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1.
Adm Policy Ment Health ; 2022 Nov 03.
Article in English | MEDLINE | ID: covidwho-2103942

ABSTRACT

Our goal was to investigate the sustainability of care practices that are consistent with the collaborative chronic care model (CCM) in nine outpatient mental health teams located within US Department of Veterans Affairs (VA) medical centers, three to four years after the completion of CCM implementation. We conducted qualitative interviews (N = 30) with outpatient mental health staff from each of the nine teams. We based our directed content analysis on the six elements of the CCM. We found variable sustainability of CCM-based care processes across sites. Some care processes, such as delivery of evidence-based psychotherapies (EBPs) and use of measurement-based care (MBC) to guide clinic decision-making, were robustly maintained or even expanded within participating teams. In contrast, other care processes-which had in some cases been developed with considerable effort-had not been sustained. For example, care manager roles were diminished in scope or eliminated completely in response to workload pressures, frontline care needs, or the COVID-19 pandemic. Similarly, processes for engaging Veterans more fully in decision-making had generally been scaled back. Leadership support in the form of adequate team staffing and time to conduct team meetings were seen as crucial for sustaining CCM-consistent care. Given the potential impact of leadership turnover on sustainability in mental health, future efforts to implement CCM-based mental health care should strive to involve multiple leaders in implementation and sustainment efforts, lest one key departure undo years of implementation work. Our results also suggest that implementing CCM processes may best be conceptualized as a partnership across multiple levels of medical center leadership.

2.
Community Ment Health J ; 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2094666

ABSTRACT

Healthcare must rapidly and systematically learn from earlier COVID-19 responses to prepare for future crises. This is critical for VA's Mental Health Residential Rehabilitation and Treatment Programs (RRTPs), offering 24/7 care to Veterans for behavioral health and/or homelessness. We adapted the World Health Organization's After Action Review (AAR) to conduct semi-structured small-group discussions with staff from two RRTPs and Veterans who received RRTP care during COVID-19, to examine COVID-19's impact on these programs. Six thematic categories emerged through qualitative analysis (participant-checked and contextualized with additional input from program leadership), representing participants' recommendations including: Keep RRTPs open (especially when alternative programs are inaccessible), convey reasons for COVID-19 precautions and programming changes to Veterans, separate recovery-oriented programming from COVID-19-related information-sharing, ensure Wi-Fi availability for telehealth and communication, provide technology training during orientation, and establish safe procedures for off-site appointments. AAR is easily applicable for organizations to debrief and learn from past experiences.

3.
J Ginseng Res ; 2022 Oct 05.
Article in English | MEDLINE | ID: covidwho-2061526

ABSTRACT

Background: Panax ginseng Meyer is a medicinal plant well-known for its antiviral activities against various viruses, but its antiviral effect on coronavirus has not yet been studied thoroughly. The antiviral activity of Korean Red ginseng (KRG) and ten ginsenosides against Human coronavirus OC43 (HCoV-OC43) was investigated in vitro. Methods: The antiviral response and mechanism of action of KRG extract and ginsenoside Rc, Re, Rf, Rg1, Rg2-20 (R) and -20 (S), Rg3-20 (R) and -20 (S), and Rh2-20 (R) and -20 (S), against the human coronavirus strain OC43 were investigated by using plaque assay, time of addition assay, real-time PCR, and FACS analysis. Results: Virus plaque formation was reduced in KRG extract-treated and HCoV-OC43-infected HCT-8 cells. KRG extract decreased the viral proteins (Nucleocapsid protein and Spike protein) and mRNA (N and M gene) expression, while increased the expression of interferon genes. Conclusion: KRG extract exhibits antiviral activity by enhancing the expression of interferons and can be used in treating infections caused by HCoV-OC43.

4.
3D Print Med ; 8(1): 29, 2022 Sep 14.
Article in English | MEDLINE | ID: covidwho-2029744

ABSTRACT

BACKGROUND: Mechanical ventilators are essential to patients who become critically ill with acute respiratory distress syndrome (ARDS), and shortages have been reported due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We utilized 3D printing (3DP) technology to rapidly prototype and test critical components for a novel ventilator multiplexer system, Vent-Lock, to split one ventilator or anesthesia gas machine between two patients. FloRest, a novel 3DP flow restrictor, provides clinicians control of tidal volumes and positive end expiratory pressure (PEEP), using the 3DP manometer adaptor to monitor pressures. We tested the ventilator splitter circuit in simulation centers between artificial lungs and used an anesthesia gas machine to successfully ventilate two swine. RESULTS: As one of the first studies to demonstrate splitting one anesthesia gas machine between two swine, we present proof-of-concept of a de novo, closed, multiplexing system, with flow restriction for potential individualized patient therapy. CONCLUSIONS: While possible, due to the complexity, need for experienced operators, and associated risks, ventilator multiplexing should only be reserved for urgent situations with no other alternatives. Our report underscores the initial design and engineering considerations required for rapid medical device prototyping via 3D printing in limited resource environments, including considerations for design, material selection, production, and distribution. We note that optimization of engineering may minimize 3D printing production risks but may not address the inherent risks of the device or change its indications. Thus, our case report provides insights to inform future rapid prototyping of medical devices.

5.
Front Public Health ; 10: 959567, 2022.
Article in English | MEDLINE | ID: covidwho-2022984

ABSTRACT

Responding rapidly to emerging public health crises is vital to reducing their escalation, spread, and impact on population health. These responses, however, are challenging and disparate processes for researchers and practitioners. Researchers often develop new interventions that take significant time and resources, with little exportability. In contrast, community-serving systems are often poorly equipped to properly adopt new interventions or adapt existing ones in a data-driven way during crises' onset and escalation. This results in significant delays in deploying evidence-based interventions (EBIs) with notable public health consequences. This prolonged timeline for EBI development and implementation results in significant morbidity and mortality that is costly and preventable. As public health emergencies have demonstrated (e.g., COVID-19 pandemic), the negative consequences often exacerbate existing health disparities. Implementation science has the potential to bridge the extant gap between research and practice, and enhance equity in rapid public health responses, but is underutilized. For the field to have a greater "real-world" impact, it needs to be more rapid, iterative, participatory, and work within the timeframes of community-serving systems. This paper focuses on rapid adaptation as a developing implementation science area to facilitate system responses during public health crises. We highlight frameworks to guide rapid adaptation for optimizing existing EBIs when responding to urgent public health issues. We also explore the economic implications of rapid adaptation. Resource limitations are frequently a central reason for implementation failure; thus, we consider the economic impacts of rapid adaptation. Finally, we provide examples and propose directions for future research and application.


Subject(s)
COVID-19 , Implementation Science , COVID-19/prevention & control , Humans , Pandemics , Public Health
6.
ASAIO J ; 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-1985168

ABSTRACT

In appropriately selected patients with COVID-19 acute respiratory distress syndrome, venovenous extracorporeal membrane oxygenation (VV ECMO) may offer a promising bridge to lung recovery or lung transplantation if lung recovery fails. Although the cannulation technique for VV ECMO via a right internal jugular (RIJ) dual-lumen catheter (DLC) requires expertise and guidance by either fluoroscopy or transesophageal echocardiography (TEE), it offers theoretical circulatory support advantages by using bicaval venous drainage to deliver oxygenated blood systemically with minimal recirculation as compared with the femoral vein and RIJ dual-site cannula configuration. In addition, patients are often too unstable to transport safely to an operating room or catheterization laboratory, and fluoroscopy is not always readily available to guide RIJ DLC placement. Here, we provide a comprehensive description of a safe, bedside protocol for VV ECMO cannulation via a RIJ DLC under TEE guidance. We will report our center's experience (March 30, 2020 to November 21, 2021) and discuss important hemodynamic, safety, and infection control considerations.

7.
J Immigr Minor Health ; 24(4): 970-976, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1971770

ABSTRACT

The aim of this study was to examine how perceived racial discrimination is associated with mental distress among diverse Asian Americans and to explore the potential moderators in the relationship. Based on the 2015 Asian American Quality of Life (AAQoL) survey (n = 2609), direct influences were tested of the contextual (demographic, health-related, and immigration-related) variables and perceived racial discrimination on mental distress, as well as their interactions. About 30% of the sample reported perceived racial discrimination, and 44% fell into the category of having mental distress. Perceived racial discrimination was associated with 1.90 times higher odds of mental distress and had significant interactions with age, education, and ethnicity. The association of mental distress with perceived racial discrimination was higher among those who were 60 or older, less educated, and Vietnamese than among their respective counterparts. Findings can guide strategic and targeted interventions for high-risk groups.


Subject(s)
Asian Americans , Racism , Asian Americans/psychology , Ethnicity , Humans , Mental Health , Quality of Life , Racism/psychology
8.
Int J Environ Res Public Health ; 19(13)2022 07 02.
Article in English | MEDLINE | ID: covidwho-1934069

ABSTRACT

Exercise training involving exercises of optimal intensity and duration improves psychological and medical variables in relative leisure-deprived people living with HIV/AIDS. This study aimed to analyze associated psychological variables and the effect of exercise intensity and duration on immune responses in relative leisure-deprived people infected with HIV. The participants completed different moderate-intensity exercises (30 min (60-80% HRmax) and 45 min (60-80% HRmax)) and high-intensity exercise for 10 min (>80% HRmax). Levels higher than "normal" were rated for relative leisure deprivation, indicating relative deprivation of leisure among participants. The overall level of quality of life was "normal", indicating that quality of life was not considered high. The stress level was psychologically considered low. Time had a significant effect on cortisol levels (p < 0.05). Compared to pre-exercise, cortisol level was significantly decreased immediately after moderate exercise for 45 min and 3 h post-exercise after high-intensity exercise for 10 min (p < 0.05). However, time and the interaction of condition and time had no significant effect on IL-6 and sIgA levels (p > 0.05). Despite the small sample size of this pilot study, the results demonstrate that moderate-intensity exercise can be recommended to improve the health and quality of life of people infected with HIV.


Subject(s)
Acquired Immunodeficiency Syndrome , Hydrocortisone , Exercise , Humans , Immunity , Leisure Activities , Pilot Projects
9.
Asian Journal of Peacebuilding ; 10(1):107-129, 2022.
Article in English | ProQuest Central | ID: covidwho-1912432

ABSTRACT

This study illustrates collaborative platforms and diversifying partnerships for South-South and triangular cooperation in development. The English School's pluralism-solidarism spectrum is applied as a tool to explain transformative features of the changing international society in times of crisis. The study focuses on the intermediary pluralist-solidarism phase that shows dynamics of middle power coalitions using nation branding and collaborative governance as key strategies. The transitional phase is exemplified by two approaches. One is the bilateral approach to coalition shown through the case of China, whereas the other is the inclusivemultilateral approach demonstrated through the case of South Korea. Implications are given toward relatively loose networks that have the potential to evolve into platforms with institutional grounds, especially for middle powers seeking opportunities in the new normal.

10.
Heart Lung Circ ; 31(2): 292-298, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1828537

ABSTRACT

BACKGROUND: Patients with Coronavirus disease 2019 (COVID-19)-related acute respiratory disease (ARDS) increasingly receive extracorporeal membrane oxygenation (ECMO) support. While ECMO has been shown to increase risk of stroke, few studies have examined this association in COVID-19 patients. OBJECTIVE: We conducted a systematic review to characterise neurological events during ECMO support in COVID-19 patients. DESIGN: Systematic review of cohort and large case series of COVID-19 patients who received ECMO support. DATA SOURCES: Studies retrieved from PubMed, EMBASE, Cochrane, Cochrane COVID-19 Study Register, Web of Science, Scopus, Clinicaltrials.gov, and medRχiv from inception to November 11, 2020. ELIGIBILITY CRITERIA: Inclusion criteria were a) Adult population (>18 year old); b) Positive PCR test for SARS-CoV-2 with active COVID-19 disease; c) ECMO therapy due to COVID-19 ARDS; and d) Neurological events and outcome described while on ECMO support. We excluded articles when no details of neurologic events were available. RESULTS: 1,322 patients from 12 case series and retrospective cohort studies were included in our study. The median age was 49.2, and 75% (n=985) of the patients were male. Diabetes mellitus and dyslipidaemia were the most common comorbidities (24% and 20%, respectively). Most (95%, n=1,241) patients were on venovenous ECMO with a median P:F ratio at the time of ECMO cannulation of 69.1. The prevalence of intracranial haemorrhage (ICH), ischaemic stroke, and hypoxic ischaemic brain injury (HIBI) was 5.9% (n=78), 1.1% (n=15), and 0.3% (n=4), respectively. The overall mortality of the 1,296 ECMO patients in the 10 studies that reported death was 36% (n=477), and the mortality of the subset of patients who had a neurological event was 92%. CONCLUSIONS: Neurological injury is a concern for COVID-19 patients who receive ECMO. Further research is required to explore how neuromonitoring protocols can inform tailored anticoagulation management and improve survival in COVID-19 patients with ECMO support.


Subject(s)
Brain Ischemia , COVID-19 , Extracorporeal Membrane Oxygenation , Stroke , Adolescent , Adult , Extracorporeal Membrane Oxygenation/adverse effects , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Stroke/epidemiology , Stroke/etiology
11.
Crit Care ; 26(1): 119, 2022 04 30.
Article in English | MEDLINE | ID: covidwho-1813362

ABSTRACT

BACKGROUND: To assess the safety and feasibility of imaging of the brain with a point-of-care (POC) magnetic resonance imaging (MRI) system in patients on extracorporeal membrane oxygenation (ECMO). Early detection of acute brain injury (ABI) is critical in improving survival for patients with ECMO support. METHODS: Patients from a single tertiary academic ECMO center who underwent head CT (HCT), followed by POC brain MRI examinations within 24 h following HCT while on ECMO. Primary outcomes were safety and feasibility, defined as completion of MRI examination without serious adverse events (SAEs). Secondary outcome was the quality of MR images in assessing ABIs. RESULTS: We report 3 consecutive adult patients (median age 47 years; 67% male) with veno-arterial (n = 1) and veno-venous ECMO (n = 2) (VA- and VV-ECMO) support. All patients were imaged successfully without SAEs. Times to complete POC brain MRI examinations were 34, 40, and 43 min. Two patients had ECMO suction events, resolved with fluid and repositioning. Two patients were found to have an unsuspected acute stroke, well visualized with MRI. CONCLUSIONS: Adult patients with VA- or VV-ECMO support can be safely imaged with low-field POC brain MRI in the intensive care unit, allowing for the assessment of presence and timing of ABI.


Subject(s)
Extracorporeal Membrane Oxygenation , Adult , Brain/diagnostic imaging , Extracorporeal Membrane Oxygenation/methods , Feasibility Studies , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies
12.
Int J Health Plann Manage ; 37(4): 2461-2467, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1787662

ABSTRACT

Resurgences of COVID-19 cases are a grave public health concern. Hence, there is an urgent need for health care systems to rapidly and systematically learn from their responses to earlier waves of COVID-19. To meet this need, this article delineates how we adapted the World Health Organization's After Action Review (AAR) framework to use within our health care system of the United States Department of Veterans Affairs. An AAR is a structured, methodical evaluation of actions taken in response to an event (e.g., recent waves of COVID-19). It delivers an actionable report regarding (i) what was expected, (ii) what actually happened, (iii) what went well, and (iv) what could have been done differently, and thus what changes are needed for future situations. We share as an example our examination of Mental Health Residential Rehabilitation and Treatment Programs in Massachusetts (a COVID-19 hotspot). Our work can be further adapted, beyond residential treatment, as a consistent framework for reviewing COVID-19 responses across multiple health care programs. This will identify both standardized and tailored preparations that the programs can make for future waves of the pandemic. Given the expected resurgences of COVID-19 cases, the time to apply AAR is now.


Subject(s)
COVID-19 , Residential Treatment , Delivery of Health Care , Humans , Pandemics , United States/epidemiology , United States Department of Veterans Affairs
13.
J Obes Metab Syndr ; 31(1): 51-60, 2022 Mar 30.
Article in English | MEDLINE | ID: covidwho-1766128

ABSTRACT

Background: Obesity is of grave concern as a comorbidity of coronavirus disease 2019 (COVID-19). We examined the factors associated with weight gain among Korean adults during the COVID-19 pandemic. Methods: We conducted an online survey of 1,000 adults (515 men and 485 women aged 20-59 years) in March 2021. Multivariable logistic regression analysis was performed to evaluate the factors associated with weight gain. The analysis was adjusted for sex, age, region, depressive mood, anxiety, eating out, late-night meals, alcohol consumption, exercise, sleep disturbance, meal pattern, subjective body image, comorbidities, marital status, living alone, and income. Results: After adjusting for confounding variables, the odds for weight gain increased in the group aged 20-34 years compared with the group aged 50-59 years (1.82; 95% confidence interval [CI], 1.01-3.32). Women were more associated with the risk of weight gain compared with men. The odds for weight gain increased in the lack of exercise group compared with the exercise group (4.89; 95% CI, 3.09-7.88). The odds for weight gain increased in the eating-out and late-night meal groups compared with that in the groups not eating out and not having late-night meals. Individuals watching a screen for 3-6 hr/day were more associated with the risk of weight gain compared with those who rarely watched a screen. The odds for weight gain increased in participants who considered themselves obese compared with those who did not consider themselves obese. Conclusion: A healthy diet and regular physical activity tend to be the best approach to reduce obesity, a risk factor for COVID-19.

14.
Journal of International Students ; 11:77-93, 2021.
Article in English | ProQuest Central | ID: covidwho-1717513

ABSTRACT

The closure of university campuses and the suspension of international student mobility programs have been common as a result of COVID-19, though not all programs have closed their doors. In the Republic of Korea, the relatively successful management of the pandemic allowed borders to remain open, nor have any national lockdowns been incurred to date, making student mobility possible throughout the pandemic. This case study reports the arrival and quarantine experiences of 10 exchange students at a university in Seoul, Korea. Findings from interviews revealed eight major themes: (a) commitment to conducting the exchange, (b) re-appropriation of time and funds, (c) confusion, disorientation, and frustration, (d) inadequate preparation and misinformation, (e) mutual support and co-quarantining, (f) inaccessibility to local services, (g) dependence on local altruism, and (h) view of Korea as a responsible and safe country. Students' views and expectations of Korea as a safe study destination amid the pandemic were juxtaposed with decidedly difficult and tumultuous arrival experiences. Implications of these findings are discussed in terms of the academic exchange life cycle and the importance of resource and service accessibility amid new pandemic-based norms with the addition of a new exchange life cycle stage.

15.
Critical Care Medicine ; 50:98-98, 2022.
Article in English | Academic Search Complete | ID: covidwho-1594621

ABSTRACT

B Introduction/Hypothesis: b Patients with Coronavirus disease 2019 (COVID-19)-related acute respiratory disease (ARDS) increasingly receive extracorporeal membrane oxygenation (ECMO) support. The overall mortality of the 1,296 ECMO patients in the 10 studies that reported death was 36% (n=477), and the mortality of the subset of patients who had a neurological event was 92%. Further research is required to explore how neuromonitoring protocols can inform tailored anticoagulation management and improve survival in COVID-19 patients with ECMO support. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

16.
Societies ; 12(1):4, 2022.
Article in English | MDPI | ID: covidwho-1580500

ABSTRACT

COVID-19 and the fourth industrial revolution have rapidly changed our society into an overall contactless one. As smartphones become more popularized, donation methods are shifting to online activities that are beyond the traditional methods. In such a contactless society, mobile payment services are emerging as an innovative payment method. However, donation consolidation and persistence are lacking in online donation marketing and other online situations. This study empirically examines the effects of personal factors (unselfishness, self-esteem, and social norms) and technical factors (perceived usefulness, ease of use, and perceived behavioral control) on donation trust, attitude, and satisfaction if donations were made through a simple mobile payment system. To this end, an online questionnaire survey was carried out on donors using the Korean Red Cross’simple mobile payment service. By collecting 250 data samples, this study verified hypotheses. As a result of the analysis, social norms under the personal factors were significant, but unselfishness and self-esteem did not affect donors. The perceived usefulness and ease of use, which are technical factors, positively affected trust in donation, but the perceived behavioral control was not significant. Consequently, intrinsic behavioral influence factors such as personal unselfishness, self-esteem, or behavioral control did not significantly affect donation behavior, in contrast with traditional donation methods.

17.
Sustainability ; 13(24):13722, 2021.
Article in English | MDPI | ID: covidwho-1572614

ABSTRACT

The purpose of this study was to examine the relationship between the job stress of employees due to changes in the employment environment of airlines under COVID-19 and job burnout and turnover intention. GAD-7 was applied to verify the influence relationship linking job stress, job burnout and turnover intention, using a structural equation model according to anxiety, namely, COVID blues. The results of this study can provide a theoretical basis for the relationship linking job stress, job burnout and turnover intention of employees due to changes in the employment environment resulting from the business crisis of airlines under the COVID-19 pandemic, which has been ongoing since 2020. In addition, it was possible to understand the degree of impact on stress, job burnout and turnover intention by measuring the anxiety disorder of employees, i.e., COVID-19 blues, due to the prolonged pandemic. This study provides basic data on human management measures in the aviation field. Furthermore, according to the results of this study, changes in the employment environment led to job stress in employees, which in turn increased employee job burnout and turnover intention. These results can provide practical implications and help human resource managers to better manage employees, as it was revealed that both changes in the organization of employees and changes in the employment environment of temporary employees increase job stress. Lastly, in the situation where COVID-19 and its associated blues continue, the GAD-7 scale, typically used for patients in hospitals, was applied to airline employees to determine their anxiety levels and psychological state, representing an effective method of lowering intention to leave, job stress and job burnout.

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