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1.
Rev. enferm. UERJ ; 28: e45920, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1097273

RESUMO

Objetivo: analisar a associação entre os riscos ocupacionais e os danos relacionados ao trabalho de enfermagem em sala de vacinação. Método: estudo transversal analítico realizado em salas de vacinação de unidades de atenção primária à saúde entre junho e julho de 2017, com 171 trabalhadores de enfermagem. Utilizou-se um instrumento com informações sobre dados sociodemográficos, laborais e riscos ocupacionais e a Escala de Avaliação dos Danos Relacionados ao Trabalho. Estudo aprovado pelo Comitê de Ética em Pesquisa. Resultados: a exposição ocupacional aos riscos físico e ergonômico esteve associada a todas as formas de adoecimento investigadas, enquanto que a exposição ao risco mecânico às formas de adoecimento relacionadas aos danos físicos e psicológicos. A exposição ao risco químico associou-se ao adoecimento físico. Conclusão: as condições de trabalho a que os profissionais da enfermagem são expostos nas salas de vacinação, expressadas em riscos ocupacionais, são associadas a danos à sua saúde.


Objective: to analyze the association between occupational risks and damages related to nursing work in the vaccination room. Method: analytical cross-sectional study conducted in the vaccination rooms of primary health care units in the city of Rio de Janeiro between June and July 2017, with 171 nursing workers. An instrument was used with information on sociodemographic, occupational and occupational risk data and the Work-Related Damage Assessment Scale. The study was approved by the research ethics committee. Results: occupational exposure to physical and ergonomic risk were associated with all forms of illness investigated, while exposure to mechanical risk to forms of illness related to Physical and Psychological Damage Exposure to chemical risk was associated to physical illness. Conclusion: the working conditions to which nursing professionals are exposed in vaccination room, expressed in occupational risks, negatively affect their health.


Objetivo: analizar la asociación entre riesgos laborales y daños relacionados con el trabajo de enfermería en la sala de vacunación. Método: estudio transversal analítico realizado en las salas de vacunación de las unidades de atención primaria de salud de la ciudad de Río de Janeiro entre junio y julio de 2017, con 171 trabajadores de enfermería. Se utilizó un instrumento con información sobre datos sociodemográficos, laborales y de riesgos laborales y la Escala de evaluación de daños relacionados con el trabajo. El estudio fue aprobado por el comité de ética de investigación. Resultados: la exposición ocupacional al riesgo físico y ergonómico se asoció con todas las formas de enfermedad investigadas, mientras que la exposición al riesgo mecánico a las formas de enfermedad relacionadas con el daño físico y psicológico La exposición al riesgo químico se asoció a la enfermedad física. Conclusión: las condiciones de trabajo a las que están expuestos los profesionales de enfermería en la sala de vacunación, expresados en riesgos laborales, afectan negativamente su salud.


Assuntos
Humanos , Masculino , Feminino , Adulto , Atenção Primária à Saúde , Exposição Ocupacional , Vacinação , Recursos Humanos de Enfermagem , Doenças Profissionais , Condições de Trabalho , Brasil , Estudos Transversais , Técnicos de Enfermagem , Enfermeiras e Enfermeiros , Assistentes de Enfermagem
2.
Rev. esp. med. legal ; 46(3): 146-152, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192316

RESUMO

España ha sido uno de los países con mayor afectación por la pandemia COVID-19. Hasta la fecha, un 22% de los casos notificados son personal sanitario, siendo significativamente mayor este porcentaje entre las mujeres (76% del personal sanitario contagiado). Ante la evidencia de que muchos profesionales sanitarios pueden haberse contagiado en su puesto de trabajo, hemos revisado la problemática en el ámbito de la salud laboral que produce la COVID-19. Se describen los decretos publicados por el Gobierno de España y las recomendaciones de la Organización Internacional del Trabajo. Concretamente se analiza la clasificación del SARS-CoV-2 como agente biológico del grupo 3, su calificación como accidente de trabajo o enfermedad profesional y sus repercusiones en las situaciones de incapacidades (temporales y permanentes), secuelas y muerte, así como el estudio de las posibles demandas de aquellos que lo han sufrido como consecuencia de falta de medidas preventivas


Spain is one of the countries most affected by the COVID-19 pandemic. To date, 22% of reported cases are healthcare professionals, and 76% of them are women. Given that many healthcare professionals may have been infected in their workplace, we have reviewed the occupational health challenges posed by COVID-19. The Spanish laws and the recommendations of the International Labor Organization are described. The review covers the classification of SARS-CoV-2 as a biological agent in group 3 and of COVID-19 as an occupational accident or disease, its repercussions in temporary and permanent disabilities, sequelae and death, and the possible claims of those who may have developed the disease due to the lack of preventive measures


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Exposição Ocupacional/legislação & jurisprudência , Licença Médica/legislação & jurisprudência , Doenças Profissionais/epidemiologia , Precauções Universais/legislação & jurisprudência , Controle de Doenças Transmissíveis/legislação & jurisprudência , Pessoal de Saúde/estatística & dados numéricos
3.
Med Lav ; 111(4): 249-268, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32869763

RESUMO

BACKGROUND: Criteria for diagnosis and compensation of occupational musculoskeletal diseases varies widely between countries as demonstrated by the large differences between countries with comparable economics and social systems (for example, within the European Union). Several countries have a list of occupational diseases and sometimes these lists include diagnostic and attribution criteria, but these criteria are usually not very specific, and they may also be very different. OBJECTIVES: The aim of this paper is to explicitly define what are the information needed for an evidence-based diagnosis and attribution of an occupational musculoskeletal disease. METHODS: Based on the general framework of evidence-based medicine, a review is presented of the information required to define: - when a musculoskeletal disease is present, according to the best available techniques; - how to define a relevant exposure to biomechanical risk factors, according to the best available techniques. RESULTS: Criteria are presented to combine information regarding the diagnosis of a musculoskeletal disease and exposure to biomechanical risk factors for an evidence-based attribution of the disease to the occupational exposure. The criteria use a probabilistic model that combine epidemiologic and medical findings, workplace exposure assessment, and non-occupational factors evaluation. DISCUSSION: The use of the proposed criteria may improve the process of diagnosis and attribution of an occupational musculoskeletal disease. In addition, it makes possible to associate a probability rank to the attribution and, ultimately, it may improve the overall quality of the decisional process of the occupational physician.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , Exposição Ocupacional , Humanos , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/etiologia , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Fatores de Risco , Local de Trabalho
4.
Med Probl Perform Art ; 35(3): 153-161, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32870967

RESUMO

AIMS: Playing-related musculoskeletal disorders (PRMDs) are a significant health concern for percussionists. Although many of the known risk factors for PRMDs likely apply to all percussion subgroups (e.g., weekly practice hours, warm-ups/cool-downs, etc.), the rates and injury patterns in drummers (herein defined as 'percussionists who play the drum set') may differ due to differences in physical demands from those of other percussion subgroups. The goal of this study was to determine the drummer-specific rates and patterns of PRMDs. METHODS: An electronic survey including questions on respondent demographics, history and patterns of PRMDs, and potential drummer-specific risk factors for reporting PRMDs was distributed via social media using a snowball sampling technique. The target population included individuals aged 18 years or older who exclusively played the drum set (minimum 5 hrs/wk). The rates of PRMDs were analyzed by body region (e.g., upper/lower limb, etc.) and by location within body regions (e.g., shoulder, knee joint, etc.). RESULTS: The lifetime history of PRMDs in the study sample (n=831) was 68%, and 23% reported currently experiencing a PRMD. Most respondents reported multiple PRMDs (59%). The upper limb was the most commonly-affected body region (59%). The wrist joint (25%) and low back (24%) were the most commonly affected locations within body regions. CONCLUSIONS: Drummers' reporting of multiple PRMDs is consistent with previous findings in percussionists, but differences in the lifetime histories and patterns of injury supports the notion that risk factors may differ between percussion subgroups. Analysis of survey responses pertaining to drummer-specific risk factors is currently underway.


