanos
3.
Artigo em Inglês | MEDLINE | ID: mdl-33114136

RESUMO

Objectives: COVID-19 has led to changes in the provision in mental health services. The current study investigated influencing factors on: (i) the comparability of psychotherapy via internet/telephone with psychotherapy in face-to-face contact as well as (ii) the actual experience with psychotherapy via internet/telephone compared to respective prior expectations in CBT therapists. Methods: A quantitative cross-sectional study was conducted in the form of an online survey. The research samples, registered cognitive-behavioral therapy (CBT) psychotherapists in Austria and Germany, were contacted by e-mail. Results: One hundred and ninety CBT therapists were analyzed in this study. The total number of patients treated via telephone/internet is a decisive factor for the subjective evaluation of the comparability of psychotherapy via telephone/internet and psychotherapy in personal contact. This factor also influences the extent (positive/negative) of the assessment of the actual experience with psychotherapy via internet/telephone compared to previous expectations. Neither age nor gender were associated with comparability of psychotherapy via internet/telephone with psychotherapy in face-to-face contact or the actual experience with psychotherapy via internet/telephone compared to respective prior expectations. Conclusions: Implications of the results are that attitudes towards remote psychotherapy might be increased in CBT therapists when they treat more patients remotely and experiences with remote psychotherapies should be included in psychotherapy training.


Assuntos
Terapia Cognitivo-Comportamental , Infecções por Coronavirus , Motivação , Pandemias , Pneumonia Viral , Psicoterapia , Telemedicina , Áustria , Betacoronavirus , Estudos Transversais , Alemanha , Humanos , Internet , Telefone
5.
Med Klin Intensivmed Notfmed ; 115(8): 633-640, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33044656

RESUMO

Intensivists are confronted with a broad spectrum of specific clinical problems while caring for critically ill cancer patients. These include defining proper goals of intensive care treatment, managing acute respiratory failure with diverse differential considerations, treating immunologic side-effects of ever new and innovative cancer therapies, as well as numerous clinical scenarios which may exclusively arise in cancer patients. To help clinicians handle such challenges, the initiative Intensive Care in Hematologic and Oncologic Patients (iCHOP) has been dealing with these topics for several years. Supported by several Austrian and German medical societies of intensive care medicine, hematology and oncology, the first "Consensus statement for cancer patients requiring intensive care support" has only recently been released. Acute respiratory failure and its management continues to be a major focus in critically ill cancer patients due to its frequency and its prognostic impact. While noninvasive oxygenation strategies were considered the gold standard of therapy, more recent high-quality data do not show clinical benefits of such techniques including high flow nasal oxygen. On the contrary, several studies revealed an unidentified etiology of an acute respiratory failure as the only potentially modifiable risk factor for adverse outcome. Consequently, evidence-based and rigorously applied diagnostic algorithms are of utmost importance in these patients. Furthermore, intensivists are increasingly confronted with the rising incidence of various and new immunotherapy-associated toxicities and their management.


Assuntos
Síndrome do Desconforto Respiratório do Adulto , Tabu , Áustria , Cuidados Críticos , Estado Terminal , Humanos
6.
Medicine (Baltimore) ; 99(40): e22623, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019485

