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1.
Artigo em Inglês | MEDLINE | ID: mdl-34064469

RESUMO

Due to the impact of the Covid-19 pandemic on dental treatments, the present research aimed to assess the infection rate among dental practitioners from Romania and to analyze the economic impact of Covid-19 on dental offices. We designed a web-based survey distributed to dental practitioners from Romania. The survey included questions that assessed demographic data from the dentists who completed the questionnaire, along with economic aspects and epidemiological aspects related to the impact of the COVID-19 pandemic on dental practitioners. Five hundred and seven dentists completed the survey. Three-quarters of the assessed dental offices reported a decrease in the income and patient volume compared to 2019. More than half of the patients visiting the dental office paid more attention to the risk of infection and to prevention methods. Most dental offices implemented specific protective equipment for doctors. Three thousand seven hundred thirty-five dental practitioners were working in the 507 assessed dental offices, and among them, 238 COVID-19 cases of contamination were recorded. High contamination rates were registered in October (48, 20.1%), November (66, 27.7%), and December 2020 (52, 21.85%). Contamination mostly took place at home (114 cases, 47.8%) or resulted from event attendance. This study underlines an overall greater level of safety and an increased patient addressability in dental offices.


Assuntos
COVID-19 , SARS-CoV-2 , Odontólogos , Humanos , Pandemias , Papel Profissional , Romênia/epidemiologia , Inquéritos e Questionários
2.
BMJ Open ; 11(6): e050043, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34135054

RESUMO

INTRODUCTION: Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out. AIM: This rapid realist review aims to understand how community pharmacy can most effectively deliver essential and advanced services, with a focus on vaccination, during the pandemic and in the future. METHOD: An embryonic programme theory was generated using four diverse and complementary documents along with the expertise of the project team. Academic databases, preprint services and grey literature were searched and screened for documents meeting our inclusion criteria. The data were extracted from 103 documents to develop and refine a programme theory using a realist logic of analysis. Our analysis generated 13 context-mechanism-outcome configurations explaining when, why and how community pharmacy can support public health vaccination campaigns, maintain essential services during pandemics and capitalise on opportunities for expanded, sustainable public health service roles. The views of stakeholders including pharmacy users, pharmacists, pharmacy teams and other healthcare professionals were sought throughout to refine the 13 explanatory configurations. RESULTS: The 13 context-mechanism-outcome configurations are organised according to decision makers, community pharmacy teams and community pharmacy users as key actors. Review findings include: supporting a clear role for community pharmacies in public health; clarifying pharmacists' legal and professional liabilities; involving pharmacy teams in service specification design; providing suitable guidance, adequate compensation and resources; and leveraging accessible, convenient locations of community pharmacy. DISCUSSION: Community pharmacy has been able to offer key services during the pandemic. Decision makers must endorse, articulate and support a clear public health role for community pharmacy. We provide key recommendations for decision makers to optimise such a role during these unprecedented times and in the future.


Assuntos
COVID-19 , Serviços Comunitários de Farmácia , Farmácias , Vacinas contra COVID-19 , Humanos , Pandemias , Farmacêuticos , Papel Profissional , Saúde Pública , SARS-CoV-2
3.
BMC Health Serv Res ; 21(1): 499, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034710

RESUMO

BACKGROUND: Pharmacists are recognized as one of the most accessible healthcare providers and are licensed to advise patients on drugs and health products including dietary and herbal supplements (DHSs). The objective of this study was to identify barriers, knowledge, and training that pharmacists report related to DHSs counselling. METHODS: MEDLINE, EMBASE, AMED and CINAHL were systematically searched from database inception to May 8th, 2020. Eligible articles contained qualitative data with a specific focus on pharmacists' perceived knowledge, training, and barriers to DHSs counselling. Relevant data were extracted, and a thematic analysis was conducted. RESULTS: Nineteen articles met the inclusion criteria. The following three main themes were identified: challenges to pharmacists obtaining DHSs education, postgraduate workplace challenges surrounding DHSs, and pharmacists' perceived role and importance on DHSs. Low knowledge of DHSs and the limited regulations surrounding DHSs acting as a barrier to counselling were common findings supported by the eligible articles. CONCLUSIONS: A lack of pharmacists' knowledge and awareness of DHSs stems from a variety of factors including a lack of education and training in the field, limited regulations surrounding DHSs, and inadequate availability of DHS information resources in the pharmacy. Pharmacists were unable to confidently counsel patients due to these aforementioned factors in addition to reporting that they lacked time. Further research that reviews pharmacy education and workplace training, and improving DHS regulations are warranted future directions.


