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1.
Brasília; IPEA; 20200500. 73 p. ilus.(Texto para Discussão / IPEA, 2559).
Monografia em Português | LILACS, ECOS | ID: biblio-1100677

RESUMO

Este texto apresenta um panorama internacional das medidas econômicas adotadas para reduzir os graves efeitos econômicos da pandemia de Sars-COV-2 em três países: Estados Unidos, Reino Unido e Espanha. A análise toma como base primordialmente documentos governamentais que normatizaram as medidas de política econômica. São analisados os diversos canais por meio dos quais a crise sanitária afeta a economia. Por um lado, estão os fatores de oferta: oferta de trabalho, produtividade do trabalho e funcionamento das cadeias produtivas. Por outro lado, encontram-se os fatores de demanda: consumo das famílias, investimento privado e comércio exterior. O terceiro canal diz respeito aos fatores financeiros que incidem sobre as variáveis de demanda e, principalmente, sobre o grau de liquidez das empresas financeiras e não financeiras. As medidas adotadas nos três países apresentam como características comuns a mobilização de grande volume de recursos fiscais e financeiros, a adoção de uma grande diversidade de instrumentos de política econômica e o uso de arranjos institucionais sofisticados em termos de regras de focalização e de mecanismos de operacionalização das medidas adotadas.


This text presents an international overview of the economic measures adopted to reduce the serious economic effects of the Sars-COV-2 pandemic in three countries: the USA, the United Kingdom and Spain. The analysis is based primarily on government documents that regulated economic policy measures. The various channels through which the health crisis affects the economy are analyzed. On one hand, there are the supply factors: labor supply, labor productivity and the functioning of production chains. On the other hand, there are demand factors: household consumption, private investment and foreign trade. The third channel concerns the financial factors on demand variables and, mainly, on the degree of liquidity of financial and non-financial companies. The measures adopted in the three countries have as common characteristics the mobilization of large volumes of fiscal and financial resources, the adoption of a wide range of economic policy instruments and the use of sophisticated institutional arrangements in terms of targeting rules and mechanisms for operationalizing the measures adopted.


Assuntos
Política Pública , Coronavirus , Pandemias , Espanha/epidemiologia , Estados Unidos/epidemiologia , Reino Unido/epidemiologia
2.
BMC Pregnancy Childbirth ; 20(1): 600, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028237

RESUMO

BACKGROUND: The aim of this national survey was to explore pregnant women's perceptions of COVID-19 and their healthcare experiences. METHODS: Through patient and public involvement, a questionnaire was developed and advertised via the BBC website, Twitter and other online media during May 2020. The findings were analysed by qualitative thematic analysis. Women who are currently pregnant, or who have delivered during the COVID-19 pandemic were invited to partake in a national online survey. RESULTS: One thousand four hundred fifty-one participants replied to the online questionnaire. Participants provided significant insight into the perceived barriers to seeking healthcare during this pandemic. These include 'not wanting to bother anyone', 'lack of wider support from allied healthcare workers' and the influence of the media. Other concerns included the use of virtual clinics antenatally and their acceptability to patients, the presence of birthing partners, and the way in which information is communicated about rapidly changing and evolving services. The influence of the media has also had a significant impact on the way women perceive hospital care in light of COVID-19 and for some, this has shaped whether they would seek help. CONCLUSIONS: This is the first ever reported study in the United Kingdom to explore pregnant women's perceptions of COVID-19 and their subsequent healthcare experiences. It has also provided insight into perceived barriers into seeking care as well as maternal concerns antenatally, intrapartum and postpartum.


Assuntos
Infecções por Coronavirus , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral , Complicações Infecciosas na Gravidez , Gestantes/psicologia , Percepção Social , Adulto , Atitude Frente a Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/psicologia , Pesquisa Qualitativa , Inquéritos e Questionários , Reino Unido/epidemiologia
3.
Rev Sci Tech ; 39(2): 503-512, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33046925

RESUMO

The world has recently witnessed the global impact of natural disease outbreaks, such as those caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Ebola virus and Middle East respiratory syndrome coronavirus, and the lasting impact of the accidental spread of foot and mouth disease in the United Kingdom. Natural outbreaks, of both emerging and re-emerging diseases, can have significant impacts on local, national and regional communities. An effective response to these outbreaks relies heavily on the coordination of both public health and Veterinary Services to identify the signs, symptoms and patterns of disease quickly and respond accordingly. The future global risks related to infectious disease are influenced by several factors, including human migration, urban development, agricultural development and climate change. As technology advances, we are more aware of the potential risks associated with dual-use equipment and research (defined as equipment or research that can be used for legitimate as well as nefarious purposes), synthetic biology, the engineering of biological systems, and the evolving modus operandi of criminals and terrorist groups. The ability to detect natural, accidental or deliberate outbreaks and incidents will rely heavily on cross-agency communication, establishment of informationsharing platforms, development of joint investigative strategies, and recognition that effective response requires a strong health and security agency interface. Therefore, the management of a suspicious biological incident requires intersectoral and interregional cooperation employing a comprehensive approach which considers prevention, preparedness, response and recovery and identifies and considers the unique characteristics and requirements of the incident.


