Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 13 de 13
Filter
1.
Journal of Health Care for the Poor & Underserved ; 33(1):1-8, 2022.
Article in English | CINAHL | ID: covidwho-1688204

ABSTRACT

The Nepali-speaking Bhutanese (NSB) community living in Central Pennsylvania has been significantly affected by COVID-19 due to various biopsychosocial determinants of health. In this paper, we discuss interventions developed by a tertiary care health system in Central Pennsylvania to provide immediate support to the NSB community.

2.
J Health Care Poor Underserved ; 33(1): 551-557, 2022.
Article in English | MEDLINE | ID: covidwho-1686070

ABSTRACT

The Nepali-speaking Bhutanese (NSB) community living in Central Pennsylvania has been significantly affected by COVID-19 due to various biopsychosocial determinants of health. In this paper, we discuss interventions developed by a tertiary care health system in Central Pennsylvania to provide immediate support to the NSB community.


Subject(s)
COVID-19 , Emigrants and Immigrants , Refugees , Bhutan , Humans , SARS-CoV-2
3.
Cureus ; 13(12), 2021.
Article in English | EuropePMC | ID: covidwho-1610447

ABSTRACT

Introduction: Healthcare workers are at an increased risk of infectious disease transmission through occupational exposure. Despite this, rates of personal protective equipment (PPE) use vary among healthcare personnel. This cross-sectional study surveyed healthcare workers at a single academic center to determine how the coronavirus disease 2019 (COVID-19) pandemic affected the perceptions and behaviors of PPE usage. Methods: An anonymous online survey through the SurveyMonkey® tool (Zendesk Inc., San Francisco, California) was sent to the University of California, Irvine, Medical Center department listserv of nurses on March 20, 2021, and was closed on June 20, 2021. Results: Of 311 respondents, 23% admitted to suffering a splash injury to the face during a procedure. When compared to one year ago prior to the COVID-19 pandemic, PPE was more important (93% vs. 80%) and more frequently used (80% vs. 54%) by respondents. The recent COVID-19 pandemic had the strongest impact on increasing respondents’ perception of the importance of PPE (44%). Conclusion: The COVID-19 pandemic positively impacted rates of PPE usage and perceptions of the importance of PPE among healthcare workers at a single academic institution. Implementing clear and effective education and training programs, ensuring adequate access to protective gear, and promoting a positive safety climate can help improve adherence to safety protocols and appropriate use of PPE. 

4.
BMJ Open Respir Res ; 8(1)2021 09.
Article in English | MEDLINE | ID: covidwho-1435063

ABSTRACT

IMPORTANCE: Use of non-invasive respiratory modalities in COVID-19 has the potential to reduce rates of intubation and mortality in severe disease however data regarding the use of high-flow nasal cannula (HFNC) in this population is limited. OBJECTIVE: To interrogate clinical and laboratory features of SARS-CoV-2 infection associated with high-flow failure. DESIGN: We conducted a retrospective cohort study to evaluate characteristics of high-flow therapy use early in the pandemic and interrogate factors associated with respiratory therapy failure. SETTING: Multisite single centre hospital system within the metropolitan Detroit region. PARTICIPANTS: Patients from within the Detroit Medical Center (n=104, 89% African American) who received HFNC therapy during a COVID-19 admission between March and May of 2020. PRIMARY OUTCOME: HFNC failure is defined as death or intubation while on therapy. RESULTS: Therapy failure occurred in 57% of the patient population, factors significantly associated with failure centred around markers of multiorgan failure including hepatic dysfunction/transaminitis (OR=6.1, 95% CI 1.9 to 19.4, p<0.01), kidney injury (OR=7.0, 95% CI 2.7 to 17.8, p<0.01) and coagulation dysfunction (OR=4.5, 95% CI 1.2 to 17.1, p=0.03). Conversely, comorbidities, admission characteristics, early oxygen requirements and evaluation just prior to HFNC therapy initiation were not significantly associated with success or failure of therapy. CONCLUSIONS: In a population disproportionately affected by COVID-19, we present key indicators of likely HFNC failure and highlight a patient population in which aggressive monitoring and intervention are warranted.


Subject(s)
COVID-19 , Oxygen Inhalation Therapy , Respiratory Insufficiency , African Americans , Aged , Aged, 80 and over , COVID-19/therapy , Cannula , Female , Humans , Male , Michigan , Middle Aged , Respiratory Insufficiency/therapy , Respiratory Insufficiency/virology , Retrospective Studies
5.
J Child Adolesc Psychopharmacol ; 31(7): 464-474, 2021 09.
Article in English | MEDLINE | ID: covidwho-1429159

ABSTRACT

Objectives: To describe the development of a protocol and practical tool for the safe delivery of telemental health (TMH) services to the home. The COVID-19 pandemic forced providers to rapidly transition their outpatient practices to home-based TMH (HB-TMH) without existing protocols or tools to guide them. This experience underscored the need for a standardized privacy and safety tool as HB-TMH is expected to continue as a resource during future crises as well as to become a component of the routine mental health care landscape. Methods: The authors represent a subset of the Child and Adolescent Psychiatry Telemental Health Consortium. They met weekly through videoconferencing to review published safety standards of care, existing TMH guidelines for clinic-based and home-based services, and their own institutional protocols. They agreed on three domains foundational to the delivery of HB-TMH: environmental safety, clinical safety, and disposition planning. Through multiple iterations, they agreed upon a final Privacy and Safety Protocol for HB-TMH. The protocol was then operationalized into the Privacy and Safety Assessment Tool (PSA Tool) based on two keystone medical safety constructs: the World Health Organization (WHO) Surgical Safety Checklist/Time-Out and the Checklist Manifesto. Results: The PSA Tool comprised four modules: (1) Screening for Safety for HB-TMH; (2) Assessment for Safety During the HB-TMH Initial Visit; (3) End of the Initial Visit and Disposition Planning; and (4) the TMH Time-Out and Reassessment during subsequent visits. A sample workflow guides implementation. Conclusions: The Privacy and Safety Protocol and PSA Tool aim to prepare providers for the private and safe delivery of HB-TMH. Its modular format can be adapted to each site's resources. Going forward, the PSA Tool should help to facilitate the integration of HB-TMH into the routine mental health care landscape.


Subject(s)
Adolescent Health Services/organization & administration , COVID-19 , Child Health Services/organization & administration , Clinical Protocols/standards , Home Care Services , Mental Health Services/organization & administration , Patient Safety , Privacy , Telemedicine , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Child , Computer Communication Networks/standards , Delivery of Health Care/methods , Delivery of Health Care/organization & administration , Home Care Services/ethics , Home Care Services/standards , Home Care Services/trends , Humans , SARS-CoV-2 , Telemedicine/ethics , Telemedicine/methods , United States
6.
J Am Acad Child Adolesc Psychiatry ; 61(2): 277-290.e2, 2022 02.
Article in English | MEDLINE | ID: covidwho-1263300

ABSTRACT

OBJECTIVE: A consortium of 8 academic child and adolescent psychiatry programs in the United States and Canada examined their pivot from in-person, clinic-based services to home-based telehealth during the COVID-19 pandemic. The aims were to document the transition across diverse sites and to present recommendations for future telehealth service planning. METHOD: Consortium sites completed a Qualtrics survey assessing site characteristics, telehealth practices, service use, and barriers to and facilitators of telehealth service delivery prior to (pre) and during the early stages of (post) the COVID-19 pandemic. The design is descriptive. RESULTS: All sites pivoted from in-person services to home-based telehealth within 2 weeks. Some sites experienced delays in conducting new intakes, and most experienced delays establishing tele-group therapy. No-show rates and use of telephony versus videoconferencing varied by site. Changes in telehealth practices (eg, documentation requirements, safety protocols) and perceived barriers to telehealth service delivery (eg, regulatory limitations, inability to bill) occurred pre-/post-COVID-19. CONCLUSION: A rapid pivot from in-person services to home-based telehealth occurred at 8 diverse academic programs in the context of a global health crisis. To promote ongoing use of home-based telehealth during future crises and usual care, academic programs should continue documenting the successes and barriers to telehealth practice to promote equitable and sustainable telehealth service delivery in the future.


Subject(s)
COVID-19 , Telemedicine , Adolescent , Humans , Mental Health , Pandemics , SARS-CoV-2 , United States
7.
Mater Today Proc ; 46: 11169-11176, 2021.
Article in English | MEDLINE | ID: covidwho-1103158

ABSTRACT

The havoc created by Corona virus has been dealt with using various integrative approaches adopted by laboratories through-out the world. Use of anti-viral peptides (AVPs) although new but has shown tremendous potential against many pathogens. Previously AVPs have been designed against spike protein of corona virus which is the major entry mediating molecule. Using various in-silico strategies, in this research work AVPs have been modeled against lesser studied viral proteins namely ORF7a protein, Envelope protein (E), Nucleoprotein (N), and Non-Structural protein (Nsp1 and Nsp2). The predicted AVPs have been docked against various host as well as viral proteins. The interaction of small AVPs seems capable of interfering with binding between viral protein and its host counterpart. Therefore, these AVPs can act as a deterrent against novel corona virus, which requires further validation through laboratory techniques.

8.
Clin Med Insights Circ Respir Pulm Med ; 15: 1179548420986659, 2021.
Article in English | MEDLINE | ID: covidwho-1084165

ABSTRACT

BACKGROUND: Hypercoagulation is one of the striking features of COVID-19. Patients hospitalized with COVID-19 are at high risk for venous thromboembolism. However, it is unknown if the risk for venous thromboembolism persists after discharge. CASE SUMMARY: We report a case with pulmonary embolism 5 months after COVID-19. No risk factors for venous thrombosis have been identified. CONCLUSION: In COVID-19 related hospitalization, large studies are needed to identify the risk of venous thromboembolism after discharge.

9.
Arch Dermatol Res ; 2021 Jan 12.
Article in English | MEDLINE | ID: covidwho-1064477

ABSTRACT

Patient-centered and physician-led innovations are key to promoting physicians as visionary leaders in the healthcare system especially during times of crises. COVID-19 has inspired some promising recent advancements within medicine worth noting, including improvements in telemedicine, 3-D printed personal protective equipment (PPE) and ventilators, drug and vaccine development, sterilization of PPE allowing for reuse, and point of care testing; they highlight a broader lesson for how we might innovate better within medicine, even after the crisis has passed. As such, with the complexities of modern-day medicine, to continue to foster this culture of innovation, it is paramount that going forward, medical education adapt and embrace an innovation curriculum that prepares physicians and healthcare workers to work with their communities and researchers to confidently tackle any challenges that may present. Integrating innovation into our careers and medical training is important for advancement of the field and to be able to handle challenges that may present to the healthcare system.

10.
Environ Dev Sustain ; 23(6): 8147-8160, 2021.
Article in English | MEDLINE | ID: covidwho-809083

ABSTRACT

The novel coronavirus disease is known as COVID-19, which is declared as a pandemic by the World Health Organization during March 2020. In this study, the COVID-19 connection with various weather parameters like temperature, wind speed, and relative humidity is investigated and the future scenario of COVID-19 is predicted based on the Gaussian model (GM). This study is conducted in Delhi, the capital city of India, during the lowest mobility rate due to strict lockdown nationwide for about two months from March 15 to May 17, 2020. Spearman correlation is applied to obtain the interconnection of COVID-19 cases with weather parameters. Based on statistical analysis, this has been observed that the temperature parameter shows a significant positive trend during the period of study. The number of confirmed cases of COVID-19 is fitted with respect to the number of days by using the Gaussian curve and it is estimated on the basis of the model that maximum cases will go up to 123,886 in number. The maximum number of cases will be observed during the range of 166 ± 36 days. It is also estimated by using the width of the fitted GM that it will take minimum of 10 months for the complete recovery from COVID-19. Additionally, the linear regression technique is used to find the trend of COVID-19 cases with temperature and it is estimated that with an increase in temperature by 1 °C, 30 new COVID-19 cases on daily basis will be expected to observe. This study is believed to be a preliminary study and to better understand the concrete relationship of coronavirus, at least one complete cycle is essential to investigate. The laboratory-based study is essential to be done to support the present field-based study. Henceforth, based on preliminary studies, significant inputs are put forth to the research community and government to formulate thoughtful strategies like medical facilities such as ventilators, beds, testing centers, quarantine centers, etc., to curb the effects of COVID-19.

11.
Respir Med Case Rep ; 31: 101231, 2020.
Article in English | MEDLINE | ID: covidwho-793634

ABSTRACT

BACKGROUND: Granulocyte colony stimulating factors (G-CSFs) induce neutrophils proliferation and cytokines production. It has often been used to treat neutropenia without solid evidence of efficacy. It has been demonstrated that respiratory distress is associated with neutropenia recovery but not with G-CSFs. In general, G-CSFs are known to be safe and well tolerated in most clinical settings. However, the safety of G-CSFs in an overwhelming inflammatory disease like coronavirus disease 2019 (COVID-19) is largely unknown. CASE SUMMARY: We report a case with COVID-19 and neutropenia who rapidly deteriorated after administration of G-CSF. CONCLUSION: We observed a faster neutropenia recovery than previously known after administration of G-CSF in our case and in three similar cases previously reported in literature. This rapid neutropenia recovery and the robust inflammatory response in COVID-19 raise concerns about G-CSF safety in patients with COVID-19.

12.
Transplant Proc ; 52(9): 2698-2702, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-720726

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2. Our understanding of this new disease continues to grow. The impact of the disease on immunocompromised transplant recipients is largely unknown. We present a case of a solid organ transplant recipient on immunosuppressive therapy who successfully recovered from COVID-19 infection. We also review 10 similar cases found in the literature and describe the clinical course and management, including immunosuppressive therapy.


Subject(s)
Coronavirus Infections/immunology , Immunocompromised Host , Pneumonia, Viral/immunology , Transplant Recipients , Adult , Betacoronavirus , COVID-19 , Female , Humans , Immunosuppressive Agents/therapeutic use , Pandemics , SARS-CoV-2
13.
J Child Adolesc Psychopharmacol ; 30(7): 404-413, 2020 09.
Article in English | MEDLINE | ID: covidwho-637071

ABSTRACT

Objective: Telemental health (TMH) is not well described for mental health service delivery during crises. Most child and adolescent psychiatry training programs have not integrated TMH into their curricula and are ill equipped to respond during crises to their patients' needs. In this study, we present the implementation of a home-based TMH (HB-TMH) service during the COVID-19 pandemic. Methods: We describe the technological, administrative, training, and clinical implementation components involved in transitioning a comprehensive outpatient child and adolescent psychiatry program to a HB-TMH virtual clinic. Results: The transition was accomplished in 6 weeks. Most in-clinic services were rapidly moved off campus to the home. Owing to challenges encountered with each implementation component, phone sessions bridged the transition from in-clinic to reliable virtual appointments. Within 3 weeks (March 20, 2020) of planning for HB-TMH, 67% of all appointments were conducted at home, and within 4 weeks (March 27, 2020), 90% were conducted at home. By week 6 (April 3, 2020), reliable HB-TMH appointments were implemented. Conclusions: The COVID-19 pandemic crisis created the opportunity to innovate a solution to disrupted care for our established patients and to create a resource for youth who developed problems during the crisis. Our department was experienced in providing TMH services that facilitated the transition to HB-TMH, yet still had to overcome known and unanticipated challenges. Our experience provides a roadmap for establishing a HB-TMH service with focus on rapid implementation. It also demonstrates a role for TMH during (rather than after) future crises when usual community resources are not available.


Subject(s)
Coronavirus Infections , Home Care Services , Mental Disorders/therapy , Mental Health Services , Pandemics , Pneumonia, Viral , Telemedicine , Adolescent , Betacoronavirus , COVID-19 , Child , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Home Care Services/organization & administration , Home Care Services/trends , Humans , Mental Health Services/organization & administration , Mental Health Services/trends , Organizational Innovation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administration , Washington/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL