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Purpose: The COVID-19 pandemic has challenged the health care and education systems on all fronts: safely providing care for patients, restructuring how care is delivered, and rapidly innovating to deliver stimulating medical education via tele-technology. The pandemic also highlighted multiple health disparities, resulting in an urgent call to action to promote health equity. In response to these challenges, the New York State (NYS) Clinical Education Initiative (CEI) Sexual Health Center of Excellence developed a video-based educational curriculum entitled, “Building Blocks for Trans & Gender Diverse Care.” The curriculum aims to guide clinical providers to create a practice space for delivering care that is gender affirming and inclusive. Methods: The curriculum provides a quick, easy to access, graduated learning experience that engages learners at multiple levels. Content includes foundational concepts and terminology, creating inclusive healthcare spaces and non-stigmatizing encounters. It also offers clinical guidance and pearls related to the gender transition process. The curriculum was unveiled at the 7th Annual NYS Sexual Health Conference, and then shared on the CEI YouTube channel where it is presented as 3 episodes, broken into 12 parts, each 5 to 18 minutes long. The YouTube link has been shared on multiple clinician listservs, with an international subscriber base. The link is also available on the employee learning and performance platform used by a major academic medical center. By disseminating through multiple access points, we aim to build awareness and competence to a broader audience. Utilization of YouTube enables our team to assess curriculum usage by tracking numbers of views and learner comments. Beginning in October 2021, the curriculum will also be accessible on the open source CEI website for free Continuing Education (CE) credits, both medical and nursing. As with all curricula on the CEI website, demographic information regarding viewers and evaluation feedback are collected. Results: Preliminary results reveal that between 6/29/21 and 9/9/21, the videos have been viewed 871 times through the CEI YouTube channel. The consensus feedback received (verbal comments, responses to listserv posts) has been overwhelmingly positive. Access to CE accredited videos will open on Oct 1, 2021. Information regarding number of views, completion of the entire 3 part series, demographics of viewers (profession, age/race/ethnicity practice specialty, practice location) will be reported along with quantitative and qualitative evaluation results. Conclusions: An accessible, short educational video curriculum has been well-received and easily disseminated via the Internet during an initial marketing rollout. It has the potential to build competence broadly among clinicians to provide an affirming and inclusive healthcare experience for transgender and gender diverse patients. The video format is particularly appropriate during a pandemic, when in-person engagement has been challenging in both patient care and continuing education activities. Sources of Support: New York State AIDS Institute, Clinical Education Initiative.
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The COVID-19 pandemic is currently a challenge worldwide. In Austria, a crisis within the health care system has so far been avoided. The treatment of patients with community-acquired pneumonia (CAP), including SARS-CoV-2 infections, should continue to be based on evidence-based CAP guidelines during the pandemic. However, COVID-19-specific adjustments are useful. The treatment of patients with chronic lung diseases must be adapted during the pandemic, but must still be guaranteed.
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The article provides an interim analysis of cases of COVID-19 reported as an occupational disease to the National Registry of Occupational Diseases in 2020 and in the 1st quarter of 2021. There were 370 cases, of which 285 are women representing 77% and 85 men representing 23%. The age range was from 18 to 70 years. The average age was 43 years. All the diseases occurred in 2020, mostly in the first wave of the epidemic. Because the average time between illness and the case reporting was 170 days, it can be expected that many cases are still under assessment. Most cases come from the Moravian-Silesian, Olomouc and Hradec Králové regions. Virtually all of these patients were infected during various health care or social work activities. They were mostly nurses, physicians, and other healthcare professionals. It is just tip of the iceberg. According to the Czech Medical Chamber, over 55 000 health professionals have contracted COVID-19 since the beginning of the epidemic until January 10, 2021. It is therefore essential that the first contact physicians thought about the possibility of the occupational origin of COVID-19, sufficiently informed their patients and referred them to the relevant occupational disease centers. Physicians should also initiate compensation for the families of workers who died of COVID-19. © 2021, University of Defence, Faculty of Military Health Sciences. All rights reserved.
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Background: Studies on SARS-Cov-2 in Behet's syndrome (BS) patients are limited to two small case series from European centres.[1,2] Objectives: We aimed to assess the prevalence of SARS-CoV-2 infection among Italian BS patients referring to Careggi University Hospital (Florence, Italy) and to evaluate the possible association between BS disease activity and treatment and the risk of Sars-CoV-2 infection among patients with BS. Methods: A survey was conducted among 335 subjects diagnosed with BS and followed at Careggi University Hospital. Moreover, we conducted a case-control study. Cases were described in term of SARS-CoV-2 manifestation and prognosis, changes in disease activity, and in pharmacological therapies. Sars-CoV-2 negative controls matched 1:3 by sex, age and disease duration ± 5 years were randomly selected. Results: Out of 335 BS patients, 12 declared to have/have had SARS-CoV-2 infection (3.6%). Eight were females (median age of 40 years), with a median duration of BS disease of 6 years;five had active disease. Nine patients reported fever, 9 myalgia/arthralgia, 5 gastrointestinal symptoms, 5 anosmia/ageusia, 5 cough, 3 headache, 3 fatigue, 2 breathlessness, panic attacks and dizziness (one each). Before infection, patients were treated with corticosteroids, colchicine, hydroxychloroquine (HCQ), traditional DMARDs [azathioprine (n patients = 4), methotrexate (n=1)], and biologics DMARDs [adalimumab (n=6), infliximab (n=2), secukinumab (n=1), and canakinumab (n=1)]. Therapy was suspended for a median time of 33 days in 9patients and resumed after a median time of 5 days from negativation. Regarding SARS-CoV-2 treatment, most patients started or increased corticosteroids, whereas heparin and antipyretic drugs were used in 4 and 5 patients, respectively. Cases were comparable to controls in terms of disease manifestations, activity, and immunomodulating therapy, with the only exception of corticosteroids, whose daily dose was significantly higher in cases (Table 1). Conclusion: Prevalence of SARS-CoV-2 infection among Italian BS patients is 3.6%, similarly to the Italian general population (4.2%). Disease activity at time of infection was not associated with an increased risk of SARS-CoV-2 infection. Most patients interrupted biologic DMARDs. However, use of DMARDs, seemed not to be associated with an increased risk of SARS-CoV-2 infection, while higher doses of corticosteroids resulted to be more common among patients with SARS-CoV-2 infection as compared to controls. No patient required hospitalization or died. Our experience shows encouraging data about BS patients who do not appear be at greater risk of SARS-CoV-2 infection or complications than the general population.
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OBJECTIVES: We aimed to assess the prevalence of SARS-CoV-2 infection among Behcet's syndrome (BS) patients, evaluating the possible association between demographic and clinical features and the risk of infection. Moreover, we aimed to evaluate the possible association between BS disease activity and treatment, and the risk of SARS-CoV-2 infection. METHODS: A survey was conducted on BS patients followed at the Behcet's Centre of the Careggi University Hospital, Florence, Italy. We further evaluated the possible association between BS disease activity and treatment, and the risk of SARS-CoV-2 infection. RESULTS: Out of 335 BS patients contacted, fourteen cases of SARS-CoV-2 were identified between April 1st, 2020 and February 9th, 2021, suggesting a prevalence of SARS-CoV-2 infection among BS patients of 4.2%, in line with the data of the general population in Italy (4.4%). When comparing clinical features between SARS-CoV-2 cases and matched SARS-CoV-2 negative BS patients, we found that the presence of different disease manifestations did not significantly differ between the two groups. SARS-CoV-2 cases and controls were also comparable in terms of immunosuppressive therapy, with the only exception of corticosteroids (71.4% vs. 35.7%, p=0.030), whose daily dose was significantly higher in cases than controls [5mg/day (IQR 0-10,) vs. 0 mg/day (IQR 0-5), p=0.005], suggesting that the right timing of usage and the more appropriate dosage of corticosteroid are a key question for the better management of these patients. CONCLUSIONS: Based on our results, patients with BS do not seem to be at a greater risk of SARS-CoV-2 infection or severe complications compared with the general population.
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Background: The Corona-Warning-App of the Robert Koch-Institute is the most widely used digital public health intervention during this pandemic. Nevertheless, in October 2020, at the beginning of a new wave of infection, it reaches just one fifth of the population. This means that the app’s potential to provide information about potential infections, which have taken place unnoticed, is dwindling. Aims: The aim of the study is to explore the subjective perception and impact of the app on the individual, as well as the inhibiting and facilitating factors of its use. These effects can provide conclusions about the needs of the population and accordingly challenges for public health. Materials and methods: The dataset was created through two procedural steps. The first step is a forum analysis of a total of 300 reviews. The second step consists of 40 qualitative, semi-structured interviews. The data were inductively–deductively coded and evaluated along a content-structuring form of qualitative content analysis. Results and conclusion: The effects of the app are a result of complex interactions. Of central importance for the dynamics are public spaces and social interactions, which are perceived as dangerous during this pandemic. Against this background, practices with the app can generate new visibilities that lead to a reassessment of the concrete threat. This again, can reopen possibilities for action. However, critical positions on data protection and data security may lead to new insecurities and possibly to the rejection of the app. © 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
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Social isolation and the loss of control associated with the COVID-19 lockdown led to elevated levels of perceived stress in many countries. The present study examines the effectiveness of 13 different coping strategies (SVF-78) and the personality trait grit (Grit-S) on perceptions of stress (PSS-10) in 438 participants (362 women, M-age = 33.45 years, SD = 12.48) from the second to third week of lockdown. A structural equation model showed that coping strategies acted as a complete mediator of the relationship between grit and perceived stress, indicating that grit does not directly affect perceived stress but that people with higher levels of grit choose more effective coping strategies and that results in lower perceived stress. Overall, active emotion-focused strategies such as minimization and positive self-instruction were associated with lower levels of helplessness and a higher self-efficacy to cope with stress. Taking into account the different ways participants adopted coping strategies and relied upon grit, non-hierarchical clustering identified four specific profiles: gritty persons, easy-goers, avoiders, and people feeling powerless. The implications for each group are discussed.