Job satisfaction in nursing during the COVID-19 pandemic

Objetivo: avaliar a satisfacao com o trabalho de profissionais de enfermagem que atuaram na assistencia e na gestao, durante a pandemia de COVID-19. Metodo: estudo epidemiologico de corte transversal. Participaram 334 profissionais de enfermagem de um hospital de ensino. Foram calculadas as frequencias absolutas e relativas das variaveis qualitativas e as medias das variaveis numericas. Foram comparadas as medias dos resultados dos dominios da escala de satisfacao profissional (Job Satisfaction Survey) com variaveis sociodemograficas-laborais. Foram aplicados os testes t de Student, Mann-Whitney, Anova seguidos de pos-teste de Tukey, Kruskal-Wallis ou Dunn, para verificar a significancia estatistica dos resultados com nivel critico de 0,05. Resultados: 90 profissionais demonstraram-se satisfeitos com o trabalho, tres profissionais demonstraram-se insatisfeitos e 241 profissionais demonstraram-se ambivalentes. Conclusao: foi evidenciada uma ambivalencia dos trabalhadores de enfermagem em relacao a sua satisfacao com o trabalho, durante o periodo da pandemia de COVID-19. Os achados indicam um caminho para que gerentes e formuladores de politica em saude facam investimentos em planos de carreira e ambiente de trabalho que melhorem as condicoes de trabalho dos trabalhadores de enfermagem.

Effect of COVID-19 on Alzheimer's and dementia measured through ocular indications

Screening for early detection of Alzheimer's disease (AD) through a comprehensive eye exam appears to be promising and could potentially provide a more sensitive, inexpensive way to visualize early signs of AD for early detection in large populations. Optical coherence tomography (OCT), as well as retinal imaging techniques such as Doppler and fluorescence lifetime imaging ophthalmoscopy (FLIO), can detect signs of early AD such as vascular changes or accumulations of Tau proteins and beta-amyloid proteins. In the age of COVID-19, this screening opportunity is threatened by increased no-show rates leading to decreased early detection of AD. Through the combination of COVID-19 neuroinflammation potentially augmenting AD neurodegeneration, as well as missed opportunity in the use of early ophthalmic detection, the pandemic may have significantly worsened the trajectory of AD. © 2023 Elsevier Inc. All rights reserved.

Satisfação profissional na enfermagem durante a pandemia de COVID-19

Objetivo: avaliar a satisfação com o trabalho de profissionais de enfermagem que atuaram na assistência e na gestão, durante a pandemia de COVID-19. Método: estudo epidemiológico de corte transversal. Participaram 334 profissionais de enfermagem de um hospital de ensino. Foram calculadas as frequências absolutas e relativas das variáveis qualitativas e as médias das variáveis numéricas. Foram comparadas as médias dos resultados dos domínios da escala de satisfação profissional (Job Satisfaction Survey) com variáveis sociodemográficas-laborais. Foram aplicados os testes t de Student, Mann-Whitney, Anova seguidos de pós-teste de Tukey, Kruskal-Wallis ou Dunn, para verificar a significância estatística dos resultados com nível crítico de 0,05. Resultados: 90 profissionais demonstraram-se satisfeitos com o trabalho, três profissionais demonstraram-se insatisfeitos e 241 profissionais demonstraram-se ambivalentes. Conclusão: foi evidenciada uma ambivalência dos trabalhadores de enfermagem em relação à sua satisfação com o trabalho, durante o período da pandemia de COVID-19. Os achados indicam um caminho para que gerentes e formuladores de política em saúde façam investimentos em planos de carreira e ambiente de trabalho que melhorem as condições de trabalho dos trabalhadores de enfermagem.

The "epidemic within the pandemic”: meeting the needs of racially minoritised women experiencing domestic abuse during the Covid-19 pandemic

PurposeIn March 2020, the UK entered its first lockdown responding to the Covid-19 pandemic. In the same month, the Domestic Abuse Bill had its first reading in Parliament. Charities and non-governmental organisations critiqued the Bill for failing to protect migrants from domestic abuse, and not complying with the Istanbul Convention. Drawing on interviews with staff from Southall Black Sisters, this paper aims to foreground the experiences of practitioners within the women's sector to explore the unique experiences and challenges migrant and racially minoritised women encountered when seeking support from domestic abuse during the Covid-19 pandemic. It highlights how the pandemic-related lockdowns created barriers to accessing support services and housing, creating an epidemic within the pandemic, and how minoritised women and the organisations that supported them had to overcome structural barriers and racism.Design/methodology/approachIn-depth semi-structured interviews were conducted with staff from a leading women's organisation that supports migrant and racially minoritised women. Four participants were asked questions within four themes: domestic abuse before and during the pandemic;accessing support from and reporting domestic abuse;accessibility of resources;and post-pandemic challenges. A phenomenological approach was used to analyse the transcribed interviews.FindingsParticipants consistently highlighted the unique threats and barriers migrant and racially minoritised women faced when seeking support. Barriers included racism, language barriers, cultural constraints, the triple threat of destitution, detention, deportation, and political resistance to protect migrant women from destitution/homelessness.Originality/valueThis paper provides a unique insight into the experiences of staff members within a specialist by and for women's support organisation in England and their perspectives on the barriers racially minoritised and migrant women experienced during the Covid-19 pandemic. It offers rare insights into how service users' needs changed during the lockdowns and how the pandemic affected their ability to operate.

Salmonellosis in the COVID-19 Pandemic Era

Relevance. In 2020, there was a unique situation caused by the COVID-19 pandemic and the anti-epidemic measures introduced in this regard. To date, the question of how these methods affect the spread of other infectious diseases, including salmonellosis, has not been studied. Target. To assess the impact of anti-epidemic measures during the COVID-19 pandemic on the epidemic process of salmonella infection in St. Petersburg. Materials and methods. Reporting form No. 2 of Rospotrebnadzor «Information on infectious and parasitic diseases» for 2018–2020 and data from the State report «On the state of sanitary and epidemiological well-being of the population in St. Petersburg in 2019», «On the state of sanitary and epidemiological well-being of the population in St. Petersburg in 2020». Data processing was carried out using Microsoft Excel (Microsoft®, USA), Statistica for Windows (StatSoft®, USA) with the determination of the level of significance (p), the calculation of confidence intervals (95% CI) was carried out in the EpiTools application. Results. The incidence of salmonellosis in 2020 was significantly lower than in the previous 2 years 28.86 (95% CI 27.45–30.34) per 100 ths population, and in 2019 and 2018 – 49.8 (95% CI 47.9–51.7) and 39.21 (95% CI 37.6– 40.9) per 100 ths of the population respectively. When analyzing the incidence of salmonellosis in 1995 to 2020, it was revealed that in 2020 the incidence rate was the lowest over the past 25 years and below the multi-year average (37 per 100 ths population) in St. Petersburg by 22%. A decrease in the incidence of salmonellosis was observed in 2020 and in the Russian Federation as a whole compared to 2019, the indicator increased 1.6 times and amounted to 14.71 per 100 ths rubles. population (multi-year average – 29.1). In 2020, there was a change in the intra-annual incidence of salmonellosis. While the peak incidence of salmonellosis persisted in the autumn period (September–October), in 2020 there was no characteristic rise in the spring period, as was observed in 2018 and 2019, which may be due to the spring lockdown (p = 0.03). The decrease in the incidence of salmonellosis was due to a significant decrease in the incidence among adults, while this was not observed in other age groups. In 2018–2020, diseases in the population were caused by 61 serotypes of Salmonella: in 2018 – 33, in 2019 – 32, and in 2020 – 39 serotypes. During the pandemic, the decrease in the incidence of salmonellosis was due to the decrease in the incidence caused by S. Enteritis, which in 2020 amounted to 19.91 (95% CI 18.73-21.14) per 100 thousand population, while in 2019 – 39, 01 (95% CI 37.4–40.7) and in 2018 – 31.24 (95% CI 29.8–32.8) per 100 ths population. At the same time, the decrease in the incidence rate was a decrease in the incidence rate among adults, while in other age groups no changes in the incidence rate were observed. The incidence due to other salmonella serotypes did not change. There were no significant differences in the incidence of salmonellosis by sex and age. Conclusion. The measures introduced during the pandemic in 2020 led to a decrease in the incidence of salmonellosis in St. Petersburg by reducing the incidence of salmonellosis caused by S. Enteritidis among adults. © Lubimova AV, et al.

Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis

Relevance. At present, three infections – HIV infection, tuberculosis, and COVID-19-are spreading simultaneously in the world. Of great practical importance is the assessment of clinical and epidemiological features of COVID-19 in HIV-infected patients with tuberculosis, COVID-19. Aim. To study the risk of COVID-19 disease and identify clinical and epidemiological features in and population of patients with HIV infection complicated by tuberculosis in comparison with patients with HIV infection and the population without these diseases. Materials and methods. Since 13.03.2020 by 31.12.2021 in the Kemerovo Region-Kuzbass, a continuous prospective analytical epidemiological study of the case-control type was performed. Of those with COVID-19, two observation groups were formed: group I (HIV +), group II (HIV/TB) and comparison group III (persons without either HIV or tuberculosis). All patients underwent: determination of SARS-CoV-2 RNA, standard examination methods in accordance with the temporary methodological recommendations «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)», relevant at the time of treatment. Results. The incidence of COVID-19 among patients with HIV infection complicated by tuberculosis exceeded the incidence of COVID-19 among HIV-infected by 14%. There were no gender differences between patients I (HIV +) and II (HIV/TB) groups. In the comparison group, the incidence of COVID-19 was 1.26 times higher in women compared to men. COVID-19 disease in patients with co-infection (HIV/TB) was predominantly mild. Viral pneumonia developed 1.86 times less often, oxygenotherapy was required only in 18.75% of cases, which is 2.5 times lower than in group I (HIV +) and 2.47 times less than in the comparison group (III). In labeled pairs, clinical symptoms of COVID-19 in all groups occurred with the same frequency. Metabolic disorders were evident in all groups. Co-infected patients (HIV/TB) had higher levels of D-dimer, ESR, total bilirubin. Conclusion. Active tuberculosis in HIV-infected people is a factor that increases the risk of COVID-19 disease without affecting the severity of the infectious process. © 2023, Numikom. All rights reserved.

Pandemia de la COVID-19 y las Políticas de Salud Pública en el Perú: marzo-mayo 2020/COVID-19 pandemic and Public Health Policies in Peru: March-May 2020

Objetivo El trabajo tiene como objetivo analizar la dinámica del comportamiento de la COVID-19 en el Perú, estimar y evaluar el impacto de la política pública de supresión (cuarentena). Métodos El modelo epidemiológico SIR y la estimación con el método de Mínimos Cuadrados Ordinarios (MCO). Resultados Se encontró que el número básico de propagación (Ro) cayó de 6,0 a 3,2 habiéndose reducido en 54% por efecto de la estrategia de supresión, y dos meses después cayó a 1,7. Sin embargo, sigue siendo alto y evidencia que aún continúa en expansión el nivel de infectados, con los efectos sociales y económicos adversos que esta medida implica. Conclusión La COVID-19 es una enfermedad que crece exponencialmente, por lo cual, la política de salud basada en la estrategia de supresión ha permitido aplanar la curva de contagio, evitando el colapso del Sistema de Salud. Objective The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). Methods The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. Results It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy;and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected continues to expand with its adverse social and economic effects. Conclusion COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.

"Fortune amidst misfortune”: The impact of Covid-19 city lockdowns on air quality

Air pollution is one of the major causes of health risks as it leads to widespread disease and death each year. Countries have invested heavily in fighting air pollution, arguably without convincing results. The outbreak of the highly infectious disease COVID-19 in December 2019 has been declared a pandemic and a worldwide health crisis by World Health Organization (WHO). Countries resorted to city lockdowns that sternly curtailed personal mobility and economic activities to control the spread of this deadly coronavirus disease. This paper examines the impact of Covid-19 city lockdowns on air quality. The researchers adopted a comprehensive interpretative document analysis for this study, which guided the careful but rigorous examination of air quality and coronavirus data. This method affirmed the authenticity of the information examined and interpreted in the US, Italy and China, the study areas. The study found that Covid-19 city lockdowns have contributed to a significant improvement in air quality within the first four months of the outbreak of Covid-19. National Aeronautics and Space Administration (NASA) had reported that NO2 concentrations in the study areas had reduced significantly using evidence from their Sentinel-5P instrument. Air quality in Covid-19 cities' lockdowns also improved because of the enforcement of other types of measures enacted to battle the virus. WHO still believes that the amount of NO2 concentration in the atmosphere is still high per their standards and regulations. Based on this, the researchers recommend that governments and other stakeholders put in much effort in terms of legislation to "win the war” against air pollution.

Infectious Morbidity in Closed Long-Term Care Facilities in the «Pre-COVID Stage»

Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases. Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY.ru, Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis. Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations. © 2023, Numikom. All rights reserved.

A puzzle of epistemic paternalism

Since the start of the Covid-19 pandemic in early 2020, conspiracy theories, misinformation, and fake news about the virus have abounded, drastically affecting global health measures to oppose it. In response, different strategies have been proposed to combat such Covid-19 collective irrationalities. One suggested approach has been that of epistemic paternalism – non-consultative interference in agents' inquiries for their epistemic improvement. While extant literature on epistemic paternalism has mainly discussed whether it is (ever) justified, in this paper, I primarily focus on the potential implementation of widespread epistemically paternalistic policies (such as no-platforming and censorship) and its consequences. I argue that pursuing epistemic paternalism to combat Covid-19 collective irrationalities leads to a hitherto unnoticed puzzle for proponents of epistemic paternalism. Central to the puzzle is the idea those (governments, corporations, social media giants) who actually can (i.e., have the requisite power to) enact widespread epistemically paternalistic policies seem the institutions who are least suited to having such informational control over the populace. Thus, epistemic paternalism appears a sword without a hilt;while it may prove an effective strategy in tackling Covid-19 collective irrationalities, we do not have any way to use it without incurring serious risks.

Predictors of Follow-Up Appointment No-Shows Before and During COVID Among Adults with Type 2 Diabetes.

Background: The coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed health care delivery into telehealth visits. Attending regular medical appointments are critical to prevent or delay diabetes-related complications. Although telehealth visits have addressed some barriers to in-person visits, appointment no-shows are still noted in the telehealth setting. It is not completely clear how the predictors of appointment no-shows differ between in-person and telehealth visits in diabetes care. Objective: This retrospective study examined if predictors of appointment no-shows differ (1) between pre-COVID (January 1, 2019-March 22, 2020) and COVID (March 23, 2020-December 31, 2020) periods and (2) by health care delivery modes (in-person or telehealth visits) during COVID among adults with type 2 diabetes mellitus (T2DM). Methods: We used electronic health records between January 1, 2019 and December 31, 2020 across four diabetes clinics in a tertiary academic hospital in Baltimore, Maryland. Appointments marked as completed or no-show by established adults with T2DM were included in the analyses. Results: Among 7,276 appointments made by 2,235 patients, overall appointment no-show was 14.99%. Being older and White were protective against appointment no-shows in both unadjusted and adjusted models during both time periods. The interaction terms of COVID periods (i.e., pre-COVID vs. COVID) were significant for when glycated hemoglobin drawn before this visit and for missing body mass index. Telehealth visits during COVID decreased more half of the odds of appointment no-shows. Conclusions: In the context of diabetes care, the implementation of telehealth reduced appointment no-shows. Future studies are needed to address social determinants of health, including access to internet access, to further reduce health disparities among adults with T2DM.

Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) and Gastroprotective NSAIDs on the Gastrointestinal Tract: A Narrative Review.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for their anti-inflammatory, antipyretic, and analgesic properties. However, their use is often associated with gastrointestinal tract (GIT) side effects due to the inhibition of both cyclooxygenase (COX)-1 and COX-2 enzymes, leading to a decrease in gastroprotective prostaglandins (PG). To minimize these adverse effects, various approaches have been explored, including selective COX-2 inhibitors, NO-NSAIDs (nitric oxide-releasing NSAIDs), and dual COX/LOX (lipoxygenase) NSAIDs. However, the effects of these gastroprotective NSAIDs on the GIT and their efficacy remains uncertain. This review aims to provide an overview of the current understanding of the effects of traditional NSAIDs and gastroprotective NSAIDs on GIT. We discuss the underlying mechanisms of GIT damage caused by NSAIDs, including mucosal injury, ulceration, and bleeding, and the potential of gastroprotective NSAIDs to mitigate these effects. We also summarize recent studies on the efficacy and safety of various gastroprotective NSAIDs and highlight the limitations and challenges of these approaches. The review concludes with recommendations for future research in this field.

COVID-19-associated lung weakness (CALW): Systematic review and meta-analysis.

OBJECTIVES: To assess mortality and different clinical factors derived from the development of atraumatic pneumothorax (PNX) and/or pneumomediastinum (PNMD) in critically ill patients as a consequence of COVID-19-associated lung weakness (CALW). DESIGN: Systematic review with meta-analysis. SETTING: Intensive Care Unit (ICU). PARTICIPANTS: Original research evaluating patients, with or without the need for protective invasive mechanical ventilation (IMV), with a diagnosis of COVID-19, who developed atraumatic PNX or PNMD on admission or during hospital stay. INTERVENTIONS: Data of interest were obtained from each article and analyzed and assessed by the Newcastle-Ottawa Scale. The risk of the variables of interest was assessed with data derived from studies including patients who developed atraumatic PNX or PNMD. MAIN VARIABLES OF INTEREST: Mortality, mean ICU stay and mean PaO2/FiO2 at diagnosis. RESULTS: Information was collected from 12 longitudinal studies. Data from a total of 4901 patients were included in the meta-analysis. A total of 1629 patients had an episode of atraumatic PNX and 253 patients had an episode of atraumatic PNMD. Despite the finding of significantly strong associations, the great heterogeneity between studies implies that the interpretation of results should be made with caution. CONCLUSIONS: Mortality among COVID-19 patients was higher in those who developed atraumatic PNX and/or PNMD compared to those who did not. The mean PaO2/FiO2 index was lower in patients who developed atraumatic PNX and/or PNMD. We propose grouping these cases under the term COVID-19-associated lung weakness (CALW).

Mortality burden due to ambient nitrogen dioxide pollution in China: Application of high-resolution models.

BACKGROUND: A large gap exists between the latest Global Air Quality Guidelines (AQG 2021) and Chinese air quality standards for NO2. Assessing whether and to what extent air quality standards for NO2 should be tightened in China requires a comprehensive understanding of the spatiotemporal characteristics of population exposure to ambient NO2 and related health risks, which have not been studied to date. OBJECTIVE: We predicted ground NO2 concentrations with high resolution in mainland China, explored exposure characteristics to NO2 pollution, and assessed the mortality burden attributable to NO2 exposure. METHODS: Daily NO2 concentrations in 2019 were predicted at 1-km spatial resolution in mainland China using random forest models incorporating multiple predictors. From these high-resolution predictions, we explored the spatiotemporal distribution of NO2, population and area percentages with NO2 exposure exceeding criterion levels, and premature deaths attributable to long- and short-term NO2 exposure in China. RESULTS: The cross-validation R2and root mean squared error of the NO2 predicting model were 0.80 and 7.78 µg/m3, respectively,at the daily level in 2019.The percentage of people (population number) with annual NO2 exposure over 40 µg/m3 in mainland China in 2019 was 10.40 % (145,605,200), and it reached 99.68 % (1,395,569,840) with the AQG guideline value of 10 µg/m3. NO2 levels and population exposure risk were elevated in urban areas than in rural. Long- and short-term exposures to NO2 were associated with 285,036 and 121,263 non-accidental deaths, respectively, in China in 2019. Tightening standards in steps gradually would increase the potential health benefit. CONCLUSION: In China, NO2 pollution is associated with significant mortality burden. Spatial disparities exist in NO2 pollution and exposure risks. China's current air quality standards may no longer objectively reflect the severity of NO2 pollution and exposure risk. Tightening the national standards for NO2 is needed and will lead to significant health benefits.

Factors Associated With No-Show to Ambulatory Tele-Video Neurology Visits.

Introduction Telehealth visits (TH) have become an important pillar of healthcare delivery during the COVID pandemic. No-shows (NS) may result in delays in clinical care and in lost revenue. Understanding the factors associated with NS may help providers take measures to decrease the frequency and impact of NS in their clinics. We aim to study the demographic and clinical diagnoses associated with NS to ambulatory telehealth neurology visits. Methods We conducted a retrospective chart review of all telehealth video visits (THV) in our healthcare system from 1/1/2021 to 5/1/2021 (cross-sectional study). All patients at or above 18 years of age who either had a completed visit (CV) or had an NS for their neurology ambulatory THV were included. Patients having missing demographic variables and not meeting the ICD-10 primary diagnosis codes were excluded. Demographic factors and ICD-10 primary diagnosis codes were retrieved. NS and CV groups were compared using independent samples t-tests and chi-square tests as appropriate. Multivariate regression, with backward elimination, was conducted to identify pertinent variables. Results Our search resulted in 4,670 unique THV encounters out of which 428 (9.2%) were NS and 4,242 (90.8%) were CV. Multivariate regression with backward elimination showed that the odds of NS were higher with a self-identified non-Caucasian race OR = 1.65 (95%, CI: 1.28-2.14), possessing Medicaid insurance OR = 1.81 (95%, CI: 1.54-2.12) and with primary diagnoses of sleep disorders OR = 10.87 (95%, CI: 5.55-39.84), gait abnormalities (OR = 3.63 (95%, CI: 1.81-7.27), and back/radicular pain OR = 5.62 (95%, CI: 2.84-11.10). Being married was associated with CVs OR = 0.74 (95%, CI: 0.59-0.91) as well as primary diagnoses of multiple sclerosis OR = 0.24 (95%, CI: 0.13-0.44) and movement disorders OR = 0.41 (95%, CI: 0.25-0.68). Conclusion Demographic factors, such as self-identified race, insurance status, and primary neurological diagnosis codes, can be helpful to predict an NS to neurology THs. This data can be used to warn providers regarding the risk of NS.

To confirm your appointment, please press one: Examining demographic and health system interface factors that predict missed appointments in a pediatric outpatient neuropsychology clinic.

Objective: Missed patient appointments have a substantial negative impact on patient care, child health and well-being, and clinic functioning. This study aims to identify health system interface and child/family demographic characteristics as potential predictors of appointment attendance in a pediatric outpatient neuropsychology clinic. Method: Pediatric patients (N = 6,976 across 13,362 scheduled appointments) who attended versus missed scheduled appointments at a large, urban assessment clinic were compared on a broad array of factors extracted from the medical record, and the cumulative impact of significant risk factors was examined. Results: In the final multivariate logistic regression model, health system interface factors that significantly predicted more missed appointments included a higher percentage of previous missed appointments within the broader medical center, missing pre-visit intake paperwork, assessment/testing appointment type, and visit timing relative to the COVID-19 pandemic (i.e. more missed appointments prior to the pandemic). Demographic characteristics that significantly predicted more missed appointments in the final model included Medicaid (medical assistance) insurance and greater neighborhood disadvantage per the Area Deprivation Index (ADI). Waitlist length, referral source, season, format (telehealth vs. in-person), need for interpreter, language, and age were not predictive of appointment attendance. Taken together, 7.75% of patients with zero risk factors missed their appointment, while 22.30% of patients with five risk factors missed their appointment. Conclusions: Pediatric neuropsychology clinics have a unique array of factors that impact successful attendance, and identification of these factors can help inform policies, clinic procedures, and strategies to decrease barriers, and thus increase appointment attendance, in similar settings.

Advances in the work of multidisciplinary teams for the care of patients with severe uncontrolled asthma. A post-COVID vision (TEAM 2.0 project). / Avances en el trabajo de equipos multidisciplinares para la atención al paciente con asma grave no controlada. Una visión post-COVID (Proyecto TEAM 2.0).

Asthma is a chronic respiratory disease with a high health, social and economic impact, particularly in the case of Severe Uncontrolled Asthma (SUA). For this reason, new strategies are especially necessary to improve its approach, with a personalized approach to each patient and from a multidisciplinary perspective, in addition to integrating the new telemedicine and telepharmacy practices promoted as a result of the COVID-19 pandemic. In this context, the TEAM 2.0 project ("Work in Multidisciplinary Asthma Teams") has been developed, following the TEAM project carried out in 2019, with the aim of updating and prioritizing good multidisciplinary work practices in SUA in a post pandemic context and analyze the progress made. A coordinating group, made up of eight multidisciplinary teams of hospital pharmacists, pulmonologists, and allergists, carried out an updated bibliographic review, sharing of good multidisciplinary practices, and analysis of advances. Through five regional meetings with other experts with experience in SUA, the good practices identified were shared and subjected to debate, evaluation and prioritization. In total, 23 good multidisciplinary work practices in SUA, grouped into five work areas: 1) Organization of work in multidisciplinary teams, 2) Patient education, self-management and adherence, 3) Health results, data monitoring and persistence, 4) Telepharmacy and experiences implemented during the COVID-19 pandemic and 5) Training and research, were evaluated and prioritized by 57 professionals from the field of Hospital Pharmacy, Pulmonology, Allergology and Nursing. This work has made it possible to update the roadmap of priority actions to continue advancing in optimal models of care for patients with AGNC in a post-COVID-19 context.

What do Portuguese cardiologists think and feel about their work?

INTRODUCTION AND OBJECTIVES: This study reports the results of an online survey carried out by the Portuguese Society of Cardiology about its medical members' work characteristics before and during the COVID-19 pandemic, their job satisfaction, work motivation, and burnout. METHODS: A sample of 157 participants answered a questionnaire with demographic, professional, and health-related information, followed by questionnaires on job satisfaction and motivation designed and validated for this study and a Portuguese version of the Maslach Burnout Inventory. Data were analyzed through descriptive statistics, ANOVA, and MANOVA, considering gender, professional level, and sector of activity, respectively. Multiple regression was used to assess the impact of job satisfaction and motivation on burnout. RESULTS: The only variable that distinguished participants was sector of activity. Cardiologists working in the private sector worked fewer weekly hours during COVID-19, while those in the public sector worked more. The latter expressed more desire to reduce their working hours than those who worked in private medicine and in both sectors. There were no differences between sectors in work motivation, while job satisfaction was higher in the private sector. Moreover, job satisfaction negatively predicted burnout. CONCLUSIONS: Our findings point to a deterioration in working conditions during the COVID-19 pandemic, with its consequences being felt especially in the public sector, which may have contributed to the lower levels of satisfaction among cardiologists who worked exclusively in this sector, but also for those working in both public and private sectors.

Consumer testing away from a sensory facility: Application of home-use test and no-contact home-use test.

COVID-19 pandemic-related restrictions for approximately three years have heavily influenced sensory evaluations. People have become accustomed to working remotely and communicating online. This has led to opportunities in sensory testing paired with logistics systems and information technologies, resulting in a wide application of the home-use test (HUT), wherein panelists evaluate samples from their homes or other off-site locations. This study aimed to compare three sensory evaluation conditions: a central location test (CLT, n = 104), a HUT (n = 120), and a no-contact HUT (N-HUT, n = 111). We recruited participants via the local community website, delivered samples using a delivery service, and conducted sensory testing using a smartphone for the N-HUT. Participants were requested to report the acceptance ratings, sensory profiles, and emotion responses to four coffee samples. Some differences in the acceptance ratings might be due to the different attitudes participating in the evaluation. In the sensory profiling of the samples, multi-factor analysis (MFA) revealed highly similar sensory characteristics across the three types of tests. All RV coefficients (RVs) among the test conditions were above 0.93. The emotion responses to coffee samples were similar among test conditions based on the MFA with RV values greater than 0.84. In conclusion, we found that N-HUT produced similar results regarding the descriptions of sensory profiles and emotions, indicating that N-HUT is a suitable test method for collecting sensory data and overcoming CLT and HUT's regional limitations. Modern logistics systems and information technologies make it possible to conduct nationwide sensory evaluations without in-person contact or participant attendance at sensory testing facilities.

Fluid transitions – "weak” constellations of participation in the process of leaving care

This conceptual article describes how, in terms of organization theories, shifts in the chronological transition to adulthood produce "weak” constellations of participation during the process of leaving care. In contrast, the professional discourse on participation is dominated by concepts that ultimately call for "strong” constellations as a means of enabling participation. In that discourse, participation is seen as being governed by the organizational structure of the child and youth care services, which, for example, determine the chronology of the steps taken by care leavers (e.g., moving out of their residential home or the foster family) and thus also affect their opportunities for participation. Altogether, chrononormativities are seen to play a prominent guiding role. Research into participation relating to child and youth care generally pays little attention to emerging adulthood: the professional debate mainly relates to the UN Convention on the Rights of the Child (UNCRC), which focuses on the age of majority as its biographical milestone. For this reason, this article will start out by summarising the research on participation during the process of leaving care. Three analyses of contemporary society taken from youth studies will then be used to describe the chronological arrangements young people currently experience during this transition. First, we will examine the dynamics influencing young people's biographies during emerging adulthood in some countries and affecting their opportunities for participation. Second, we will focus on the varied range of life circumstances, coping situations and social disadvantages facing care leavers. Third, we will study how the "beyond Covid” situation is affecting care leavers. Finally, we will argue that in view of these unclear chronological transitional constellations during the process of leaving care, it would be fruitful for research on participation to examine "weak” constellations of as a means of identifying and analysing different signals through which people make their voices heard. This understanding of participation against the background of leaving care will make it possible to recognise not just "strong”, activating forms of participation, but also different degrees of participation and ways in which it is expressed.