Assuntos
Doenças Musculoesqueléticas , Música , Doenças Profissionais , Adolescente , Adulto , Humanos , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
5.
Med Probl Perform Art ; 35(3): 162-166, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32870968

RESUMO

AIMS: Among musicians, string players have the highest prevalence for musculoskeletal overuse. Playing a violin or viola requires rapid, repetitive, and complicated movements of the hands and fingers. This cross-sectional study aimed to examine whether violin/viola, violin/cello, and violin/French horn players experience more intense musculoskeletal pain than other instrumentalists. METHODS: The study sample consisted of 590 orchestra musicians (354 male, 236 female, mean age 36 yrs). Self-administered questionnaires were used to assess pain of the back, neck, shoulder, face, jaw, and upper extremity. Pain intensity during the last 7 days was measured by an 11-point numeric rating scale (NRS) with a score from 0 to 10, as well as was disadvantage at work and leisure. RESULTS: Of the interviewed musicians, 20% presented playing-related musculoskeletal disorders at the time of the interview. Compared to other professional orchestra musicians, violin and viola players reported significantly more intense pain in the hand during the last week. Also, they had experienced more frequent neck pain ever and in 5 years than the others. During the past 30 days, violin and viola players had also perceived more harm in their upper limb joints. Violin/cello and violin/French horn players did not differ from the others. CONCLUSIONS: Our study showed that musicians playing the violin or viola have more intense hand pain and more frequent neck pain than other musicians, but these seem to disturb their daily tasks only a little.


Assuntos
Dor Musculoesquelética , Música , Cervicalgia , Doenças Profissionais , Adulto , Braço , Estudos Transversais , Feminino , Humanos , Masculino
7.
Med Probl Perform Art ; 35(3): 167-179, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32886734

RESUMO

AIMS: Classical guitarists may experience unique occupational health problems due to a constellation of biopsychosocial demands associated with the physical characteristics of the classical guitar, performance techniques, repertoire, and performance practices consistent with the classical music genre. Unfortunately, epidemiologic studies of classical guitarists are limited. The purpose of this study was to examine musculoskeletal and non-musculoskeletal problems in classical guitarists. METHODS: A sample of 190 classical guitarists completed a web-based survey. The survey assessed demographics, music-related variables, musician identity, non-musculoskeletal problems, and site-specific pain. Novel interactive body and hand maps were deployed to assess site-specific frequency, intensity, influence on playing, and quality of pain. RESULTS: A total of 168 subjects (88.9%) reported experiencing classical guitar-related pain in the past year at one or more musculoskeletal sites. The left thenar (25%) was the most prevalent pain site. Pain at the right upper back was reported to influence performance the most. Classical guitarists reported problems with non-musculoskeletal problems at rates similar or higher to other instrument-specific groups. CONCLUSION: Classical guitarists are an understudied group of musicians who experience occupational health problems. The novel assessment protocols developed for this study produced outcomes that may be helpful to both clinicians and pedagogues.


Assuntos
Doenças Musculoesqueléticas , Música , Doenças Profissionais , Saúde do Trabalhador , Humanos , Dor , Prevalência , Inquéritos e Questionários
8.
J Bras Nefrol ; 42(2 suppl 1): 4-8, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877490

RESUMO

The Covid-19 pandemic brought several challenges to the healthcare system: diagnosis, treatment and measures to prevent the spread of the disease. With the greater availability and variety of diagnostic tests, it is essential to properly interpret them. This paper intends to help dialysis units concerning the use of clinical criteria and diagnostic tests for decision making regarding the discontinuation of isolation of patients with suspected or confirmed Covid-19, as well as the return to work activities for employees with suspected or confirmed Covid-19.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Nefrologia/normas , Pneumonia Viral/diagnóstico , Diálise Renal , Retorno ao Trabalho , Algoritmos , Brasil , Lista de Checagem , Tomada de Decisão Clínica , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/epidemiologia , Humanos , Doenças Profissionais/diagnóstico , Pandemias , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase em Tempo Real/normas , Sociedades Médicas/normas , Unidade Hospitalar de Urologia/normas
9.
J Bras Nefrol ; 42(2 suppl 1): 9-11, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877491

