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1.
Int J Aging Hum Dev ; 96(1): 91-105, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35821570

RESUMO

Mentoring underrepresented students in aging research during the COVID-19 pandemic affords many opportunities for innovation and learning, for both students and program leaders. Here, we describe lessons learned from an Advancing Diversity in Aging Research (ADAR) program at a women-centered, minority-serving undergraduate institution. We share program elements and assessment results related to scholars' education in aging, support through community-building and mentorship, and research experiences in gerosciences. Notably, we highlight lessons learned for retaining and training undergraduate students as graduate school-ready researchers: 1) draw students into a community focused on social justice, 2) show students that geroscience is inclusive and integrative, 3) model professionalism with flexibility, 4) keep open lines of communication, and 5) build a team of mentors around each scholar. By sharing insights from our community of practice in geroscience research and education, we hope to model best practices for URM student support in aging research.


Assuntos
COVID-19 , Tutoria , Feminino , Humanos , Gerociência , Pandemias , COVID-19/epidemiologia , Mentores , Tutoria/métodos , Grupos Minoritários
2.
Life Sci Alliance ; 6(1)2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36347544

RESUMO

Understanding the molecular mechanism underlying the rampant mutation of SARS-CoV-2 would help us control the COVID-19 pandemic. The APOBEC-mediated C-to-U deamination is a major mutation type in the SARS-CoV-2 genome. However, it is unclear whether the novel mutation rate u is higher for C-to-U than for other mutation types, and what the detailed driving force is. By analyzing the time course SARS-CoV-2 global population data, we found that C-to-U has the highest novel mutation rate u among all mutation types and that this u is still increasing with time (du/dt > 0). Novel C-to-U events, rather than other mutation types, have a preference over particular genomic regions. A less local RNA structure is correlated with a high novel C-to-U mutation rate. A cascade model nicely explains the du/dt > 0 for C-to-U deamination. In SARS-CoV-2, the RNA structure serves as the molecular basis of the extremely high and continuously accelerating C-to-U deamination rate. This mechanism is the driving force of the mutation, adaptation, and evolution of SARS-CoV-2. Our findings help us understand the dynamic evolution of the virus mutation rate.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Pandemias , Desaminação , Genoma Viral/genética , RNA
3.
Med Educ Online ; 28(1): 2143926, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36351170

RESUMO

INTRODUCTION: The residency application process is a critical time for medical students. The COVID-19 pandemic prompted changes to the residency recruitment procedures with the conversion of interviews to a virtual format. For medical school advisors guiding students on an all-virtual residency application process brought uncertainty to their advising practices. Thus, this study aimed to identify advising practices during the 2021 virtual application cycle. METHODS: We administered an IRB-exempt national survey through the Clerkship Directors in Internal Medicine to 186 internal medicine core/co-/associate/assistant clerkship directors and sub-internship directors representing 140 Liaison Committee on Medical Education-accredited U.S./U.S.-territory-based medical schools in spring 2021. The 23-question survey was designed and pilot-tested by faculty-educators and leaders with expertise in undergraduate medical education. Data analysis included paired t- and z-tests and thematic analysis of open-ended questions. RESULTS: The institutional response rate was 67% (93/140) and individual rate 55% (103/186). Half of the respondents felt prepared/very prepared (40% and 13% respectively) for their advising roles. Compared to pre-pandemic cycles, respondents advised a typical student in the middle-third of their class at their institution to apply to more residency programs (mean 24 programs vs 20, p < 0.001) and accept more interviews (mean 14 interviews vs 12, p < 0.001). Sixty-three percent (64/101) of respondents spent more time on student advising; 51% (51/101) reported more students asked them for informal advice. Fifty-nine percent (60/101) of respondents reported their advisees were able to assess a residency program 'somewhat well;' 31% (31/101) expressed that residency recruitment should remain entirely virtual in the future. CONCLUSION: The transition to virtual residency recruitment due to COVID-19 prompted advising practices that may have contributed to application inflation and increased advising workload. Future studies should explore longitudinal outcomes of virtual interviews on student success to guide best practices in how to advise students during residency recruitment.