RESUMO

PURPOSE: To identify the 100 most cited research articles on cervical cancer radiotherapy. METHODS: The Web of Science and Scopus databases were searched to identify the 100 most cited articles on cervical cancer radiotherapy as of September 29, 2019. Articles were ranked based on the total citations received from 2 databases. One hundred articles about radiotherapy for cervical cancer were identified. The following important information was extracted: author, journal, year and month of publication, country or region, and radiotherapy technologies. RESULTS: The 100 most cited articles on cervical cancer radiotherapy were published between 1964 and 2016, and the total citations from 2 databases ranged from 3478 to 211, including a total of 49,262 citations as of September 29, 2019. The index of citations per year ranged from 170.4 to 13.1. These articles were from 16 countries or regions, with most publications being from the United States (n = 38), followed by Austria (n = 15), Canada (n = 8), France (n = 8) and the United Kingdom (n = 7). The International Journal of Radiation Oncology, Biology, Physics produced the most articles (n = 42), followed by Radiotherapy and Oncology (n = 13), Cancer (n = 8) and Journal of Clinical Oncology (n = 7). These articles were categorized as original studies (n = 86), recommendations (n = 5), guidelines (n = 5) and reviews (n = 4). Of the 100 most cited articles, intracavitary brachytherapy (n = 50) and 3-dimensional conformal radiotherapy (n = 34) were the most commonly used treatment techniques. CONCLUSION: To the best of our knowledge, this is the first report and analysis of the most cited articles on cervical cancer radiotherapy. This bibliographic study presents the history of technological development in external radiation therapy and brachytherapy. Brachytherapy is an indispensable part of radiotherapy for cervical cancer. The International Journal of Radiation Oncology Biology Physics is the journal with the most publications related to cervical cancer radiotherapy.


Assuntos
Braquiterapia/métodos , Publicações/estatística & dados numéricos , Neoplasias do Colo do Útero/radioterapia , Áustria/epidemiologia , Bibliometria , Biologia/estatística & dados numéricos , Canadá/epidemiologia , Bases de Dados Factuais , Feminino , França/epidemiologia , Humanos , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Física/estatística & dados numéricos , Publicações/tendências , Radioterapia (Especialidade)/estatística & dados numéricos , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
7.
Zootaxa ; 4783(1): zootaxa.4783.1.1, 2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-33056509

RESUMO

A checklist of the oribatid mites from Vorarlberg (Austria) which covers all published records and hitherto unpublished results of additional collecting is presented. Several species are revised, doubtful and erroneous records from previous publications are discussed and corrected. At present a total of 327 described species are known from Vorarlberg, complemented by three subspecific taxa and two undetermined or undescribed species, altogether from 61 families. A total of 96 species (including 3 subspecific taxa) are newly reported from Vorarlberg, among them 16 species are new records for Austria. The compilation includes the occurrence of each species in different vegetation units and habitats of Vorarlberg, their known distribution in Austria and the neighbouring Alps, Switzerland and Southern Germany, as well as their general distribution. Occasional additional remarks give taxonomic and other information. A historical overview of the exploration of the oribatid mites in Vorarlberg is outlined. The general distribution of the oribatid mite fauna of Vorarlberg is analysed. Remarkable results are, among others, the findings of some mostly rare species which were described by Schweizer and Mahunka Mahunka-Papp from Switzerland as well as species restricted to the Alps, mainly in higher montane regions.


Assuntos
Ácaros , Animais , Áustria , Ecossistema
8.
Zootaxa ; 4798(1): zootaxa.4798.1.1, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-33056685

RESUMO

In this paper we revise the chordeumatidan genus Haasea Verhoeff, 1895 for the first time and describe two new species viz., H. gruberi sp. nov. and H. makarovi sp. nov. discovered in Austria and Serbia, respectively. A new terminology is proposed to standardize the description of the gonopod structures in the genus. Type material obtained from several institutions was examined and documented herein, whereby lectotypes are designated. We clarified the taxonomic status of a few taxa and consider the species H. norica (Verhoeff, 1913) and H. guidononveilleri Makarov, 2008 as a junior subjective synonyms of H. cyanopida (Attems, 1903) and H. vidinensis (Strasser, 1973a), respectively. The following subspecies or varieties, viz., Orobainosoma filicis ossiacum Verhoeff, 1939b, Orobainosoma flavescens vornatscheri Verhoeff, 1935, Orobainosoma hungaricum orientale Tabacaru, 1965, and Orobainosoma inflatum var. aspidiorum Verhoeff, 1929 are here regarded as junior subjective synonyms of their nominal taxa. The taxonomic relationships within the genus Haasea are discussed and an identification key to its 17 species is presented, based on number of body segments and gonopod structures.                Maps showing species occurences based on historical and recent records are presented to understand their respective geographic ranges. H. flavescens is now deleted from the list of species in Croatia, Bosnia and Herzegovina, Slovenia and Italy as these records were based on misidentified material. H. inflata is deleted from the fauna of Bosnia and Herzegovina, whereas H. hungarica is newly recorded from Austria, Serbia and Slovenia.


