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1.
Revista Medica del Instituto Mexicano del Seguro Social ; 59(5):387-394, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1824232

ABSTRACT

BACKGROUND: Social distancing and lockdown imposed by the world governments as a result of the coronavirus pandemic declaration has resulted in a perfect scenario to the appearance of mental disorders. OBJECTIVE: To identify the levels of anxiety, depression and stress (emotional affective state) that people assigned to a primary health care clinic present during the lockdown. MATERIAL AND METHODS: The DASS-21 questionnaire was administered to 150 pacients at the principal entry door of a family medicine unit of the Mexican Institute for Social Security, located in Reynosa, Tamaulipas, between April and May 2020. In addition, the internal validity test of the questionnaire was estimated using Cronbach's alpha, and also an association analysis was estimated using Pearson's chi squared test. RESULTS: The internal validity analysis indicated that the questionnaire is acceptable in its general version: Cronbach's alpha = 0.907. However, at the subscales level it is barely acceptable. The results indicated that 42% of the sample present some type of mental disorder, with anxiety being the most persistent. In addition, the estimated levels vary according to sex, educational level and nutritional status. CONCLUSIONS: During periods of lockdown, mental problems tend to arise and get worse, which is why it is necessary to implement emotional support programs, especially for working women with obesity weight problems, because they are the most vulnerable group in the face of this situation.

2.
Revista Espanola de Salud Publica ; 96:14, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1824209

ABSTRACT

OBJECTIVE: Primary Care (PC) must attend and follow COVID-19 patients with mild and moderate symptoms, and identify severe cases. The aim of this study was to describe the characteristics of patients attended in PC with suspicious COVID-19 and health care provision by PC. METHODS: Retrospective longitudinal observational study of electronic health records (EHR) and agendas. Probabilistic sampling of suspicious COVID-19 patients' pathway in 5 health centers in Madrid between March 16 and 20, 2020. The variables used were sociodemographic, symptoms, examination, radiography, characteristics of schedules and professional sick leaves. Descriptive analysis and time to event (pneumonia). RESULTS: 240 EHR were reviewed. Average age 48 years, 60% women. Most frequent symptoms: cough (80%) and elevation of temperature (63%). Pneumonia appeared in 23%. 73% were bilateral. Age and male gender were related to pneumonia. 20% required admission. 7 patients died (2.9%). 19,027 COVID-19 appointments were scheduled in PC. 60% of patients were attended in PC without performing chest X-ray or assistance by other care level. 22.4% of GPs working days were absent because of sick leaves. Differences were found amongst facilities in chest X-ray requesting (max. 62%, min. 2%). The PC center with the fewest X-rays requested was the one with the major number of sick leaves. CONCLUSIONS: Age and male gender were related to pneumonia onset in PC. Health care activity was intense, and variability was found amongst facilities. Professional sick leaves could affect the quality of care.

3.
Frontiers in Pharmacology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1822398

ABSTRACT

Background: The appropriateness of antibiotic prescriptions in primary care has not been well evaluated in China in recent years. Furthermore, the impact of coronavirus disease 2019 (COVID-19) on antibiotic prescriptions has not yet been investigated in China. We aimed to assess the appropriateness of antibiotic prescriptions and to evaluate the potential association between the COVID-19 pandemic and antibiotic prescriptions in primary care settings of Yinchuan, a city in China. Methods: This study included 155 primary care institutions and 10,192,713 outpatient visits. Outpatient prescriptions were classified as appropriate, potentially appropriate, inappropriate, or not linked to any diagnosis for antibiotic use following a validated evaluation scheme. Interrupted time-series analyses were performed to assess the effects of the COVID-19 pandemic on antibiotic prescriptions in Chinese primary care facilities. Results: During the study period, 1,287,678 (12.6%, 95% confidence interval [12.6–12.7]) of 10,192,713 outpatient visits in primary care resulted in antibiotic prescriptions. Among 1,287,678 antibiotic prescriptions, 653,335 (50.7% [50.6–50.9]) were inappropriate, 463,081 (36.0% [35.8–36.1]) were potentially appropriate, 171,056 (13.3% [13.1–13.5]) were appropriate, and 206 could not be linked to any diagnosis. Furthermore, patient, physician, and institutional factors were associated with inappropriate antibiotic prescriptions;there was an overall decreasing trend in the proportions of inappropriate antibiotic prescriptions, with the highest level in 2017 (67.1% [66.8–67.5]) and the lowest in 2021 (40.8% [40.3–41.3]). A total of 1,416,120 individual antibiotics were prescribed, of which 1,087,630 (76.8%) were broad-spectrum and 777,672 (54.9%) were classified in the World Health Organization’s “Watch” category. In addition, the COVID-19 pandemic was associated with changes of −2.8% (−4.4 to −1.3) in the level and 0.3% (0.2–0.3) in the monthly trend of antibiotic prescription rates, as well as changes of −5.9% (−10.2 to −1.5) in the level and 1.3% (1.0–1.6) in the monthly trend of the proportions of inappropriate antibiotic prescriptions. Conclusion: More than half of the antibiotic prescriptions were inappropriate during the study period in primary care in Yinchuan. The COVID-19 pandemic may be associated with a decrease in the overall and inappropriate use of antibiotics in primary care settings in China.