Assuntos
Infecções por Coronavirus , Coronavírus da Síndrome Respiratória do Oriente Médio , Pandemias , Pneumonia Viral , Animais , Betacoronavirus , Humanos , Reino Unido/epidemiologia
5.
BMJ ; 371: m3588, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028597

RESUMO

OBJECTIVE: To replicate and analyse the information available to UK policymakers when the lockdown decision was taken in March 2020 in the United Kingdom. DESIGN: Independent calculations using the CovidSim code, which implements Imperial College London's individual based model, with data available in March 2020 applied to the coronavirus disease 2019 (covid-19) epidemic. SETTING: Simulations considering the spread of covid-19 in Great Britain and Northern Ireland. POPULATION: About 70 million simulated people matched as closely as possible to actual UK demographics, geography, and social behaviours. MAIN OUTCOME MEASURES: Replication of summary data on the covid-19 epidemic reported to the UK government Scientific Advisory Group for Emergencies (SAGE), and a detailed study of unpublished results, especially the effect of school closures. RESULTS: The CovidSim model would have produced a good forecast of the subsequent data if initialised with a reproduction number of about 3.5 for covid-19. The model predicted that school closures and isolation of younger people would increase the total number of deaths, albeit postponed to a second and subsequent waves. The findings of this study suggest that prompt interventions were shown to be highly effective at reducing peak demand for intensive care unit (ICU) beds but also prolong the epidemic, in some cases resulting in more deaths long term. This happens because covid-19 related mortality is highly skewed towards older age groups. In the absence of an effective vaccination programme, none of the proposed mitigation strategies in the UK would reduce the predicted total number of deaths below 200 000. CONCLUSIONS: It was predicted in March 2020 that in response to covid-19 a broad lockdown, as opposed to a focus on shielding the most vulnerable members of society, would reduce immediate demand for ICU beds at the cost of more deaths long term. The optimal strategy for saving lives in a covid-19 epidemic is different from that anticipated for an influenza epidemic with a different mortality age profile.


Assuntos
Infecções por Coronavirus/mortalidade , Transmissão de Doença Infecciosa/estatística & dados numéricos , Previsões , Pneumonia Viral/mortalidade , Quarentena/tendências , Instituições Acadêmicas/organização & administração , Betacoronavirus , Simulação por Computador , Infecções por Coronavirus/transmissão , Feminino , Humanos , Unidades de Terapia Intensiva/tendências , Masculino , Irlanda do Norte/epidemiologia , Pandemias , Pneumonia Viral/transmissão , Quarentena/métodos , Reino Unido/epidemiologia
6.
MMWR Morb Mortal Wkly Rep ; 69(40): 1450-1456, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031361

RESUMO

During the course of the coronavirus disease 2019 (COVID-19) pandemic, reports of a new multisystem inflammatory syndrome in children (MIS-C) have been increasing in Europe and the United States (1-3). Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein (CRP), ferritin, D-dimer, and interleukin-6 (1). Since June 2020, several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals (4-6). These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2, the virus that causes COVID-19, by polymerase chain reaction (PCR) or antibody assays indicating recent infection. Reports of these patients highlight the recognition of an illness referred to here as multisystem inflammatory syndrome in adults (MIS-A), the heterogeneity of clinical signs and symptoms, and the role for antibody testing in identifying similar cases among adults. Clinicians and health departments should consider MIS-A in adults with compatible signs and symptoms. These patients might not have positive SARS-CoV-2 PCR or antigen test results, and antibody testing might be needed to confirm previous SARS-CoV-2 infection. Because of the temporal association between MIS-A and SARS-CoV-2 infections, interventions that prevent COVID-19 might prevent MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this newly described condition.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/virologia , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
8.
J Foot Ankle Res ; 13(1): 63, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059721