Assuntos
Invertebrados , Animais , Áustria , Sérvia
9.
Wien Klin Wochenschr ; 132(Suppl 4): 115-152, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-33048212

RESUMO

The first regulations of the healthcare system in the domains and cities of the German Empire were the infection and plague regulations issued in many places from the sixteenth century onwards; however, as early as 1348 the Venetian state formed precise state structures to combat the black death that had broken out in Europe at the time. These were taken over analogously and in part in the Austrian states. Defense measures against the plague became particularly important on the k. k. (imperial-royal) military frontier against the Ottoman Empire. Under Empress Maria Theresa's enlightened absolutism, the state felt obliged to provide the largest possible healthy population with the help of the medical police. The fight against smallpox in Austria is described as an example. Through the collaboration of Maria Theresia with her protomedicus Gerard van Swieten, a codification of the k. k. healthcare system was created. As a quasi preliminary attempt the Empress proclaimed the Main Medical Regulations for Bohemia in 1753, which were supplemented 2 years later by the General Health Regulations for the Austrian Littoral. The result was the comprehensive medical standard for all hereditary lands from 1770. This brought about a regulation of all healthcare professions and their use for public health. Maria Theresa's son and successor introduced a further development of the administration in the direction of centralization and promotion of social conditions and humanitarian institutions, such as hospitals, infirmaries, childbirth houses and madhouses as well as foundling institutions and orphanages and poor and workhouses as special institutions. He was also very interested in promoting military medicine. The last major step in the development of the Austrian public healthcare system was the Imperial Sanitary Act of 1870. This is also the basis for the current structure of healthcare administration. The sanitary tasks are (and were) regulated in the legislation and enforcement of the (k.k.) State, and the federal states (kingdoms and countries represented in the Imperial Assembly) and the municipalities in, however, still existing complex division of some affairs between federal, state and local authorities.


Assuntos
Assistência à Saúde/história , Saúde Pública/história , Áustria , Europa (Continente) , História do Século XVIII , História do Século XIX , Humanos
10.
Int J Gynecol Cancer ; 30(11): 1667-1671, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33033166

RESUMO

BACKGROUND: On March 16, 2020, the federal government of Austria declared a nationwide lockdown due to the COVID-19 pandemic. Since the lockdown, screening examinations and routine checkups have been restricted to prevent the spread of the virus and to increase the hospitals' bed capacity across the country. This resulted in a severe decline of patient referrals to the hospitals. OBJECTIVE: To assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological and breast cancers in Austria. METHODS: Data of 2077 patients from 18 centers in Austria with newly diagnosed gynecological or breast cancer between January and May 2019 and January and May 2020 were collected. Clinical parameters, including symptoms, performance status, co-morbidities, and referral status, were compared between the time before and after the COVID-19 outbreak. RESULTS: Our results showed a slight increase of newly diagnosed cancers in January and February 2020 as compared with 2019 (+2 and +35%, respectively) and a strong decline in newly diagnosed tumors since the lockdown: -24% in March 2020 versus March 2019, -49% in April 2020 versus April 2019, -49% in May 2020 versus May 2019. Two-thirds of patients diagnosed during the pandemic presented with tumor-specific symptoms compared with less than 50% before the pandemic (p<0.001). Moreover, almost 50% of patients in 2020 had no co-morbidities compared with 35% in 2019 (p<0.001). Patients, who already had a malignant disease, were rarely diagnosed with a new cancer in 2020 as compared with 2019 (11% vs 6%; p<0.001). CONCLUSIONS: The lockdown led to a decreased number of newly diagnosed gynecological and breast cancers. The decreased accessibility of the medical services and postponed diagnosis of potentially curable cancers during the COVID-19 pandemic may be a step backwards in our healthcare system and might impair cancer treatment outcomes. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future.