4.
Saúde Soc ; 30(2): e210029, 2021.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1817574

ABSTRACT

Resumo A questão da desigualdade social tem sido objeto de muitos estudos que buscam compreender como a dirimir na construção de sociedades mais justas. A pandemia de covid-19 acirrou situações de pobreza e violência vivenciadas pela população excluída de seus direitos. A complexidade da questão estudada exige a abertura de frentes de conhecimento interdisciplinares. Nesta perspectiva, os estudos sobre a afetividade no campo da psicologia sócio-histórica têm fortalecido o papel da subjetividade nos estudos sobre processos dialéticos de inclusão e exclusão social. O objetivo deste dossiê é buscar interpretações possíveis sobre a relação entre saúde e sociedade, visando construir subsídios para a implementação de políticas públicas. Desde 2012 têm sido desenvolvidos estudos, balizados principalmente na pesquisa participante, que consideram as práticas da atenção primária à saúde como desencadeadoras de temas associados ao processo saúde-doença-cuidado em território vulnerável de Cubatão. A hermenêutica de profundidade tem sido a principal referência de análise, que dialoga com o com a epistemologia qualitativa. Os artigos apresentados neste dossiê trazem ricas experiências e reflexões: cuidado em território de exclusão social e interseccional; participação social de lideranças comunitárias neste contexto; vivências da violência em território vulnerável.


Abstract Social inequality has been the subject of several studies seeking the understanding of how to mitigate this issue in the construction of fairer societies. The COVID-19 pandemic aggravated the poverty and violence situations experienced by right-deprived population groups. The complexity of this issue requires the setting of interdisciplinary research fronts. From this perspective, studies on affectivity in social-historical psychology reinforced the role of subjectivity in studies regarding dialectical processes of social inclusion and exclusion. The goal of this dossier is to investigate potential interpretations on the connection between health and society, aiming at building subsidies for the implementation of public policies. Since 2012, participatory research studies considering the practices of Primary Health Care as triggers associated with the health-disease-care process have been conducted in the vulnerable territory of Cubatão, State of São Paulo, Brazil. Depth hermeneutics was the main reference for analysis, which ties up with qualitative epistemology. The papers presented here display a wealth of experiences and considerations: care in a territory of social and intersectional exclusion; social participation of community leaders in this context; experiences with violence in a vulnerable territory.


Subject(s)
Humans , Male , Female , Primary Health Care , Public Policy , Socioeconomic Factors , Hermeneutics , Social Inclusion , COVID-19
5.
Pakistan Journal of Medical and Health Sciences ; 16(3):471-475, 2022.
Article in English | EMBASE | ID: covidwho-1819186

ABSTRACT

Background: Pregnancy is a condition of partial immune suppression which makes pregnant women riskier to viral infections, and the morbidity is increased even with seasonal influenza. Therefore, the COVID-19 epidemic may have dangers consequences for pregnant women. Although the high incidence of cases of COVID-19 are currently in China, the risk of outward transmission appears to be significantly high global concern. Objectives: To assess pregnant women's practices about prevention of covid 19 before and after implementation of instruction program and to determine the effectiveness of instruction program on pregnant women practices about prevention methods of corona virus, covid 19 in PHCC in Kirkuk city. Methods: A quasi-experimental design was conducted during the period from (6th may 2021 through 20th August 2021) on non-probability sample (purposive) consists of (100) pregnant women) who visited the primary health care center. The sample practices was exposed to pretest, educational program, posttest. The study was conducted in Kirkuk city, Kirkuk health Director, three primary health care centers from the Kirkuk 1st sector which include (Al- Mansur center for primary health care, Al-Wassity center for primary health care, and Bader center for primary health care), than select three primary health care centers from Kirkuk 2nd sector which include (AL-Rasheed center for Primary health care, Azady center for Primary health care, ALNassir center for Primary health care, and Al- Mansur center for primary health care) Questionnaire was used as a tool of data collection. A pilot study was conducted at Al- Wassity center for primary health care in order to determine the reliability of the study and the testing the pregnant women practices about prevention methods of corona virus diseases 19. Data were collected through the questionnaire. Data were analyzed through the application of descriptive and inferential statistical data analysis approach through the use of (SPSS) version 22.0 and Excel system Results: The results of the study have revealed that significant correlation between pretest and posttest periods after the implementation of education program for pregnant women Practices regarding prevention methods of corona virus and reducing infected by it. There were high significant correlations between pre and post periods at (p. value: 0.101) in evaluation of the effectiveness of the instruction program in the practices of pregnant women on prevention methods to reduce the incidence of infection between Pre and post evaluation. Conclusions: The study concluded that the educational program can be considered as an effective mean for the improvement of the pregnant women's practices about the importance prevention methods of corona virus. Recommendations: Pregnant women should be given instructional booklets in order to raise practice level of preventive measures of COVID-19 infection at the beginning of their pregnancy and who can protect their families' members from such pandemic.

6.
Sante Publique ; Vol. 33(6):991-995, 2022.
Article in French | EuropePMC | ID: covidwho-1818289

ABSTRACT

INTRODUCTION: Facing COVID-19, most of health care system first responded with the confinement of the population and an increase of intensive care resources. Primary care was then mobilized variably and more or less coordinated. PURPOSE OF RESEARCH: Comparing the involvement of primary care in four francophone regions with similar primary care to draw lessons for reforms directions in light of the COVID experience. RESULTS: Mobilization of primary care actors was important, heterogeneous and linked to local context and previous dynamics at the territorial level or the practice level except in Quebec where primary care is governed by health authorities. The creation of COVID centers was systematic as "warm practices" in Quebec or left to the initiative of local stakeholders more or less supported by health authorities. Teleconsultation, largely dominated by the use of the telephone, was implemented everywhere, generally supported by flexible and adapted pricing. The performance of diagnostic tests such as vaccination by new professionals within a legal, financial and simple training framework is a major area for improvement. Information systems to assess local needs were insufficient everywhere. CONCLUSION: The definition of primary care governance methods and, in particular, the link between professionals and public health operators in the four areas studied is a priority area for improvement at both local and national levels.

7.
Sante Publique ; Vol. 33(6):923-934, 2022.
Article in French | EuropePMC | ID: covidwho-1818283

ABSTRACT

INTRODUCTION: The COVID-19 epidemic represented a major challenge for the primary care sector. We present the results of an interprofessional collaborative research endeavor conducted by the ACCORD network to describe primary care actors' and organizations' response to the first wave of the epidemic and national lockdown in France. METHODS: This work draws from quantitative and qualitative material. The quantitative data results from the cross-analysis of the six online surveys carried out by the ACCORD network between March and May 2020, among general practitioners, midwives, and multi-professional primary care organizations in France. This data was enriched by collective multi-professional and multi-disciplinary exchanges conducted in virtual focus groups during an online seminar. RESULTS: There was a significant decrease in primary care activity during the first wave of the epidemic. Many primary care actors adapted their organizations to lower the risk of coronavirus transmission while maintaining access and continuity of care. Professionals received and used information from multiple sources. The crisis revealed both the importance and the diversity of local networks of exchange and collaboration. CONCLUSIONS: Primary care actors adapted quickly and with important local variability to the COVID epidemic, highlighting the importance of pre-existing organizations and collaborations at the local level.

8.
BJGP Open ; 6(1):1-4, 2022.
Article in English | EMBASE | ID: covidwho-1818240

ABSTRACT

Introduction The COVID-19 pandemic has accelerated the widespread adoption of remote consultations in general practice in the UK;using telephones, video, or e-consults accompanied by a reduction in routine face-to-face consultations. These approaches allow for continued healthcare provision while reducing the risk of transmission of communicable infections. Telephone consultations have already been a staple within general practice for many years, despite a lack of high quality evidence supporting their use.1 Reported benefits include convenience for patients and cost savings.2 However, patients tend to disclose fewer medical issues on telephone calls than in face-to-face consultations.3 Similarly, video calls rely on high quality internet and patient ability to operate the required technology.4 Autism is a neurodevelopmental condition encompassing differences in social interaction, communication, and sensory perception.5 Differences occur in the use of verbal and non-verbal communication. Challenges can include situational mutism or reliance on augmentative and alternative communication (AAC) devices for individuals who are non-speaking. Autism is not synonymous with learning disability. In fact, the majority of autistic adults do not have a learning disability.6 Autism diagnoses have a prevalence of at least 1%,7 but autism is likely much more prevalent due to underrecognition and under-diagnosis.7 As such, autistic individuals are a patient group all primary care professionalsare likely to encounter on a regular or semi-regular basis. Autistic adults face increased barriers to accessing health care,5 and have higher mortality rates than the general population.5 Considering the needs of autistic patients in accessing primary health care is therefore vital if we are to embody the ethical tenets of beneficence and social justice. We write this article as neurodivergent doctors. SS is autistic and dyslexic. He is a GP speciality trainee with a parallel academic career. He has researched and published widely around the topic of neurodiversity, with particular interests in dyslexia, dyspraxia, and autism. He is currently the research lead for Autistic Doctors International. LJD is also a GP speciality trainee, with a background in academic research and public health. She is dyspraxic and has a specialist interest in supporting neurodivergent patients. MD is an autistic consultant anaesthetist and is the founder of Autistic Doctors International. Using a combination of the wider literature and our own experiences, both as clinicians and as patients, we explore the potential strengths and limitations of telemedicine in the context of autistic patients. We also propose some suggestions for increasing its accessibility.

9.
International Journal of Pharmacy Practice ; 30(SUPPL 1):i9-i10, 2022.
Article in English | EMBASE | ID: covidwho-1816113

ABSTRACT

Introduction: Practice-based pharmacists (PBPs) have been introduced into general practice across the United Kingdom (UK) to relieve some of the pressures within primary care (1,2). However, there is little existing UK literature that has explored healthcare professionals' (HCPs') views about PBP integration and how this role has evolved. Aim: To explore the views and experiences of general practitioners (GPs), PBPs, and community pharmacists (CPs) about PBPs' integration into general practice and their impact on primary healthcare delivery. Methods: Purposive and snowball sampling were used to recruit triads (a GP, a PBP, and a CP) from across five administrative healthcare areas in one region in the UK to participate in one-to-one semi-structured interviews. Sampling of practices to recruit GPs and PBPs commenced in August 2020. These HCPs identified the CPs who had most contact with the general practices in which the recruited GPs and PBPs were working. The interview topic guides were developed based on the published literature, and through discussion within the research team;they were piloted with two GPs, two PBPs, and two pharmacists. Due to the Covid-19 pandemic, interviews were conducted via telephone or Microsoft Teams platform. All interviews were recorded, transcribed verbatim, and analysed using inductive thematic analysis. Results: Eleven triads were recruited from across the five administrative areas. Analysis of interview transcripts is ongoing. Findings to date have revealed four main themes in relation to PBPs' integration into general practices (Table): evolution of the role, PBP attributes, collaboration and communication, and impact on care. A number of areas for development were identified such as patient awareness of the role and communication pathways between PBPs and CPs. Many saw PBPs as a central hub-middleman' between general practice and community pharmacies and between primary and secondary care. Conclusion: Participants reported that PBPs had integrated well, and perceived a positive impact on primary health care delivery. Although recruitment was limited to one UK geographical region, the triad approach provided a more comprehensive overview of the working relationships between the three HCP groups. Further work is needed to increase patient awareness of the PBP role.

10.
Non-conventional in English | WHOIRIS, Grey literature | ID: grc-754200

ABSTRACT

This document sets out a vision for transforming primary health care in the WHO European Region based on the lessons learned from the COVID-19 pandemic. This vision was inspired by the transformative action of Member States before and during the pandemic. The 53 Member States of the Region endorsed this vision at the 71st Session of the WHO Regional Committee for Europe in September 2021. The document also serves as a guide to WHO’s products and services to Member States to strengthen primary health care, implementing the visionary commitments in the European Programme of Work 2020–2025 — United Action for Better Health and the Regional Committee resolution. Primary health care stands at the nexus of the core priorities of the European Programme of Work and is an important platform to advance each of its flagships.

11.
Atención Primaria ; : 102372, 2022.
Article in Spanish | ScienceDirect | ID: covidwho-1814116

ABSTRACT

Resumen Objetivo: Conocer los factores asociados con una evolución desfavorable (ED) de pacientes diagnosticados de COVID-19 con seguimiento total o parcial en atención primaria. Diseño: Serie de casos. Emplazamiento: Centro de salud urbano. Participantes: Pacientes de 18 o más años diagnosticados de COVID-19, con confirmación analítica, en 2020 y seguidos por sus médicos de familia, seleccionados por muestreo sistemático. Mediciones principales: Variable dependiente: ingreso en hospital o fallecimiento por COVID-19. Variables independientes: edad, sexo, antecedentes personales, y datos clínicos y de tratamiento relacionados con la enfermedad. Análisis estadístico, con SPSS 25.0: estadística descriptiva, comparación de proporciones (ji cuadrado) y medianas (U de Mann-Whitney). Se completó el análisis con regresión logística. Resultados: Se incluyeron en el estudio 610 pacientes, cuya mediana de edad era de 49 años (rango intercuartiles: 35-61);51,8% eran mujeres. Presentaron ED el 14,9% (IC95%: 12,0-17,8). Las variables sociodemográficas o relacionadas con antecedentes personales que mostraron una asociación independiente con una ED fueron edad (OR: 1,066;IC95%:1,038-1,095), sexo (OR para hombre: 3,277;IC95%:1,304-8,235) y ser fumador o exfumador (OR: 2,565;IC95%:1,135-5,800). En cuanto a variables clínicas propias de la enfermedad, esa asociación se encontró para alteración de la consciencia (OR:62,829;IC95%: 9,177-430,149), disnea (OR:14,339;IC95%:6,046-34,009), expectoración (4,764 (1,858-12,213) y astenia (OR:3,993;IC95%:1,705-9,351). Conclusiones: Presentaron una ED el 14,9% de los pacientes diagnosticados de COVID-19. Una mayor edad, el sexo masculino y ser fumador o exfumador aumentaban la probabilidad de ED. Los datos clínicos que mejor predecían la ED fueron alteración de la consciencia, disnea, expectoración y astenia. Objectives: To know the factors associated with an unfavorable evolution (UE) of patients diagnosed with COVID-19 with total or partial follow-up in primary care. Design: A case series. Location: Urban health center. Participants: By systematic sampling, patients ≥18 years, diagnosed with COVID-19, with analytical confirmation, in 2020 and followed up by their family doctors, were selected. Main measurements: Dependent variable: hospital admission or death due to COVID-19. Independent variables: age, sex, medical background, clinical data and treatments related to the disease. Statistical analysis, with SPSS 25.0: descriptive analysis, comparison of proportions (chi square) and medians (Mann-Whitney U). The analysis is completed with logistic regression. Results: 610 patients were included in the study. The median age was 49 years (interquartile range: 35-61);51.8% were women;14.9% presented UE (95%CI: 12.0-17.8). The sociodemographic variables or the variables related to medical background that showed an independent association with UE were age (OR: 1.066;95%CI: 1.038-1.095), sex (OR for men: 3.277;95%CI: 1.304-8.235) and being a smoker or former smoker (OR: 2.565;95%CI: 1.135-5.800). Regarding the clinical variables of the disease, an association was found for altered consciousness (OR: 62.829;95% CI: 9.177-430.149), dyspnea (OR: 14.339;95% CI: 6.046-34.009), expectoration (4.764 (1.858-12.213) and asthenia (OR: 3.993;95% CI: 1.705-9.351). Conclusions: 14.9% of the patients diagnosed with COVID-19 presented an UE. Older age, male sex and being a smoker or former smoker increased the probability of it. Altered consciousness, dyspnea, expectoration, and asthenia were the clinical data that best predicted UE.

12.
Cliniques mediterraneennes: Psychanalyse et Psychopathologie Freudiennes ; 103(1):81-94, 2021.
Article in French | APA PsycInfo | ID: covidwho-1812700

ABSTRACT

The resistance to recognizing the importance of care and care professionals is notorious, as is their invisibility and their devaluation in a society that prefers to promote excellence, elites, and leaders. When COVID-19 hit in early 2020, care professionals were applauded as their visibility was glaring and their skills essential at a time when everyone's vulnerability was being exposed. But the value that society places on key workers does not make them truly visible. A fragment of our clinical work, alongside Capek's theatre and its robots, Chaplin's film The Kid, and Winnicott's work, highlight what caring means, the fundamental human values that underpin it, and those that oppose it today. We need to recognize the vulnerability in each of us, see sensitivity as a strength and not a weakness, and realize the importance of administering primary care in an adequate environment and with kindness and mutual concern. The road to the recognition of care activities is long, and means that we must carry on fighting to give care a central place in our democracies. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (French) La resistance a reconnaitre l'importance du soin et des metiers qui en ont la charge, leur invisibilite et leur devaluation dans une societe qui promeut l'excellence et les << premiers de cordee sont notoires. Avec le Covid au debut de l'annee 2020, les professionnels du soin ont ete applaudis tant leur visibilite etait flagrante et leurs metiers essentiels a un moment ou la vulnerabilite de tous etait mise a nu. Mais la valeur que la societe octroie aux << premiers de corvee ne les rend pas veritablement visibles. Un fragment de notre clinique, ainsi que le theatre de Capek et ses robots, le cinema de Chaplin avec Le Kid et le travail de Winnicott viennent soutenir ce que prendre soin veut dire, les valeurs humaines fondamentales qui le fondent et celles qui s'y opposent aujourd'hui. Il convient de reconnaitre la vulnerabilite en chacun de nous, la sensibilite comme une force et non une faiblesse, l'importance des premiers soins dans un environnement suffisamment bon, dans la sollicitude et le souci mutuel. Le chemin de la reconnaissance des activites de soin est bien long, il nous engage a poursuivre sans faiblir la lutte pour donner au << prendre soin une place centrale dans nos democraties. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

13.
British Journal of Healthcare Management ; 28(4):1-3, 2022.
Article in English | CINAHL | ID: covidwho-1811401

ABSTRACT

Caroline Rollings, wellbeing lead for the National Association of Primary Care and joint chair of the One Voice Group, shares her insight into the immense pressure facing NHS primary care services, the consequences of that pressure, and strategies that managers can use to help their colleagues to cope.

14.
Middle East Journal of Family Medicine ; 20(4):65-74, 2022.
Article in English | Academic Search Complete | ID: covidwho-1811159

ABSTRACT

Background: Sleep disturbances are extremely common among doctors with profound effect on quality of life. Coronaphobia is the dread of COVID-19 that can affect physicians and their sleep quality. Aim of Study: Our study aimed to assess sleep disturbance and its association with coronaphobia among primary health care (PHC) physicians in Primary Health care Centers (PHCCs) of the Ministry of Health, Jazan Province, Saudi Arabia. Method: The study is a cross-sectional questionnaire- based observational investigation using a simple random sampling scheme. The sampling frame was all PHC physicians practicing in Jazan Province. We used the Fear-of-COVID and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Poisson Regression modelling techniques were used to analyse the adjusted effect of sociodemographic factors on Fear-of-COVID and Pittsburgh Sleep Quality scores. Results: A total of 385 physicians participated in the study. The prevalence of poor quality of sleep among our physicians was 47.3%, while prevalence of coronaphobia was 56.2%. Coronaphobia had significant negative impact on sleep quality, even with adjustment for the effect of all other clinical and demographic variables. A rise by one point in the fear of COVID questionnaire is associated with a rise by 2.3% points in the PSQI score (indicative of poorer sleep quality, p = 0.00081). Conclusions: Coronaphobia is common and has detrimental effect of sleep quality among PHC physicians. Coronaphobia has negative impact on sleep quality. Higher burden of depressive symptoms worsens physicians' sleep quality. Recommendations: Support for PHC physicians' psychological and physical well-being is paramount during the current COVID-19 crisis. [ FROM AUTHOR] Copyright of Middle East Journal of Family Medicine is the property of Medi+WORLD International Pty. Ltd 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.)

15.
Middle East Journal of Family Medicine ; 20(4):62-64, 2022.
Article in English | Academic Search Complete | ID: covidwho-1811158

ABSTRACT

Multiple Myeloma commonly presents with a myriad of symptoms, signs and abnormal laboratory findings namely bone pains, pathological fractures, lytic bone lesions, anaemia, high ESR, hypercalcemia, raised globulin and presence of monoclonal band in serum/urine. Here, we present a 54-year-old gentleman whose initial presentation was a pathological rib fracture. However, review of his past medical history revealed gout (now asymptomatic) and abnormal laboratory findings that helped us to subsequently diagnose as Multiple Myeloma. The importance of simple investigations like ESR when managing patients with nonspecific symptoms in primary care, listening and looking for signals that suggest an alarming aetiology, following up of investigations and the continuity of care assured by the electronic medical record is highlighted by this case report. [ FROM AUTHOR] Copyright of Middle East Journal of Family Medicine is the property of Medi+WORLD International Pty. Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

16.
Br J Gen Pract ; 2022.
Article in English | PubMed | ID: covidwho-1810376

ABSTRACT

BACKGROUND: Colchicine has been proposed as a COVID-19 treatment. AIM: To determine whether colchicine reduces time to recovery and COVID-19-related admissions to hospital and/or deaths among people in the community. DESIGN AND SETTING: Prospective, multicentre, open-label, multi-arm, randomised, controlled, adaptive platform trial (PRINCIPLE). METHOD: Adults aged ≥65 years or ≥18 years with comorbidities or shortness of breath, and unwell for ≤14 days with suspected COVID-19 in the community, were randomised to usual care, usual care plus colchicine (500 µg daily for 14 days), or usual care plus other interventions. The co-primary endpoints were time to first self-reported recovery and admission to hospital/death related to COVID-19, within 28 days, analysed using Bayesian models. RESULTS: The trial opened on 2 April 2020. Randomisation to colchicine started on 4 March 2021 and stopped on 26 May 2021 because the prespecified time to recovery futility criterion was met. The primary analysis model included 2755 participants who were SARS-CoV-2 positive, randomised to colchicine (n = 156), usual care (n = 1145), and other treatments (n = 1454). Time to first self-reported recovery was similar in the colchicine group compared with usual care with an estimated hazard ratio of 0.92 (95% credible interval (CrI) = 0.72 to 1.16) and an estimated increase of 1.4 days in median time to self-reported recovery for colchicine versus usual care. The probability of meaningful benefit in time to recovery was very low at 1.8%. COVID-19-related admissions to hospital/deaths were similar in the colchicine group versus usual care, with an estimated odds ratio of 0.76 (95% CrI = 0.28 to 1.89) and an estimated difference of -0.4% (95% CrI = -2.7 to 2.4). CONCLUSION: Colchicine did not improve time to recovery in people at higher risk of complications with COVID-19 in the community.

17.
Br J Gen Pract ; 2022.
Article in English | PubMed | ID: covidwho-1810375

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had a major impact on the mental health of healthcare workers, yet studies in primary care workers are scarce. AIM: To investigate the prevalence of and associated factors for psychological distress in primary care workers during the first COVID-19 outbreak. DESIGN AND SETTING: This was a multicentre, cross-sectional, web-based survey conducted in primary healthcare workers in Spain, between May and September 2020. METHOD: Healthcare workers were invited to complete a survey to evaluate sociodemographic and work-related characteristics, COVID-19 infection status, exposure to patients with COVID-19, and resilience (using the Connor-Davidson Resilience Scale), in addition to being screened for common mental disorders (depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder). Positive screening for any of these disorders was analysed globally using the term 'any current mental disorder'. RESULTS: A total of 2928 primary care professionals participated in the survey. Of them, 43.7% (95% confidence interval [CI] = 41.9 to 45.4) tested positive for a current mental disorder. Female sex (odds ratio [OR] 1.61, 95% CI = 1.25 to 2.06), having previous mental disorders (OR 2.58, 95% CI = 2.15 to 3.10), greater occupational exposure to patients with COVID-19 (OR 2.63, 95% CI = 1.98 to 3.51), having children or dependents (OR 1.35, 95% CI = 1.04 to 1.76 and OR 1.59, 95% CI = 1.20 to 2.11, respectively), or having an administrative job (OR 2.24, 95% CI = 1.66 to 3.03) were associated with a higher risk of any current mental disorder. Personal resilience was shown to be a protective factor. CONCLUSION: Almost half of primary care workers showed significant psychological distress. Strategies to support the mental health of primary care workers are necessary, including designing psychological support and resilience-building interventions based on risk factors identified.

18.
Scand J Caring Sci ; 2022.
Article in English | PubMed | ID: covidwho-1807264

ABSTRACT

AIM: The aim of this study was to explore lessons from the pandemic by registered and assistant nurses in Swedish primary health care (PHC) of potential relevance for the future operation of PHC. METHODS: Twenty-one semi-structured interviews were conducted with registered and assistant nurses. We used a purposeful sampling strategy to achieve a diverse sample with regard to size and location of PHC centres. Data were analysed using qualitative content analysis. RESULTS: Analysis yielded two categories: lessons from the pandemic pertaining to PHC personnel and patient behaviours (adaptability of the personnel;importance of hygiene and maintaining physical distance;and importance of being attentive to illness symptoms) and lessons from the pandemic related to primary healthcare work routines (effectiveness of digital job meetings;advantages of digital patient consultations;importance of keeping infectious patients separate from other patients;and the need to allow only pre-booked patient appointments). CONCLUSIONS: The seven sub-categories represent seven lessons from the pandemic. The lessons generated both instrumental knowledge, which the nurses could apply in work-related decisions, and conceptual knowledge which yielded improved understanding of problems and potential solutions for PHC.

19.
The Lancet Global Health ; 10(5):e602-e603, 2022.
Article in English | EMBASE | ID: covidwho-1799632
20.
Open Access Macedonian Journal of Medical Sciences ; 10:498-505, 2022.
Article in English | EMBASE | ID: covidwho-1798869

ABSTRACT

BACKGROUND: Low availability of medical care and low level of comfort living in rural areas, underdeveloped infrastructure, and difficult working conditions lead to the deterioration of health of rural residents. Rural areas are characterized by less comfortable living conditions than in the city, which can affect health-related quality of life. AIM: The purpose of this study was to assess the satisfaction of the population with the quality of life in rural areas as well as to study the quality of life of the rural population of the Republic of Kazakhstan related to health. METHODS: This study was a one-stage cross-sectional study. Online questionnaire was asked by 411 local residents, of which only 302 were suitable for processing. RESULTS: The results showed that almost a third of the respondents are unemployed (27.2%). In the course of the survey, respondents could subjectively assess their own health, for example, almost a third of respondents (35.76%) assess their health as “poor” and “below average.” At the same time, 18.21% of respondents are not satisfied with the quality of medical services provided in rural areas. The coefficients of correlation between the desire to move to the city and age, income level, family composition, marital status, and type of housing were established. The universal social functioning-36 index was 0.6 (±0.02) for women and 0.55 (±0.033) for men CONCLUSIONS: We can say that the quality of life of the rural population remains quite low. This is evidenced by low income, high unemployment, and the problem of drinking water. Quarantine measures related to COVID-19 also had an impact on the increase in unemployment, however, during the quarantine, there is a deterioration in mental health indicators among men compared to women. The results of the study confirmed that the issue of accessibility of medical services remains very urgent for rural residents.

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