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1.
Am J Public Health ; 111(1): 54-57, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33211580

RESUMO

Contact tracing was one of the core public health strategies implemented during the first months of the COVID-19 pandemic. In this essay, we describe the rapid establishment of a volunteer contact tracing program in New Haven, Connecticut. We describe successes of the program and challenges that were faced. Going forward, contact tracing efforts can best be supported by increased funding to state and local health departments for a stable workforce and use of evidence-based technological innovations.


Assuntos
/transmissão , Busca de Comunicante , Saúde Pública/economia , Voluntários/educação , Connecticut , Surtos de Doenças/prevenção & controle , Humanos
4.
Sao Paulo Med J ; 138(5): 433-440, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33053051

RESUMO

BACKGROUND: The rapid spread of the COVID-19 epidemic has led to extraordinary measures taken worldwide, and has led to serious psychological disorders. Healthcare professionals face greater severity of stress burden, due both to their direct contact with patients with the virus and to the isolation dimension of this outbreak. OBJECTIVE: To examine psychiatric disorders such as anxiety, depression and sleep disorders among healthcare professionals working in an emergency department and a COVID-19 clinic. DESIGN AND SETTING: Cross-sectional study including healthcare professionals in the emergency department and other units serving patients with COVID-19, of a training and research hospital in Turkey. METHODS: 210 volunteers, including 105 healthcare professionals in the emergency department and 105 healthcare professionals working in other departments rendering services for COVID-19 patients, were included in this study. A sociodemographic data form and the Hospital Anxiety Depression Scale (HAD), Pittsburg Sleep Quality Index (PSQI), World Health Organization Quality of Life scale (WHOQOL-BREF-TR) and Religious Orientation Scale were applied to the volunteers. RESULTS: The perceived stress levels and PSQI subscores were found to be significantly higher among the volunteers working in the emergency department than among those in other departments. The risk of development of anxiety among women was 16.6 times higher than among men. CONCLUSIONS: Healthcare professionals on the frontline need systematic regular psychosocial support mechanisms. Anxiety due to fear of infecting family members can be prevented through precautions such as isolation. However, it should be remembered that loneliness and feelings of missing family members consequent to isolation may increase the risk of depression.


Assuntos
Infecções por Coronavirus , Saúde Mental , Estresse Ocupacional/epidemiologia , Pandemias , Recursos Humanos em Hospital/psicologia , Pneumonia Viral , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Masculino , Qualidade de Vida , Turquia/epidemiologia , Voluntários/psicologia
7.
Clin Med (Lond) ; 20(6): e244-e247, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33037028

RESUMO

BACKGROUND: Medical students internationally have volunteered and stepped up to support frontline clinical teams during the COVID-19 pandemic. We know very little about the motivation of those volunteering, or their concerns in deploying to a new role. We aim to establish the reasons that medical students volunteered in one Trust and understand to their concerns. METHODS: Structured survey, thematic analysis and categorisation of volunteer student perceptions. RESULTS: Medical students volunteered for broadly four reasons: to make a contribution, to learn, to benefit from remuneration and for an activity during the national lockdown. There were disparate concerns; however, the most common involved availability of personal protective equipment, uncertainty as to expectations and becoming infected. CONCLUSIONS: We must recognise and applaud the motivations of our future workforce who have stepped up to support the NHS at a time of unprecedented demand. The experiences and learning gained during this period will undoubtedly shape their future medical training and careers.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Educação Médica , Inglaterra , Humanos , Motivação , Pandemias , Inquéritos e Questionários , Voluntários
8.
IEEE Pulse ; 11(5): 17-20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064639

RESUMO

Before the novel coronavirus (COVID-19) started sweeping across the United States, it began on the coasts. The first known case was reported in a county just outside of Seattle, WA, with other cases quickly cropping up in California and in the greater New York City region. As the virus lingered on the periphery of the country, doctors and physicians working in inland, rural communities worried about what might happen if the virus hit their homes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Pandemias , Pneumonia Viral/terapia , Serviços de Saúde Rural , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Criatividade , Humanos , Colaboração Intersetorial , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde da População Rural , Serviços de Saúde Rural/organização & administração , População Rural , Estados Unidos/epidemiologia , Universidades , Voluntários
9.
Sci Rep ; 10(1): 16464, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020579