Assuntos
Neoplasias da Mama/epidemiologia , Infecções por Coronavirus , Neoplasias dos Genitais Femininos/epidemiologia , Pandemias , Pneumonia Viral , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/terapia , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
11.
J Environ Manage ; 276: 111194, 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-32891036

RESUMO

Mountain environments provide habitats for many wild animal species and are of great importance to recreational activities. In the European Alps, winter recreation activities such as ski mountaineering are becoming increasingly popular, which may lead more often to disturbance of Alpine wildlife. Assessment of ski mountaineering activities and related potential conflict zones is needed to implement protection measures and to guide skiers towards nature-friendly behaviour in sensitive locations. Yet basic data regarding frequencies of ski mountaineers is still missing at regional scale. For the Region of the Tyrol (Austria), this study therefore aimed to advance methods of assessing ski mountaineering activities for use in the spatial analysis of conflict zones with grouse species. We overlaid high-resolution information on the spatial and temporal distribution of ski mountaineers from crowd-sourced data (Strava) with distribution maps of capercaillie (Tetrao urogallus L.) and black grouse (Tetrao tetrix L.). Our results indicate that ski mountaineering activities affected 10.3% of the distribution area of black grouse and 8.6% of the distribution area of capercaillie. The raw crowd-sourced data was pre-processed with local information on skiing resorts, cross-country trails and infrastructure and use of the tested method was validated, with good spatial resolution (0.076 km2 per minimum mapping unit) for large study areas. We identified four intensity classes of ski mountaineering activity, which were randomly distributed in the study area. The spatial distribution of ski mountaineering activities showed an accumulation of activities in the south of the Inn valley. Our results could provide a valuable basis for developing mitigation measures and strategies in order to reduce the disturbance of Alpine wildlife by ski mountaineering.


Assuntos
Galliformes , Montanhismo , Esqui , Animais , Animais Selvagens , Áustria , Atividades Humanas , Humanos , Estações do Ano
12.
Gesundheitswesen ; 82(11): 885-889, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-32977345

RESUMO

BACKGROUND: Despite considerable progress in the fight against tuberculosis, it is still the most deadly bacterial infectious disease worldwide. Every year, up to 10 million people worldwide still die of tuberculosis. The World Health Assembly has set itself the goal of reducing the number of tuberculosis deaths by 90% and the number of new infections by 80% by 2030. Prevention and infection control measures in public health facilities and wherever the risk of transmission of the tuberculosis bacterium "Mycobacterium tuberculosis" is high are especially important. OBJECTIVE: The aim of the guideline is to provide updated and evidence-based recommendations for public health measures to prevent the spread of the tuberculosis bacterium in clinical settings and in tuberculosis management. METHODOLOGY: The World Health Organization (WHO) developed these recommendations according to the methods outlined in the WHO handbook for guideline development. This publication is a summary of the most important aspects of this guideline translated into German by members of the WHO Collaborating Centre at the Danube University Krems (Austria). RESULTS: This guideline takes into account the current evidence base and provides recommendations and comments on the implementation of tuberculosis prevention and control measures at the level of health care institutions and at the national level.


Assuntos
Tuberculose , Áustria/epidemiologia , Alemanha/epidemiologia , Humanos , Controle de Infecções , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Organização Mundial da Saúde
14.
Z Evid Fortbild Qual Gesundhwes ; 156-157: 11-23, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32980282

