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1.
Acta Paul. Enferm. (Online) ; 35: eAPE02206, 2022. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-20234531

ABSTRACT

Resumo Objetivo Analisar os fatores associados à restrição do acompanhamento de lactentes que nasceram prematuros e/ou baixo peso durante a pandemia da COVID-19 e a percepção de mães e profissionais de saúde quanto a essa realidade. Métodos Pesquisa de método misto com delineamento paralelo convergente, realizada com 14 mães de lactentes que nasceram prematuros e/ou baixo peso acompanhados no ambulatório de follow-up de uma maternidade em um município da Paraíba, e quatro profissionais de saúde desse serviço. A coleta de dados foi realizada no período de junho a julho de 2020, concomitantemente, em fonte de dados secundários, constituída de todos os 140 prontuários dos respectivos lactentes para abordagem quantitativa, por meio de entrevista semiestruturada, para abordagem qualitativa. A análise quantitativa ocorreu por estatística descritiva e inferencial, e a qualitativa, conforme análise temática indutiva. Resultados Houve associação significativa entre a idade dos lactentes e a restrição do seu acompanhamento no follow-up durante a pandemia, com priorização do atendimento presencial dos menores de seis meses, contatos pontuais com os familiares, via ligação telefônica ou aplicativo digital, e lacunas na atualização do calendário vacinal dos que tiveram o acompanhamento interrompido. Isso gerou insatisfação das mães e receio de prejuízos ao desenvolvimento dos lactentes. Também não houve continuidade do cuidado desses na unidade básica de saúde. Conclusão Houveram restrições no acompanhamento dos lactentes nascidos prematuros no serviço de follow-up durante a pandemia, gerando insatisfação materna e receio de prejuízos ao desenvolvimento de seus filhos.


Resumen Objetivo Analizar los factores asociados a la restricción del seguimiento de lactantes que nacieron prematuros o de bajo peso durante la pandemia de COVID-19 y la percepción de madres y profesionales de la salud respecto a esta realidad. Métodos Estudio de método mixto con diseño paralelo convergente, realizado con 14 madres de lactantes que nacieron prematuros o de bajo peso atendidos en consultorios externos de follow-up de una maternidad en un municipio del estado de Paraíba, y cuatro profesionales de la salud de este servicio. La recopilación de datos fue realizada en el período de junio a julio de 2020, simultáneamente en fuente de datos secundarios, compuesta por las 140 historias clínicas de los respectivos lactantes para el enfoque cuantitativo, por medio de entrevista semiestructurada, para el enfoque cualitativo. El análisis cuantitativo se llevó a cabo por estadística descriptiva e inferencial, y el cualitativo mediante análisis temático inductivo. Resultados Hubo relación significativa entre la edad de los lactantes y la restricción de su seguimiento en el follow-up durante la pandemia, con priorización de atención presencial a los menores de seis meses, contactos puntuales con los familiares, vía llamada telefónica o aplicación digital, y vacíos en la actualización del calendario de vacunación de los que tuvieron el seguimiento interrumpido. Esto generó insatisfacción de las madres y temor de perjudicar el desarrollo de los lactantes. Tampoco hubo continuidad del cuidado de estos en la unidad básica de salud. Conclusión Hubo restricciones en el seguimiento de los lactantes nacidos prematuros en el servicio de follow-up durante la pandemia, lo que generó insatisfacción materna y temor de perjudicar el desarrollo de sus hijos.


Abstract Objective To analyze the factors associated with restricting the follow-up of infants who were born premature and/or low birth weight during the COVID-19 pandemic and mothers' and health professionals' perception regarding this reality. Methods This is mixed methods research with a parallel convergent design, carried out with 14 mothers of infants who were born premature and/or low birth weight, followed up at a follow-up outpatient clinic of a maternity hospital in a municipality in Paraíba, and four health professionals from this service. Data collection was carried out from June to July 2020, concomitantly, in a secondary data source, consisting of all 140 medical records of the respective infants for a quantitative approach, through a semi-structured interview, for a qualitative approach. Quantitative analysis was performed using descriptive and inferential statistics, and qualitative analysis, according to inductive thematic analysis. Results There was a significant association between infant age and the restriction of their follow-up during the pandemic, with prioritization of one-to-one care for children under six months of age, occasional contacts with family members, via phone call or digital application, and gaps in updating the vaccination schedule of those whose follow-up was interrupted. This generated dissatisfaction on the part of mothers and fear of harm to the development of infants. There was also no continuity of care for these in the Basic Health Unit. Conclusion There were restrictions on follow-up of premature infants in the follow-up service during the pandemic, generating maternal dissatisfaction and fear of damage to the development of their children.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Breast Feeding , Infant, Premature , Maternal-Child Health Services , COVID-19 , Mothers , Child Health Services , Medical Records , Interviews as Topic , Evaluation Studies as Topic
2.
Rev. Ciênc. Méd. Biol. (Impr.) ; 21(1): 79-84, maio 05,2022. tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2325255

