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1.
JAMA network open ; 6(1):e2250954, 2023.
Article in English | EuropePMC | ID: covidwho-2208818

ABSTRACT

ImportancePhysician parents, particularly women, are more likely to experience burnout, poor family-career balance, adverse maternal and fetal outcomes, and stigmatization compared with nonparent colleagues. Because many physicians delay child-rearing due to the rigorous demands of medical training, favorable parental leave policies for faculty physicians are crucial to prevent physician workforce attrition.ObjectiveTo evaluate paid and unpaid parental leave policies at medical schools ranked by US News & World Report in 2020 and identify factors associated with leave policies.Design, setting, and participantsThis cross-sectional national study was performed at US medical schools reviewed from December 1, 2019, through May 31, 2020, and February 1 through March 31, 2021, due to the COVID-19 pandemic. All medical schools ranked by US News & World Report in 2020 were included.Main outcomes and measuresThe primary outcome was the number of weeks of paid and unpaid leave for birth, nonbirth, adoption, and foster care physician parents. Institutional policies for the number of weeks of leave and requirements to use vacation, sick, or disability leave were characterized. Institutional factors were evaluated for association with the duration of paid parental leave using χ2 tests.ResultsAmong the 90 ranked medical schools, 87 had available data. Sixty-three medical schools (72.4%) had some paid leave for birth mothers, but only 13 (14.9%) offered 12 weeks of fully paid leave. While 11 medical schools (12.6%) offered 12 weeks of full paid leave for nonbirth parents, 38 (43.7%) had no paid leave for nonbirth parents. Adoptive and foster parents had no paid leave in 35 (40.2%) and 65 (74.7%) medical schools, respectively. Median paid parental leave was 4 (IQR, 0-8) weeks for birth parents, 4 (IQR, 0-6) weeks for adoptive parents, 3 (IQR, 0-6) weeks for nonbirth parents, and 0 (IQR, 0-1) weeks for foster parents. About one-third of medical schools required birth mothers to use vacation (29 [33.3%]), sick leave (31 [35.6%]), or short-term disability (9 [10.3%]). Among institutional characteristics, higher ranking (top vs bottom quartile: 30.4% vs 4.0%;P = .03) and private designation (private vs public, 23.5% vs 9.4%;P < .001) was associated with a higher rate of 12 weeks of paid leave for birth mothers.Conclusions and relevanceIn this cross-sectional national study of medical schools ranked by US News & World Report in 2020, many physician faculty receive no or very limited paid parental leave. The lack of paid parental leave was associated with higher rates of physician burnout and work-life integration dissatisfaction and may further perpetuate sex, racial and ethnic, and socioeconomic disparities in academic medicine.

2.
Cureus ; 14(9): e29604, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2100368

ABSTRACT

The prone position is a crucial position used in the operating rooms and the intensive care units, with its importance highly recognized during the COVID-19 pandemic in patients with acute respiratory distress syndrome (ARDS). Cardiopulmonary resuscitation (CPR) is a cardinal procedure that is indicated and performed on any eligible patient who has cardiopulmonary arrest and resultant lack of perfusion and oxygenation. When a patient has a cardiopulmonary arrest in the prone position, the options include rotating the patient supine before starting cardiopulmonary resuscitation (CPR) or beginning CPR while prone. Prone CPR has not had a widely accepted use so far. In this article, we narrate the process of protocol development and staff education at our hospital for the initiation of prone CPR and review the literature related to it. Prone CPR is an effective technique with good outcomes and involves a learning curve. Appropriate training needs to be done before implementing the protocol, and adequate quality control measures need to be set to ensure that the skill set is maintained.

3.
J Community Hosp Intern Med Perspect ; 12(4): 7-13, 2022.
Article in English | MEDLINE | ID: covidwho-2081653

ABSTRACT

Multisystem inflammatory syndrome is a life-threatening condition associated with elevated inflammatory markers and multiple organ injury. A diagnosis of exclusion, it has been reported after severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) in children and adults; recently it has been described in some post-COVID-19 vaccinated individuals. The prognosis with supportive care and immunomodulatory therapy is good, although some individuals may require treatment in the intensive care unit (ICU). Here we report a case of a 58-year-old man who developed multi-organ failure after receiving the second dose of the Moderna mRNA-1273 COVID-19 vaccine. He required critical organ support in the ICU. An extensive workup was done to rule out alternative infectious and inflammatory processes. Following a period of gradual in-hospital convalescence, our patient made a full recovery. To our knowledge, this is the first comprehensively described case of multisystem inflammatory syndrome associated with Moderna mRNA-1273 COVID-19 vaccine in an adult over 50 years of age.

4.
J Med Internet Res ; 24(10): e38949, 2022 10 17.
Article in English | MEDLINE | ID: covidwho-2074602

ABSTRACT

BACKGROUND: Given the widespread and concerted efforts to propagate health misinformation on social media, particularly centered around vaccination during the pandemic, many groups of clinicians and scientists were organized on social media to tackle misinformation and promote vaccination, using a national or international lens. Although documenting the impact of such social media efforts, particularly at the community level, can be challenging, a more hyperlocal or "place-based approach" for social media campaigns could be effective in tackling misinformation and improving public health outcomes at a community level. OBJECTIVE: We aimed to describe and document the effectiveness of a place-based strategy for a coordinated group of Chicago health care workers on social media to tackle misinformation and improve vaccination rates in the communities they serve. METHODS: The Illinois Medical Professionals Action Collaborative Team (IMPACT) was founded in March 2020 in response to the COVID-19 pandemic, with representatives from major academic teaching hospitals in Chicago (eg, University of Chicago, Northwestern University, University of Illinois, and Rush University) and community-based organizations. Through crowdsourcing on multiple social media platforms (eg, Facebook, Twitter, and Instagram) with a place-based approach, IMPACT engaged grassroots networks of thousands of Illinois health care workers and the public to identify gaps, needs, and viewpoints to improve local health care delivery during the pandemic. RESULTS: To address vaccine misinformation, IMPACT created 8 "myth debunking" infographics and a "vaccine information series" of 14 infographics that have generated >340,000 impressions and informed the development of vaccine education for the Chicago Public Libraries. IMPACT delivered 13 policy letters focusing on different topics, such as health care worker personal protective equipment, universal masking, and vaccination, with >4000 health care workers signatures collected through social media and delivered to policy makers; it published over 50 op-eds on COVID-19 topics in high-impact news outlets and contributed to >200 local and national news features. Using the crowdsourcing approach on IMPACT social media channels, IMPACT mobilized health care and lay volunteers to staff >400 vaccine events for >120,000 individuals, many in Chicago's hardest-hit neighborhoods. The group's recommendations have influenced public health awareness campaigns and initiatives, as well as research, advocacy, and policy recommendations, and they have been recognized with local and national awards. CONCLUSIONS: A coordinated group of health care workers on social media, using a hyperlocal place-based approach, can not only work together to address misinformation but also collaborate to boost vaccination rates in their surrounding communities.


Subject(s)
COVID-19 , Social Media , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Humans , Pandemics/prevention & control , Power, Psychological , Trust , Vaccination
7.
J Med Internet Res ; 24(7): e38324, 2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1952075

ABSTRACT

Social media is an important tool for disseminating accurate medical information and combating misinformation (ie, the spreading of false or inaccurate information) and disinformation (ie, spreading misinformation with the intent to deceive). The prolific rise of inaccurate information during a global pandemic is a pressing public health concern. In response to this phenomenon, health professional amplifiers such as IMPACT (Illinois Medical Professional Action Collaborative Team) have been created as a coordinated response to enhance public communication and advocacy around the COVID-19 pandemic.


Subject(s)
COVID-19 , Social Media , Communication , Humans , Pandemics , SARS-CoV-2
8.
Hearts ; 3(3):66-75, 2022.
Article in English | MDPI | ID: covidwho-1928531