RESUMO

These recommendations were created after the publication of informative note 3/2020- CGGAP/DESF/SAPS/MS, of April 4, 2020, in which the Brazilian Ministry of Health recommended the use of a cloth mask by the population, in public places. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. The present recommendations have eleven items, related to this rationale, the procedures, indications, contraindications, as well as appropriate fabrics for the mask, and hygiene care to be adopted. These recommendations may change, at any time, in the light of new evidence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Máscaras/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Diálise Renal , Têxteis , Brasil , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Humanos , Nefrologia/normas , Doenças Profissionais/prevenção & controle , Pneumonia Viral/epidemiologia , Roupa de Proteção/normas , Insuficiência Renal Crônica/terapia , Sociedades Médicas , Unidade Hospitalar de Urologia/normas
10.
J Bras Nefrol ; 42(2 suppl 1): 18-21, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877494

RESUMO

Considering the new coronavirus epidemic (Covid-19), the Brazilian Society of Nephrology, represented by the Peritoneal Steering Committee, in agreement with the and the Dialysis Department, developed a series of recommendations for good clinical practices for peritoneal dialysis (PD) clinics, to be considered during the period of the Covid-19 epidemic. We aim to minimize the disease spread, protecting patients and staff, and ensuring the quality of the treatment provided and adequate follow-up for PD patients. The recommendations suggested at this moment must be adapted to each clinic's reality and the conditions of the structural and human resources, dependent on the adequate financial provision of the public health system for its full implementation.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Falência Renal Crônica/terapia , Pandemias/prevenção & controle , Diálise Peritoneal/normas , Pneumonia Viral/prevenção & controle , Brasil , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Desinfecção/métodos , Desinfecção/normas , Humanos , Falência Renal Crônica/complicações , Máscaras , Nefrologia/normas , Doenças Profissionais/prevenção & controle , Equipe de Assistência ao Paciente , Educação de Pacientes como Assunto , Isolamento de Pacientes/métodos , Isolamento de Pacientes/normas , Diálise Peritoneal/instrumentação , Diálise Peritoneal/métodos , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Sociedades Médicas , Telemedicina/legislação & jurisprudência , Telemedicina/métodos , Telemedicina/normas , Unidade Hospitalar de Urologia/organização & administração , Unidade Hospitalar de Urologia/normas
11.
J Bras Nefrol ; 42(2 suppl 1): 22-31, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877495

RESUMO

We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.


Assuntos
Lesão Renal Aguda/terapia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Terapia de Substituição Renal/normas , Dispositivos de Acesso Vascular/normas , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/etiologia , Brasil/epidemiologia , Tomada de Decisão Clínica , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Cuidados Críticos , Humanos , Rim/efeitos dos fármacos , Nefrologia/normas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Recuperação de Função Fisiológica , Terapia de Substituição Renal/métodos , Respiração Artificial/efeitos adversos , Sociedades Médicas
12.
J Bras Nefrol ; 42(2 suppl 1): 32-35, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877496

RESUMO

INTRODUCTION: The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. METHODS: Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. RESULTS: We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil. DISCUSSION: Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Nefropatias/terapia , Pneumonia Viral/epidemiologia , Terapia de Substituição Renal/normas , Adolescente , Assistência Ambulatorial , Brasil/epidemiologia , Criança , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Higiene/normas , Transplante de Rim , Máscaras , Nefrologia/normas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Isolamento de Pacientes , Pediatria , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Terapia de Substituição Renal/métodos , Sociedades Médicas , Avaliação de Sintomas , Transporte de Pacientes
13.
Rev Esp Salud Publica ; 942020 Sep 03.
Artigo em Espanhol | MEDLINE | ID: mdl-32880381