Assuntos
COVID-19 , Estágio Clínico , Internato e Residência , Estudantes de Medicina , Humanos , Pandemias , COVID-19/epidemiologia , Inquéritos e Questionários
4.
Med Educ Online ; 28(1): 2143307, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36369921

RESUMO

The COVID-19 pandemic transformed the final year of undergraduate medical education for thousands of medical students across the globe. Out of concern for spreading SARS-CoV-2 and conserving personal protective equipment, many students experienced declines in bedside clinical exposures. The perceived competency of this class within the context of the pandemic is unclear. We designed and distributed a survey to measure the degree to which recent medical school graduates from the USA felt clinically prepared on 13 core clinical skills. Of the 1283 graduates who matched at HCA Healthcare facilities, 90% (1156) completed the survey. In this national survey, most participants felt they were competent in their clinical skills. However, approximately one out of four soon-to-be residents felt they were clinically below where they should be with regard to calling consultations, performing procedures, and performing pelvic and rectal exams. One in five felt they were below where they should be with regard to safely transitioning care. These perceived deficits in important skill sets suggest the need for evaluation and revised educational approaches in these areas, especially when traditional in-person practical skills teaching and practice are disrupted.


Assuntos
COVID-19 , Educação Médica , Internato e Residência , Médicos , Estudantes de Medicina , Humanos , COVID-19/epidemiologia , Pandemias , SARS-CoV-2
5.
J Environ Sci (China) ; 125: 553-567, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36375938

RESUMO

Based on the online and membrane sampling data of Yuncheng from January 1st to February 12th, 2020, the formation mechanism of haze under the dual influence of Spring Festival and COVID-19 (Corona Virus Disease) was analyzed. Atmospheric capacity, chemical composition, secondary transformation, source apportionment, backward trajectory, pollution space and enterprise distribution were studied. Low wind speed, high humidity and small atmospheric capacity inhibited the diffusion of air pollutants. Four severe pollution processes occurred during the period, and the pollution degree was the highest around the Spring Festival. In light, medium and heavy pollution periods, the proportion of SNA (SO42-, NO3- and NH4+) was 59.6%, 56.0% and 54.9%, respectively, which was the largest components of PM2.5; the [NO3-]/[SO42-] ratio was 2.1, 1.5 and 1.7, respectively, indicating that coal source had a great influence; the changes of NOR (nitrogen oxidation ratio, 0.44, 0.45, 0.61) and SOR (sulphur oxidation ratio, 0.40, 0.49, 0.65) indicated the accumulation of secondary aerosols with increasing pollution. The coal combustion, motor vehicle, secondary inorganic sources and industrial sources contributed 36.8%, 26.59%, 11.84% and 8.02% to PM2.5 masses, respectively. Backward trajectory showed that the influence from the east was greater during the Spring Festival, and the pollutants from the eastern air mass were higher, which would aggravate the pollution. Meteorological and Spring Festival had a great impact on heavy pollution weather. Although some work could not operate due to the impact of the COVID-19 epidemic, the emission of pollutants did not reduce much.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Humanos , Material Particulado/análise , COVID-19/epidemiologia , Férias e Feriados , Pandemias , Monitoramento Ambiental , Aerossóis e Gotículas Respiratórios , Poluentes Atmosféricos/análise , Estações do Ano , Carvão Mineral , China/epidemiologia , Emissões de Veículos/análise , Poluição do Ar/análise
6.
J Environ Sci (China) ; 124: 933-951, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36182196

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented worldwide health crisis. Many previous research studies have found and investigated its links with one or some natural or human environmental factors. However, a review on the relationship between COVID-19 incidence and both the natural and human environment is still lacking. This review summarizes the inter-correlation between COVID-19 incidence and environmental factors. Based on keyword searching, we reviewed 100 relevant peer-reviewed articles and other research literature published since January 2020. This review is focused on three main findings. One, we found that individual environmental factors have impacts on COVID-19 incidence, but with spatial heterogeneity and uncertainty. Two, environmental factors exert interactive effects on COVID-19 incidence. In particular, the interactions of natural factors can affect COVID-19 transmission in micro- and macro- ways by impacting SARS-CoV-2 survival, as well as human mobility and behaviors. Three, the impact of COVID-19 incidence on the environment lies in the fact that COVID-19-induced lockdowns caused air quality improvement, wildlife shifts and socio-economic depression. The additional value of this review is that we recommend future research perspectives and adaptation strategies regarding the interactions of the environment and COVID-19. Future research should be extended to cover both the effects of the environment on the COVID-19 pandemic and COVID-19-induced impacts on the environment. Future adaptation strategies should focus on sustainable environmental and public policy responses.


