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2.
Revista Cient..fica Multidisciplinar RECIMA21 ; 3(2), 2022.
Article in Portuguese | GIM | ID: covidwho-1744316

ABSTRACT

Introduction: Exhaustion, cynicism or negative feelings related to work and reduced professional performance are the characteristics of Burnout syndrome, which has a high prevalence among health professionals, even more susceptible to professionals who have a more stressful work routine, such as in ICU. Discussion: Burnout among doctors is on the rise, and studies show that the risk and clinical features of the syndrome vary according to the specialty and conditions to which the professional is exposed, such as workload, emotional aspects of the patient and family, mortality rates, etc. Therefore, intensive care medicine is particularly highlighted in the presence of emotional and physical strain, a fact that was greatly aggravated at the time of the COVID-19 pandemic. Several distinct characteristics influence mental exhaustion, psychological imbalance and professional frustration related to intensive care doctors, including female professionals, with a higher prevalence. It was found that there are repercussions for both the professional's quality of life, such as emotional lability and susceptibility to other diseases, as well as impairment to medical care, a consequence of the professional's exhaustion.

3.
European Journal of Neurology ; 28(SUPPL 1):102, 2021.
Article in English | EMBASE | ID: covidwho-1307707

ABSTRACT

Background and aims: Register studies and cohort analyses of clinical data are essential to study neurological manifestations of COVID-19 at a large scale. Methods: We analyzed neurological manifestations in COVID-19 patients, diagnosed before Aug 25th 2020, and registered in the European multinational LEOSS registry. Results: Of the 3127 COVID-19 patients, 95.2% were hospitalized. In 54.4% at least one neurological symptom, and in 3.3% a new neurological complication occurred. Preexisting neurological comorbidities were reported in 18.1% of the patients. Neurological symptoms were excessive tiredness (27.6%), headache (15.3%), nausea/emesis (14.0%), muscular weakness (13.2%), smell (6.9%), taste disorder (8.3%) and delirium (6.3%). Intracerebral bleeding occurred in 1.2%, ischemic stroke in 0.5%, and meningitis/ encephalitis in 0.4%. Overall, the death rate was 17.5%. It was higher in patients with the following neurological comorbidities: dementia 38.0%, movement disorders 32.8%, and prior cerebrovascular disease 32.3%. A multivariable logistic regression model found age (OR 1.53), cardiovascular diseases (OR 1.74), muscle weakness (OR 1.40), pulmonary diseases (1.49) and male gender (OR 1.52) to be associated with a significantly increased risk for a critical COVID-19 disease course, failed recovery, and death. Conclusion: The neurological manifestations revealed in COVID-19 patients of this study are mostly in agreement with previously published data. Several neurological conditions, such as prior cerebrovascular diseases or dementia appeared to be associated with a higher risk in unadjusted analyses, which was not confirmed in a multivariable analysis adjusting for confounding variables such as age and sex. These findings contrast previously published studies and stress the importance of considering putative confounds in medical statistics carefully.

4.
Ann Chir Plast Esthet ; 66(4): 285-290, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1293549

ABSTRACT

BACKGROUND: Child burns rank among the most frequent domestic accidents in France. COVID-19 lockdown between March 16th and May 11th of 2020 increased time spent at home by children. MATERIAL: This retrospective, observational study described the epidemiological impact of COVID-19 lockdown on child burns in a pediatric surgery department compared with previous five years. Child burns in the previous five years constituted the "before COVID-19 group" as the reference group. Child burns during the first lockdown formed the "COVID-19 group". Demographics characteristics, the delay before first attendance at the surgery department, burns characteristics, the place of the incident, need of skin graft, and child reactions to trauma or isolation were recorded for these two groups. RESULTS: A total of thirty-seven children were included, 16 of them in the COVID-19 group. In the COVID-19 group, burned children were mainly boys, with a median age of 18 months. The median time before first attendance was four days. Main burns characteristics were to be deep partial thickness burns, involved lower limbs, caused by scalding. All burns occurred at home. Half parents reported child reactions to trauma or isolation among their children before burn injury. CONCLUSION: The incidence of child burn injuries in the COVID-19 group was higher compared to the before COVID-19 group, but no increased delay to attendance recorded. Time spent at home and psychosocial impact of lockdown might partially explain this high incidence rate of child burns. LEVEL OF EVIDENCE: IV.


Subject(s)
Accidents, Home/statistics & numerical data , Burns/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Adolescent , Age Distribution , Child , Child, Preschool , Female , France/epidemiology , Humans , Incidence , Infant , Infant, Newborn , Male , Pandemics , Retrospective Studies , Sex Distribution
5.
Journal of Pharmaceutical Health Services Research ; 12(2):303-305, 2021.
Article in English | Web of Science | ID: covidwho-1284883

ABSTRACT

Objectives: Over 50 million people in the USA are enrolled in a Medicaid Managed Care plan. If they do not select a primary care provider, they are auto-assigned to one. The impact of auto-assignment has largely been understudied outside the context of patient satisfaction with the insurance plan. The purpose of the study was to explore the association between auto-assignment and flu vaccination use, which will contribute to our understanding of factors influencing the COVID-19 vaccine uptake. Methods: Retrospective data from the Enterprise Data Warehouse of a health system were obtained for adult Medicaid enrolees assigned to a Midwestern health system in 2019. Descriptive statistics, independent t-tests and tetrachoric correlations were used to explore the relationship between auto-assignment and flu vaccine receipt among a large sample of Illinois residents (N = 7224). The sample was then divided into those who chose their provider (n = 6027) and those who were auto-assigned (n = 1197). Key findings: Individuals who selected their provider were deemed to have flu vaccine coverage over those who were auto-assigned (33.2% vs. 6.6%). Furthermore, among those who were auto-assigned, age, number of office visits and having chronic morbidities, including chronic obstructive pulmonary disease (P < 0.01), diabetes (P < 0.01) and heart failure (P < 0.01), were positively associated with flu vaccine receipt. Conclusions: Individuals who are auto-assigned to a primary care provider are less likely to be flu vaccine recipients than those who choose their provider. This suggests that auto-assignment is a risk factor that influences vaccine receipt. This research provides perspectives for outreach efforts that target individuals who are auto-assigned to a provider.

6.
Neurologie und Rehabilitation ; 26(3):185, 2020.
Article in German | EMBASE | ID: covidwho-1006514
7.
Journal of the American Academy of Child and Adolescent Psychiatry ; 59(10):S258, 2020.
Article in English | EMBASE | ID: covidwho-886620

ABSTRACT

Objectives: The objective of this presentation is to examine how visit completion rates were affected by the transformation of a large community-based pragmatic clinical trial (entitled Metformin for overweight and OBese chILdren with bIpolar spectrum disorders Treated with second-generation antipsYchotics [MOBILITY]) to remote follow-up visits with the use of telepsychiatry and virtual research methodology in light of a pandemic. Methods: MOBILITY is a Patient-Centered Outcome Research Institute (PCORI)-funded, large, randomized pragmatic clinical trial designed to examine the effectiveness of metformin and healthy lifestyle instruction vs healthy lifestyle instruction alone on BMI and other metabolic and clinically useful parameters. We examined visit completion rates of patients due for a study visit on April 1, 2020 performed in the remote care visit window (April 1, 2020 to May 31, 2020) by visit type (month 6, month 24, other visit) and institution type (community vs academic) to in-person visits from the coinciding preceding enrollment period (April 1, 2019 to May 31, 2019). Results: Of the total 603 patients in-window on April 1, 2020 for a visit, 180 patients (29.9%) had an in-window remote visit. Of the total 620 patients in-window on April 1, 2019 for a visit, 159 patients (25.6%) had an in-window in-person visit. There were no significant time x type interaction effects for visit type (p = 0.37) or institution type (p = 0.26). However, there were significant main effects for visit type and institution type, with higher month-24 in-window visits for remote visits vs in-person visits (2020 = 14.9% vs 2019 = 9.4%;p < 0.01) and higher overall visits in academic vs nonacademic centers (2020 = 34.4% vs 2019 = 27.7%). Conclusions: Overall visit completion rates comparing the pre-COVID-19 enrollment period in 2019 to the same period in 2020 did not show significant changes in visit completion rates. Despite the shift to remote visits, visit completion rates for this large, pragmatic study that are linked to clinical care visits did not suffer. However, month-24 visit completion rates were significantly improved. Academic institutions were able to hold or improve visit completion rates more effectively than community-based ones. Making virtual visits available in clinical effectiveness research may be beneficial by decreasing patient and caregiver burden, improving data quality, and reducing cost, although this may be more easily accomplished in academic centers. R, BRD, TVM

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