RESUMO

OBJECTIVE: The Covid-19 pandemic is testing the resistance of health systems, the preservation of health professionals is a priority in processes of this type. The professionals' exposure to suspicious contacts often requires their confinement. The objective was to know the epidemiological characteristics of the primary care professionals who required confinement. METHODS: The research was carried out in the North Metropolitan Primary Care Area of Barcelona, from February 17 to May 3, 2020. 1,418 professionals who required confinement due to the epidemic by Covid-19 participated. The reasons for confinement, symptomatology, the confinement time and the results of PCR tests results were recorded. Univariate descriptive analysis was performed. RESULTS: 78.8% of the professionals were women and the mean age was 45.2 years. 67.8% were doctors and nurses, in the remaining 32.2% there were different healthcare and non-care professionals. 64.1% of the sample presented symptoms compatible with Covid-19. Participants described multiple symptoms during confinement. 1,050 diagnostic RT- PCR tests were performed, being positive in 323 cases, of which 33 were in asymptomatic people. CONCLUSIONS: The impact of the epidemic by Covid-19 is anticipated in health personnel compared to the general population. The distribution of symptoms in healthcare professionals is similar to that of other studies in the general population. Of the total number of professionals requiring isolation, 22.7% confirmed the diagnosis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Doenças Profissionais/epidemiologia , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde , Quarentena , Adulto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Espanha/epidemiologia
15.
Trials ; 21(1): 754, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867852

RESUMO

OBJECTIVES: To evaluate the effect of the combination of hydroxychloroquine (HCQ) and standard personal protective equipment (PPE) compared to the use of standard personal protective equipment alone on the proportion of laboratory confirmed COVID-19 infections among frontline healthcare workers(HCWs) in India TRIAL DESIGN: HOPE is an investigator initiated multi-centre open-label parallel group randomized controlled trial. PARTICIPANTS: All HCWs currently working in an environment with direct exposure to patients with confirmed COVID-19 infection are eligible to participate in the trial. The trial aims to be conducted across 20-30 centres (public and private hospitals) in India. HCWs who decline consent, who have a confirmed COVID-19 infection, those who are already on chloroquine/HCQ for any indication, or if pregnant or breast-feeding, or have known QT prolongation or are on medications that when taken with HCQ can prolong the QTc will be excluded. INTERVENTION AND COMPARATOR: The interventions to be compared in this trial are standard practice (use of recommended PPE) and HCQ plus standard practice. In the standard practice arm, HCWs will use recommended PPE as per institutional guidelines and based on their roles. They will be discouraged from taking HCQ to prevent contamination and contacted every week for the duration of the study to ascertain if they have taken any HCQ. Any such use will be reported as a protocol violation. In the intervention arm, HCWs will be administered 800mg of HCQ as a loading dose on the day of randomization (as two 400mg doses 12hrs apart) and subsequently continued on 400mg once a week for 12 weeks. This will be in addition to the use of recommended PPE as per institutional guidelines and based on their roles. HCWs will collect the drug once every week from designated research and pharmacy staff at site. A weekly phone reminder will be provided to participants in this arm to ensure compliance. An ECG will be performed between 4-6 weeks in this arm and if the QTc is prolonged (greater than 450milliseconds), the drug will be stopped. Follow-up will however continue. Participants in both arms will receive a weekly phone call for evaluation of the primary outcome, to monitor protocol compliance and development of any adverse events (in the HCQ group). MAIN OUTCOMES: Participants will be followed on a weekly basis. The primary outcome is the proportion of HCWs developing laboratory confirmed COVID-19 infection within 6 months of randomization. We will also evaluate a number of secondary outcomes, including hospitalization related to suspected/confirmed COVID-19 infection, intensive care unit or high-dependency unit admission due to suspected/confirmed COVID-19 infection, all-cause mortality, need for organ support ( non-invasive or invasive ventilation, vasopressors and renal replacement therapy), ICU and hospital length of stay, readmission, days off work and treatment-related adverse events. RANDOMISATION: Randomisation will be conducted through a password-protected, secure website using a central, computer-based randomisation program. Randomisation will be stratified by participating institutions and by the role of HCW - nursing, medical and other. Participants will be randomised 1:1 to either standard practice only or HCQ plus standard practice. Allocation concealment is maintained by central web-based randomisation BLINDING (MASKING): This is an unblinded study: study assigned treatment will be known to the research team and participant. Bias will be mitigated through an objective end point (laboratory confirmed COVID-19 infection). NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 6,950 HCWs will be enrolled (3475 to the intervention) and (3475 to the standard practice group) to detect a 25% relative reduction, or 2.5% absolute reduction, in the infection rate from an estimated baseline infection rate of 10%, with 80% statistical power using a two-sided test at 5% level of significance. Available data from China and Italy indicate that the rate of infection among frontline healthcare workers varies between 4% to 12%. We therefore assumed a baseline infection rate of 10% among HCWs. This sample size allows for a potential loss to follow-up rate of 10% and a potential non-compliance rate of 10% in both the treatment and control arms. TRIAL STATUS: HOPE protocol version 3.0 dated June 3rd 2020. Recruitment started on 29th June 2020 and currently 56 participants have been enrolled. Planned completion of enrolment is January 31st 2021. TRIAL REGISTRATION: Clinical Trials Registry of India: CTRI/2020/05/025067 (prospectively registered) Date of registration: 6th May 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expedited dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Assuntos
Infecções por Coronavirus/prevenção & controle , Inibidores Enzimáticos/uso terapêutico , Pessoal de Saúde , Hidroxicloroquina/uso terapêutico , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Betacoronavirus , Quimioprevenção , Infecções por Coronavirus/transmissão , Humanos , Índia , Pneumonia Viral/transmissão
16.
Indian J Dent Res ; 31(3): 354-357, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32769266

