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2.
Am J Trop Med Hyg ; 106(1): 15-16, 2021 11 22.
Article in English | MEDLINE | ID: covidwho-1708724

ABSTRACT

A 3-year analysis released in August 2021 by the WHO indicated that more than 700 healthcare workers and patients have died (2,000 injured) as a result of attacks against health facilities since 2017. The COVID-19 pandemic has made the risks even worse for doctors, nurses, and support staff, unfortunately. According to the latest figures from the International Committee of the Red Cross, 848 COVID-19-related violent incidents were recorded in 2020, and this is likely an underrepresentation of a much more widespread phenomenon. In response to rises in COVID-19-related attacks against healthcare, some countries have taken action. In Algeria, for instance, the penal code was amended to increase protection for healthcare workers against attacks and to punish individuals who damage health facilities. In the United Kingdom, the police, crime, sentencing, and courts bill proposed increased the maximum penalty from 12 months to 2 years in prison for anyone who assaults an emergency worker. Measures taken by countries represent a good practical way to counteract this crisis within COVID-19. However, we stress the importance of primary prevention with the use of communication: social media and other communication channels are fundamentally important to combat violence against health professionals, both to inform the population with quality data and to disseminate campaigns to prevent these acts.


Subject(s)
Delivery of Health Care/trends , Violence , Health Personnel , Humans , Patients , Risk Factors , Violence/prevention & control , Violence/statistics & numerical data
3.
rev. cuid. (Bucaramanga. 2010) ; 12(3)20210821.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1698769

