ABSTRACT
The use of common garden technology to improve access to rheumatology care would seem an obvious step. None of it is rocket science. And yet, the implementation has proven difficult due to a degree of inertia and poorly aligned incentives. In this chapter, I describe the experience for my private practice rheumatology group, operating in the community rather than in hospitals. Our practice is based in Sydney, Australia, where the government's response with extended lockdowns to Covid-19 has accelerated the acceptance of telehealth. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.
ABSTRACT
Background: Infections during pregnancy can increase the risk for neurodevelopmental disorders in offspring. This study aimed to prospectively monitor children exposed in utero to SARS-CoV-2 from birth to 15 years of age with a secondary aim to identify biomarkers of neurodevelopmental impairments. Method(s): Women infected with SARS-CoV-2 during pregnancy and sociodemographic and age matched non-exposed women were recruited from Monash Health, Australia (N=112 mother-infant dyads). Demographics, biospecimens and clinical data are collected at multiple time points from birth-15 years using standardised sample collection and neurological and behavioural scales. We present here the birth data. Result(s): Mother-infant dyads are classified as;non-exposed, mild SARS-CoV-2 (limitation of activities) and severe SARS-CoV-2 (hospitalised). Edinburgh postnatal depression scale scores were significantly higher in severe SARS-CoV-2 vs. non-exposed mothers (p<0.05). Maternal attachment scores were unchanged. Hammersmith neonatal neurological assessment scores were unchanged across groups, as were anthropometric measures. Severe SARS-CoV-2 exposed infants had lower scores on the sensory profile 2 questionnaire auditory domain than non-exposed infants (p<0.05). Analysis of infant buccal DNA (Illumina MethylationEPIC BeadChip >850,000 CpGs, N=8) showed hypomethylation of the gene AFAP-1 (q value<0.0008), and hypermethylation of neurodevelopmental pathways;'dendrite morphology' and 'axogenesis' in SARS-CoV-2 infants vs. non-exposed. Conclusion(s): While most assessments show no group differences thus far, the severe SARS-CoV-2 exposed group are faring worse in terms of maternal mental health, infant auditory domains and infant hypermethylation of genes belonging to neurodevelopmental pathways. Follow up assessments at 1-15 years will inform as to whether these initial group differences are early signs of more severe neurodevelopmental outcomes. Funding Source: Other - One in Five Philanthropic organisation Keywords: SARS-CoV-2, Pregnancy, DNA methylation, in utero, Neurodevelopmental trajectoriesCopyright © 2023
ABSTRACT
Nurses’ Quality Work Life affects the quality of services provided by the hospital. Nurses’ QWL has decreased especially since the covid-19 pandemic. This phenomenon may cause nurses at risk of experiencing physical and psychological problems which can leads to burnout among nurses. This study aims to find a relationship between quality of work life and burnout, especially in the midst of the COVID-19 pandemic at Dirgahayu Hospital in Samarinda. This study used a cross-sectional design with a sample size of 266 respondents who meet the inclusion criteria. Data collection was conducted in April 2021. The results of the research are there is a relationship between the quality of work life on burnout of nurses during the COVID-19 pandemic at Dirgahayu Hospital with the variable found with the greatest influence is the relationship with managers. High motivation and hard work of nurses in carrying out their responsibilities make the performance of nurses good. Evaluation of the quality of work life of nurses needs to be carried out as a whole so that improvements can be made to the quality of work life and prevent burnout.
ABSTRACT
Background: Although codes of ethics in Western medicine extend back to ancient Greece, it was only in 1973 that a specific code for psychiatrists was devised to address ethical dilemmas that arise in their practice. On the eve of the 50th anniversary of this notable achievement, it is timely to reflect on how these codes have evolved. Objectives: Our aim is to provide a historically informed perspective of codes of ethics in psychiatry, particularly their place in contemporary practice and their potential prospects. Methods: We reviewed the relevant literature, examined codes and related documents produced by member societies of the World Psychiatric Association (WPA), and of psychiatric regional and sub-speciality associations;and interviewed psychiatrists who have played prominent roles in the field. Findings: Only 11% of the WPA's 142 member societies have devised codes of ethics. Moreover, only a minority of these have undertaken their revision. However, several societies have issued statements periodically on ethical matters, most in response to societal developments such as the challenge to meet the mental health needs of communities grappling with the COVID-19 pandemic. Empirical research on the effectiveness of codes to reduce misconduct or to promote moral integrity of psychiatrists has been negligible. Conclusion: While the place of code of ethics in psychiatry is limited, they still have the potential to promote clinicians' sensitivity to ethical challenges and to contribute to their knowledge about the foundations of psychiatric ethics.
ABSTRACT
Half a year after the emergence of COVID-19, research is still going on to gain insight in the importance of different SARS-CoV-2 transmission routes and their impact on the clinical picture of COVID-19. Our findings suggest that coughing is not as important for transmission as initially anticipated and we discuss the potentially important role for loud conversation as a driver for transmission. DisclosureNone of the authors have any financial associations or other possible conflicts of interest to declare.