RESUMO

Remote imaging photoplethysmography (iPPG) senses the cardiac pulse in outer skin layers and is responsive to mean arterial pressure and pulse pressure in critically ill patients. Whether iPPG is sufficiently sensitive to monitor cutaneous perfusion is not known. This study aimed at determining the response of iPPG to changes in cutaneous perfusion measured by  Laser speckle imaging (LSI). Thirty-seven volunteers were engaged in a cognitive test known to evoke autonomic nervous activity and a Heat test. Simultaneous measurements of iPPG and LSI were taken at baseline and during cutaneous perfusion challenges. A perfusion index (PI) was calculated to assess iPPG signal strength. The response of iPPG to the challenges and its relation to LSI were determined. PI of iPPG significantly increased in response to autonomic nervous stimuli and to the Heat test by 5.8% (p = 0.005) and 11.1% (p < 0.001), respectively. PI was associated with LSI measures of cutaneous perfusion throughout experiments (p < 0.001). iPPG responses to study task correlated with those of LSI (r = 0.62, p < 0.001) and were comparable among subjects. iPPG is sensitive to autonomic nervous activity in volunteers and is closely associated with cutaneous perfusion.


Assuntos
Fotopletismografia/métodos , Pele/fisiopatologia , Adulto , Pressão Sanguínea/fisiologia , Diagnóstico por Imagem/métodos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Monitorização Fisiológica/métodos , Perfusão/métodos , Voluntários
10.
Proc Natl Acad Sci U S A ; 117(44): 27292-27299, 2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-33067395

RESUMO

Strong local institutions are important for the successful governance of common-pool resources (CPRs), but why do such institutions emerge in the first place and why do they sometimes not emerge at all? We argue that voluntary local leaders play an important role in the initiation of self-governance institutions because such leaders can directly affect local users' perceived costs and benefits associated with self-rule. Drawing on recent work on leadership in organizational behavior, we propose that voluntary leaders can facilitate a cooperative process of local rule creation by exhibiting unselfish behavior and leading by example. We posit that such forms of leadership are particularly important when resource users are weakly motivated to act collectively, such as when confronted with "creeping" environmental problems. We test these ideas by using observations from a laboratory-in-the-field experiment with 128 users of forest commons in Bolivia and Uganda. We find that participants' agreement to create new rules was significantly stronger in group rounds where voluntary, unselfish leaders were present. We show that unselfish leadership actions make the biggest difference for rule creation under high levels of uncertainty, such as when the resource is in subtle decline and intragroup communication sparse.


Assuntos
Comportamento Cooperativo , Governo , Liderança , Bolívia , Humanos , Participação dos Interessados/psicologia , Uganda , Voluntários/psicologia
11.
Int J Dermatol ; 59(12): 1468-1474, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33040344

RESUMO

BACKGROUND: An association between wearing protective gear and eosinophilic folliculitis has not been reported. We aimed to investigate such during the COVID-19 pandemic. METHODS: In three outpatient clinics, we hand-reviewed records of all patients having consulted us during a Study Period (90 days) in the early phase of the pandemic. Our inclusion criteria for Study Subjects were: (i) clear clinical diagnosis, (ii) dermoscopic confirmation, (iii) differential diagnoses excluded, (iv) eosinophilia, (v) protective gear worn during sanitation services, (vi) temporal correlation, (vii) distributional correlation, (viii) physician-assessed association, and (ix) patient-assessed association. Control Periods in the same season were elected. RESULTS: Twenty-five study subjects fulfilled all inclusion criteria. The incidence was significantly higher than in the control periods (IR: 3.57, 95% CI: 1.79-7.43). Male predominance was significant (P < 0.001). Such for patients in the control periods were insignificant. Study subjects were 21.2 (95% CI: 11.0-31.4) years younger than patients in the control periods. For the study subjects, the distribution of erythematous or skin-colored folliculocentric dome-shaped papules and pustules were all compatible with body parts covered by the gear. Lesional biopsy performed on two patients revealed eosinophilic dermal infiltrates within and around the pilosebaceous units. Polarized dermoscopy revealed folliculitis with peri-/interfollicular vascular proliferation. Lesion onsets were 6.4 (SD: 2.1) days after wearing gear. Remissions were 16.7 (SD: 7.5) days after ceasing to wear gear and treatments. CONCLUSIONS: Wearing protective gear in volunteered sanitizing works could be associated with eosinophilic folliculitis. Owing to the significant temporal and distributional correlations, the association might be causal.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Eosinofilia/epidemiologia , Foliculite/epidemiologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Pneumonia Viral/prevenção & controle , Dermatopatias Vesiculobolhosas/epidemiologia , Voluntários/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/patogenicidade , Biópsia , Controle de Doenças Transmissíveis/instrumentação , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Dermoscopia , Diagnóstico Diferencial , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Eosinofilia/patologia , Feminino , Foliculite/diagnóstico , Foliculite/etiologia , Foliculite/patologia , Folículo Piloso/diagnóstico por imagem , Folículo Piloso/patologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , Saneamento , Fatores Sexuais , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/etiologia , Dermatopatias Vesiculobolhosas/patologia , Fatores de Tempo , Adulto Jovem
12.
J Am Dent Assoc ; 151(11): 808, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33121596
13.
Haemophilia ; 26(6): 1031-1037, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32892465

