ABSTRACT
The role of advocating for individuals and communities not only includes advocating for the basic needs and resources of communities and entails conducting policy advocacy. This chapter provides two accounts of how CHWs provide advocacy and advocate for their profession. CHWs in Arizona advocated for their communities and their workforce on the state, local, and federal level to address the social determinants of health and structural issues such as poverty, unemployment, the built environment, and discrimination. The first team explores stories of CHWs who have advocated on multiple levels, including organizational and policy levels, and discusses the factors that support and hinder CHW advocacy efforts. The team describes how local and grassroots advocacy efforts ultimately helped to create a CHW workforce sustainability movement and support the statewide CHW professional association, Arizona Community Health Workers Association (AzCHOW), in advocating for voluntary certification on the state level. The second team provides timely information on how CHWs with Enlace Chicago advocated for their communities during COVID-19 to address social determinants of health, including poverty, unemployment, discrimination, and exploitation of worker rights, and provide basic needs. The CHW stories describe how advocacy efforts were instrumental in directing community members to food banks, personal protection equipment, sources of employment and workers' rights, and emergency rental assistance programs. These stories underscore how CHWs were often the only links connecting their community members to what they needed while facilitating the community's understanding to public health guidelines during COVID-19 and addressing mental health needs. © Springer Nature Switzerland AG 2021.
ABSTRACT
Coronavirus disease-19 (COVID-19) has triggered the worst public health crisis of modern times. The prothrombotic state induced by the infection is considered directly and substantially related to acute lung damage and other medical complications, including death. This scoping review summarises and critically assesses the existing evidence on the association between thrombosis and COVID-19, and is based on a systematic literature search of all articles published up to May 5th, 2020, included in the following databases: PubMed, Scopus, Cochrane, and Clinicaltrials.gov. A total of 26 articles were included, and their quality evaluated using STROBE guidelines. The main symptoms presented by patients that had been diagnosed with COVID-19 are dyspnoea, fever, cough, diarrhoea, and vomiting. In the laboratory findings, it is characteristic to observe an increase in D-dimer, fibrinogen, prothrombin time, and lymphopenia. Ultrasound and computed axial tomography were the radiological techniques most used for diagnosing pulmonary thromboembolism, deep vein thrombosis, and other thrombotic phenomena. In conclusion, there is still limited scientific evidence on COVID-19 and its thrombotic complications. This review summarises the body of evidence, assesses its quality, and offers conclusions that should help in the next steps in this highly relevant and expanding research area. © 2020 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
ABSTRACT
The severe restrictions on mobility experienced between March and June 2020, due to the measures taken by the Spanish Government to stop the advance of the COVID-19 pandemic, forced many organizations, including Spanish geoparks, to adopt a purely digital communication. A study of all their publications during this period reveals the social media strategy used by these geoparks. Through quantitative and qualitative analysis, the research focuses on issues such as regularity, type of content, the use of different networks, or the creation of new communication proposals - adapted to the demands of such a sudden change. The data, which reflect great differences between the strategies that the parks use regarding the use of these tools, offer us ways to rethink the use and the type of information shared in social media networks, in the face of an increasingly digital future.
ABSTRACT
Objectives. In recent years, hospital emergency departments have experienced a progressive increase in the demand for care, at the expense of trivial pathology. This trend changes from 14 March 2020, when the state of alarm was declared due to the COVID-19 pandemic, which led to the compulsory confinement of the population. The main objective of this study was to determine the impact that this state of alarm has had on the volume of paediatric emergencies in a third level hospital. Material and methods. A retrospective study of cohorts was carried out and included those under 14 years of age who demanded care during the months of the state of alarm and during the same months in the previous year. Different epidemiological and clinical data have been analysed. Results. 3,371 patients attended our Emergency Department in 2019, and 650 in 2020, with a similar average patient age. The most frequent diagnostic groups at discharge in both time periods were infectious and digestive diseases. In terms of hospital admissions, 7.12% required admission in 2019 and 13.69% in 2020. Regarding the department in charge of the patient during admission, in 2020 27.72% of patients were admitted by Paediatric Surgery. Conclusions. The activity in the paediatric emergency departments of our hospital varied considerably during the state of alarm. There has been a considerable decrease in the number of patients who have requested assistance due to the perceived risk of contagion by the population. In addition, we have perceived a relative increase in hospital admissions and, specifically, in urgent surgical pathology compared to the previous year.
ABSTRACT
Objective: The objective of this study was to review the EEG findings in patients diagnosed with COVID-19 infection through a systematic review of published articles. Background: Growing evidence of neurologic involvement seen in COVID-19 infection necessitates the pooling of neurodiagnostic findings like electroencephalography (EEG) that may guide clinical management. Design/Methods: We systematically searched until July 25, 2020 for published articles that reported on descriptive EEG findings in patients diagnosed with COVID-19 in PUBMED by Medline, EMBASE, and CENTRAL by the Cochrane Library. Results: From a total of 94 identified records, 29 relevant articles were included in this review. A total of 177 patients with COVID-19 with descriptive EEG reports were analyzed. The most common indication for EEG was unexplained altered mental status. Disturbances of background activity such as generalized and focal slowing were seen as well epileptiform abnormalities and rhythmic or periodic discharges. There were no consistent EEG findings specific to COVID-19 infection. Conclusions: The EEG findings in COVID-19 appear to be non-specific. Further research on the relationship of the EEG findings to the clinical state and short- or long-term prognosis of COVID-19 patients may be conducted to help clinicians discern which patients would necessitate an EEG procedure and would eventually require treatment.
ABSTRACT
Objective: This review aimed to examine the treatment gaps and challenges that burden Philippine epilepsy care. Background: Epilepsy is a neurologic disease that carries a high disease burden and, likely, a huge treatment gap, especially in low-to-middle income countries such as the Philippines. Design/Methods: Pertinent data on epidemiology, research, health systems and financing, pharmacologic and surgical treatment options, cost of care, and workforce were obtained through a literature search and review of relevant Philippine government websites. Results: The estimated prevalence of epilepsy in the Philippines is 0.9%. Epilepsy research in the Philippines is low in quantity compared to the rest of Southeast Asia. Inequities in healthcare services delivered to local government units have arisen due to devolution. Programs for epilepsy care by both government and non-government institutions have been implemented. Healthcare expenditure in the Philippines is largely out-of-pocket, with only partial coverage from the public sector. There is limited access to antiseizure medications, mainly due to cost. Epilepsy surgery is an underutilized treatment option. There are only twenty epileptologists in the Philippines, with one epileptologist for every 45,000 epilepsy patients. Epilepsy care delivery has been further impeded by the coronavirus disease of 2019 pandemic. Conclusions: There is a large treatment gap in epilepsy care in the Philippines due to high disease burden, sparse research, inadequate public support, inaccessibility of healthcare services and pharmacotherapy, underutilization of surgical options, and low specialist density. Addressing the treatment gap is expected to improve the overall survival and quality of life of epilepsy patients in the Philippines.