RESUMO

Background: Work-related musculoskeletal pain (MSPs) is not uncommon among dentist and often limits their work efficiency impacting their quality of life. Aim: The present research was conducted to identify site-specific pain resulting from musculoskeletal disorders (MSDs) among practicing dentists and determine its impact on their quality of life. Setting and Design: A cross-sectional questionnaire study conducted among practicing dentists of Puducherry Taluk, Puducherry, India. Method and Materials: A closed-ended, self-administered questionnaire was distributed to 95 practicing dentists to identify site-specific MSP from the study subjects. Data on pain due to MSDs, frequency of pain, its impact on quality of life, relieving factors, patients attended per day, working hours per day, and awareness on ergonomics were also recorded. Statistical Analyses: The data were analyzed for descriptive statistics, and Chi-square tests was used for proportions. Results: Almost all respondents experienced pain due to MSDs. Approximately, 11.1% "always" experienced elbow pain; 5.6% "always" experienced pain in neck and back. Approximately, 83% "sometimes" experienced pain in the back. Pain in elbow was significantly associated with gender (P = 0.036), qualification (P = 0.029), and years of practice (P = 0.032). Approximately, 36% reported having an impact on their life. Conclusion: The magnitude of the problem is slowly shifting from "sometimes" to "always." Although small in proportion, pain due to MSDs has an impact on dental practitioners' quality of life, and elbow pain was reportedly higher in the study setting. Measures need to be implemented before MSD becomes a career limiting occupational hazard.