Assuntos
Poluição do Ar , COVID-19 , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2
7.
J Hazard Mater ; 441: 129831, 2023 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-36084457

RESUMO

The contagious coronavirus disease-2019 pandemic has led to an increasing number of disposable face masks (DFMs) abandoned in the environment, when they are exposed to the air condition, the broken of chemical bond induced aging is inevitably occurred which meantime would cause a drastic decrease of the mechanical flexibility. However, the understanding of between chemical bond change related to aging and its micromechanical loss is limited due to the lack of refined techniques. Herein, the atomic force microscopy (AFM) technique was firstly used to observe the aging process induced by methine of the polypropylene-based DFMs. By comparing the micromechanical properties loss, the influences of humidity and light density on the DFM aging were systematically studied in the early 72 h, and it revealed that the increasing scissions number of the easiest attacked methine (Ct-H) can gradually decrease the micromechanical properties of the polypropylene (PP)-based DFM. Furthermore, the results are also validated by the in- situ FTIR and XPS analysis. This work discloses that an aging process can be initially estimated with the micromechanical changes observed by AFM, which offers fundamental data to manage this important emerging plastic pollution during COVID-19 pandemic.


Assuntos
COVID-19 , Polipropilenos , Envelhecimento , COVID-19/prevenção & controle , Humanos , Máscaras , Microscopia de Força Atômica , Pandemias
8.
Appl Ergon ; 106: 103884, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36030734

RESUMO

BACKGROUND: Hospitalists are physicians trained in internal medicine and play a critical role in delivering care in in-patient settings. They work across and interact with a variety of sub-systems of the hospital, collaborate with various specialties, and spend their time exclusively in hospitals. Research shows that hospitalists report burnout rates above the national average for physicians and thus, it is important to understand the key factors contributing to hospitalists' burnout and identify key priorities for improving hospitalists' workplace. METHODS: Hospitalists at an academic medical center and a community hospital were recruited to complete a survey that included demographics, rating the extent to which socio-technical (S-T) factors contributed to burnout, and 22-item Maslach Burnout Inventory - Human Services Survey (MBI-HSS). Twelve contextual inquiries (CIs) involving shadowing hospitalists for ∼60 h were conducted varied by shift type, length of tenure, age, sex, and location. Using data from the survey and CIs, an affinity diagram was developed and presented during focus groups to 12 hospitalists to validate the model and prioritize improvement efforts. RESULTS: The overall survey participation rate was 68%. 76% of hospitalists reported elevated levels on at least one sub-component within the MBI. During CIs, key breakdowns were reported in relationships, communication, coordination of care, work processes in electronic healthcare records (EHR), and physical space. Using data from CIs, an affinity diagram was developed. Hospitalists voted the following as key priorities for targeted improvement: improve relationships with other care team members, improve communication systems and prevent interruptions and disruptions, facilitate coordination of care, improve workflows in EHR, and improve physical space. CONCLUSIONS: This mixed-method study utilizes participatory and data-driven approaches to provide evidence-based prioritization of key factors contributing to hospitalists' burnout. Healthcare systems may utilize this approach to identify workplace factors contributing to provider burnout and consider targeting the factors identified by providers to best optimize scarce resources.


Assuntos
Esgotamento Profissional , COVID-19 , Médicos Hospitalares , Humanos , Local de Trabalho , COVID-19/epidemiologia , Pandemias
9.
J Hazard Mater ; 443(Pt A): 130177, 2023 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-36308932

RESUMO

Disinfection plays an essential role in waterborne pathogen control and disease prevention, especially during the COVID-19 pandemic. Catalyst-free solar light/periodate (PI) system has recently presented great potential in water disinfection, whereas the in-depth chemical and microbiological mechanisms for efficient bacterial inactivation remain unclear. Our work delineated firstly the critical role of singlet oxygen, instead of reported hydroxyl radicals and superoxide radicals, in dominating bacterial inactivation by the PI/simulated sunlight (SSL) system. Multi-evidence demonstrated the prominent disinfection performance of this system for Staphylococcus aureus in terms of culturability (> 6 logs CFU), cellular integrity, and metabolic activity. Particularly, the excellent intracellular DNA removal (> 95%) indicated that PI/SSL system may function as a selective disinfection strategy to diminish bacterial culturability without damaging the cell membrane. The PI/SSL system could also effectively inhibit bacterial regrowth for > 5 days and horizontal gene transfer between E. coli genera. Nontargeted metabolomic analysis suggested that PI/SSL system inactivated bacteria by triggering the accumulation of intracellular reactive oxygen species and the depletion of reduced glutathione. Additionally, the PI/SSL system could accomplish simultaneous micropollutant removal and bacterial inactivation, suggesting its versatility in water decontamination. Overall, this study deciphers more comprehensive antibacterial mechanisms of this environmentally friendly disinfection system, facilitating the technical development and application of the selective disinfection strategy in environmental pathogen control.


Assuntos
COVID-19 , Purificação da Água , Humanos , Desinfecção , Oxigênio Singlete , Escherichia coli , Pandemias , Água/farmacologia
10.
J Theor Biol ; 556: 111299, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36252843

RESUMO

One of the key features of any infectious disease is whether infection generates long-lasting immunity or whether repeated reinfection is common. In the former, the long-term dynamics are driven by the birth of susceptible individuals while in the latter the dynamics are governed by the speed of waning immunity. Between these two extremes a range of scenarios is possible. During the early waves of SARS-CoV-2, the underlying paradigm was for long-lasting immunity, but more recent data and in particular the 2022 Omicron waves have shown that reinfection can be relatively common. Here we investigate reported SARS-CoV-2 cases in England, partitioning the data into four main waves, and consider the temporal distribution of first and second reports of infection. We show that a simple low-dimensional statistical model of random (but scaled) reinfection captures much of the observed dynamics, with the value of this scaling, k, providing information of underlying epidemiological patterns. We conclude that there is considerable heterogeneity in risk of reporting reinfection by wave, age-group and location. The high levels of reinfection in the Omicron wave (we estimate that 18% of all Omicron cases had been previously infected, although not necessarily previously reported infection) point to reinfection events dominating future COVID-19 dynamics. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Assuntos
COVID-19 , Reinfecção , Humanos , Reinfecção/epidemiologia , SARS-CoV-2 , COVID-19/epidemiologia , Pandemias , Inglaterra/epidemiologia
11.
Ann Lab Med ; 43(2): 137-144, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36281507

RESUMO

While the coronavirus disease 2019 pandemic is ongoing, monkeypox has been rapidly spreading in non-endemic countries since May 2022. Accurate and rapid laboratory tests are essential for identifying and controlling monkeypox. Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have proposed guidelines for diagnosing monkeypox in clinical laboratories in Korea. These guidelines cover the type of tests, selection of specimens, collection of specimens, diagnostic methods, interpretation of test results, and biosafety. Molecular tests are recommended as confirmatory tests. Skin lesion specimens are recommended for testing in the symptomatic stage, and the collection of both blood and oropharyngeal swabs is recommended in the presymptomatic or prodromal stage.


Assuntos
COVID-19 , Varíola dos Macacos , Humanos , Varíola dos Macacos/diagnóstico , COVID-19/diagnóstico , Técnicas de Laboratório Clínico , Pandemias , República da Coreia
12.
Holist Nurs Pract ; 37(1): 34-44, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36378090

RESUMO

Given the serious threats posed by the COVID-19 virus, preventive measures and coping strategies are critical in lowering infection rates, managing disease transmission, and improving people's psychological well-being. This study aimed to evaluate the effect of telehealth nursing intervention on psychological status and coping strategies among parents during the second wave of COVID-19. A quasi-experimental (one group pre-/posttest) design was used. A purposive sample of 209 parents in Menoufia governorate, Egypt, was collected using Google Form. Tools: (1) Structured questionnaire for parents (a) Demographic data (b) Parents' knowledge regarding COVID-19. (2) Parents' preventive practices of the COVID-19 questionnaire. (3) Parents" coping strategies with COVID-19 pandemic questionnaire. (4) Depression, Anxiety, and Stress Scale (Arabic DASS-21). Approximately 82.8% of the participants had normal to mild depression after the telehealth nursing intervention compared with 62.6% before the telehealth nursing intervention. Approximately 55.4% of them had moderate to extremely severe level of anxiety before the telehealth nursing intervention compared with (21.6%) after the telehealth nursing intervention. Approximately 85.2% reported a normal level of stress after the telehealth nursing intervention compared with (62.7%) before the telehealth nursing. Telehealth nursing intervention was effective for improving parents' knowledge, preventive practice, and coping strategies during the second wave of COVID-19.


Assuntos
COVID-19 , Telemedicina , Humanos , Pandemias , Adaptação Psicológica , Ansiedade/psicologia , Pais , Estresse Psicológico/psicologia
13.
J Infect Chemother ; 29(1): 20-25, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36103948

RESUMO

OBJECTIVES: To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. METHODS: A retrospective chart review of children 0-14 years old admitted to PICU with a viral infection. RESULTS: Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). CONCLUSION: Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations.


Assuntos
COVID-19 , Viroses , Criança , Humanos , Lactente , Recém-Nascido , Pré-Escolar , Adolescente , Pandemias , Centros de Atenção Terciária , Estudos Retrospectivos , COVID-19/epidemiologia , Unidades de Terapia Intensiva Pediátrica , Viroses/epidemiologia , Tempo de Internação
14.
J Infect Chemother ; 29(1): 98-101, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36113846

RESUMO

The impact of the COVID-19 pandemic on the incidence of microbial infections and other metrics related to antimicrobial resistance (AMR) has not yet been fully described. Using data from Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE), a national surveillance database system that routinely collects clinical and epidemiological data on microbial infections, infection control practices, antimicrobial use, and AMR emergence from participating institutions in Japan, we assessed the temporal changes in AMR-related metrics before and after the start of the COVID-19 pandemic. We found that an apparent decrease in the incidence of microbial infections in 2020 compared with 2019 may have been driven primarily by a reduction in bed occupancy, although the incidence showed a constant or even slightly increasing trend after adjusting for bed occupancy. Meanwhile, we found that the incidence of Streptococcus pneumoniae dramatically decreased from April 2020 onward, probably due to stringent non-pharmaceutical interventions against COVID-19. Antimicrobial use showed a weak increasing trend, while the use of hand sanitiser at the included medical institutions increased by about 50% in 2020 compared with 2019.


Assuntos
COVID-19 , Farmacorresistência Bacteriana , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Japão/epidemiologia , Pandemias/prevenção & controle , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Atenção à Saúde
15.
J Infect Chemother ; 29(1): 90-94, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36116719

RESUMO

INTRODUCTION: During the COVID-19 pandemic, the incidence of many droplet-transmitted infections decreased due to increased mask-wearing and social distancing. Contrastingly, there has been concern that COVID-19 countermeasures, such as lockdowns, may increase legionellosis incidence via water stagnation. During the pandemic in Japan, four state of emergency declarations were imposed between 2020 and 2021, which makes it particularly suitable to test this hypothesis. METHODS: We use country-level surveillance data from the National Institute of Infectious Diseases to track the relative incidence of legionellosis compared to invasive pneumococcal disease (IPD) during the COVID-19 pandemic in Japan, with a focus on the periods just after state of emergency declarations were lifted. RESULTS: The absolute number of legionellosis and IPD cases decreased in 2020 and 2021 compared to previous years. The average relative incidence of legionellosis as well as the variance of the relative incidence significantly increased during the pandemic compared to previous years. There were no increases in the relative incidence of legionellosis during the periods immediately following emergency declaration liftings, but the relative incidence did increase considerably during the first two states of emergency. CONCLUSIONS: COVID-19 countermeasures appear more effective at decreasing the incidence of human-to-human transmitted infections, such as IPD, compared to environmentally-transmitted infections, such as legionellosis. Though no evidence was found to suggest that legionellosis cases increased after state of emergency declarations, public health efforts should continue to emphasize the importance of routine sanitation and water system maintenance to prevent water stagnation and Legionella spp. contamination.


Assuntos
COVID-19 , Legionelose , Infecções Pneumocócicas , Humanos , COVID-19/epidemiologia , Pandemias , Incidência , Japão/epidemiologia , Controle de Doenças Transmissíveis , Legionelose/epidemiologia , Infecções Pneumocócicas/epidemiologia , Água
16.
J Infect Chemother ; 29(1): 39-42, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36168999

RESUMO

BACKGROUND: To mitigate the COVID-19 pandemic, many countries have recommended the use of booster vaccinations. The relationship between the degree of adverse vaccine reactions and elevated antibody titers is of interest; however, no studies have investigated the temporal changes in antibody titers based on repeated measurements after a third dose of the BNT162b2 vaccine. METHODS: This prospective longitudinal cohort study was conducted with 62 healthcare workers who received a third dose of the BNT162b2 at Okayama University Hospital, Japan. Venous blood draw and fingertip whole blood test sample collection were conducted at the early (3-13 days) and 1-month time points; only FWT sample collection was conducted at the 2-month time point. Information on adverse reactions within 1 week after vaccination was also obtained. The association between fever of 37.5 °C or higher and antibody titers after the third dose of BNT162b2 was examined using a mixed-effects model and Poisson regression with robust variance. RESULTS: A trend toward higher antibody titers in the early period after vaccination was observed in the febrile individuals, but the differences were not significant at 1 and 2 months post-vaccination (the partial regression coefficient for fever was 8094.3 [-1910.2, 18,098.8] at 1 month after vaccination, and 1764.1 [-4133.9, 7662.1] at 2 months after vaccination in the adjusted models). CONCLUSION: The findings suggest that the presence of fever after the third vaccine does not predict a sustained elevation in serum antibody titers.


Assuntos
COVID-19 , Vacinas , Humanos , Vacina BNT162 , Estudos Prospectivos , Estudos Longitudinais , Pandemias , COVID-19/prevenção & controle , Anticorpos Antivirais
17.
Arch Gerontol Geriatr ; 104: 104832, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36219895

RESUMO

BACKGROUND AND PURPOSE: The aim of this nationwide study was to assess the impact of the COVID-19 pandemic on cerebrovascular disease hospitalization rates, out-of-pocket rates, and in-hospital case fatality rates. METHODS: All hospitalizations for cerebrovascular disease from 1599 hospitals from 2019 to 2020 were selected using the International Classification of Diseases, 10th revision, in the Hospital Quality Monitoring System (HQMS). We defined 2019 as the pre-pandemic group and 2020 as the post-pandemic group. Multivariate analyses were done to assess the association between the pandemic and patient outcomes and out-of-pocket rate with odds ratios (OR) and 95% CIs presented. RESULTS: In total, 9 640 788 patients with the cerebrovascular disease were recruited (mean age was 65.7[SE.0.004] years, and 55.7% were male), and data is available for 5145358 patients in 2019 (pre-epidemic) and 4495430 patients in 2020(post-pandemic), indicating a 12.6% decrease. Out-of-pocket rate increase of 9.3% (2020 vs 2019: 34.1%% vs 31.2% [absolute difference, 2.9% {95% CI, 1.3% to 4.5%}, odd ratio {OR}, 1.1{95% CI, 1.0 to 1.1}]. The epidemic has led to an 18.0% increase in in-hospital mortality (2020 vs 2019: 1.1%% vs 0.9% [absolute difference, 0.2% {95% CI, 0.1% to 0.2%}, odd ratio {OR}, 1.1{95% CI, 1.1 to 1.2}]. The epidemic has led to significantly increased in-hospital mortality for patients with stroke but had no significant impact on other cerebrovascular diseases. CONCLUSIONS: During the COVID-19 pandemic lockdown, patients hospitalized for stroke fell by 12.6%, and there were substantial increases in out-of-pocket rates (9.3%) and in-hospital case fatality rates (18.0%).


Assuntos
COVID-19 , Transtornos Cerebrovasculares , Acidente Vascular Cerebral , Humanos , Masculino , Idoso , Feminino , Mortalidade Hospitalar , Pandemias , Controle de Doenças Transmissíveis , Hospitalização , Transtornos Cerebrovasculares/epidemiologia , Acidente Vascular Cerebral/epidemiologia
18.
Ann Ig ; 35(1): 61-74, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35403663

RESUMO

Background: As a producer of hazardous waste, hospitals have the responsibility to manage the waste they produce. Hospital non-compliance in managing hazardous waste can have a negative impact on the environment and public health, especially during the COVID-19 pandemic, when the amount of hazardous waste produced by healthcare facilities is increasing. To protect the environment and public health from the negative impact of hazardous medical waste, this study was conducted to determine the level of compliance of hazardous waste management in hospitals in Indonesia before and during the COVID-19 pandemic, from 2019 to 2020. Study design: Cross-sectional. Methods: This study was conducted at 343 hospitals in Indonesia using secondary data obtained from Sikelim (Medical Waste Management Information System), which is owned and operated by the Ministry of Health. The data have been analyzed using chi-square tests and logistic regressions of the determinant model. Results: There was an increase in the level of compliance of hazardous waste management in hospitals from 82% to 86% during the pandemic. Furthermore, the availability of environmental documents and environmental health units were determinant factors of hazardous waste management compliance by hospitals before the pandemic in 2019. The only factor in 2020 was the availability of environmental health units. Conclusions: Despite the good level of compliance, additional efforts are needed to increase the activities of the treatment of hazardous medical waste by hospitals, as before the pandemic (i.e., in a normal situation) only 8% of hospitals was able to independently manage hazardous medical waste using authorized incinerators, a percentage that was reduced to 6% during the pandemic.


Assuntos
COVID-19 , Eliminação de Resíduos de Serviços de Saúde , Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Humanos , Resíduos de Serviços de Saúde/análise , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Indonésia/epidemiologia , Resíduos Perigosos/análise
19.
Ann Ig ; 35(1): 39-48, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35442385

RESUMO

Introduction: Healthcare workers on duty at the hospital are at high risk of COVID-19 infection. However, despite the introduction of risk-lowering practices in the hospital setting, there have been many cases of SARS-COV-2 infection among Health Care Workers. Fast and efficient contact tracing and Sars-CoV-2 PCR-based testing of the close contacts of Health Care Workers with confirmed infections are essential steps to limit nosocomial outbreaks. Methods: This cross-sectional study was conducted at Bari Policlinico General University-Hospital (Apulia, Italy) and describes the management of a cluster of SARS-COV-2 infections in three Operative Units. The contact tracing activities and the measures implemented to control the outbreak are described. Results: Among the 186 Health Care Workers active in the cluster setting, there were 9 (4.8%) confirmed cases, including the index case. Due to the outbreak, three Operative Units were closed to limit virus circulation. Health Care Workers with confirmed infections tested negative after a mean of 28.0±6.6 days (range: 13-37) and none required hospitalization. Conclusions: Protection of the health of Health Care Workers during the COVID-19 pandemic should be a public health priority. However, despite recent recommendations and the implementation of protective measures, SARS-COV-2 infections of Health Care Workers remain at a high rate, indicative of the continued high risk of cluster onset in the nosocomial setting.


Assuntos
COVID-19 , Infecção Hospitalar , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias/prevenção & controle , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Estudos Transversais , Análise de Rede Social , Pessoal de Saúde , Hospitais Universitários
20.
Ann Ig ; 35(1): 34-38, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35452071

RESUMO

Background: As other indoor sports facilities, swimming pools were closed in Italy from March to May 2020 and from October 2020 to July 2021 due to the outbreak of the COVID-19 pandemic; access to these facilities was restricted to athletes of national relevance. This decision was based on "precautionary principles" and without evidence of a high risk of SARS-COV-2 circulation among swimming pools' attendants. The aim of this paper is to describe the pattern of SARS-COV-2 circulation among swimming athletes in Apulia (Southern Italy). Study design: The study aims to investigate the hypothesis that attending a pool increases the risk of SARS-COV-2 infection. The outcome measure is the incidence of SARS-COV-2 infection among swimming athletes compared with the general population. Methods: This is a retrospective cross-sectional study carried out in Apulia, Southern Italy. The study was performed through the analysis of both the database of the Italian Swimming Federation and the SARS-COV-2 infections in Apulia Region, from July 2020 to August 2021. Results: Among 2,939 federally licensed athletes, 221 had an history of SARS-COV-2 infection from July 2020 to August 2021, with an incidence of 75.2 /1,000. In the general Apulian population, during the same time span, the incidence of SARS-COV-2 infection was 67.3/1,000 and - considering the incidence rate ratio - there is no difference between the two populations (IRR=1.1; 95% CI=0.9-1.3; p>0.05). Conclusions: The incidence of SARS-COV-2 infection in Apulian swimmers showed no significant differences with the general population.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias , Incidência , Natação , Estudos Transversais , Estudos Retrospectivos , Itália/epidemiologia , Atletas
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