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1.
Mol Cell ; 81(3): 418-420, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33545056

RESUMO

Transcription factors (TFs) are frequently altered in human diseases. Identifying the direct and immediate target genes of TFs is critical to understanding their role in pathophysiology. Stengel et al. (2020) applied chemogenetic and nascent transcriptome mapping technologies to define the core gene set regulated by AML1-ETO-an oncogenic TF fusion protein frequently found in acute myeloid leukemia (AML).


Assuntos
Socorristas , Leucemia Mieloide Aguda , Subunidade alfa 2 de Fator de Ligação ao Core/genética , Humanos , Leucemia Mieloide Aguda/genética , Proteínas de Fusão Oncogênica/genética , Proteína 1 Parceira de Translocação de RUNX1/genética , Translocação Genética
2.
Health Policy ; 125(2): 135-140, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33390280

RESUMO

During the COVID-19 pandemic, in some jurisdictions, police have become involved in enforcing coronavirus-related measures. Relatedly, several North American jurisdictions have established COVID-19 data sharing protocols with law enforcement. Research across a range of fields has demonstrated that involving police in matters of public health disproportionately impacts the most vulnerable and does more harm than good. This is reflected in the consensus against COVID-19 criminalization that has emerged among civil society organizations focused on HIV, human rights, and harm reduction. The European Data Protection Board has also released guidelines against re-uses of COVID-19 data for law enforcement purposes. This article offers an overview of the harms of criminalizing illnesses and strategies for health stakeholders to seek alternatives to sharing COVID-19 data with police agencies while facilitating interoperability with healthcare first responders. It also presents case studies from two North American jurisdictions - Ontario and Minnesota - that have established routine COVID-19 data sharing with police. We recommended seven alternatives, including designating COVID-19 data as sensitive and implementing segmented interoperability with first responder agencies. These guidelines can help ensure that health information technology platforms do not become vehicles for the criminalization of COVID-19, and that health data stay within the health system.


Assuntos
/epidemiologia , Direitos Humanos , Disseminação de Informação , Aplicação da Lei , Participação dos Interessados , Socorristas , Humanos , Minnesota/epidemiologia , Ontário/epidemiologia , Estudos de Casos Organizacionais , Saúde Pública
3.
Artigo em Inglês | MEDLINE | ID: mdl-33374138

RESUMO

Emergency workers are frequently exposed to hazardous situations and such life patterns can influence their wellbeing. This study examined the relationships among South Korean emergency workers' precedents and consequences of positive emotion, engagement, relationship, meaning, and achievement (PERMA), a wellbeing concept, and offered solutions. A total of 597 emergency workers in Daegu, South Korea, participated in a survey. This study measured post-traumatic stress disorder syndrome, burnout, depression, PERMA, quality of life, life satisfaction, and sleep quality to test the relationships. Results demonstrated that post-traumatic stress disorder syndrome and burnout predicted distracting sleep behavior and sleep health. Depression was significantly related to PERMA. The better the emergency workers' PERMA was, the better their quality of life and life satisfaction were. PERMA significantly predicted sleep behavior, a portion of sleep quality. Depression had an indirect influence on quality of life mediated by PERMA. Post-traumatic stress disorder syndrome, burnout, and PERMA were significant predictors of low sleep health and sleep behavior. The results indicate that South Korean emergency workers struggle with depression and sleep quality. As the data were collected during the coronavirus disease 19 pandemic, individual efforts and relevant programs to improve South Korean emergency workers' PERMA and sleep quality in a crisis are recommended. Possible solutions to improve the wellbeing of South Korean emergency workers are suggested.