RESUMO

INTRODUCTION: To give an overview of patient-reported outcome measures (PROMs) programs in routine cancer care that allow for both major purposes of PROM assessment: 1) monitoring of an individual patient's outcome to assist treatment decision making, and 2) use in quality improvement initiatives including the benchmarking of providers. We synthesize information on program elements like the mode of assessment and questionnaire used, as well as information relevant for adaptation following a PDCA scheme. METHOD: We carried out a systematic literature research in the databases PubMed and EMBASE using MeSH terms and keywords related to PROM assessment in routine cancer care to identify eligible studies published between January 2003 and November 2018 (PROSPERO reg. no. CRD42019141402). We included studies in which PROM assessment programs had been reported as being implemented in clinical practice as well as collected multicentrically with at least one site in Europe and in which PROMs had been collected before and at least once after intervention. Study authors were queried to verify or correct the program elements extracted and merged during the review. Study quality assessment was not done, since it is not expedient for the objective of this review. RESULTS: Overall, 5,545 unique references were identified, 5,416 of which were excluded after the screening of titles and abstracts. Of the 29 references assessed, five programs were identified and included in the synthesis. The programs included those from Germany, Austria, Denmark, the Netherlands and the UK, and patients with different cancer types and tumor stages, which used paper-based or purely electronic PROM assessment. DISCUSSION AND CONCLUSION: Few reports have so far been published on PROM programs that allow for both the monitoring of an individual patient's outcome and use in quality improvement initiatives. The studies revealed relevant information on existing PROM programs and gave valuable insight into issues that need to be considered when setting up such an infrastructure. Some critical issues, however, were hardly addressed, among them costs, staff resources and methods of reporting and responding.


Assuntos
Neoplasias , Medidas de Resultados Relatados pelo Paciente , Áustria , Europa (Continente) , Alemanha , Humanos , Neoplasias/terapia , Países Baixos
15.
Wien Klin Wochenschr ; 132(Suppl 3): 89-113, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32990821

RESUMO

Scientific Members of the Austrian Society of Pneumology describe the expected development in respiratory health and provide guidance towards patient-oriented and cost-efficient respiratory care in Austria.Methods: In November 2017, respiratory care providers (physicians, nurses, physiotherapists) together with patient's advocacy groups and experts in health development, collaborated in workshops on: respiratory health and the environment, bronchial asthma and allergy, COPD, pediatric respiratory disease, respiratory infections, sleep disorders, interventional pneumology, thoracic oncology and orphan diseases.Results: Respiratory disease is extremely prevalent and driven by ill-health behavior, i.e. cigarette smoking, over-eating and physical inactivity. For the majority of respiratory diseases increased prevalence, but decreased hospitalizations are expected.The following measures should be implemented to deal with future challenges:1. Screening and case-finding should be implemented for lung cancer and COPD.2. E-health solutions (telemedicine, personal apps) should be used to facilitate patient management.3. Regional differences in respiratory care should be reduced through E­health and harmonization of health insurance benefits across Austria.4. Patient education and awareness, to reduce respiratory health illiteracy should be increased, which is essential for sleep disorders but relevant also for other respiratory diseases.5. Respiratory care should be inter-professional, provided via disease-specific boards beyond lung cancer (for ILDs, sleep, allergy)6. Programs for outpatient's pulmonary rehabilitation can have a major impact on respiratory health.7. Increased understanding of molecular pathways will drive personalized medicine, targeted therapy (for asthma, lung cancer) and subsequently health care costs.


Assuntos
Pneumopatias Obstrutivas , Pneumologia , Transtornos Respiratórios , Asma/terapia , Áustria , Criança , Efeitos Psicossociais da Doença , Humanos , Pneumopatias Obstrutivas/terapia , Doença Pulmonar Obstrutiva Crônica , Pneumologia/normas , Pneumologia/tendências , Transtornos Respiratórios/terapia , Sociedades Médicas
16.
Prax Kinderpsychol Kinderpsychiatr ; 69(6): 590-602, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32988307

RESUMO

Therapeutic Models for Children and Adolescents with Gender Dysphoria: Overview with Focus on Austrian Treatment Reality Young people whose experienced gender differs from their aligned sex are increasingly visible in public life as well as in the medical care system. For those children and adolescents, who can experience a high degree of suffering because of the discrepancy between aligned sex and desired gender, treatment guidelines have been developed. In this short narrative review, classification options, epidemiological data, health-care data and treatment guidelines are presented with an emphasis on the Austrian health care system.