RESUMO

OBJECTIVE: To identify lessons learned from haemophilia care experience in Wuhan (COVID-19 outbreak epicenter in China) and Tianjin (with relatively low COVID-19 incidence) in the pandemic. METHODS: We compared the challenges in haemophilia management attributed to local COVID-19 containment policies, healthcare resource availability, clotting factors supply, daily living restrictions and coping strategies employed. RESULTS: Wuhan was in lockdown with strict traffic controls, enforced quarantine and overwhelmed resources. Tianjin was in relatively relaxed countermeasures to COVID-19. In Wuhan, haemophilia treatment (for bleeding, prophylaxis, multidisciplinary team care, immune tolerance induction) and patient education were severely affected, while the challenges in Tianjin were less. In both cities, patients' fear for COVID-19 infection also affected their management. Coping strategy in Wuhan included channelling of clotting factors supply from hospitals to nine pharmacies; timely transfers of in-need patients to healthcare facilities by a volunteer service network jointly coordinated by the government, hospitals and the community. Although factor concentrate supply in each city was adequate, patients still worried whether there would be enough supply to last through the pandemics. Consequently, many downgraded their treatment regimens resulting in increased bleeding episodes. In both cities, telemedicine was promoted for patient care and education. CONCLUSIONS: The COVID-19 pandemic had varying adverse impacts on haemophilia care depending on the local infection incidence. Our experience suggests that haemophilia management strategies in the pandemic need to be established according to the local virus containment/mitigation policies, daily living restrictions and resource availability.


Assuntos
/epidemiologia , Hemofilia A/epidemiologia , Quarentena/métodos , /fisiologia , Adaptação Psicológica , China/epidemiologia , Cidades , Contenção de Riscos Biológicos , Política de Saúde , Recursos em Saúde , Acesso aos Serviços de Saúde , Humanos , Incidência , Pandemias , Assistência ao Paciente , Telemedicina , Voluntários
14.
BMJ Open ; 10(9): e039082, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938602

RESUMO

OBJECTIVE: To identify what motivates medical students to join a pandemic emergency healthcare workforce. DESIGN: Cross-sectional study. SETTING: Aalborg University, Denmark. PARTICIPANTS: All medical students. MAIN OUTCOME MEASURES: Motivational points as perceived by the students to be important. Demographic characteristics and 11 motivational domains scored on a Visual Analog Scale from 0 (low) to 100 (high) responding to the question: 'To what degree are the following statements important for you to join a national emergency preparedness workforce?' The questionnaire was developed by an expert panel in a process of four iterations. RESULTS: A total of 486 students of 688 (70.6%) completed the survey within 7 days in March 2020. 80% had decided to join the pandemic emergency healthcare workforce. Ranked median scores for motivational statements in each domain were: care, 100; learn, 90; pride, 83; team, 77; needed, 75; safety, 75; supervision, 75; job, 73; duty, 66; salary, 62; historic, 50. Supervision (p<0.001), salary (p<0.001) and duty (p=0.001) were given increasing priority with advancing study years. Interestingly, students added that support by the university and clarification of study plans were priorities. CONCLUSIONS: Results guide decision-makers and colleagues on how to motivate or reinforce medical students in joining the pandemic emergency healthcare workforce. Importantly, students emphasised protection for themselves.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus/epidemiologia , Mão de Obra em Saúde , Motivação , Pneumonia Viral/epidemiologia , Estudantes de Medicina/psicologia , Voluntários/psicologia , Adulto , Betacoronavirus , Comportamento de Escolha , Estudos Transversais , Dinamarca/epidemiologia , Educação Médica , Feminino , Humanos , Masculino , Pandemias , Salários e Benefícios , Inquéritos e Questionários , Adulto Jovem
15.
Tex Med ; 116(8): 38-40, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32866276