Assuntos
Socorristas/psicologia , Saúde Mental , Pandemias , Esgotamento Profissional/epidemiologia , Depressão/epidemiologia , Humanos , Qualidade de Vida , República da Coreia/epidemiologia , Sono , Transtornos de Estresse Pós-Traumáticos/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-33322095

RESUMO

Public safety personnel (PSP) experience unique occupational stressors and suffer from high rates of mental health problems. The COVID-19 pandemic has impacted virtually all aspects of human life around the world and has introduced additional occupational stressors for PSP. The objective of this study was to explore how PSP, especially those seeking digital mental health services, have been affected by the pandemic. Our research unit, PSPNET, provides internet-delivered cognitive behavioral therapy to PSP in the Canadian province of Saskatchewan. When the pandemic spread to Saskatchewan, PSPNET began inquiring about the impact of the pandemic on prospective clients during the eligibility screening process. We used content analysis to analyze data from telephone screening interviews (n = 56) and descriptive statistics to analyze data from a questionnaire concerning the impacts of COVID-19 (n = 41). The results showed that most PSP reported facing several novel emotional challenges (e.g., social isolation, boredom, anger, and fear) and logistical challenges (e.g., related to childcare, finances, work, and access to mental healthcare). Most participants indicated they felt at least somewhat afraid of contracting COVID-19 but felt more afraid of their families contracting the virus than themselves. However, few participants reported severe challenges of any kind, and many (40%) indicated that they had not been significantly negatively impacted by the pandemic. Overall, the results suggest that PSP are not expressing significant concern at this time in meeting the novel challenges posed by COVID-19. Continued research will be required to monitor how diverse PSP populations and treatment outcomes are affected by the pandemic as the situation evolves.


Assuntos
/psicologia , Socorristas/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Saskatchewan
5.
J Prim Care Community Health ; 11: 2150132720971390, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33161808

RESUMO

BACKGROUND: The ongoing coronavirus disease (COVID-19) pandemic has a major impact on first responders. Scarce personal protective equipment (PPE) has forced them to conserve and reuse some of their PPE. The efficacy of these practices in preventing transmission of COVID-19 from patients to first responders is unclear. There are limited data on the prevalence of antibodies specific for COVID-19 exposure in these front-line workers. AIM: Our objective was to determine the prevalence of positive immunoglobulin G antibody specific to COVID-19 among first responders in Lubbock, Texas. METHODS: Blood samples were collected on 683 asymptomatic first responders who work in Lubbock, Texas and the surrounding area, after informed consents were signed. IgG antibody to SARS-CoV-2 was measured using Abbott's SARS-CoV-2 IgG Reagent Kit in combination with the SARS-CoV-2 IgG Calibrator Kit on the Abbott's ARCHITECT i1000SR analyzer. RESULTS: The prevalence of IgG specific antibodies to COVID-19 was 0.73%, five of the 683 participants tested positive. Four of those who tested positive had no known prior SARS-CoV-2 infection or exposure without adequate PPE. CONCLUSIONS: The prevalence of IgG specific antibodies to COVID-19 was much lower than expected in our study population despite high sensitivity and specificity of the test reagent. The most likely explanations for this finding include limited exposure, inadequate time for a IgG response, possible clearance of COVID-19 infection locally by the respiratory tract IgA defense system without eliciting a systemic IgG response, and short persistence of IgG antibodies in mild or asymptomatic cases.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus , Infecções por Coronavirus , Socorristas , Imunoglobulina G/sangue , Pandemias , Equipamento de Proteção Individual , Pneumonia Viral , Adulto , Idoso , Infecções Assintomáticas , Cidades , Técnicas de Laboratório Clínico/métodos , Coronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Prevalência , Texas/epidemiologia
8.
Resuscitation ; 156: 157-163, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32961304

RESUMO

AIM: Out-of-hospital cardiac arrest (OHCA) during COVID-19 has been reported by countries with high case numbers and overwhelmed healthcare services. Imposed restrictions and treatment precautions may have also influenced OHCA processes-of-care. We investigated the impact of the COVID-19 pandemic period on incidence, characteristics, and survival from OHCA in Victoria, Australia. METHODS: Using data from the Victorian Ambulance Cardiac Arrest Registry, we compared 380 adult OHCA patients who received resuscitation between 16th March 2020 and 12th May 2020, with 1218 cases occurring during the same dates in 2017-2019. No OHCA patients were COVID-19 positive. Arrest incidence, characteristics and survival rates were compared. Regression analysis was performed to understand the independent effect of the pandemic period on survival. RESULTS: Incidence of OHCA did not differ during the pandemic period. However, initiation of resuscitation by Emergency Medical Services (EMS) significantly decreased (46.9% versus 40.6%, p = 0.001). Arrests in public locations decreased in the pandemic period (20.8% versus 10.0%; p < 0.001), as did initial shocks by public access defibrillation/first-responders (p = 0.037). EMS caseload decreased during the pandemic period, however, delays to key interventions (time-to-first defibrillation, time-to-first epinephrine) significantly increased. Survival-to-discharge decreased by 50% during the pandemic period (11.7% versus 6.1%; p = 0.002). Survivors per million person-years dropped in 2020, resulting in 35 excess deaths per million person-years. On adjusted analysis, the pandemic period remained associated with a 50% reduction in survival-to-discharge. CONCLUSION: The COVID-19 pandemic period did not influence OHCA incidence but appears to have disrupted the system-of-care in Australia. However, this could not completely explain reductions in survival.