Assuntos
Serviços Comunitários de Farmácia , Assistência Farmacêutica , Aconselhamento , Suplementos Nutricionais , Humanos , Farmacêuticos , Papel Profissional
4.
J Contin Educ Nurs ; 52(6): 294-300, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34048301

RESUMO

BACKGROUND: The global COVID-19 pandemic has created unprecedented challenges to the health care workforce. Little is known about the effect of the pandemic on new RNs and their preparedness for such a crisis. This study explored the lived experiences of RNs transitioning from students to professionals during the pandemic. METHOD: Semistructured interviews were conducted with 15 new RNs working in acute care facilities during the Maryland COVID-19 State of Emergency. RESULTS: Three themes were identified to describe the experiences of new nurses transitioning to practice in the midst of the COVID-19 pandemic: uncertainty, vulnerability, and resilience. CONCLUSION: New nurses need greater support during transition to practice. Initiatives to improve trusting relationships between new nurses and their organizations and support of the development of essential relationships (e.g., peers, frontline management, and educators) could enhance new nurses' resilience and commitment to stay with the organization. [J Contin Educ Nurs. 2021;52(6):294-300.].


Assuntos
COVID-19/enfermagem , Competência Clínica , Enfermagem de Cuidados Críticos , Papel do Profissional de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/psicologia , Papel Profissional/psicologia , Adulto , Feminino , Humanos , Masculino , Maryland , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Adulto Jovem
5.
BMC Health Serv Res ; 21(1): 518, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049555

RESUMO

BACKGROUND: Malnutrition, sarcopenia and cachexia are clinical wasting syndromes characterised by muscle loss. Systematic monitoring by body composition assessment (BCA) is recommended for the diagnosis, treatment and monitoring of the syndrome(s). This study investigated practices, competency, and attitudes of Australian dietitians regarding BCA, to inform a local implementation process. METHODS: Applying the Action cycle in the Knowledge to Action framework, surveys were distributed to the 26 dietitians of an 800-bed tertiary hospital. The survey assessed barriers and enablers to performing routine BCA in clinical care. Results were categorised using the Theoretical Domains Framework (TDF) and suitable interventions mapped using the Behaviour Change Wheel. RESULTS: Twenty-two dietitians (84.6%) completed the survey. Barriers to BCA were identified in all TDF domains, particularly in Knowledge, Skills, Social/professional role and identity, Beliefs about capabilities, and Environmental context and resources. Enablers existed in domains of: Skills; Beliefs about consequences; Goals; Environmental context and resources; Social influences; Intentions; Optimism; Reinforcement. CONCLUSIONS: This study showed that hospital dietitians experience individual, team, and organisational barriers to adopt BCAs in clinical practice. We were able to formulate targeted implementation strategies to overcome these barriers to assist BCA adoption into routine practice.


Assuntos
Nutricionistas , Austrália , Composição Corporal , Humanos , Intenção , Papel Profissional
6.
Stud Health Technol Inform ; 281: 1122-1123, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042867

RESUMO

Patients' electronic records in community pharmacy are an untapped resource to uncover new ways of providing healthcare services. In this paper, we present a preliminary work, where we explore this resource, aiming to identify patients' clusters that will help to define a future algorithm. This algorithm will then enable community pharmacists to provide tailored pharmaceutical interventions according to patient's risk assessment and needs. In this way, this work will provide a way to overcome known barriers for community pharmacists' provision of services and integration in the health system, while also contributing to support a better care for chronic patients.


Assuntos
Serviços Comunitários de Farmácia , Farmácia , Atitude do Pessoal de Saúde , Análise por Conglomerados , Eletrônica , Humanos , Farmacêuticos , Papel Profissional
7.
Sr Care Pharm ; 36(6): 317, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34016229

RESUMO

Emerging from a year-long crisis offers us a fresh stimulus to reflect on the pharmacy profession and the challenges that lie ahead. Industry observers have long noted the limited value of the dispensing function, and some have predicted that it will ultimately succumb to automation. Pharmacists have been jealous guardians of the professional role of pharmacists in overseeing the dispensing of prescription drugs, but the economics may eventually dictate that the process can safely be turned over to machines.