Assuntos
Disforia de Gênero/terapia , Adolescente , Áustria , Criança , Identidade de Gênero , Humanos
17.
PLoS One ; 15(9): e0239801, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970774

RESUMO

While hospital admissions for myocardial infarction (MI) and pulmonary embolism (PE) are decreased during the COVID-19 pandemic, controversy remains about respective complication and mortality rates. This study evaluated admission rates, complications, and intrahospital mortality for selected life-threatening cardiovascular emergencies (MI, PE, and acute aortic dissection (AAD)) during COVID-19-associated restrictive social measures (RM) in Styria, Austria. By screening a patient information system for International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis codes covering more than 85% of acute hospital admissions in the state of Styria (~1.24 million inhabitants), we retrospectively identified patients with admission diagnoses for MI (I21, I22), PE (I26), and AAD (I71). Rates of complications such as cardiogenic shock and cardiopulmonary resuscitation, treatment escalations (thrombolysis for PE), and mortality were analyzed by patient chart review during 6 weeks following onset of COVID-19 associated RM, and during respective time frames in the years 2016 to 2019. 1,668 patients were included. Cumulative admissions for MI, PE and AAD decreased (RR 0.77; p<0.001) during RM compared to previous years. In contrast, intrahospital mortality increased by 65% (RR 1.65; p = 0.041), mainly driven by mortality following MI (RR 1.80; p = 0.042). PE patients received more frequently thrombolysis treatment (RR 3.63; p = 0.006), while rates of cardiogenic shock and cardiopulmonary resuscitation remained unchanged. Of 226 patients hospitalized during RM, 81 patients with suspected COVID-19 disease were screened for SARS-CoV-2 infection with only 5 testing positive. Thus, cumulative hospital admissions for cardiovascular emergencies decreased during COVID-19 associated RM while intrahospital mortality increased.


Assuntos
Aneurisma Dissecante/mortalidade , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Infarto do Miocárdio/mortalidade , Pneumonia Viral/epidemiologia , Embolia Pulmonar/mortalidade , Idoso , Idoso de 80 Anos ou mais , Áustria , Betacoronavirus , Serviço Hospitalar de Emergência/tendências , Feminino , Mortalidade Hospitalar/tendências , Hospitalização/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos
18.
Pflege ; 33(5): 319-328, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32996864

RESUMO

The process of medication self-management: a model revision based on a qualitative secondary analysis Abstract. Background: For safe and effective use of medication, specific skills are required which are inherent in the concept of medication self-management. In order to provide adequate counseling, it is important for registered nurses, physicians and pharmacists to know how medication self-management works in everyday life for the people affected. This process was presented in 2013 in a first conceptual model by Bailey et al. Aim: The purpose of this study was to enhance the empirical foundation of the existing model and to gain an in-depth theoretical understanding of the process of medication self-management. METHOD: A qualitative secondary analysis was conducted based on data from a semi-standardized survey (n = 395) of people in Austria, who regularly take medicine. The data were analysed according to the structuring content analysis. RESULTS: The extended model shows a new kind of logic. While the steps "fill", "take", "monitor" and "react" are always conducted one after the other, "integrate" and "maintain" form components that are mutually dependent and start after successfully completing the first four steps. "Understand" is a component that influences all steps. The whole process is influenced by personal, socio-economic, disease and medication-related factors, by supportive systems and by the overall health care system. CONCLUSIONS: Based on the present study, the drug self-management process is a complex, multi-layered and iterative one. In the context of counselling, it is important to focus on "understanding" at every step.