Assuntos
Ambulâncias/estatística & dados numéricos , Betacoronavirus , Reanimação Cardiopulmonar/métodos , Infecções por Coronavirus/complicações , Serviços Médicos de Emergência/métodos , Parada Cardíaca Extra-Hospitalar/terapia , Pneumonia Viral/complicações , Sistema de Registros , Idoso , Infecções por Coronavirus/epidemiologia , Socorristas , Feminino , Seguimentos , Humanos , Incidência , Masculino , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Vitória/epidemiologia
9.
J Spec Oper Med ; 20(3): 141-156, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969020

RESUMO

This Role 1, prolonged field care (PFC) clinical practice guideline (CPG) is intended to be used after Tactical Combat Casualty Care (TCCC) Guidelines, when evacuation to higher level of care is not immediately possible. A provider must first and foremost be an expert in TCCC, the Department of Defense standard of care for first responders. The intent of this PFC CPG is to provide evidence and experience-based solutions to those who manage airways in an austere environment. An emphasis is placed on utilizing the tools and adjuncts most familiar to a Role 1 provider. The PFC capability of airway is addressed to reflect the reality of managing an airway in a Role 1 resource-constrained environment. A separate Joint Trauma System CPG will address mechanical ventilation. This PFC CPG also introduces an acronym to assist providers and their teams in preparing for advanced procedures, to include airway management.


Assuntos
Manuseio das Vias Aéreas , Serviços Médicos de Emergência , Socorristas , Humanos , Medicina Militar
12.
JMIR Mhealth Uhealth ; 8(9): e22079, 2020 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-32955456

RESUMO

BACKGROUND: A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there may be an increase in the demand for timely, virtual delivery of services among trauma-affected populations, including public safety personnel (PSP; eg, paramedics, police, fire, correctional officers), military members, and veterans. There is a lack of evidence on the question of whether digital delivery of trauma-therapies for military members, veterans, and PSP leads to similar outcomes to in-person delivery. Information on barriers and facilitators and recommendations regarding digital-delivery is also scarce. OBJECTIVE: This study aims to evaluate the scope and quality of peer-reviewed literature on psychotherapeutic digital health interventions delivered remotely to military members, veterans, and PSP and synthesize the knowledge of needs, gaps, barriers to, and facilitators for virtual assessment of and virtual interventions for posttraumatic stress injury. METHODS: Relevant studies were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), APA (American Psychological Association) PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health Literature) Plus with Full Text, and Military & Government Collection. For collation, analysis, summarizing, and reporting of results, we used the CASP (Critical Skills Appraisal Program) qualitative checklist, PEDro (Physiotherapy Evidence Database) scale, level of evidence hierarchy, PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), and narrative synthesis. RESULTS: A total of 38 studies were included in this review. Evidence for the effectiveness of digital delivery of prolonged exposure therapy, cognitive processing therapy, behavioral activation treatment with therapeutic exposure to military members, veterans, and PSP was rated level 1a, whereas evidence for cognitive behavioral therapy was conflicting. The narrative synthesis indicated that virtual delivery of these therapies can be as effective as in-person delivery but may reduce stigma and cost while increasing access to therapy. Issues of risk, safety, potential harm (ie, suicidality, enabling avoidance), privacy, security, and the match among the therapist, modality, and patient warrant further consideration. There is a lack of studies on the influences of gender, racial, and cultural factors that may result in differential outcomes, preferences, and/or needs. An investigation into other therapies that may be suitable for digital delivery is needed. CONCLUSIONS: Digital delivery of trauma therapies for military members, veterans, and PSP is a critical area for further research. Although promising evidence exists regarding the effectiveness of digital health within these populations, many questions remain, and a cautious approach to more widespread implementation is warranted.


Assuntos
Socorristas/psicologia , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Telemedicina , Veteranos/psicologia , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
13.
Artigo em Inglês | MEDLINE | ID: mdl-32858885

RESUMO

Strokes are a time-dependent medical emergency. The training of emergency medical service (EMS) professionals is essential to ensure the activation of stroke codes with pre-notification, as well as a rapid transfer to achieve early therapy. New assessment scales for the detection of patients with suspected large vessel occlusion ensures earlier access to endovascular therapy. The aim of this study was to evaluate the impact on an online training intervention focused on the Rapid Arterial oCclusion Evaluation (RACE) scoring of EMS professionals based on the prehospital stroke code in Catalonia from 2014 to 2018 in a pre-post intervention study. All Catalonian EMS professionals and the clinical records from primary stroke patients were included. The Kirkpatrick model guided the evaluation of the intervention. Data were collected on the knowledge on stroke recognition and management, pre-notification compliance, activated stroke codes and time performance of EMS professionals. Knowledge improved significatively in most items and across all categories, reaching a global achievement of 82%. Pre-notification compliance also improved significantly and remained high in the long-term. Increasingly higher notification of RACE scores were recorded from 60% at baseline to 96.3% in 2018, and increased on-site clinical care time and global time were also observed. Therefore, the online training intervention was effective for increasing EMS professionals' knowledge and pre-notification compliance upon stroke code activation, and the wide adoption of a new prehospital scale for the assessment of stroke severity (i.e., the RACE scale) was achieved.


Assuntos
Educação a Distância/métodos , Serviços Médicos de Emergência/estatística & dados numéricos , Socorristas/educação , Conhecimentos, Atitudes e Prática em Saúde , Avaliação de Programas e Projetos de Saúde/métodos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Adulto , Arteriopatias Oclusivas , Avaliação Educacional , Feminino , Humanos , Internet , Masculino , Estudos Retrospectivos , Espanha , Tempo para o Tratamento
14.
Am J Disaster Med ; 15(1): 71-77, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804387

RESUMO

Anthrax was widely discussed in the media several years ago during the American Anthrax attacks. Despite a less-ened interest in the subject today, anthrax still poses a threat to the United States government and its people. This article looks at publically available data and resources in an effort to combine current information into one easy to ready docu-ment. It can be used as an informational reference for first responders when learning about the anthrax threat.


Assuntos
Antraz , Bioterrorismo , Socorristas , Humanos , Estados Unidos
15.
J Bus Contin Emer Plan ; 14(1): 75-81, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32847656

RESUMO

Teaching university students and employees how to react during a damaging earthquake can save lives and prevent injuries. Most earthquakes are over in less than a minute, but the real work of emergency managers begins once everyone climbs out from under their safe place and checks for damage to bodies, buildings and infrastructure. Business recovery and academic continuity can take years. Supplementing uniformed responders with trained employee volunteers can make a huge difference toward recovering quickly. Universities are generally not charged with the role of providing public safety in the same way that government is, so they must train and exercise regularly to get faculty, staff, administrators and even some students to transition quickly during crisis to new responsibilities within an incident command system (ICS) command post or emergency operations centre. During an area-wide emergency like an earthquake, a university campus must be able to run a significant part of its response and recovery efforts on its own, as governments and other institutions around them around will be doing the same - and competing for similar resources. This paper will discuss the advantages and outcomes of providing emergency response training to civilian employees and students, empowering them to become first responders, recovery workers and incident managers to supplement the few professionals paid to fulfil those roles on a full-time basis.


Assuntos
Planejamento em Desastres , Terremotos , Socorristas , Emergências , Humanos , Estudantes , Universidades
17.
Emergencias (Sant Vicenç dels Horts) ; 32(4): 227-232, ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-190939

RESUMO

OBJETIVO: Evaluar la efectividad de un programa de prevención y control de infecciones (PCI) por COVID-19 en los trabajadores sanitarios (TS) del servicio de urgencias de un hospital terciario. MÉTODO: Se recogió el número de casos confirmados de COVID-19 en TS del 2 de marzo al 12 de abril de 2020. Los TS fueron evaluados si presentaban síntomas o en el marco de estudios de contactos. Se recogió: edad, sexo, estamento, área trabajo y motivo contacto. Se comparó si existían diferencias entre los TS del SU y los del resto del Departamento de Salud (DS). RESULTADOS: De los 3.900 TS del DS (279 adscritos al SU), se evaluaron 1.744 TS (92 del SU). Presentaron síntomas 736 (52 del SU); 151 fueron confirmados COVID-19 (9 del SU). Dos casos del SU (22,2%) se atribuyeron a la asistencia sanitaria, y 7 (77,8%) a relaciones sociales en el lugar de trabajo o fuera de este. La prevalencia de TS con COVID-19 en el SU fue de un 3,2% (9/279), y en el resto de TS del 3,9% (142/3621). Entre los TS del SU y del resto del DS no hubo diferencias significativas en la prevalencia de afectados, ni entre los motivos de contacto. CONCLUSIONES: Teniendo en cuenta la prevalencia de TS con COVID-19 del SU respecto al resto del DS, el motivo del contacto de riesgo y su distribución en el tiempo, se puede considerar que el PCI orientado al SU fue efectivo


OBJECTIVE: To evaluate the effectiveness of a coronavirus disease 2019 (COVID-19) prevention and control program for health care workers in a tertiary care hospital emergency department (ED). METHODS: We recorded the number of confirmed COVID-19 workers in the ED on March 2, 2020, and April 12, 2020. Workers were screened if they had symptoms or were traced as contacts. Variables recorded were age, sex, staff position, work area, and reason for contact. We used the χ2 test to compare ED workers to workers in other areas of the health care system. RESULTS: Of the 3900 health care workers (279 in the ED), 1744 cases (92 in the ED) were included for analysis. A total of 736 workers (52 in the ED) had symptoms, and 151 had positive test results (9 from the ED). Two of the infections in the ED workers (22.2%) were attributed to patient contact and 7 (77.8%) to nonwork-related contact either in the workplace or in the community. The prevalence of COVID-19 among ED workers was 3.2% (9/279). The prevalence among other health system workers was 3.9% (142/3621). The differences in COVID-19 prevalencebetween the 2 groups was not significant. Nor was there a significant difference in the reasons for contact with the virus between the 2 groups. CONCLUSION: Based on the prevalence of COVID-19 among ED workers and other health care workers, the reasons for risk of contact with the virus, and the time frame for gathering the data, we conclude that the prevention and control measures in the ED have been effective


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Serviços Médicos de Emergência/estatística & dados numéricos , Socorristas/estatística & dados numéricos , Resultado do Tratamento , Pneumonia Viral/prevenção & controle , Intervalos de Confiança , Equipamentos de Proteção/normas
18.
Hum Factors ; 62(7): 1061-1068, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32648781

RESUMO

OBJECTIVE: We aimed to identify opportunities for application of human factors knowledge base to mitigate disaster management (DM) challenges associated with the unique characteristics of the COVID-19 pandemic. BACKGROUND: The role of DM is to minimize and prevent further spread of the contagion over an extended period of time. This requires addressing large-scale logistics, coordination, and specialized training needs. However, DM-related challenges during the pandemic response and recovery are significantly different than with other kinds of disasters. METHOD: An expert review was conducted to document issues relevant to human factors and ergonomics (HFE) in DM. RESULTS: The response to the COVID-19 crisis has presented complex and unique challenges to DM and public health practitioners. Compared to other disasters and previous pandemics, the COVID-19 outbreak has had an unprecedented scale, magnitude, and propagation rate. The high technical complexity of response and DM coupled with lack of mental model and expertise to respond to such a unique disaster has seriously challenged the response work systems. Recent research has investigated the role of HFE in modeling DM systems' characteristics to improve resilience, accelerating emergency management expertise, developing agile training methods to facilitate dynamically changing response, improving communication and coordination among system elements, mitigating occupational hazards including guidelines for the design of personal protective equipment, and improving procedures to enhance efficiency and effectiveness of response efforts. CONCLUSION: This short review highlights the potential for the field's contribution to proactive and resilient DM for the ongoing and future pandemics.


Assuntos
Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/métodos , Serviços Médicos de Emergência/métodos , Ergonomia/métodos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Comunicação , Socorristas , Fidelidade a Diretrizes , Necessidades e Demandas de Serviços de Saúde , Humanos , Capacitação em Serviço , Comunicação Interdisciplinar , Colaboração Intersetorial , Pandemias/prevenção & controle , Equipamento de Proteção Individual
19.
Clin J Sport Med ; 30(4): 296-304, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32639439

RESUMO

INTRODUCTION: Sports participation is among the leading causes of catastrophic cervical spine injury (CSI) in the United States. Appropriate prehospital care for athletes with suspected CSIs should be available at all levels of sport. The goal of this project was to develop a set of best-practice recommendations appropriate for athletic trainers, emergency responders, sports medicine and emergency physicians, and others engaged in caring for athletes with suspected CSIs. METHODS: A consensus-driven approach (RAND/UCLA method) in combination with a systematic review of the available literature was used to identify key research questions and develop conclusions and recommendations on the prehospital care of the spine-injured athlete. A diverse panel of experts, including members of the National Athletic Trainers' Association, the National Collegiate Athletic Association, and the Sports Institute at UW Medicine participated in 4 Delphi rounds and a 2-day nominal group technique (NGT) meeting. The systematic review involved 2 independent reviewers and 4 rounds of blinded review. RESULTS: The Delphi process identified 8 key questions to be answered by the systematic review. The systematic review comprised 1544 studies, 49 of which were included in the final full-text review. Using the results of the systematic review as a shared evidence base, the NGT meeting created and refined conclusions and recommendations until consensus was achieved. CONCLUSIONS: These conclusions and recommendations represent a pragmatic approach, balancing expert experiences and the available scientific evidence.


Assuntos
Traumatismos em Atletas/terapia , Serviços Médicos de Emergência/métodos , Traumatismos da Coluna Vertebral/terapia , Traumatismos em Atletas/prevenção & controle , Técnica Delfos , Remoção de Dispositivo , Serviços Médicos de Emergência/normas , Socorristas/educação , Dispositivos de Proteção da Cabeça , Humanos , Equipamentos de Proteção , Restrição Física , Traumatismos da Coluna Vertebral/prevenção & controle , Transporte de Pacientes , Estados Unidos
20.
Minerva Pediatr ; 72(3): 226-235, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32613821

RESUMO

Although medical literature shows that children are minimally susceptible to 2019-Corona virus disease (COVID-19), they are hit the hardest by psychosocial impact of this pandemic. Being quarantined in homes and institutions may impose greater psychological burden than the physical sufferings caused by the virus. School closure, lack of outdoor activity, aberrant dietary and sleeping habits are likely to disrupt children's usual lifestyle and can potentially promote monotony, distress, impatience, annoyance and varied neuropsychiatric manifestations. Incidences of domestic violence, child abuse, adulterated online contents are on the rise. Children of single parent and frontline workers suffer unique problems. The children from marginalized communities are particularly susceptible to the infection and may suffer from extended ill-consequences of this pandemic, such as child labor, child trafficking, child marriage, sexual exploitation and death etc. Parents, pediatricians, psychologists, social workers, hospital authorities, government and non-governmental organizations have important roles to play to mitigate the psychosocial ill-effects of COVID-19 on children and adolescents. To provide the basic amenities, social security, medical care, and to minimize the educational inequities among the children of the different strata of the society are foremost priorities.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Estresse Psicológico/etiologia , Atividades Cotidianas , Adolescente , Criança , Maus-Tratos Infantis/psicologia , Socorristas/psicologia , Acesso aos Serviços de Saúde , Humanos , Deficiência Intelectual/psicologia , Acontecimentos que Mudam a Vida , Fatores de Risco , Instituições Acadêmicas , Isolamento Social/psicologia , Marginalização Social , Fatores Socioeconômicos , Estresse Psicológico/prevenção & controle , Populações Vulneráveis/psicologia
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