Assuntos
Doenças Musculoesqueléticas , Dor Musculoesquelética , Doenças Profissionais , Estudos Transversais , Odontólogos , Humanos , Índia , Postura , Prevalência , Papel Profissional , Qualidade de Vida , Fatores de Risco , Autorrelato
17.
Curr Med Sci ; 40(4): 625-635, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32767264

RESUMO

Nurses' work-related fatigue has been recognized as a threat to nurse health and patient safety. The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan, China, and to analyze its influencing factors on fatigue. A multi-center, descriptive, cross-sectional design with a convenience sample was used. The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3, 2020 to March 10, 2020 in Wuhan of China. A total of 2667 samples from 2768 contacted participants completed the investgation, with a response rate of 96.35%. Social-demographic questionnaire, work-related questionnaire, Fatigue Scale-14, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Chinese Perceived Stress Scale were used to conduct online survey. The descriptive statistic of nurses' social-demographic characteristics was conducted, and the related variables of work, anxiety, depression, perceived stress and fatigue were analyzed by t-tests, nonparametric test and Pearson's correlation analysis. The significant factors which resulted in nurses' fatigue were further analyzed by multiple linear regression analysis. The median score for the first-line nurses' fatigue in Wuhan was 4 (2, 8). The median score of physical and mental fatigue of them was 3 (1, 6) and 1 (0, 3) respectively. According to the scoring criteria, 35.06% nurses (n=935) of all participants were in the fatigue status, their median score of fatigue was 10 (8, 11), and the median score of physical and mental fatigue of them was 7 (5, 8) and 3 (2, 4) respectively. Multiple linear regression analysis revealed the participants in the risk groups of anxiety, depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses' fatigue, the frequency of exercise and nurses' fatigue had a statistically significant negative correlation, and average daily working hours had a significantly positive correlation with nurses' fatigue, and the frequency of weekly night shift had a low positive correlation with nurses' fatigue (P<0.01). There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan, China. Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors, and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses, and to enhance their health status and provide a safe occupational environment worldwide. Promoting both medical and nursing safety while combating with the pandemic currently is warranted.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Fadiga/etiologia , Enfermeiras e Enfermeiros , Doenças Profissionais/etiologia , Estresse Ocupacional/etiologia , Pandemias , Pneumonia Viral/enfermagem , Adulto , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Fadiga/epidemiologia , Fadiga/psicologia , Feminino , Humanos , Modelos Lineares , Masculino , Fadiga Mental/epidemiologia , Fadiga Mental/etiologia , Fadiga Mental/psicologia , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/psicologia , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , Pneumonia Viral/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Centros de Atenção Terciária , Carga de Trabalho/psicologia , Adulto Jovem
18.
J Med Internet Res ; 22(8): e21366, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32763891

RESUMO

BACKGROUND: The response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has created an unprecedented disruption in work conditions. This study describes the mental health and well-being of workers both with and without clinical exposure to patients with coronavirus disease (COVID-19). OBJECTIVE: The aim of this study is to measure the prevalence of stress, anxiety, depression, work exhaustion, burnout, and decreased well-being among faculty and staff at a university and academic medical center during the SARS-CoV-2 pandemic and describe work-related and personal factors associated with their mental health and well-being. METHODS: All faculty, staff, and postdoctoral fellows of a university, including its medical school, were invited in April 2020 to complete an online questionnaire measuring stress, anxiety, depression, work exhaustion, burnout, and decreased well-being. We examined associations between these outcomes and factors including work in high-risk clinical settings and family/home stressors. RESULTS: There were 5550 respondents (overall response rate of 34.3%). Overall, 34% of faculty and 14% of staff (n=915) were providing clinical care, while 61% of faculty and 77% of staff were working from home. Among all workers, anxiety (prevalence ratio 1.37, 95% CI 1.09-1.73), depression (prevalence ratio 1.28, 95% CI 1.03-1.59), and high work exhaustion (prevalence ratio 1.24, 95% CI 1.13-1.36) were independently associated with community or clinical exposure to COVID-19. Poor family-supportive behaviors by supervisors were also associated with these outcomes (prevalence ratio 1.40, 95% CI 1.21-1.62; prevalence ratio 1.69, 95% CI 1.48-1.92; and prevalence ratio 1.54, 95% CI 1.44-1.64, respectively). Age <40 years and a greater number of family/home stressors were also associated with these poorer outcomes. Among the subset of clinicians, caring for patients with COVID-19 and working in high-risk clinical settings were additional risk factors. CONCLUSIONS: Our findings suggest that the pandemic has had negative effects on the mental health and well-being of both clinical and nonclinical employees. Mitigating exposure to COVID-19 and increasing supervisor support are modifiable risk factors that may protect mental health and well-being for all workers.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Saúde Mental , Pandemias , Pneumonia Viral , Adulto , Ansiedade/epidemiologia , Depressão , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Doenças Profissionais , Prevalência , Fatores de Risco , Inquéritos e Questionários
19.
Medicine (Baltimore) ; 99(30): e21396, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791752

RESUMO

A large number of healthcare workers have been infected with coronavirus disease-2019 (COVID-19). We aimed to investigate their clinical and chest computed tomography (CT) characteristics.The clinical, laboratory test and CT features of 43 medical and hospital staff with confirmed COVID-19 (MP group, 26-70 years old) were retrospectively analyzed, and compared to 43 non-medical related patients (non-MP group, 26-71 years old). Follow-up CT characteristics were analyzed to assess the disease progression in the period of hospitalization.At admission, the main complaints of the MP group, including fever (81.4%), fatigue (48.8%) and cough (41.9%), were similar to the non-MP group. The C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase levels were higher in the non-MP group than the MP group (17.5 ±â€Š22.4 mg/L, 20.2 ±â€Š23.4 mm/H and 219 ±â€Š66U/L, respectively, P < .05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The severity of opacities on initial CT were less in the MP group (5.3 ±â€Š3.9 scores) than in the non-MP group (9.1 ±â€Š4.8 scores, P < .05). Before regular treatments, the sum score of the opacities showed weak to moderate correlations with duration, C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels (R ranged from 0.341-0.651, P < .05). In the study time window, the duration from illness onset to when the most obvious pulmonary opacities were observed, according to CT findings, were similar in the MP group (13.3 ±â€Š6.6 days) and the non-MP group (13.8 ±â€Š5.1 days, P = .69). Mild to moderate anxiety and depression were observed in both groups.Despite greater knowledge of how to protect themselves than the general population, healthcare workers are also susceptible to COVID-19 infection. Occupational exposure is a very important factor. Healthcare workers have a higher vigilance about the infection in the early stage of the disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Doenças Profissionais/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/virologia , Exposição Ocupacional/efeitos adversos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Estudos Retrospectivos
20.
Medicine (Baltimore) ; 99(30): e21413, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791757

RESUMO

The aim of this study was to examine the anxiety status of the frontline clinical nurses in the designated hospitals for the treatment of coronavirus disease 2019 (COVID-19) in Wuhan and to analyze the influencing factors, to provide data for psychologic nursing.This study used a cross-sectional survey design and convenience sampling. The questionnaires were completed by 176 frontline clinical nurses. Anxiety was determined using the Hamilton anxiety scale. General data were collected using a survey. Correlation analyses were used.Among the 176 frontline nurses, 77.3% (136/176) had anxiety. The anxiety scores of the frontline clinical nurse fighting COVID-19 were 17.1 ±â€Š8.1. Anxiety symptoms, mild to moderate anxiety symptoms, and severe anxiety symptoms were found in 27.3%, 25%, and 25% of the nurses, respectively. Sex, age, marital status, length of service, and clinical working time against COVID-19 were associated with anxiety (P < .05).The frontline nurses working in the designated hospitals for the treatment of COVID-19 in Wuhan had serious anxiety. Sex, age, length of service, and clinical working time against COVID-19 were associated with anxiety in those nurses. Psychologic care guidance, counseling, and social support should be provided to the nurses to reduce their physical and mental burden. Nursing human resources in each province should be adjusted according to each province's reality.


Assuntos
Ansiedade/epidemiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Doenças Profissionais/epidemiologia , Pneumonia Viral/psicologia , Adulto , Ansiedade/psicologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Doenças Profissionais/psicologia , Pandemias , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
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