ABSTRACT

Objetivo: analisar as mudanças no processo de trabalho do Agente Comunitário de Saúde, entre os anos de 2019 e 2020, em meio ao cenário da pandemia da COVID-19. Metodologia: caracteriza-se por um estudo documental, quantitativo, do tipo ecológico, de série temporal. Os dados foram coletados na base de dados do Sistema de Informação em Saúde para a Atenção Básica. As variáveis do estudo tratam-se de dados referentes às atividades do Agente Comunitário de Saúde quanto às atividades coletivas, visitas domiciliares e os indicadores de desempenho elencados pelo sistema. Os dados foram analisados no SPSS versão 24.0, por meio de um cálculo do percentual de variação (%V) entre os anos coletados. Logo após, foi realizado o Teste T de Student para verificar diferenças estatisticamente relevantes entre os anos avaliados (p<0,05). Resultados: quanto às atividades coletivas, houve redução significativa (p<0,001) de 51,1% entre os anos. As visitas domiciliares também apresentaram uma diminuição do percentual de variação (18,6%); já os indicadores de desempenho não demonstraram significativas mudanças. Conclusões: diante do estudado, as ações de prevenção e promoção da saúde foram as mais prejudicadas nesse cenário, sendo necessário um maior empenho do Poder Público para a melhoria desses indicadores.


Objective: to analyze the changes in the work process of the Community Health Agent, of the Family Health Strategy, between 2019 and 2020, amid the COVID-19 pandemic scenario. Methods: characterized by a documentary, quantitative, ecological study, with a time series. Data were collected from the database of the Health Information System for Primary Care. The study variables are data referring to the activities of the Community Health Agent regarding collective activities, home visits, and the performance indicators listed by the system. Data were analyzed using SPSS version 24.0, by calculating the percentage of variation (%V) between the years collected. Soon after, the Student's T-test was performed to verify statistically relevant differences between the evaluated years (p<0.05). Results: regarding collective activities, there was a significant reduction (p<0.001) of 51.1% between the years. Home visits also showed a decrease in the percentage of variation (18.6%); performance indicators did not show significant changes. Conclusions:given the study, prevention, and health promotion actions were the most affected in this scenario, requiring greater efforts by the Government to improve these indicators.


Subject(s)
Humans , Female , Pregnancy , Primary Health Care , Unified Health System , Community Health Workers , National Health Strategies , COVID-19 , Ecological Studies , Evaluation Studies as Topic
3.
PLoS One ; 17(3): e0265257, 2022.
Article in English | MEDLINE | ID: covidwho-1745311

ABSTRACT

This research aims to find out the phenomenon of webinar competition from the viewpoint of the audience. Covid-19 pandemic makes webinars a means for knowledge dissemination. Many events offered turned out to be a tight competition among organizers and caused a different response for the audience. Academics participants' responses had never been known in depth so that they could be the basis for determining the strategy for the organizers. Using quantitative data through online surveys to further interpreted with the help of previous literature. The independent variables gender, age, frequency, cost, and place are used to determine their effect on loyalty, which is represented by the length of duration in participating in each webinar. The effectiveness of webinars as a means of disseminating ideas in the pandemic era still faces various challenges. Among academics, the loyalty at the webinar event is influenced by gender and age. It is important for organizers to effectively communicate to webinar participants so that they get the message they want to convey.


Subject(s)
COVID-19/epidemiology , Education, Distance/methods , Evaluation Studies as Topic , Humans , Indonesia/epidemiology , Male , Surveys and Questionnaires
5.
BMC Med Imaging ; 22(1): 21, 2022 02 06.
Article in English | MEDLINE | ID: covidwho-1666633

ABSTRACT

OBJECTIVE: The purpose of this study was to compare imaging features between COVID-19 and mycoplasma pneumonia (MP). MATERIALS AND METHODS: The data of patients with mild COVID-19 and MP who underwent chest computed tomography (CT) examination from February 1, 2020 to April 17, 2020 were retrospectively analyzed. The Pneumonia-CT-LKM-PP model based on a deep learning algorithm was used to automatically quantify the number, volume, and involved lobes of pulmonary lesions, and longitudinal changes in quantitative parameters were assessed in three CT follow-ups. RESULTS: A total of 10 patients with mild COVID-19 and 13 patients with MP were included in this study. There was no difference in lymphocyte counts at baseline between the two groups (1.43 ± 0.45 vs. 1.44 ± 0.50, p = 0.279). C-reactive protein levels were significantly higher in MP group than in COVID-19 group (p < 0.05). The number, volume, and involved lobes of pulmonary lesions reached a peak in 7-14 days in the COVID-19 group, but there was no peak or declining trend over time in the MP group (p < 0.05). CONCLUSION: Based on the longitudinal changes of quantitative CT, pulmonary lesions peaked at 7-14 days in patients with COVID-19, and this may be useful to distinguish COVID-19 from MP and evaluate curative effects and prognosis.


Subject(s)
COVID-19/diagnostic imaging , Pneumonia, Mycoplasma/diagnostic imaging , Tomography, X-Ray Computed , Adult , Evaluation Studies as Topic , Female , Humans , Longitudinal Studies , Male , Middle Aged , Retrospective Studies
6.
PLoS One ; 16(11): e0259995, 2021.
Article in English | MEDLINE | ID: covidwho-1533419

ABSTRACT

INTRODUCTION: Digital technology has the potential to improve health outcomes and health system performance in fragmented and under-funded mental health systems. Despite this potential, the integration of digital technology tools into mental health systems has been relatively poor. This is a protocol for a synthesis of qualitative evidence that will aim to determine the barriers and facilitators to integrating digital technologies in mental health systems and classify them in contextual domains at individual, organisational and system levels. METHODS AND ANALYSIS: The methodological framework for systematic review of qualitative evidence described in Lockwood et al. will be applied to this review. A draft search strategy was developed in collaboration with an experienced senior health research librarian. A systematic search of Medline, Embase, Scopus, PsycInfo, Web of Science and Google Scholar, as well as hand searching of reference lists and reviews will identify relevant studies for inclusion. Study selection will be carried out independently by two authors, with discrepancies resolved by consensus. The quality of selected studies will be assessed using JBI Critical Appraisal Checklist for Qualitative Research. Data will be charted using JBI QUARI Data Extraction Tool for Qualitative Research. Findings will be defined and classified both deductively in a priori conceptual framework and inductively by a thematic analysis. Results will be reported based on the Enhancing transparency in reporting the synthesis of qualitative research. The level of confidence of the findings will be assessed using GRADE-CERQual. ETHICS AND DISSEMINATION: This study does not require ethics approval. The systematic review will inform policy and practices around improving the integration of digital technologies into mental health care systems.


Subject(s)
Health Services Accessibility/trends , Mental Health Services/trends , Systematic Reviews as Topic/methods , Checklist , Consensus , Digital Technology/trends , Evaluation Studies as Topic , Government Programs , Health Services Accessibility/statistics & numerical data , Humans , Medical Assistance , Mental Health/trends , Policy , Qualitative Research
7.
Nutrients ; 13(10)2021 Oct 09.
Article in English | MEDLINE | ID: covidwho-1463779

ABSTRACT

The COVID-19 pandemic has caused disruption to food security in many countries, including Kenya. However, the impact of this on food provision to children at an individual level is unknown. This small study aimed to provide a qualitative snapshot of the diets of children during the COVID-19 pandemic. During completion of 24-h food recalls, with 15 families with children aged 5-8 years, caregivers were asked about changes they had made to foods given to their children due to the pandemic. Food recalls were analysed to assess nutrient intakes. Qualitative comments were thematically analysed. Most of the families reported making some changes to foods they provided to their children due to COVID-19. Reasons for these changes fell into three themes, inability to access foods (both due to formal restriction of movements and fear of leaving the house), poorer availability of foods, and financial constraints (both decreases in income and increases in food prices). The COVID-19 pandemic has affected some foods parents in rural Kenya can provide to their children.


Subject(s)
COVID-19 , Diet/methods , Eating , Food Supply/methods , Food Supply/statistics & numerical data , Rural Population/statistics & numerical data , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Income , Kenya , Male , Pandemics , SARS-CoV-2
8.
J Comput Assist Tomogr ; 45(6): 970-978, 2021.
Article in English | MEDLINE | ID: covidwho-1440699

ABSTRACT

OBJECTIVE: To quantitatively evaluate computed tomography (CT) parameters of coronavirus disease 2019 (COVID-19) pneumonia an artificial intelligence (AI)-based software in different clinical severity groups during the disease course. METHODS: From March 11 to April 15, 2020, 51 patients (age, 18-84 years; 28 men) diagnosed and hospitalized with COVID-19 pneumonia with a total of 116 CT scans were enrolled in the study. Patients were divided into mild (n = 12), moderate (n = 31), and severe (n = 8) groups based on clinical severity. An AI-based quantitative CT analysis, including lung volume, opacity score, opacity volume, percentage of opacity, and mean lung density, was performed in initial and follow-up CTs obtained at different time points. Receiver operating characteristic analysis was performed to find the diagnostic ability of quantitative CT parameters for discriminating severe from nonsevere pneumonia. RESULTS: In baseline assessment, the severe group had significantly higher opacity score, opacity volume, higher percentage of opacity, and higher mean lung density than the moderate group (all P ≤ 0.001). Through consecutive time points, the severe group had a significant decrease in lung volume (P = 0.006), a significant increase in total opacity score (P = 0.003), and percentage of opacity (P = 0.007). A significant increase in total opacity score was also observed for the mild group (P = 0.011). Residual opacities were observed in all groups. The involvement of more than 4 lobes (sensitivity, 100%; specificity, 65.26%), total opacity score greater than 4 (sensitivity, 100%; specificity, 64.21), total opacity volume greater than 337.4 mL (sensitivity, 80.95%; specificity, 84.21%), percentage of opacity greater than 11% (sensitivity, 80.95%; specificity, 88.42%), total high opacity volume greater than 10.5 mL (sensitivity, 95.24%; specificity, 66.32%), percentage of high opacity greater than 0.8% (sensitivity, 85.71%; specificity, 80.00%) and mean lung density HU greater than -705 HU (sensitivity, 57.14%; specificity, 90.53%) were related to severe pneumonia. CONCLUSIONS: An AI-based quantitative CT analysis is an objective tool in demonstrating disease severity and can also assist the clinician in follow-up by providing information about the disease course and prognosis according to different clinical severity groups.


Subject(s)
Artificial Intelligence , COVID-19/diagnostic imaging , Lung/diagnostic imaging , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity , Severity of Illness Index , Time , Young Adult
10.
Nutrients ; 13(8)2021 Aug 14.
Article in English | MEDLINE | ID: covidwho-1355019

ABSTRACT

The COVID-19 pandemic restrictions sent college students online and off campus, potentially reducing access to healthy food. The objective of this cross-sectional, internet-based study was to use qualitative and quantitative survey methods to evaluate whether COVID-19 pandemic restrictions in Texas, USA affected college students' ability to buy food, how/what they shopped for, how they prepared food, what they ate, how they felt about eating, and overall dietary quality (assessed using Healthy Eating Index [HEI] scores). Survey responses from 502 students (87.5% female; 59.6% nonwhite, mean age 27.5 ± 0.4 years, >50% graduate students) were analyzed. The qualitative analysis of open-ended questions revealed 110 codes, 17 subthemes, and six themes. Almost all students experienced changes in at least one area, the most common being changes in shopping habits. Participants with low or very low food security had lower HEI scores compared to food secure students (p = 0.047). Black students were more likely to report changes in their ability to buy food (p = 0.035). The COVID-19 restrictions varied in their impact on students' ability to access sufficient healthy food, with some students severely affected. Thus, universities should establish procedures for responding to emergencies, including identifying at-risk students and mobilizing emergency funds and/or food assistance.


Subject(s)
COVID-19/epidemiology , Diet, Healthy/statistics & numerical data , Diet/statistics & numerical data , Adult , COVID-19/psychology , Cross-Sectional Studies , Diet/psychology , Diet/standards , Diet, Healthy/psychology , Evaluation Studies as Topic , Feeding Behavior , Female , Food Assistance , Food Security , Humans , Male , Pandemics , SARS-CoV-2/isolation & purification , Students , Texas/epidemiology , Universities/statistics & numerical data
11.
Urology ; 158: 26-32, 2021 12.
Article in English | MEDLINE | ID: covidwho-1331279

ABSTRACT

OBJECTIVE: To assess whether pandemic-related restrictions with video-based interviewing increased geographic clustering of urology applicants matching at a residency program near where they were raised or attended medical school. MATERIALS AND METHODS: We utilized publicly available data from the urology match to compare dispersal patterns between applicants matching during the COVID-19 application cycle (2021) and those matching in the 5 prior application cycles (2016-2020). Variables included home state, undergraduate institution, medical school, and residency. Latitudes and longitudes were obtained for each institution and home state. The primary endpoint was distance (miles, as the most direct path) between medical school and residency program. We also assessed dispersal patterns by American Urological Association section. RESULTS: Of the 1965 applicants matching to a urology program between 2016 and 2021, medical school was identified for 1956 (99.7%) applicants, undergraduate program for 1551 (79%) applicants, and home state for 1351 (69%) applicants. Comparing the COVID-19 application cycle to the 5 prior application cycles, there was no significant difference in the median distance between medical school and residency, undergraduate university and residency, or home state and residency. Similarly, there was no significant difference in the proportion of applicants matching at their home institution, matching from medical schools without a home urology program, matching from medical schools with a historically low volume of urology applicants (<1 matched applicant per year), or matching from a D.O. CONCLUSION: Virtual interviewing and the loss of in-person clinical rotations did not significantly alter dispersal patterns or hamper an applicant's ability to match at program outside their geographic region.


Subject(s)
COVID-19 , Internship and Residency , Job Application , Urology/education , Evaluation Studies as Topic , Geography , Schools, Medical , United States
12.
J Foot Ankle Res ; 14(1): 46, 2021 Jun 30.
Article in English | MEDLINE | ID: covidwho-1286830

ABSTRACT

BACKGROUND: In response to the COVID-19 pandemic, populations were advised to remain at home to control viral spread. Government-mandated restrictions on free movement affected individuals' engagement with physical activity, with reported increases leading to biopsychosocial health benefits and conversely increased sedentary behaviour leading to poorer health. Good foot health is key to enabling physical activity and maximal participation in activities of occupation and daily living. METHODS: A population-based cross-sectional study was performed, using a web-based platform. Quantitative and qualitative data were captured through responses to closed and open survey questions. Anybody with a foot health condition was eligible to participate in the online survey. Links were sent through professional networks, support groups and charities, using a snowball strategy to maximise participation. RESULTS: Two hundred fifty-five respondents completed the survey. Most (n = 193, 75.69%) reported an ongoing foot pain or problem that had been present for 4 weeks or longer, whilst 49 respondents (19.22%) noted a new pain or problem. Pain was the most frequently reported symptom (n = 139, 54.51%), whilst change in appearance of the foot was also commonly reported (n = 122, 47.84%), often alongside the observable presence of swelling. Musculoskeletal foot symptoms were frequently reported (n = 123, 48%), and were significantly associated with reported reduced physical activity (X2 = 6.61, p = 0.010). Following qualitative analysis five themes and 11 subthemes emerged, informed by 49 independent codes. A central theme of lockdown disrupting support networks, both formal (healthcare providers) and informal (friends or family members) emerged. The 5 sub-themes were: 1. foot pain is a constant companion, 2. self-care, 3. 'cope or crumble' scenarios, 4. future intent to access healthcare and 5. reduced ability to undertake physical activity. CONCLUSIONS: Pain was the most frequently reported foot problem during COVID-19 lockdown restriction. Lockdown restrictions disrupted support networks integral to maintaining foot health. Poor foot health impacted people's ability to remain physically active. Complaints previously considered relatively 'minor' such as support for skin and nail care, were found to be exacerbated by restricted support networks, leading to greater negative impact.


Subject(s)
COVID-19/prevention & control , Exercise/psychology , Foot/pathology , Musculoskeletal Pain/epidemiology , Social Isolation/psychology , Activities of Daily Living/psychology , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Communicable Disease Control/statistics & numerical data , Cross-Sectional Studies , Evaluation Studies as Topic , Female , Government Regulation , Humans , Male , Middle Aged , Musculoskeletal Pain/diagnosis , Patient Participation , SARS-CoV-2/genetics , Sedentary Behavior , Self Care/psychology , Self-Help Groups/organization & administration , Surveys and Questionnaires
15.
Ann Ig ; 33(4): 347-359, 2021.
Article in English | MEDLINE | ID: covidwho-1207913

ABSTRACT

Background: Health authorities and organizations consider non-medical face masks as an additional passive means to prevent virus diffusion. Communication strategies disseminate information among the population that such masks are essential for mitigating virus diffusion. However, scientific studies are not conclusive in showing the undisputed filtration efficiency of fabric/cloth facial masks (both commercial and homemade). Objectives: This study examines scientific data about the effectiveness of face masks before and during the COVID-19 emergency. Present trends in the making of commercial and homemade fabric/cloth face masks are also examined. Methods: Statistical data of published studies are analyzed and compared. Main considerations and sugge-stions are also extracted and discussed. Current approaches are examined for assessing the characteristics and effectiveness of fabric/cloth commercial and homemade face masks intended for the population. Results: Conflicting data exist as to whether non-medical masks have a protective effect from the spread of respiratory viruses. Both medical masks (MDs) and respiratory personal protection equipment (PPE) show a given effectiveness value. Conclusion: Concerning commercial and homemade fabric/cloth masks, giving general indications on the choice of materials and their assemblage is difficult as it is not possible to assess the effectiveness of the filter media with respect to the kind of multiphase fluid that may be emitted upon breathing, sneezing, or coughing under different environmental conditions. This is particularly important because airflow rate, temperature, humidity, and duration of use will affect the performance of filter media. Moreover, while a mask may have excellent filter media, droplets may leak into the face-piece unless there is an adequate facial seal. In the presence of leaks, any type of mask may actually offer less protection independently of its nominal filtering effìciency.


Subject(s)
COVID-19/prevention & control , Masks , SARS-CoV-2 , Aerosols , Air Microbiology , Cough , Equipment Design , Evaluation Studies as Topic , Filtration , Humans , Humidity , Masks/standards , Masks/trends , Polypropylenes , Respiration , SARS-CoV-2/isolation & purification , Sneezing , Temperature , Textiles
16.
J Soc Psychol ; 161(4): 477-491, 2021 Jul 04.
Article in English | MEDLINE | ID: covidwho-1205474

ABSTRACT

What mitigates prejudice against migrants in situations of uncertainty? Addressing this question, we explored how individuals with greater COVID-19 concern perceive migrants as a greater threat and show prejudice against them, indirectly through the mechanism of need for cognitive closure and binding moral foundations.This study was conducted in two European countries: Malta and Italy. Six hundred and seventy-six individuals participated in this quantitative study (Malta: N = 204; Italy N = 472). Results from this study showed that the need for cognitive closure and binding moral foundations mediate the relationship between COVID-19 concern and prejudice against migrants in both countries. When testing the three binding moral foundations (loyalty, authority, and purity), the authority foundation seems to be the most consistent predictor.The implications of the findings contribute to theories about how situational uncertainty caused by COVID-19, together with the need for epistemic certainty and binding morality, contribute to increased prejudiced attitudes against migrants.


Subject(s)
COVID-19/psychology , Morals , Prejudice/psychology , Transients and Migrants/psychology , Uncertainty , Adolescent , Adult , Aged , Aged, 80 and over , Cognition , Evaluation Studies as Topic , Female , Humans , Italy , Male , Malta , Middle Aged , Prejudice/statistics & numerical data , SARS-CoV-2 , Transients and Migrants/statistics & numerical data , Young Adult
17.
Laryngoscope ; 131(11): 2545-2549, 2021 11.
Article in English | MEDLINE | ID: covidwho-1198394

ABSTRACT

OBJECTIVES/HYPOTHESIS: Vocal fold movement impairment (VFMI) in infants and children is most commonly evaluated by flexible nasolaryngoscopy (FNL). FNL in this population can be challenging due to movement, floppy supraglottic structures, or secretions. Laryngeal ultrasound (LUS) may be an alternative, less invasive means of evaluating VFMI that also decreases aerosolization during the COVID-19 pandemic. The primary objective was to examine LUS interpretation proficiency for VFMI via an educational module. A secondary outcome was to determine whether quantitative measurements increase interpretation accuracy. STUDY DESIGN: Prospective cohort trial. METHODS: Medical students, residents, fellows, faculty, and staff were recruited to complete the module, composed of a 13-minute teaching video followed by 20 cases. Participants determined both qualitatively (subjective assessment) and then quantitatively (through protractor measurements of the vocal fold to arytenoid angle) whether there was normal versus impaired vocal fold mobility. RESULTS: Thirty participants completed the LUS training module, and about one-third were otolaryngology residents. On average, each participant correctly identified 18 cases. The mean rank percent correct for quantitative measurements was significantly higher than that of qualitative interpretations (P < .0001). Measurements significantly caused participants to change their answer correctly compared to incorrectly (P < .0001). As the module progressed, there was no significant trend of more correct interpretations (P = .30). The sensitivity was higher for quantitative interpretations (89.0% vs. 87.3%) but specificity remained unchanged (92.6%). CONCLUSION: Quantitative measurements may increase LUS interpretation accuracy. There was not a specific number of cases interpreted to achieve learning proficiency. LUS is an easily learned method to evaluate for VFMI across all training levels. LEVEL OF EVIDENCE: 3 (local cohort study nonrandomized) Laryngoscope, 131:2545-2549, 2021.


Subject(s)
Larynx/diagnostic imaging , Preceptorship/methods , Ultrasonography/methods , Vocal Cords/diagnostic imaging , Aerosols/adverse effects , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Child , Cohort Studies , Evaluation Studies as Topic , Humans , Infant , Larynx/anatomy & histology , Larynx/physiology , Male , Outcome Assessment, Health Care , Prospective Studies , SARS-CoV-2/genetics , Sensitivity and Specificity , Vocal Cords/physiopathology
18.
Rofo ; 193(5): 537-543, 2021 05.
Article in English, German | MEDLINE | ID: covidwho-1127197

ABSTRACT

PURPOSE: The recent COVID-19 pandemic has resulted in an increasing overload of the medical system. Healthcare workers (HCW) in radiology departments are exposed to a high infection risk similar to HCWs in the ICU or dedicated COVID wards. The goal of our paper is to evaluate the prevalence of IgG antibody against SARS-CoV-2 among radiology HCWs in two different hospitals and regions in Germany with a low and high COVID-19 prevalence and to compare it to the prevalence in other clinical personnel. Additionally, we assessed the number of radiological procedures performed in patients with a positive PCR test (C+) followed by a short review of the risk for nosocomial infections of radiology HCWs. MATERIALS AND METHODS: During the first COVID-19 wave between March and July 2020, we evaluated a region with one of the highest COVID-19 rates (776-1570/100 000) in Germany (Hospital A). Additionally, we assessed Hospital B in a region with a low prevalence (65/100 000). We tested the serum prevalence of SARS-CoV-2 IgG antibodies among the whole staff with a subgroup analysis for radiology in both hospitals. We calculated the total number of different radiological procedures performed in C+ patients. RESULTS: In Hospital A 594 PCR-proven C+ patients were treated resulting in 2723 radiological procedures. 24 % (n = 6) of the radiology technicians and 13.35 (n = 2) of radiologists had a positive IgG test. The rates were similar to positive rates in HCWs in COVID-19 wards and ICUs within the hospital. The most frequently performed procedures in C+ patients were chest X-rays (3.17/patient) and CT examinations (1.15/patient). In Hospital B 50 C+ patients were treated, resulting in 64 radiological procedures. None of the HCWs tested IgG positive. The most frequently performed examinations were also chest X-rays (1.04/patient) and CT (0.2/patient). CONCLUSION: HCWs in radiology have a high occupational infection risk similar to that of HCWs in ICUs and dedicated COVID wards. KEY POINTS: · The risk of acquiring COVID-19 increases with the amount of contact with infected individuals.. · The occupational risk of a SARS-CoV-2 infection for radiology staff is similar to that of nurses and physicians in COVID wards.. · Hygiene concepts and medical resources have to be adapted for further COVID outbreaks.. · Reporting of an occupational disease can be considered in the case of seropositive staff.. CITATION FORMAT: · Finkenzeller T, Lenhart S, Reinwald M et al. Risk to Radiology Staff for Occupational COVID-19 Infection in a High-Risk and a Low-Risk Region in Germany: Lessons from the "First Wave". Fortschr Röntgenstr 2021; 193: 537 - 543.