RESUMO

BACKGROUND: The arrival of the novel coronavirus (SARS-CoV-2) has impacted the many aspects of modern life, especially, in the immediate term, the delivery of healthcare. CONTEXT: This commentary examines the profession of podiatry and how it has adapted and responded to the emerging crisis. It focusses on but is not exclusive to the position in the United Kingdom (UK) and the edicts and direction from the UK Government. PODIATRY ROLES DURING THE PANDEMIC: It describes the role of podiatry in the pandemic and highlights the deployment of podiatry resources to fight the pandemic beyond traditional podiatric practice. It also looks at the shift from conventional consultation to digital solutions for managing patients in an effort to achieve the goals of maintenance of foot health whilst reducing the spread of the virus. The commentary summarises the emerging data related to a possible foot related presentation of the coronavirus. CONCLUSION: The podiatry profession proved its flexibility and adaptability during the pandemic, to adjust rapidly to ensure that patients were able to access treatment to reduce risk of infection, ulceration and amputation. Dermatological presentations on the feet have been associated with Covid-19 in adolescents as is often the case in viral infections. CPD webinars to support clinicians and manage and prevent the spread of Covid-19 have been widely disseminated along with algorithms to ensure that patients that need treatment are being treated appropriately. Podiatrists have embraced remote technology to ensure that patients are correctly and safely triaged and, signposted and given appropriate self-care advice. MSK podiatrists have the ability to play an intrinsic role within the post discharge rehabilitation pathway.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Podiatria/organização & administração , Idoso , Idoso de 80 Anos ou mais , Tecnologia Biomédica/métodos , Tecnologia Biomédica/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Assistência à Saúde/tendências , Doenças do Pé/prevenção & controle , Humanos , Pandemias/prevenção & controle , Maleabilidade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Podiatria/estatística & dados numéricos , Comportamento de Redução do Risco , Reino Unido/epidemiologia
9.
Br J Nurs ; 29(18): 1082-1083, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33035084

RESUMO

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the Prime Minister's personal campaign to reduce the impact of COVID-19 by addressing rising levels of obesity in society.


Assuntos
Infecções por Coronavirus/epidemiologia , Obesidade/epidemiologia , Obesidade/prevenção & controle , Pneumonia Viral/epidemiologia , Governo , Humanos , Pandemias , Políticas , Medicina Estatal , Reino Unido/epidemiologia
10.
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
12.
BMJ Open Respir Res ; 7(1)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32873607

RESUMO

BACKGROUND: Studies suggest that certain black and Asian minority ethnic groups experience poorer outcomes from COVID-19, but these studies have not provided insight into potential reasons for this. We hypothesised that outcomes would be poorer for those of South Asian ethnicity hospitalised from a confirmed SARS-CoV-2 infection, once confounding factors, health-seeking behaviours and community demographics were considered, and that this might reflect a more aggressive disease course in these patients. METHODS: Patients with confirmed SARS-CoV-2 infection requiring admission to University Hospitals Birmingham NHS Foundation Trust (UHB) in Birmingham, UK between 10 March 2020 and 17 April 2020 were included. Standardised admission ratio (SAR) and standardised mortality ratio (SMR) were calculated using observed COVID-19 admissions/deaths and 2011 census data. Adjusted HR for mortality was estimated using Cox proportional hazard model adjusting and propensity score matching. RESULTS: All patients admitted to UHB with COVID-19 during the study period were included (2217 in total). 58% were male, 69.5% were white and the majority (80.2%) had comorbidities. 18.5% were of South Asian ethnicity, and these patients were more likely to be younger and have no comorbidities, but twice the prevalence of diabetes than white patients. SAR and SMR suggested more admissions and deaths in South Asian patients than would be predicted and they were more likely to present with severe disease despite no delay in presentation since symptom onset. South Asian ethnicity was associated with an increased risk of death, both by Cox regression (HR 1.4, 95% CI 1.2 to 1.8), after adjusting for age, sex, deprivation and comorbidities, and by propensity score matching, matching for the same factors but categorising ethnicity into South Asian or not (HR 1.3, 95% CI 1.0 to 1.6). CONCLUSIONS: Those of South Asian ethnicity appear at risk of worse COVID-19 outcomes. Further studies need to establish the underlying mechanistic pathways.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Mortalidade/etnologia , Pandemias , Pneumonia Viral , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Pneumonia Viral/etnologia , Pneumonia Viral/terapia , Modelos de Riscos Proporcionais , Fatores de Risco , Índice de Gravidade de Doença , Reino Unido/epidemiologia
17.
BMJ Open ; 10(9): e042867, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32994262

RESUMO

OBJECTIVES: To determine any change in referral patterns and outcomes in children (0-18) referred for child protection medical examination (CPME) during the COVID-19 pandemic compared with previous years. DESIGN: Retrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown. SETTING: Birmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children. PARTICIPANTS: Children aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018-2020. MAIN OUTCOME MEASURES: Numbers of referrals, source of disclosure and outcomes from CPME. RESULTS: There were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns. CONCLUSIONS: School closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.


Assuntos
Maus-Tratos Infantis , Serviços de Proteção Infantil , Bem-Estar da Criança , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Serviços de Saúde Escolar/estatística & dados numéricos , Betacoronavirus , Criança , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Serviços de Proteção Infantil/métodos , Serviços de Proteção Infantil/estatística & dados numéricos , Bem-Estar da Criança/estatística & dados numéricos , Bem-Estar da Criança/tendências , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , População , Isolamento Social , Serviço Social/métodos , Serviço Social/estatística & dados numéricos , Reino Unido/epidemiologia
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