Assuntos
Assistência Farmacêutica , Farmácias , Farmácia , Humanos , Farmacêuticos , Papel Profissional
8.
Int J Oral Implantol (Berl) ; 14(1): 57-66, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-34006071

RESUMO

PURPOSE: In recent years, dental malpractice claims have increased dramatically worldwide. The present study aimed to categorise and analyse claims related to implant dentistry that resulted in legal decisions in Israel, seeking to contribute to dental risk management and improve patient safety. MATERIALS AND METHODS: This study analysed legal claims registered by Medical Consultants International between 2005 and 2015. Only closed cases in which a decision was made were included. The parameters studied included patient age and sex, date of the complaint, treatment setting (private/public clinic), description of the adverse event and type of negligence claimed. RESULTS: The cohort included 709 settled claims out of a total of 1066 that were litigated against dental practitioners in Israel during the study period. Of the patients included, 60.0% were women and 63.9% were aged 40 to 59 years. The most common treatment-related damage was neural injury in 133 patients (18.7% of the cohort). Unplanned changes in the treatment plan and violation of autonomy were the most frequent documentation-/information-related claims (66.3% and 32.7%, respectively). The legal responsibility of the dental practitioner was acknowledged in 89.0% of cases. Dental practitioners working in the private sector were more likely to be sued due to violation of autonomy than those working in public clinics. CONCLUSIONS: Although the main cause for lawsuits was actual bodily injury, the high percentage of documentation-/information-related malpractice claims calls for increased awareness of patients' autonomy and rights. Practitioners should dedicate a significant part of the entire treatment time to preoperative diagnosis and planning.


Assuntos
Implantes Dentários , Imperícia , Adulto , Implantes Dentários/efeitos adversos , Odontólogos , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Papel Profissional
9.
BMJ Case Rep ; 14(5)2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33986008

RESUMO

Recurrent aphthous ulcers are the most prevalent oral mucosal disease, but the subset major aphthous ulcer is a less frequent type. These ulcers are refractory, may persist for several weeks to months, and interfere with the normal state of health. The aetiology is multifactorial and so is the treatment. We present a case of an adolescent male patient reported with multiple oral ulcers. He developed three ulcers simultaneously and suffered for 10 months despite using topical medications prescribed by different dental practitioners. We executed a multidisciplinary treatment approach that resulted in a long-term disease-free state. The treatment methods followed in our case could be a successful model to implement by medical practitioners and oral physicians when the situation demands.


Assuntos
Úlceras Orais , Estomatite Aftosa , Adolescente , Odontólogos , Humanos , Masculino , Papel Profissional , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/etiologia
10.
Front Public Health ; 9: 610245, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33987160

RESUMO

Regular physical activity has a range of benefits for children's health, academic achievement, and behavioral development, yet they face barriers to participation. The aim of the study was to systematically develop an intervention for improving Chinese children's physical activity participation, using the Behavior Change Wheel (BCW) and Theoretical Domains Framework (TDF). The BCW and TDF were used to (i) understand the behavior (through literature review), (ii) identify intervention options (through the TDF-intervention function mapping table), (iii) select content and implementation options [through behavior change technique (BCT) taxonomy and literature review], and (iv) finalize the intervention content (through expert consultation, patient and public involvement and engagement, and piloting). A systematic iterative process was followed to design the intervention by following the steps recommended by the BCW. This systematic process identified 10 relevant TDF domains to encourage engagement in physical activity among Chinese children: knowledge, memory, attention and decision processes, social influences, environmental context and resources, beliefs about capabilities, beliefs about consequences, social/professional role and identity, emotions, and physical skills. It resulted in the selection of seven intervention functions (education, persuasion, environmental restricting, modeling, enablement, training, and incentivization) and 21 BCTs in the program, delivered over a period of 16 weeks. The BCW and TDF allowed an in-depth consideration of the physical activity behavior among Chinese children and provided a systematic framework for developing the intervention. A feasibility study is now being undertaken to determine its acceptability and utility.