Assuntos
Adesão à Medicação/psicologia , Autogestão/psicologia , Áustria , Humanos , Modelos Psicológicos , Pesquisa Qualitativa
19.
ESMO Open ; 5(5)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32878898

RESUMO

BACKGROUND: During the COVID-19 outbreak, healthcare professionals (HCP) are at the frontline of clinical management and at increased risk for infection. The SARS-CoV-2 seroprevalence of oncological HCP and their patients has significant implications for oncological care. METHODS: HCP and patients with cancer at the Division of Oncology, Medical University of Vienna were included between 21 March and 4 June and tested for total antibodies against SARS-CoV-2 employing the Roche Elecsys Anti-SARS-CoV-2 immunoassay. Reactive samples were confirmed or disproved by the Abbott SARS-CoV-2 IgG test. Additionally, a structured questionnaire regarding basic demographic parameters, travel history and COVID-19-associated symptoms had to be completed by HCP. RESULTS: 146 subjects (62 HCP and 84 patients with cancer) were enrolled. In the oncological HCP cohort, 20 (32.3%) subjects were medical oncologists, 28 (45.2%) nurses at our ward and 14 (22.6%) fulfil other functions such as study coordinators. In the patient cohort, most individuals are on active anticancer treatment (96.4%). 26% of the HCP and 6% of the patients had symptoms potentially associated with COVID-19 since the end of February 2020. However, only in 2 (3.2%) HCP and in 3 (3.6%) patients, anti-SARS-Cov-2 total antibodies were detected. The second assay for anti-SARS-Cov-2 IgG antibodies confirmed the positive result in all HCP and in 2 (2.4%) patients, suggesting an initial assay's unspecific reaction in one case. In individuals with a confirmed test result, an active COVID-19 infection was documented by a positive SARS-CoV-2 RNA PCR test. CONCLUSION: Specific anti-SARS-CoV-2 antibodies were found solely in persons after a documented SARS-CoV-2 viral infection, thus supporting the test methods' high sensitivity and specificity. The low prevalence of anti-SARS-CoV-2 antibodies in our cohorts indicates a lack of immunity against SARS-CoV-2. It highlights the need for continued strict safety measures to prevent uncontrolled viral spread among oncological HCPs and patients with cancer.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Corpo Clínico Hospitalar , Serviço Hospitalar de Oncologia , Pacientes , Pneumonia Viral/diagnóstico , Testes Sorológicos , Centros de Atenção Terciária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Betacoronavirus/patogenicidade , Biomarcadores/sangue , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Interações Hospedeiro-Patógeno , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital , Oncologistas , Enfermagem Oncológica , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
20.
Prax Kinderpsychol Kinderpsychiatr ; 69(5): 443-462, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32886045

RESUMO

Supporting Children of Parents With a Mental Illness: State of Research and Two Practice Approaches and Claims for the Government Children of parents with a mental illness (COPMI) are at an increased risk to develop (severe) mental disorders (SMI) themselves. Estimates for Germany result in about 25 % of COPMI. This is thus a large and high risk group. On the other hand, prevention programs for COPMI are still scarce, especially in Germany, and central features of the transgenerational transmission of mental disorders have not been studied in conjunction to shed light on potential transmission mechanisms. The current article presents two current research projects on COPMI focusing on preventive approaches. The BMBF funded project "Children of Parents with a Mental Illness At Risk Evaluation" (COMPARE) targets parents of children aged 1.5 to 16 years of age. Parents need to fulfil a current DSM-5 based diagnosis of a mental disorder and then receive either 25-45 sessions gold standard cognitive behavioural therapy (CBT) or CBT plus 10 sessions Positive Parenting Program (PPP) to test the effects of parental therapy on the children and whether an additional parent training results in incremental effects above and beyond CBT alone. The project "The Village" is a model project in the region Tyrol, Austria, targeting the improved identification and collaborative care of COPMI.


Assuntos
Filho de Pais Incapacitados/psicologia , Terapia Cognitivo-Comportamental , Governo , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Pais/psicologia , Adolescente , Adulto , Áustria , Criança , Pré-Escolar , Suscetibilidade a Doenças , Alemanha , Humanos , Lactente , Transtornos Mentais/diagnóstico , Poder Familiar/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA