Collaboration ville–aide médicale urgente–hôpital à l'épreuve de la crise Covid-19, l'expérience des Yvelines

L'évolution actuelle de la demande de soins non programmés porte autant sur une augmentation de volume que sur sa nature. Les missions assurées par les structures d'urgence se sont décentrées vers la prise en charge des complications des pathologies chroniques et des problématiques médicosociales. Une démarche collaborative entre la médecine de ville et l'aide médicale urgente (AMU) a été initiée depuis deux ans dans les Yvelines, entre le Samu 78, l'hôpital de Versailles, le Conseil de l'ordre des médecins 78 et l'Association Plateforme territoriale d'appui 78. Ses objectifs visent, par un travail de coordination multidisciplinaire, à éviter les ruptures de parcours des patients complexes, à favoriser le maintien à domicile et à réorienter les patients vers la ville après un recours à l'hôpital. La crise sanitaire liée au Covid-19 a permis d'accélérer le processus de collaboration ville– AMU avec des objectifs propres à cette crise, notamment grâce à des outils numériques dédiés. Les principaux axes de travail ont été de répondre à l'urgence de la crise sanitaire en organisant une offre de soins sécurisée, d'organiser les parcours des patients fragiles pendant le confinement puis de préparer et d'accompagner le déconfinement grâce à une cellule d'appui et de suivi des cas positifs et de leurs contacts. Les difficultés organisationnelles ou liées à l'acceptabilité de ces nouveaux outils de surveillance et de coordination ont trouvé leurs solutions grâce à un environnement institutionnel favorable et l'implication de leaders intéressés par la conduite de projets innovants. Cette expérience peut préfigurer le futur service d'accès aux soins (SAS).Alternate abstract: The type and amount of the current demand for unplanned healthcare is evolving. Tasks of emergency services moved towards chronic diseases complications, and towards the increasing amount of medico-social issues. For two years, a collaborative approach between community medicine and emergency medical communication center in the Yvelines (78) has been undertaken. The stakeholders are the Samu 78, the Versailles Hospital, the Yvelines Medical Board and the territorial coordination association. This approach aims at preventing inappropriate hospitalization, promoting home care, and redirecting patients to community medicine after a hospital stay, thanks to multidisciplinary coordination teamwork. The health crisis due to COVID- 19 boosted and strengthened community medicine—emergency medical communication center cooperation with specific goals, with the help of dedicated digital tools (among other things). The leading workstreams were to handle the health crisis urgency through the set-up of secured health care provision over the Yvelines area, to manage the course of the precarious patients during the lockdown period and finally to support the lifting of the lockdown with a dedicated backup team, and the follow-up of COVID-19 patients and their close relatives. Solutions to the organizational issues and issues related to the acceptance of the new monitoring and coordination digital tools were found, thanks to a supportive institutional environment, and to the committed leaders interested in the innovative projects. This collaboration should be a model for the new access to healthcare system.

Communication on risk perception of over-the-counter drugs: A systematic review: Presenter(s): Ana García-Arranz, Universidad Rey Juan Carlos, Spain

Increasingly autonomous patients, the growing complexity of healthcare systems, and an overload of confusing information are only some of the factors at the root of a self-medicated society. In the last decade, sales of over-the-counter drugs have increased by 50.04% (Euromonitor International, 2021). More recently, COVID-19, with unprecedented information flows, has triggered their consumption in an act of self-preservation. This proposal aims to determine the role that scientific literature —focused on raising patient awareness and perception of the risks linked to the consumption of these products— gives to the media and advertising, and to the nature of the information provided. The methodology has two parts: the first analyses all relevant research published between 2001 and 2021 and registered in reference databases (Web of Science, Communication and Mass Media Complete, PubMed and PsycINFO). The second develops a residual analysis based on the corresponding contingency table, after conducting relevant significance tests (?2). The corpus is composed of 516 studies. In the last decade, the interest of the scientific community in these products has increased in parallel to their consumption (67%). The main evidenced risks are side effects (89.1%), the potential generation of diseases (56.8%), misuse or abuse (53.9%), as well as possible interactions (49%) with other medication. Also 26.4% of the analysed corpus confirm the media's influence in the consumption of these products, and 29.7% indicate the need for greater advertising restrictions. Moreover, 36.4% of the studies evidence the absence of relevant and/or verified information. Given the emphasis on selfcare and the empowerment of the public to manage their health with OTC drugs, the Findings: of our work underline the potentially harmful effects and inefficiency of health communication, and highlight the need to acknowledge the media's and advertiser's obvious responsibility in the promotion and visibility of these products. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

COVID-19 information sources in culturally diverse communities in Australia: Cross-sectional survey: Presenter(s): Julie Ayre, The University of Sydney, Australia

Culturally and linguistically diverse communities are a priority group that has been disproportionately affected by the pandemic. However, they have been largely excluded from Australian surveys that capture data about people's knowledge, attitudes, and experiences relating to COVID-19. This study sought to investigate preferred COVID-19 communication channels and information-seeking experiences within these communities. The cross-sectional survey was co-designed with Multicultural Health and bilingual staff, and translated into 11 languages. Participants were recruited in Sydney, Australia, from March 21 to July 9, 2021, with supporting bilingual staff. Linear regression models identified factors associated with difficulty finding easy-to-understand COVID-19 information. Across 708 participants (88% born overseas, 31% poor English proficiency), difficulty finding easy-to-understand COVID-19 information was rated 4.13 for English materials (95%CI: 3.85 to 4.41) and 4.36 for translated materials (95%CI: 4.07 to 4.66) (1 easy to 10 hard). Participants who were older (p<0.001), had low health literacy (Mean Difference (MD)=-1.43, 95%CI -2.03 to -0.82, p<0.001), or poor English proficiency (MD=-1.9, 95%CI-2.51 to -1.29, p<0.001) found it harder to find easy-to-understand English-language COVID-19 information. Those who had greater difficulty finding easy-to-understand translated COVID-19 information were younger (p=0.004), had poor English proficiency (MD=-1.61, 95%CI -2.29 to -0.9, p<0.001), university education (MD=0.77, 95%CI 0.00 to 1.53, p=0.05), and had spent longer living in Australia (p=0.001). They were more likely to rely on friends and family for COVID-19 information (p=0.02). There was significant variation in information-seeking experiences across language groups (p's<0.001). Easy-to-understand and accessible COVID-19 information is urgently needed and must meet the needs of people in culturally and linguistically diverse communities. The findings are highly applicable to other public health issues, highlighting the limitations of a one-size-fits-all approach to public health communication. Health services must work alongside these communities to tailor public health messages and leverage existing communication channels. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Tactical risk communication: Observations from teaching and learning about crisis communication during COVID-19

In a Spring 2020 Technical and Professional Communication (TPC) course on risk communication, we watched the COVID-19 pandemic unfold and discussed how technical communicators can foreground vulnerable and marginalized populations who are often excluded from official communication channels. The article below offers perspectives on tactical communication and/or coalition building during a pandemic, coining the term tactical risk communication (TRC) and examining how TRC functions in the face of a global health crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Health communication and self-care: the Wellbeing And Lifestyle in Transplantation study (WALT).: Presenter(s): Lina Johansson, Imperial Healthcare NHS Trust, United Kingdom

Health communication between practitioners and patients is integral to supporting self-care, which is a top NHS priority. Renal transplantation is a life changing event where responsibility to self-care takes centre-stage overnight. There is a high risk of rejection if complex medication regimens are not adhered to, and the possibility of weight gain, new onset Diabetes and dyslipidaemia, if lifestyle is not adequately modified. Health communication is therefore vital in developing self-care capacity. This study aims to explore the lived experience of people with a transplant, from multiple view-points, focusing on wellbeing and lifestyle, with the aim to develop practical interventions that promote self-care. This qualitative study employs focus group and semi-structured interview methods, conducted online due to Covid-19. Several interviews were run via telephone for greater participant accessibility. Participants included kidney transplant recipients, healthcare professionals and significant others. Purposeful sampling increased participation from diverse backgrounds and age ranges. The data analysis utilises framework methodology to identify key themes on the barriers and facilitators recipients and practitioners face in developing self-care. Health communication between practitioners and patients was a key theme identified that served as both a barrier and facilitator to self-care in kidney transplantation. Nursing staff reported examples illustrating a multimodal approach when communicating complex health concepts e.g. using 3D models and diagrams that extended beyond traditional verbal communication and printed literature. Others reported allowing patients to make (safe) treatment errors which embedded learning and understanding of their health condition. However, an overburdened and time-constrained service disrupted effective health communication. Reported examples highlight a practitioner need to develop health literacy in others through personalised health communications that fosters self-care. The Findings: inform future work that aims to design, test and evaluate multimodal interventions in building self-care capacity and promoting lifestyle and wellbeing throughout the transplant journey. [ FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. 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.)

Public perception of institutional health communication during pandemic: a cross-sectional study: Presenter(s): Maddalena Fiordelli, Institute of Public Health, Università della Svizzera italiana, Switzerland

To inform future efforts on institutional public health emergency management, investigating public perception of institutional health communication is key. It is of paramount importance to monitor what happened that made acceptable institutional decisions among the public during the pandemic. The main aim of our study is to understand factors associated with the acceptance of governmental public health measures during COVID-19 pandemic in Switzerland. We conducted a cross-sectional survey of the Swiss population to investigate their information-seeking behavior, attitudes, and beliefs towards the COVID-19 pandemic and the protective measures enforced by public health institutions, and their trust in public institutions. Data were collected in January 2022, right after the decision of the Federal Office of Public Health to further restrict protective measures (e.g., covid certificate check regulating access to public spaces), through computer-assisted web interviews (CAWI). A total of 2587 people composed the final sample. Participants were on average 49 years old (SD: 16) and were equally distributed in terms of gender (Male 49.7%). The majority were Swiss (95%), Swiss German mother tongue (64%), living with family (70%), and in a Swiss-German canton (65%). One in five was infected at the time of the survey and the vast majority were vaccinated (85%). Overall, Swiss residents seemed to accept the different public health measures enacted over almost two years of pandemic, and some factors can explain a stronger acceptance. There are some Findings: worth noting, which result in clear implications for public institutions in the management of a public health crisis. These implications related both to the content (what) and the mode (how) for institutional health communication. Our study suggests areas of improvement in institutional health communication, both in terms of resources that can be saved and further efforts needed. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Contribution of Live Video to Physicians' Remote Assessment of Suspected COVID-19 Patients in an Emergency Medical Communication Centre: A Retrospective Study and Web-Based Survey.

The COVID-19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID-19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID-19 number) with suspected COVID-19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. A total of 8957 patients were included, and 2157 (48.0%) of the 4493 patients assessed on the official emergency number had dyspnoea, 4045 (90.6%) of 4464 patients assessed on the COVID-19 number had flu-like symptoms and 1798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n = 81) of cases and caught 7 (7.7%) patients in a life-threatening emergency. Medical triage decisions for suspected COVID-19 patients are strongly influenced by the use of live video.

'Where are the graves of coronavirus victims?' Beliefs, conspiracy theories and representations of COVID-19 in Africa

The COVID-19 pandemic severely affected everyday life in Africa, a continent that is known for its high levels of religious belief. Using a corpus of news articles and the social representations research paradigm, this study examines African understandings of the pandemic. It uses installation theory, the wind rose model and the accommodation hypothesis to explore the coexistence between science and belief. The accommodation hypothesis demonstrates that the representations were hierarchical, to elevate God above science. Faith leaders also used the pandemic to enhance faith by blaming sin and urging repentance or blaming science by espousing conspiracy theories about the pandemic being a grand design to draw believers away from God. This paper highlights the great disparity in experience between Africa and the West, initially fuelling conspiracy theories. The findings also reinforce two key conceptual approaches: installation theory on the influence of rules imposed by society on behaviour, and the wind rose model in which representations change over time and in response to social interactions. [ FROM AUTHOR]

Enacting care by being experts and managing relationships: A discourse analysis of chief medical officer of health media briefings during the COVID-19 pandemic.

In Canada, Chief Medical Officers of Health (CMOHs) are responsible for protecting and promoting the health of their respective populations, but few studies have examined this role and its connections with the practice of medicine. In Canada and elsewhere, CMOHs and other public health physicians have articulated their actions as caring for their populations as patients. In order to understand the components of enacted care, this study is a functional discourse analysis of transcribed CMOH media briefings at three time points in five Canadian jurisdictions during the first full year of the COVID-19 pandemic (2020). Transcripts were coded and analysed in an iterative, comparative process to understand the content, actions and purpose of CMOH communication during media briefings. CMOHs used their public communications to enact their care of populations by "being experts" and "managing relationships". "Being experts" involved describing disease characteristics, assessing risk and evidence, framing risk and evidence, and making judgments about intervention and exemption. "Managing relationships" involved self-regulating emotions, acknowledging the emotions of others, seeking adherence and collaboration, and setting expectations and boundaries. The findings suggest that traditional biomedical roles were performed by CMOHs in media briefings, implying the existence of a patient (or multiple patient-like relationships) and supporting further research into the processes by which public health physicians care for populations as patients.

Impact of two-level filtering on emergency medical communication center triage during the COVID-19 pandemic: an uncontrolled before-after study.

BACKGROUND: Rapid access to emergency medical communication centers (EMCCs) is pivotal to address potentially life-threatening conditions. Maintaining public access to EMCCs without delay is crucial in case of disease outbreak despite the significant increased activity and the difficulties to mobilize extra staff resources. The aim of our study was to assess the impact of two-level filtering on EMCC performance during the COVID-19 outbreak. METHODS: A before-after monocentric prospective study was conducted at the EMCC at the Nantes University Hospital. Using telephone activity data, we compared EMCC performance during 2 periods. In period one (February 27th to March 11th 2020), call takers managed calls as usual, gathering basic information from the caller and giving first aid instructions to a bystander on scene if needed. During period two (March 12th to March 25th 2020), calls were answered by a first-line call taker to identify potentially serious conditions that required immediate dispatch. When a serious condition was excluded, the call was immediately transferred to a second-line call taker who managed the call as usual so the first-line call taker could be rapidly available for other incoming calls. The primary outcome was the quality of service at 20 s (QS20), corresponding to the rate of calls answered within 20 s. We described activity and outcome measures by hourly range. We compared EMCC performance during periods one and two using an interrupted time series analysis. RESULTS: We analyzed 45,451 incoming calls during the two study periods: 21,435 during period 1 and 24,016 during period 2. Between the two study periods, we observed a significant increase in the number of incoming calls per hour, the number of connected call takers and average call duration. A linear regression model, adjusted for these confounding variables, showed a significant increase in the QS20 slope (from - 0.4 to 1.4%, p = 0.01), highlighting the significant impact of two-level filtering on the quality of service. CONCLUSIONS: We found that rapid access to our EMCC was maintained during the COVID-19 pandemic via two-level filtering. This system helped reduce the time gap between call placement and first-line call-taker evaluation of a potentially life-threatening situation. We suggest implementing this system when an EMCC faces significantly increased activity with limited staff resources.

Impact of COVID-19 on the communication of hospitals in Spain. Adaptations and evaluation by their professionals.

COVID-19 has caused a transformation in the organizational structure of the healthcare system that directly affects the management of its communication. This article aims to know the communication strategy of hospitals in Spain in a context of normality and what have been the main changes and adaptation needs caused by the pandemic. For this purpose, the information is collected and analyzed from a structured questionnaire and two focus group with health communication professionals. The results obtained confirm that pandemic modifies the type of tasks carried out in the three communication areas and transforms both the information requested and the priority in the use of channels for its transmission. Furthermore the work concludes that the health crisis has accelerated the development of the digitization and of Spanish health and communication systems. Finally, the professionals consider that the pandemic has favored the knowledge and recognition of the communication function inside and outside the hospital. (English) [ FROM AUTHOR] La COVID-19 ha provocado una transformación en la estructura organizativa y asistencial del sistema sanitario que afecta de manera directa a la gestión de su comunicación. Este artículo tiene como propósito conocer la estrategia comunicativa de los hospitales en España en contexto de normalidad y cuáles han sido los principales cambios y necesidades de adaptación originados por la pandemia. Para ello, se recopila y analiza la información recabada a partir de un cuestionario y dos grupos de discusión con profesionales de la comunicación hospitalaria. Los resultados obtenidos confirman que la pandemia modifica la intensidad, el tipo de tareas que desarrollan y la prioridad en el uso de canales de comunicación. De manera transversal, el trabajo muestra que la crisis sanitaria ha acelerado el desarrollo de la digitalización de la sanidad española y de su comunicación. Paradójicamente, los profesionales estiman que la pandemia ha favorecido el conocimiento y el reconocimiento de la función de comunicación dentro y fuera del hospital. (Spanish) [ FROM AUTHOR] Copyright of Revista de Comunicación is the property of Revista de Comunicacion-Universidad de Piura 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.)

Leveraging Digital Tools for Health Communication and Promotion

Globally, one-third of the world's population has difficulty searching, comprehending, and using information needed to maintain health and well-being (Van den Broucke, 2020). Empowering people to learn and practice healthy behaviors and engage in self-care is at the core of health promotion (Van den Broucke, 2020). Appropriate health communication has been vital during the COVID-19 pandemic. The pandemic impact can be alleviated by promoting healthy behaviors while using appropriate tools to publicize information in easily understood language by the public. Most health information is accessed online so digital health communication and promotion is important. Numerous digital tools are available. Electronic mail (email) is a powerful tool to engage with various audiences using electronic devices. Worldwide 3.9 billion people use email, spending up to five hours daily to check work and personal emails (SlideShare, 2019) (Statista, 2021). Emails are cost effective and directly connect the intended audience with personalized content. MailChimp is a digital tool that the Institute for Population Health (IPH), Weill Cornell Medicine-Qatar uses to disseminate credible information via email to create awareness about health-related topics. MailChimp is convenient to use with in-built templates to create visually appealing content along with the option to add unique links as required. Embedding useful links and eye-catching visuals attracts consumers to read and learn from the content. MailChimp also hosts the audience database, manages audience preferences, and facilitates scheduling/sending the newsletters. For example, the IPH 'Stay Safe, Stay Healthy' newsletter created on MailChimp, focuses on topics relevant to COVID-19, health, and well-being. The newsletters guide the public to navigate, and access trusted/reputable sources to adopt lifestyles appropriate for optimum health and well-being. They provide information in simple language using appealing and culturally appropriate visuals and communicate new or updated evidence as necessary. The newsletter email campaigns have garnered 111,789 opens (total times the campaign was opened by recipients) and 28,507 clicks (total times any tracked link was clicked) from March 2020-2022 (MailChimp, 2022). Reliable, evidence-based, and well-crafted health communication can facilitate behavior change, dispel fear and uncertainty, promote compliance with positive health behaviors, and disseminate reliable and succinct information (Finset, 2020). It can also help alleviate stress and feelings of 'overwhelm' when confronted with information overload online (Van den Broucke, 2020). Most digital tools such as MailChimp are accessible via a paid subscription. Subscription fees could be a deterrent to their use. Nevertheless, digital tools like MailChimp are an effective means to optimize emails and can contribute to health promotion by facilitating the dissemination of health-related information via email, in a timely, efficient, and effective manner. [ FROM AUTHOR] Copyright of QScience Connect is the property of Hamad bin Khalifa University Press (HBKU Press) 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.)

Lego™ Learning: A Scalable Approach to Pedagogy in the Rhetoric of Health and Medicine

Complex health and medical contexts demand not only responsive, mutable research but also responsive, flexible pedagogies. Arguing for a shift from the dominant conception of pedagogy as a pre-planned, linear scaffold, this article proposes instead an approach—called Lego™ Learning—that re-conceptualizes instructional content as self-standing, short-term units or modules, much like Lego™ bricks. Because such modules have self-contained learning objectives and corresponding tasks, they can be shifted within a course or across courses as-needed. This approach allows rhetoric of health and medicine (RHM) instructional content to respond to, and prepare students for, the ever-changing exigencies and contexts of RHM-related work. It also encourages collaborations across classes, institutions, and other contexts. In this entry, we frame our discussion around four learning outcomes and teaching practices that can be facilitated through this approach, and we provide an extended example of an ongoing cross-institutional partnership that employs Lego™ Learning.

Open access to global health information in mass media: Specialized translation and Russian-German-Spanish terminology

The situation triggered by the coronavirus pandemic has demonstrated the need to simplify medical terminology for better understanding by the public. The goal of specialized communication on medical topics is to more efficiently transfer and assimilate information that is important to human health, which has become literally vital in the times of COVID-19. Such circumstances lead to the fact that medical terminology is no longer the exclusive prerogative of the professional vocabulary of medical personnel, but is already more and more integrated into the vocabulary of everyday use, and is also widely used in mass media. A cognitive approach to terminology helps to extract specialized knowledge encoded in terms, simplifies specialized translation and contributes to mass communication at a global level. This study, using the example of Russian-German-Spanish medical terminology, demonstrates the fact that an effective and intuitive presentation of specialized concepts helps to correctly apply international terminology, and most importantly, allows its target audience to assimilate the knowledge behind it in a structured form. This cognitive approach to medical terminology serves public health purposes by facilitating the communication between doctor and patient, on the success of which the life and health of society depends. It also argued that the correct interlanguage terminology management facilitates the constructive exchange of experience and cooperation between doctors, specialists, scientists, healthcare organizations and specialized translators, whose joint work at the global level is now especially necessary for medicine. © 2021 The authors.

Digital Communication at the Time of COVID-19: Relieve the Refugees' Psychosocial Burden and Protect Their Wellbeing

The study aims to evaluate the usefulness and effectiveness of digital communication tools implemented by an Italian NGO during the coronavirus disease 2019 (COVID-19) emergency period, considering their relations with perception of health-related risk, sense of belonging to host community, psychological distress, and wellbeing of the refugees taken in charge by the association. The study was conducted through an anonymous questionnaire proposed to a group of 102 refugees. The results confirmed that by increasing the sense of belonging to the Italian community, the time refugees spent on digital communication negatively associated with their psychological distress and positively associated with their wellbeing. Refugees' access to digital communication also increased their health-related risk perception that in turn raised their psychological distress. It specifically occurred when digital communication has been perceived as less affordable, i.e. as less clear, easy and reassuring. The results will be used to improve digital communication for health, educational, and proximity services dedicated to refugees. [ FROM AUTHOR] Copyright of Journal of Refugee Studies is the property of Oxford University Press / USA 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.)

Say No to This: Unilateral Do-Not-Resuscitate Orders for Patients with COVID-19.

In this article, we comment on Ciaffa's article 'The Ethics of Unilateral Do-Not-Resuscitate Orders for COVID-19 Patients.' We summarize his argument criticizing futility and utilitarianism as the key ethical justifications for unilateral do-not-resuscitate orders for patients with COVID-19.

A Study of Differences in Compulsory Courses Offering Medicine Humanization and Medical Communication in Polish Medical Schools: Content Analysis of Secondary Data.

Medical humanity is an essential element of medical education, and the respective courses are introduced to the curricula of medical schools worldwide. However, significant differences in this type of medical education were identified in Italy, Spain, and the UK. In Poland, this issue was not yet analyzed. The classes offered on a compulsory and not elective basis secure the uniform skills of future physicians. Therefore, we were prompted to ask a question: do Polish medical students receive equal compulsory education in medical humanities? To answer that question, we performed a content analysis of mandatory classes' frequency, types, and content on medical humanization and communication in Polish medical schools. The study used publicly available information provided on the home pages of the universities to perform content and comparative analyses. Of 22 identified universities, 15 had publicly listed teaching programs, and nine had freely available syllabi. The names and types of courses varied from school to school. The number of hours the courses offered throughout medical education ranged from 15 to 216. In some medical schools, the classes were scheduled during the early, pre-clinical part of the study, whereas in other schools they were offered each year. The content of the courses always covered the topics of physician-patient communication but rarely offered protocols, such as the Calgary Cambridge guide. We conclude that the medical humanities represented by medical humanization and communication courses are included in the publicly available compulsory curriculum of most Polish medical schools. However, to secure equal education of future Polish physicians, there is a need to unify the medical humanities program.

Surveillance of COVID-19 using a keyword search for symptoms in reports from emergency medical communication centers in Gironde, France: a 15 year retrospective cross-sectional study.

During periods such as the COVID-19 crisis, there is a need for responsive public health surveillance indicators related to the epidemic. To determine the performance of keyword-search algorithm in call reports to emergency medical communication centers (EMCC) to describe trends in symptoms during the COVID-19 crisis. We retrospectively retrieved all free text call reports from the EMCC of the Gironde department (SAMU 33), France, between 2005 and 2020 and classified them with a simple keyword-based algorithm to identify symptoms relevant to COVID-19. A validation was performed using a sample of manually coded call reports. The six selected symptoms were fever, cough, muscle soreness, dyspnea, ageusia and anosmia. We retrieved 38,08,243 call reports from January 2005 to October 2020. A total of 8539 reports were manually coded for validation and Cohen's kappa statistics ranged from 75 (keyword anosmia) to 59% (keyword dyspnea). There was an unprecedented peak in the number of daily calls mentioning fever, cough, muscle soreness, anosmia, ageusia, and dyspnea during the COVID-19 epidemic, compared to the past 15 years. Calls mentioning cough, fever and muscle soreness began to increase from February 21, 2020. The number of daily calls reporting cough reached 208 on March 3, 2020, a level higher than any in the previous 15 years, and peaked on March 15, 2020, 2 days before lockdown. Calls referring to dyspnea, anosmia and ageusia peaked 12 days later and were concomitant with the daily number of emergency room admissions. Trends in symptoms cited in calls to EMCC during the COVID-19 crisis provide insights into the natural history of COVID-19. The content of calls to EMCC is an efficient epidemiological surveillance data source and should be integrated into the national surveillance system.

Trends in reasons for emergency calls during the COVID-19 crisis in the department of Gironde, France using artificial neural network for natural language classification.

OBJECTIVES: During periods such as the COVID-19 crisis, there is a need for responsive public health surveillance indicators in order to monitor both the epidemic growth and potential public health consequences of preventative measures such as lockdown. We assessed whether the automatic classification of the content of calls to emergency medical communication centers could provide relevant and responsive indicators. METHODS: We retrieved all 796,209 free-text call reports from the emergency medical communication center of the Gironde department, France, between 2018 and 2020. We trained a natural language processing neural network model with a mixed unsupervised/supervised method to classify all reasons for calls in 2020. Validation and parameter adjustment were performed using a sample of 39,907 manually-coded free-text reports. RESULTS: The number of daily calls for flu-like symptoms began to increase from February 21, 2020 and reached an unprecedented level by February 28, 2020 and peaked on March 14, 2020, 3 days before lockdown. It was strongly correlated with daily emergency room admissions, with a delay of 14 days. Calls for chest pain and stress and anxiety, peaked 12 days later. Calls for malaises with loss of consciousness, non-voluntary injuries and alcohol intoxications sharply decreased, starting one month before lockdown. No noticeable trends in relation to lockdown was found for other groups of reasons including gastroenteritis and abdominal pain, stroke, suicide and self-harm, pregnancy and delivery problems. DISCUSSION: The first wave of the COVID-19 crisis came along with increased levels of stress and anxiety but no increase in alcohol intoxication and violence. As expected, call related to road traffic crashes sharply decreased. The sharp decrease in the number of calls for malaise was more surprising. CONCLUSION: The content of calls to emergency medical communication centers is an efficient epidemiological surveillance data source that provides insights into the societal upheavals induced by a health crisis. The use of an automatic classification system using artificial intelligence makes it possible to free itself from the context that could influence a human coder, especially in a crisis situation. The COVID-19 crisis and/or lockdown induced deep modifications in the population health profile.