Assuntos
Exercício Físico , Papel Profissional , Terapia Comportamental , Criança , China , Humanos , Instituições Acadêmicas
11.
BMC Health Serv Res ; 21(1): 432, 2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957900

RESUMO

BACKGROUND: Prescribing errors (PEs) are a common cause of morbidity and mortality, both in community practice and in hospitals. Pharmacists have an essential role in minimizing and preventing PEs, thus, there is a need to document the nature of pharmacists' interventions to prevent PEs. The purpose of this study was to describe reported interventions conducted by pharmacists to prevent or minimize PEs in a tertiary care hospital. METHODS: A retrospective analysis of the electronic medical records data was conducted to identify pharmacists' interventions related to reported PEs. The PE-related data was extracted for a period of six-month (April to September 2017) and comprised of patient demographics, medication-related information, and the different interventions conducted by the pharmacists. The study was carried in a tertiary care hospital in Riyadh region. The study was ethically reviewed and approved by the hospital IRB committee. Descriptive analyses were appropriately conducted using the IBM SPSS Statistics. RESULTS: A total of 2,564 pharmacists' interventions related to PEs were recorded. These interventions were reported in 1,565 patients. Wrong dose (54.3 %) and unauthorized prescription (21.9 %) were the most commonly encountered PEs. Anti-infectives for systemic use (49.2 %) and alimentary tract and metabolism medications (18.2 %) were the most common classes involved with PEs. The most commonly reported pharmacists' interventions were dose adjustments (44.0 %), restricted medication approvals (21.9 %), and therapeutic duplications (11 %). CONCLUSIONS: In this study, PEs occurred commonly and pharmacists' interventions were critical in preventing possible medication related harm to patients. Care coordination and prioritizing patient safety through quality improvement initiatives at all levels of the health care system can play a key role in this quality improvement drive. Future studies should evaluate the impact of pharmacists' interventions on patient outcomes.


Assuntos
Farmacêuticos , Serviço de Farmácia Hospitalar , Estudos Transversais , Hospitais , Humanos , Pacientes Internados , Erros de Medicação/prevenção & controle , Papel Profissional , Estudos Retrospectivos
12.
Compend Contin Educ Dent ; 42(5): 242-246, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33980023

RESUMO

Mönckeberg arteriosclerosis, also known as Mönckeberg sclerosis or Mönckeberg medial calcinosis, is a well-documented phenomenon in medicine due to its association with a number of serious systemic conditions and aging. This article presents a unique case of Mönckeberg arteriosclerosis in the oral facial region demonstrated clearly on cone-beam computed tomography (CBCT). The reporting of Mönckeberg arteriosclerosis in dental literature is uncommon even though the radiographic features of the head and neck on plain film and CBCT are unique to the condition. As dentistry and medicine strive to move toward an integrated one-health model, it will be important for dental practitioners to recognize this condition during dental radiographic evaluation. A practitioner's understanding of the potential medical implications and the need for appropriate referral to a medical colleague could be lifesaving for a dental patient.


Assuntos
Arteriosclerose , Esclerose Calcificante da Média de Monckeberg , Tomografia Computadorizada de Feixe Cônico Espiral , Arteriosclerose/complicações , Arteriosclerose/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Odontólogos , Humanos , Papel Profissional
13.
BMC Oral Health ; 21(1): 241, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957922

RESUMO

BACKGROUND: Coronavirus Disease 2019 (COVID-19) is a major global threat. Healthcare professionals including dentists are facing real challenges during this pandemic. This study aimed to evaluate knowledge, attitudes, and prevention measures of Lebanese dentists towards COVID-19 and determinants of high level of knowledge and prevention practices. METHODS: A cross-sectional study was conducted between May and August 2020 in Lebanon on a random sample of 323 Lebanese dentists. Data were collected through an online survey questionnaire. A multivariate linear regression model was used to evaluate factors associated with COVID-19 knowledge. A multivariate logistic regression was conducted to evaluate the factors associated with high level of prevention measures towards COVID-19. RESULTS: The mean COVID-19 knowledge index was 24.5 over 38 with only 15% achieving high knowledge level. The mean prevention measures index was 11.4 over 16 with only 35% achieving high prevention level. Higher knowledge index was associated with younger age, being employed, and considering dentist's role significant in teaching others about COVID-19. General dental practitioners, dentists living with family members and concerned about their family members to get infected because of their occupational exposure were more likely to report higher level of adopted prevention measures. Higher knowledge was associated with high level of prevention measures. CONCLUSIONS: Given the rapid evolution of information related to COVID-19 pandemic, dentists should be regularly educated through trainings, workshops, and updates of national guidelines for dental healthcare.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , Odontólogos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Líbano/epidemiologia , Pandemias/prevenção & controle , Papel Profissional , SARS-CoV-2 , Inquéritos e Questionários
14.
BMC Oral Health ; 21(1): 243, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33962609

RESUMO

BACKGROUND: The coronavirus outbreak (COVID-19) in China has influenced every aspect of life worldwide. Given the unique characteristics of the dental setting, the risk of cross-infection between dental practitioners and patients is high in the absence of adequate protective measures, and dentists may develop severe anxiety in relation to the current pandemic. The limited provision of services and widespread closure of dental practices have raised concerns among dental professionals about the financial impact. The present study assessed the frequency of dental practice closure during the pandemic's first wave in several countries and whether closures and their associated factors differ between the private and non-private sectors. METHODS: An electronic cross-sectional survey questionnaire was sent to dentists in several countries, from April to May 2020. The survey assessed professional, practice related and country-level structural factors elucidating the reason for practice closure. Multilevel logistic regression was used to assess the association between practice closure and these factors, and differences were evaluated by sector type. RESULTS: Dentists from 29 countries (n = 3243) participated in this study. Most of the participants (75.9%) reported practice closure with significantly higher percentage in the private sector than the non-private sector. Greater pandemic-related fears were associated with a significantly higher likelihood of practice closure in the private (odds ratio [OR] = 1.54, 95% confidence interval [CI] 1.24, 1.92) and non-private (OR = 1.38, 95% CI 1.04, 1.82) sectors. Dentists in non-private rural areas (OR = 0.58, 95% CI 0.42, 0.81), and those in hospitals (overall OR = 0.60, 95% CI 0.36, 0.99) reported a low likelihood of closure. A high likelihood of closure was reported by dentists in the academia (OR = 2.13, 95% CI 1.23, 3.71). More hospital beds at the country-level were associated with a lower likelihood of closure in the non-private sector (OR = 0.65, 95% CI 0.46, 0.91). Private- sector dentists in high- income countries (HICs) reported fewer closures than those in non-HICs (OR = 0.55, 95% CI 0.15, 1.93). CONCLUSIONS: Most dentists reported practice closure because of COVID-19, and greater impacts were reported in the private sector than in the non-private sector. Closure was associated with professional, practice, and country-levels factors.


Assuntos
COVID-19 , China/epidemiologia , Estudos Transversais , Odontólogos , Humanos , Papel Profissional , SARS-CoV-2 , Inquéritos e Questionários
15.
Adv Exp Med Biol ; 1318: 605-622, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33973201

RESUMO

Pharmacists play a vital role in public health during the COVID-19 pandemic. In this chapter, we present the most significant contributions that pharmacists could make to communitarian and hospital settings. It includes the provision of essential services, such as continuous access to medication and supplies, support to medical services, education and information to the population and the health team to reduce the misuse of medications, patient monitoring and follow-up, and the detection and referral of suspected cases of COVID-19. The chapter ends with a discussion over certain elements related to innovation needs, such as telepharmacy services.


Assuntos
COVID-19 , Assistência Farmacêutica , Humanos , Pandemias/prevenção & controle , Farmacêuticos , Papel Profissional , SARS-CoV-2
16.
J Contemp Dent Pract ; 22(1): 93-100, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34002717

RESUMO

AIM: The present review aimed to summarize and evaluate the available literature regarding the survival rate and outcomes of dental implants in patients with Papillon-Lefèvre syndrome (PLS). MATERIALS AND METHODS: An extensive search of the literature was conducted on PubMed, Scopus and Web of Science databases for all data published from January 1996 till April 2020 using a combination of the following keywords: 'Papillon Lefévre Syndrome', 'prosthodontic rehabilitation' and 'dental implant' according to the PRISMA guidelines for the focused research question constructed using the PICO criteria. Clinical trials and observational studies on implant placement in PLS patients reported in English language were included in the study. RESULTS: A total of 10 studies (nine case reports and one case series) comprising 124 dental implants placed in 13 PLS patients were included. The follow-up period ranged from 4 months to 9 years. With regard to implant loading, 9 studies reported delayed loading, while one study did not provide any information regarding the nature of implant loading. The design of prosthodontic superstructure was either a removable or fixed prosthesis. Out of the 124 inserted implants, 20 (16%) were reported as failed. The overall survival rate was 84%. CONCLUSION: The limited available evidence suggests that the survival rate of dental implants in patients with PLS is lower than that among healthy individuals. Nevertheless, no strict contraindication for implant-supported prosthesis seems to be justified in this group of patients. Further longitudinal studies with adequate follow-up periods are highly warranted. CLINICAL SIGNIFICANCE: The prognosis of implant treatment for PLS patients has not yet been established. Dental practitioners should follow a careful approach in planning the dental implant treatment for this cohort of patients.