RESUMO

Under Texas law, physicians treating COVID-19 patients in a volunteer capacity have potential defenses against lawsuits that might arise from that care. But for non-volunteer physicians on the COVID battlefield - often working in harrowing, overloaded settings, high on patient count and low on equipment - the same liability shields don't exist. And with a resurgence in COVID-19 cases and hospitalizations taking hold in June, the Texas Medical Association continued its pandemic-long push to extend liability protections to all frontline physicians, volunteer or not.


Assuntos
Infecções por Coronavirus , Responsabilidade Legal , Pandemias , Administração dos Cuidados ao Paciente , Médicos , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Humanos , Seguro de Responsabilidade Civil/legislação & jurisprudência , Determinação de Necessidades de Cuidados de Saúde , Administração dos Cuidados ao Paciente/ética , Administração dos Cuidados ao Paciente/legislação & jurisprudência , Administração dos Cuidados ao Paciente/métodos , Médicos/ética , Médicos/legislação & jurisprudência , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Texas/epidemiologia , Voluntários/legislação & jurisprudência
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(9): 963-967, 2020 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-32907286

RESUMO

Objective: To evaluate and share the novel method for recruiting participants in clinical trials of vaccines in emergency situations. Methods: To publish recruitment notice in local areas of Wuhan through websites and medium, and guide interested persons to log in to the"Clinical Trials of SARS-CoV-2 Vaccine Reservation and Health Declaration System"to appoint and register their health information. The "Health Declaration System" provides each volunteer evaluation and risk levels to preliminarily exclude those who do not meet the inclusion criteria. Researchers review the qualified volunteers by telephone, organize them to go to the vaccination site, and finally conduct a strict medical screening to determine the final subjects. Results: A total of 4 819 people and 5 132 people registered in the Phase Ⅰ and Phase Ⅱ recruitment system respectively, with men 2 912 (60.43%) and 2 887 (56.25%) more than women 1 907 (39.57%) and 2 245 (43.75%), mostly in the 20-39 age group, with 3 211 (66.63%) and 3 966 (77.28%). All 13 districts in Wuhan have interested residents to participate clinical research.The initial qualified rate of the Phase Ⅱ recruitment system was higher than that of Phase Ⅰ, with men 2 047 (70.28%) and 2 135(73.95%), higher than women 1 083 (56.80%) and 1 472 (65.57%); 440 and 689 people were reviewed by telephone in Phase Ⅰ and Phase Ⅱ respectively, and the number of verified volunteers was about 440 (35.00%) and 689 (67.20%); Of the 201 603 people who arrived at the vaccination site, 12 and 26 of them were positive for the SARS-CoV-2 antibody with an antibody positive rate of 6.00% and 4.31% respectively. Conclusion: The novel method for recruiting subjects in this clinical study is efficient and reliable, and the recruitment situation of Phase Ⅰ had set a good example for Phase Ⅱ but the medium-and long-term compliance of subjects and the separation of willingness and behaviors still need to be further studied.


Assuntos
Ensaios Clínicos como Assunto/organização & administração , Seleção de Pacientes , Vacinas Virais , Adulto , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Emergências , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Voluntários/estatística & dados numéricos , Adulto Jovem
18.
J Interprof Care ; 34(5): 679-681, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32962471

RESUMO

Due to the unprecedented pressures on healthcare systems during the COVID-19 pandemic, many medical students internationally volunteered to assist in hospitals. In the United Kingdom, most students worked in roles similar to Healthcare Assistants: helping to support nurses in providing patient care. Although the current situation is exceptional, with medical students eager to contribute to the COVID-19 response, they have also gained valuable experience in interprofessional collaboration. By working closely with nurses, medical students have gained practical understanding of the different roles within the hospital environment and been involved in providing hands-on care to patients. The experience of the current pandemic has shown the willingness of medical students to volunteer in Healthcare Assistant roles and demonstrated the ability of hospitals to successfully integrate students into established nursing teams. This short report provides a reflection on the advantages of these placements and argues for their continuation in future practice.


Assuntos
Comportamento Cooperativo , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Estudantes de Medicina , Voluntários , Betacoronavirus , Humanos , Papel Profissional , Reino Unido
19.
Cad Saude Publica ; 36(9): e00132120, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965375

RESUMO

Brazil is the country of the world with the second most COVID-19 cases and deaths, and the pandemic's impacts pose multiple challenges for mental health. This paper reports on experience with the emergency organization of the volunteer and collaborative Working Group (GT, in Portuguese) on mental health and psychosocial care aimed at producing rapid responses for health services in the context of COVID-19. The study involved the identification and systematization of current evidence in the scientific literature on mental health and psychosocial care in public health emergencies and pandemics, with the establishment of a network involving 117 researchers and 25 institutions, and the organization of themes for the elaboration of materials, referenced on the response phases in public health emergencies and pandemics. In less than 60 days, 18 technical documents were produced, ranging from services organization and management for different vulnerable groups. The materials became references in health institutions and services. A national course on mental health and psychosocial care in COVID-19 was also organized, with more than 60,000 people registered. The experience provides food for thought and a contribution for future experiences involving knowledge translation in the current pandemic and in future public health emergencies and pandemics, with the following: (1) combination of volunteer and collaborative work involving professionals with experience in the organization of services and care in past events; (2) reliance on institutional support and resources; (3) speed and credibility of work involving the establishment of networks of professionals and institutions; and (4) responses to the urgent needs with the capacity to shape paths for care in mental health and psychosocial care.


Assuntos
Comportamento Cooperativo , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Saúde Mental , Pandemias , Pneumonia Viral/psicologia , Sistemas de Apoio Psicossocial , Voluntários/estatística & dados numéricos , Betacoronavirus , Brasil/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Desenvolvimento de Programas
20.
Global Health ; 16(1): 85, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967691

RESUMO

OBJECTIVES: Restricting mobility is a central aim for lowering contact rates and preventing COVID-19 transmission. Yet the impact on mobility of different non-pharmaceutical countermeasures in the earlier stages of the pandemic is not well-understood. DESIGN: Trends were evaluated using Citymapper's mobility index covering 2nd to 26th March 2020, expressed as percentages of typical usage periods from 0% as the lowest and 100% as normal. China and India were not covered. Multivariate fixed effects models were used to estimate the association of policies restricting movement on mobility before and after their introduction. Policy restrictions were assessed using the Oxford COVID-19 Government Response Stringency Index as well as measures coding the timing and degree of school and workplace closures, transport restrictions, and cancellation of mass gatherings. SETTING: 41 cities worldwide. MAIN OUTCOME MEASURES: Citymapper's mobility index. RESULTS: Mobility declined in all major cities throughout March. Larger declines were seen in European than Asian cities. The COVID-19 Government Response Stringency Index was strongly associated with declines in mobility (r = - 0.75, p < 0.001). After adjusting for time-trends, we observed that implementing non-pharmaceutical countermeasures was associated with a decline of mobility of 10.0% for school closures (95% CI: 4.36 to 15.7%), 15.0% for workplace closures (95% CI: 10.2 to 19.8%), 7.09% for cancelling public events (95% CI: 1.98 to 12.2%), 18.0% for closing public transport (95% CI: 6.74 to 29.2%), 13.3% for restricting internal movements (95% CI: 8.85 to 17.8%) and 5.30% for international travel controls (95% CI: 1.69 to 8.90). In contrast, as expected, there was no association between population mobility changes and fiscal or monetary measures or emergency healthcare investment. CONCLUSIONS: Understanding the effect of public policy on mobility in the early stages is crucial to slowing and reducing COVID-19 transmission. By using Citymapper's mobility index, this work provides the first evidence about trends in mobility and the impacts of different policy interventions, suggesting that closure of public transport, workplaces and schools are particularly impactful.


Assuntos
Infecções por Coronavirus/prevenção & controle , Saúde Global , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Viagem/estatística & dados numéricos , Cidades/epidemiologia , Infecções por Coronavirus/epidemiologia , Sistemas de Informação Geográfica , Humanos , Pneumonia Viral/epidemiologia , Política Pública , Fatores de Tempo , Viagem/legislação & jurisprudência , Voluntários
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