Subject(s)
COVID-19/transmission , Cross Infection/etiology , Occupational Diseases/etiology , Radiologists , COVID-19/epidemiology , Cross Infection/epidemiology , Cross-Sectional Studies , Evaluation Studies as Topic , Germany , Humans , Occupational Diseases/epidemiology , Radiology Department, Hospital/statistics & numerical data , Risk
19.
Future Oncol ; 17(13): 1593-1600, 2021 May.
Article in English | MEDLINE | ID: covidwho-1105970

ABSTRACT

Aims: This project aims to address the question of whether patients were satisfied with using a video visit for prechemotherapy evaluation during the COVID-19 pandemic. Methods & materials: This project used a survey tool with patients undergoing prechemotherapy evaluation that was administered at the time of chemotherapy; 70 surveys were collected. Descriptive statistics of survey questions are presented. Results: 73% of patients reported satisfaction with their video visit experience. 65% of patients reported that they prefer in-person visits as their preferred choice for prechemotherapy evaluation. Conclusion: Patient satisfaction was favorable, but not consistent with results from prior published studies. Patients also mostly preferred an in-person visit for prechemotherapy evaluation. Further research is needed to determine patient attitudes to telemedicine for different types of consultations.


Lay abstract In this study, we looked at how satisfied patients were with video visits to consult with their physicians prior to receiving chemotherapy. We collected 70 surveys from June to July 2020 in the clinic's infusion center. Most patients were satisfied with using video visits, but maybe were not as satisfied with using video visits as has been reported in other studies. Most patients also still preferred an in-person visit to a video visit. Patients may have preferred in-person visits because that is what they were used to. More research is needed to find why satisfaction with video visits can be so varied.


Subject(s)
Antineoplastic Agents/administration & dosage , COVID-19/complications , Neoplasms/drug therapy , Patient Satisfaction , SARS-CoV-2/isolation & purification , Telemedicine/methods , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/transmission , COVID-19/virology , Delivery of Health Care , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Neoplasms/virology , Surveys and Questionnaires , Young Adult
20.
Chest ; 159(3): 1126-1135, 2021 03.
Article in English | MEDLINE | ID: covidwho-1099074

ABSTRACT

BACKGROUND: CT is thought to play a key role in coronavirus disease 2019 (COVID-19) diagnostic workup. The possibility of comparing data across different settings depends on the systematic and reproducible manner in which the scans are analyzed and reported. The COVID-19 Reporting and Data System (CO-RADS) and the corresponding CT severity score (CTSS) introduced by the Radiological Society of the Netherlands (NVvR) attempt to do so. However, this system has not been externally validated. RESEARCH QUESTION: We aimed to prospectively validate the CO-RADS as a COVID-19 diagnostic tool at the ED and to evaluate whether the CTSS is associated with prognosis. STUDY DESIGN AND METHODS: We conducted a prospective, observational study in two tertiary centers in The Netherlands, between March 19 and May 28, 2020. We consecutively included 741 adult patients at the ED with suspected COVID-19, who received a chest CT and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR (PCR). Diagnostic accuracy measures were calculated for CO-RADS, using PCR as reference. Logistic regression was performed for CTSS in relation to hospital admission, ICU admission, and 30-day mortality. RESULTS: Seven hundred forty-one patients were included. We found an area under the curve (AUC) of 0.91 (CI, 0.89-0.94) for CO-RADS using PCR as reference. The optimal CO-RADS cutoff was 4, with a sensitivity of 89.4% (CI, 84.7-93.0) and specificity of 87.2% (CI, 83.9-89.9). We found a significant association between CTSS and hospital admission, ICU admission, and 30-day mortality; adjusted ORs per point increase in CTSS were 1.19 (CI, 1.09-1.28), 1.23 (1.15-1.32), 1.14 (1.07-1.22), respectively. Intraclass correlation coefficients for CO-RADS and CTSS were 0.94 (0.91-0.96) and 0.82 (0.70-0.90). INTERPRETATION: Our findings support the use of CO-RADS and CTSS in triage, diagnosis, and management decisions for patients presenting with possible COVID-19 at the ED.


Subject(s)
COVID-19 , Emergency Service, Hospital/statistics & numerical data , Patient Admission/statistics & numerical data , Pneumonia, Viral , Radiology Information Systems , Tomography, X-Ray Computed , COVID-19/diagnosis , COVID-19/epidemiology , Clinical Decision-Making , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Mortality , Netherlands/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/etiology , Prognosis , Radiology Information Systems/organization & administration , Radiology Information Systems/standards , Research Design/statistics & numerical data , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/statistics & numerical data
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