ABSTRACT

COVID-19 mainly causes pulmonary manifestation;nonetheless, its systemic inflammatory response involves multiple organs, including the heart. We aimed to evaluate the prevalence, predictors, and outcomes of myocardial injury in hospitalized patients with SARS-CoV-2 infection. Methods and Results: We performed an observational retrospective analysis on patients hospitalized with COVID-19 in a moderate-sized community hospital system. Myocardial injury was defined as highly sensitive troponin T levels in the 99th percentile above the normal upper limit for the respective biological sex. Multivariable logistic regression models were fitted to assess the association between the myocardial-injury and the no-myocardial-injury groups for primary and secondary outcomes. A total of 1632 (49.3% male, 41.7% aged 60–79 years) patients with COVID-19 were included, out of which 312 (19.1%) had a myocardial injury. Patients with myocardial injury were older (36.9% > 80 years) and had higher cardiovascular-related comorbidities than those without. The prevalence of cardiovascular risk factors (78.5% vs. 52.0%) and cardiovascular diseases (78.2% vs. 56.1%) was much higher in the myocardial-injury group. Older age (50–64 years vs. <49 years;OR, 3.67 [1.99–6.74]), Angiotensin Receptor Blockers (ARBs) (OR, 1.44 [1.01–2.05]), Beta-blockers (OR, 2.37 [1.80–3.13]), and cardiovascular comorbidities (OR, 1.49 [1.09–2.05]) were strong predictors of cardiac injury after multivariable adjustment. Myocardial injury was strongly associated with ICU admission (adjusted OR, 1.68 [1.29–2.19]) and longer length of hospital stay (median days, 5 (3, 9) vs. 4 (2, 7)). The results do not show a significant difference in the use of mechanical ventilation (OR, 1.29 [0.87–1.89]) or in-hospital mortality (OR, 1.37 [0.98–1.91]) with respect to myocardial injury. Conclusion: This multicenter retrospective study of nearly 1600 patients revealed the following findings: Myocardial injury was observed in 1 out of 5 patients hospitalized with COVID-19 but was more often clinically insignificant. Patients of age > 65 had very high odds of having elevated troponin levels after adjusting for sex and other illnesses. Pre-existing cardiac diseases and risk factors were robust predictors of cardiac injury after adjusting for age and sex. In the adjusted model, myocardial injury was not associated with the requirement of mechanical ventilation or change in in-hospital mortality.

10.
J Psychosoc Rehabil Ment Health ; 9(4): 447-452, 2022.
Article in English | MEDLINE | ID: covidwho-1803240

ABSTRACT

Use of Smart phones had created new opportunities for individuals with developmental disabilities for the meaningful engagement in different activities during the pandemic situation. Online learning provides extensive opportunities for individuals during this pandemic situation when everything is closed due to the fear of transmission of COVID-19. Similarly individuals with developmental disabilities are also getting opportunity to learn online through Smartphone. Special educators were conducting online classes with students with developmental disabilities to make them meaningfully engaged during this pandemic situation. 415 students and their parents with developmental disabilities were approached by their special educators on telephone to know if they can use smartphone. This paper reports on use of Smart phones by individuals with developmental disabilities. It was found that they can learn academics like others if there is availability of Smart phones during daytime and proper training and assistance provided by parents or sibling.

11.
Indian J Community Med ; 47(1): 138-141, 2022.
Article in English | MEDLINE | ID: covidwho-1760927

ABSTRACT

Introduction: Ahmedabad city reported the highest number of cases and deaths. In order to guide various interventions and monitor future trends, evidence is required. Hence, we conducted the present study to explore the epidemiological determinants, clinical profile, risk factors, and predictors of mortality of COVID-19. Methods: This was a retrospective record-based descriptive study of 2268 confirmed COVID-19 patients admitted in a designated COVID hospital of Ahmedabad city from March to July 2020. Results: The median age of patients was 54 years, and 60.9% of them were males. Majority (83.27%) had comorbidities; the most common comorbidity was hypertension (62.59%) followed by diabetes (44.76%). The most common symptoms reported were fever (69.76%), breathlessness (55.47%), and cough (53.18%). Majority (61.12%) of the patients showed lymphocytopenia, and in one-third (34.85%), D-dimer levels were elevated (>1 µg/ml). Odds of inhospital deaths were higher in patients having breathlessness and gastrointestinal symptoms and comorbidities. More of the deceased had leukocytosis and lymphocytopenia, high D-dimer levels, C-reactive protein, and altered liver function tests as compared to the survivors. Conclusion: While making decisions such as prevention of exposure of high-risk population to the infection, control of the existing comorbid condition, and prioritization of this population for vaccination, criteria of case definition for surveillance keeping in mind the typical and atypical manifestations of the disease, require robust evidence which the current study could provide insight to.

12.
Brain Behav Immun Health ; 20: 100420, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1631479

ABSTRACT

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has negatively impacted the global healthcare and economic systems worldwide. The COVID-19 pandemic has also created an emotional and psychological pandemic among people of all ages irrespective of economic status and physical wellbeing. As a consequence of prolonged lockdowns, one of the most severely affected age groups globally is the young adults' group, especially students. Uncertainties in the academic calendar, restricted outdoor activities, and unusual daily routines during lockdowns led to higher incidences of stress, anxiety, and depression among students worldwide. In this review, we summarise the available evidence on the effect of lockdowns on students and discuss possible positive impacts of yoga and meditation on various psychological, emotional, and immunological parameters, which can significantly influence the general wellbeing and academic performance of students. Perspectives shared in the review will also bring awareness on how yoga and meditation could boost students' performance and assist them in maintaining physical and mental wellbeing during stressful conditions such as future epidemics and pandemics with novel infections. This information could help create better educational curriculums and healthy routines for students.

13.
Womens Health Rep (New Rochelle) ; 2(1): 396-399, 2021.
Article in English | MEDLINE | ID: covidwho-1475763

ABSTRACT

Background: Gender inequity is apparent for women in medicine. With the onset of the COVID-19 pandemic, there are concerns about how women physicians are personally and professionally impacted. Materials and Methods: Participants of the Women in Medicine Summit were anonymously surveyed about their perspectives about COVID-19 affecting women in medicine. Questions were centered around perceived gender bias, productivity expectations, and stressors. Results: At the Women in Medicine Summit, 454 attendees were invited to complete the survey with a response rate of 27% (n = 124). Of those participants, 46% of participants perceived gender bias in the workplace, with 39% citing further inequities with intersectional identities (p < 0.05). Productivity expectations were reported to be higher than before the pandemic in 41% of survey participants. The majority of respondents (70%) reported experiencing high levels of stress during the pandemic, compared with only 16% reporting high levels of stress before the pandemic (p < 0.05). Discussion: It is clear that women physicians are experiencing the pandemic differently. Gender bias is a common occurrence, especially by individuals with intersectional identities. These stressors are not new to women in medicine, but with the overriding impact of the pandemic, higher expectations for productivity, and increased personal responsibilities, employers should focus on preventing further exacerbations of gender inequity in medicine.

14.
Monaldi Arch Chest Dis ; 92(2)2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1444406

ABSTRACT

The Coronavirus disease 19 (COVID-19) pandemic is associated with an unprecedented requirement for intensive care unit (ICU) admission, invasive mechanical ventilation, and thereby significantly increasing the risk of secondary nosocomial pneumonia, ventilator-associated pneumonia (VAP). Our study aims to identify the overall incidence of VAP, common organisms associated with it, and outcome in COVID-19 patients in comparison to the non-SARS-CoV-2 infected critically ill ventilated COVID-19 patients. A comprehensive screening was conducted using major electronic databases), from January 1st 2020 to May 31st 2021, as per the PRISMA statement. In our rapid review, we included a total of 34 studies (involving 8901 cases. Overall VAP was reported in 48.15 % (95% CI 42.3%-54%) mechanically ventilated COVID-19 patients and the mortality rate was 51.4% (95% CI 42.5%-60%). COVID-19 patients had increased risk of VAP and mortality in comparison to other non-SARS-CoV-2 viral pneumonia (OR=2.33; 95%CI 1.75-3.11; I2=15%, and OR=1.46; 95%CI 1.15-1.86; I2=0% respectively). Critically ill COVID-19 patients are prone to develop VAP, which worsens the outcome.


Subject(s)
COVID-19 , Pneumonia, Ventilator-Associated , Viruses , COVID-19/epidemiology , Critical Illness , Humans , Intensive Care Units , Pneumonia, Ventilator-Associated/epidemiology , Pneumonia, Ventilator-Associated/prevention & control
15.
J Am Pharm Assoc (2003) ; 62(1): 224-231, 2022.
Article in English | MEDLINE | ID: covidwho-1364191

ABSTRACT

BACKGROUND: Visual communication strategies are becoming increasingly prevalent for conveying information to health professionals as well as to the general public. The potential of social media for rapid knowledge dissemination using infographics was recognized early in the coronavirus disease (COVID-19) pandemic by health professionals. OBJECTIVE: The purpose of this study was to describe a coalition of health professionals' approach to developing infographics about COVID-19 vaccines and the reach and engagement of those infographics when shared through social media. METHODS: Infographics were created by a core team within the coalition following a stepwise approach. Each underwent a multistep review process, readability evaluation, and translation into Spanish. Infographics were then shared through multiple social media platforms. They were grouped into 1 of 3 categories for this analysis: COVID-19 vaccine series, myth debunkers, or other. RESULTS: All infographics had greater outreach, impressions, and engagement on Twitter than they did on other platforms. When comparing the 3 groups, no 1 infographic type was consistently performing higher than the others. CONCLUSION: Each infographic reached thousands to tens of thousands of people. We do not know whether those who viewed these infographics changed their perspective on vaccination, so we are unable to draw a conclusion about their impact on vaccine hesitancy based on this study alone.


Subject(s)
COVID-19 , Social Media , COVID-19 Vaccines , Communication , Data Visualization , Humans , SARS-CoV-2 , Vaccination
16.
J Womens Health (Larchmt) ; 30(5): 665-671, 2021 05.
Article in English | MEDLINE | ID: covidwho-1223313

ABSTRACT

Background: Currently, physicians face an unprecedented crisis with the novel coronavirus disease 2019 (COVID-19) pandemic. The impact of the pandemic on dual-physician households remains unknown. In this survey study, we examined the impact of the COVID-19 pandemic on dual-physician families and described gendered differences related to the impact of the pandemic. Methods: This was a cross-sectional survey distributed via e-mail and social media, with results collected from April 30, 2020 until May 26, 2020. Respondents were members of a dual-physician couple. Respondents provided information on demographic characteristics and the impact of the pandemic on their professional lives, personal lives, and well-being. Categorical variables were compared using chi-squared or Fisher's exact test. Ordinal variables were compared between genders using Cochran-Armitage trend test. Feeling emotionally and physically drained compared to pre-pandemic was analyzed as a binary outcome in a multivariable logistic model. Results: Of the 1799 physicians who completed the survey, 52% were between 30 and 39 years old, 81% self-identified as women, and 62% were white. Women were more likely to report increased worry about their job security, finances, personal health, partner's health, and children's health (p = 0.02, p = 0.01, p < 0.001, p < 0.001, and p < 0.001, respectively). Seventy-eight percent of respondents reported feeling more drained during the pandemic. Multivariable analysis revealed that female gender (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.7-3.3, p < 0.001), and having children younger than 5 years of age (OR 1.43, 95% CI 1.05-1.95, p = 0.02) were associated with an increased risk of feeling more drained. Conclusions: Women were more likely to report increased worry about job security, finances, and health and had an increased risk of feeling more drained during the pandemic. While the COVID-19 pandemic is a significant stress for all physicians, women in dual-physician families were disproportionately affected, demonstrating the need for increased support from hospital administrations.


Subject(s)
COVID-19 , Physicians, Women , Physicians , Adult , Child , Cross-Sectional Studies , Female , Humans , Male , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
18.
Biosens Bioelectron ; 179: 113074, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1064881

ABSTRACT

On global scale, the current situation of pandemic is symptomatic of increased incidences of contagious diseases caused by pathogens. The faster spread of these diseases, in a moderately short timeframe, is threatening the overall population wellbeing and conceivably the economy. The inadequacy of conventional diagnostic tools in terms of time consuming and complex laboratory-based diagnosis process is a major challenge to medical care. In present era, the development of point-of-care testing (POCT) is in demand for fast detection of infectious diseases along with "on-site" results that are helpful in timely and early action for better treatment. In addition, POCT devices also play a crucial role in preventing the transmission of infectious diseases by offering real-time testing and lab quality microbial diagnosis within minutes. Timely diagnosis and further treatment optimization facilitate the containment of outbreaks of infectious diseases. Presently, efforts are being made to support such POCT by the technological development in the field of internet of medical things (IoMT). The IoMT offers wireless-based operation and connectivity of POCT devices with health expert and medical centre. In this review, the recently developed POC diagnostics integrated or future possibilities of integration with IoMT are discussed with focus on emerging and re-emerging infectious diseases like malaria, dengue fever, influenza A (H1N1), human papilloma virus (HPV), Ebola virus disease (EVD), Zika virus (ZIKV), and coronavirus (COVID-19). The IoMT-assisted POCT systems are capable enough to fill the gap between bioinformatics generation, big rapid analytics, and clinical validation. An optimized IoMT-assisted POCT will be useful in understanding the diseases progression, treatment decision, and evaluation of efficacy of prescribed therapy.


Subject(s)
Biosensing Techniques/instrumentation , Communicable Diseases/diagnosis , Internet of Things , Point-of-Care Testing , Animals , Artificial Intelligence , Biosensing Techniques/methods , COVID-19/diagnosis , Coronavirus Infections/diagnosis , Dengue/diagnosis , Equipment Design , HIV Infections/diagnosis , Hemorrhagic Fever, Ebola/diagnosis , Humans , Influenza, Human/diagnosis , Malaria/diagnosis , Orthomyxoviridae Infections/diagnosis , Zika Virus Infection/diagnosis
19.
N Engl J Med ; 383(27): e145, 2020 12 31.
Article in English | MEDLINE | ID: covidwho-1003380
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