Assuntos
Implantes Dentários , Doença de Papillon-Lefevre , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Odontólogos , Seguimentos , Humanos , Papel Profissional , Taxa de Sobrevida
17.
Anesthesiol Clin ; 39(2): 353-361, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34024436

RESUMO

COVID-19 challenged many facets of medicine. At the frontlines of managing the health care of the infected were anesthesiologists and critical care physicians, especially those in large cities. The Hospital of the University of Pennsylvania [HUP] was no exception. Through simulations, online education platforms, and most importantly creative scheduling that allows acquisition of skills and ACGME milestones to be met, COVID-19 allowed the Department of Anesthesiology and Critical Care at HUP to meet the challenges presented during the surge and create a template for future challenges to the US health care system.


Assuntos
Anestesiologia/educação , COVID-19 , Internato e Residência/tendências , Pandemias , Anestesiologistas , Competência Clínica , Recursos em Saúde , Humanos , Admissão e Escalonamento de Pessoal , Papel Profissional
18.
AANA J ; 89(2): 133-140, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33832573

RESUMO

Certified Registered Nurse Anesthetists (CRNAs) are uniquely skilled anesthesia providers with substantial experience managing critically ill patients. During the coronavirus disease 2019 (COVID) pandemic, CRNAs at a large academic medical center in the Mid-Atlantic United States experienced a shift in their daily responsibilities. As the hospital transitioned to the management of patients who tested positive for the virus that causes COVID, the severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2), CRNAs were redeployed into the roles of respiratory therapists and intensive care unit registered nurses. Although facing the stress of the global pandemic, this facility's CRNAs proved to be flexible, capable, and necessary members of the care team for patients with COVID-19.


Assuntos
COVID-19/enfermagem , COVID-19/psicologia , Enfermeiras Anestesistas/psicologia , Papel do Profissional de Enfermagem/psicologia , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Papel Profissional , Carga de Trabalho/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Mid-Atlantic Region , Pessoa de Meia-Idade , Enfermeiras Anestesistas/estatística & dados numéricos , Pandemias , SARS-CoV-2
20.
Medicina (Kaunas) ; 57(4)2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-33917276

RESUMO

A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has become a global ongoing pandemic. This pandemic represents a great work risk for all health professionals, it includes dental professionals who are in constant contact with saliva, which represents one of the main routes of transmission of the disease. This is due to the fact that a wide variety of oral tissues and cells are susceptible to infection by SARS-CoV-2 and that they express the ACE2 receptor, which is the main route of entry of the virus into cells, as well as the proteins TMPRSS and furin that contributes to the binding of the virus to the host cells. According to recent studies, some of the oral cells most susceptible to infection by SARS-CoV-2 are the epithelial cells of the salivary glands. This explains the presence of the virus in the saliva of infected patients and provides scientific evidence that supports the use of saliva as a biofluid that offers the opportunity to develop new detection and diagnostic techniques. This is because saliva is much easier to collect compared to nasopharyngeal swab. However, the presence of the virus in saliva, also represents a great source of transmission, since the main form of infection is through microscopic drops that are generated when infected people cough or sneeze. Likewise, health professionals, such as dentists are exposed to contagion through saliva. The objective of this review article is to provide a perspective on the main cells and tissues that can be affected by the virus, the risk of contagion that the presence of the virus in saliva represents for dentists; and the new techniques developed from saliva samples for the diagnosis and surveillance of SARS-CoV-2 infection. This review is expected to contribute to the knowledge of oral health professionals about the risk of saliva in the spread of SARS-CoV-2, but also its advantages as a diagnostic tool for pandemic control. In conclusion, the authors can mention that information that provides more scientific evidence of the mechanisms of infection of the coronavirus in oral cells and tissues is being published continually. This also explains the presence of the virus in the saliva of infected people and the risk of contagion that this means. It also provides scientific evidence of the use of saliva as a biofluid for the detection, diagnosis, monitoring, and control of the spread of the virus.


Assuntos
COVID-19 , SARS-CoV-2 , Odontólogos , Humanos , Papel Profissional , Saliva
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