ABSTRACT

O vírus SARS-CoV-2 foi detectado na cidade de Wuhan, na China, no final de 20191. Desde então, a alta transmissibilidade deste novo coronavirus e a elevada morbimortalidade relacionada à COVID-19, a infecção viral causada pelo SARS-CoV-2, cresceu exponencialmente em todo o planeta, culminando, primeiramente, em uma emergência de saúde pública de importância internacional e, logo em seguida, em uma grave pandemia2,3. A transmissão do vírus ocorre tanto por vias respiratórias quanto extrarrespiratórias e durante o período de desenvolvimento da COVID-19 no organismo humano a apresentação clínica inclui sintomas relacionados a alterações no olfato, paladar e complicações gastrointestinais, além do acometimento de forma mais acentuada do sistema respiratório.4 Em consequência dos sintomas da COVID-19, muitos pacientes precisam ser internados e, em alguns casos, são submetidos a procedimentos invasivos para garantir a condição fisiológica básica para a manutenção da vida. Durante o período de internação os pacientes desenvolvem condição clínica com debilitação fisiológica e a aptidão física geral reduz sensivelmente.5 Ao receber alta hospitalar, muitos desses pacientes precisam de tratamentos voltados à recuperação da condição física debilitada pela ação da doença.6 A Secretaria Municipal de Saúde Pública (SESAU) de Campo Grande/MS, na Região Centro-Oeste do Brasil, se mostrou atenta a esta demanda. O Serviço de Doenças Crônicas Não Transmissíveis (DANT), juntamente com a Coordenadoria de Atenção Especializada, estruturou no Sistema Único de Saúde (SUS) um serviço de reabilitação funcional destinado às pessoas com doenças crônicas não transmissíveis, que estiveram internadas por infecção pelo SARS-CoV-2 e precisam de atenção especializada para restabelecer a capacidade de trabalho e de realização das atividades da vida diária. O atendimento é realizado na Unidade Especializada de Reabilitação e Diagnóstico (UERD), que faz parte da Rede Municipal de Saúde (REMUS). Um projeto de reabilitação funcional foi elaborado pela equipe técnica da SESAU, para ser desenvolvido por meio de uma equipe multiprofissional formada por fisioterapeuta, profissional de educação física, nutricionista e psicólogo. As intervenções são realizadas com o uso de Projetos Terapêuticos Singulares (PTS), seguindo critérios de inclusão e exclusão pré-estabelecidos7, para pacientes com doenças crônicas não transmissíveis, em condição de pós-internação decorrente de COVID-19. O encaminhamento dos pacientes, vindos dos demais pontos da REMUS, é realizado por médicos dos três níveis de atenção à saúde (primária, secundário e terciário), via Sistema de Regulação (SISREG). Foi estabelecido um fluxo para as intervenções, sendo que no primeiro atendimento cada paciente passa por um acolhimento dado pela equipe multiprofissional (fisioterapeuta, profissional de educação física, nutricionista e psicólogo) em uma consulta compartilhada. Nesta etapa a equipe faz uma triagem e identifica a condição clínica da pessoa atendida. Posteriormente, os profissionais constroem, de forma coletiva, um PTS. Nos dias subsequentes, o paciente é contatado para iniciar o tratamento de reabilitação, por meio de agendamento nos dias e horários em que haja compatibilidade entre as vagas ofertadas e a disponibilidade do paciente. O protocolo do PTS consiste de intervenções com frequência de duas vezes por semana, com alternância entre os profissionais que desenvolvem as atividades. Os pacientes são atendidos, inicialmente, com um total de 10 sessões de 40 a 60 minutos cada, durante cinco semanas. Se a equipe identificar que há indicação de continuidade do tratamento, o paciente pode ser mantido no programa por mais sessões, com avaliação caso a caso. O processo de alta do paciente ocorre quando são finalizadas as sessões do PTS. Esse processo é caracterizado pelas orientações ao paciente e sua família/cuidador, com encaminhamento profissional para a contrarreferência da unidade de saúde à qual o paciente está vinculado na atenção primária, por meio de relatório de alta, com informações referentes ao tratamento e orientações, visando a integralidade do cuidado. Com isso, a atenção primária dará prosseguimento do cuidado em saúde ao usuário em seu território de abrangência. O programa de reabilitação funcional prevê uma abordagem multiprofissional, com longitudinalidade do cuidado e respeito às singularidades de cada paciente. Os propósitos são aliviar os efeitos das disfunções musculares e respiratórias, mitigar os danos do imobilismo após longo período de internação hospitalar, além de atenuar as sequelas psicológicas e necessidades nutricionais. Para obter a almejada melhora da saúde geral e da qualidade de vida das pessoas atendidas, cada área profissional envolvida no PTS intervém da seguinte forma: A Fisioterapia atua em duas vertentes: a) fisioterapia respiratória, com o objetivo de aumentar a capacidade pulmonar e recuperar disfunções referentes ao processo de respiração; b) fisioterapia motora, com o objetivo de corrigir e restabelecer as condições físicas do paciente. A abordagem do profissional de Educação Física é voltada à melhora dos componentes cardiorrespiratório e neuromuscular, visando a promoção da autonomia funcional, o controle dos fatores de risco para comorbidades, correção postural e manutenção do peso ideal. O atendimento inclui o treinamento aeróbio, o treinamento resistido, ações de educação em saúde, além de incentivo à continuidade da prática de atividades físicas após o término das sessões do PTS, para manutenção e ampliação dos ganhos obtidos. A Nutrição atua com o propósito de manutenção do bom estado do sistema imunológico dos pacientes e, para isso, realiza avaliação nutricional e orientações ligadas à promoção de uma alimentação saudável. A Psicologia disponibiliza suporte psicológico, com oferecimento de um espaço para que o paciente compartilhe seus sentimentos e necessidades, buscando a auto segurança. Com isso, objetiva-se minimizar o trauma psicológico decorrentes do período de internação, que pode ter gerado reações emocionais como medo, angústia, ansiedade e tristeza. O conjunto de intervenções propostas representa uma readequação do serviço de saúde, em função da demanda oriunda da pandemia de COVID-19. Para isso, são necessárias estratégias capazes de proporcionar recuperação físico-funcional e reintegração social dos indivíduos infectados pelo vírus SARS-CoV-2, uma vez que essa infecção pode prejudicar a capacidade de realizar atividades da vida diária e a funcionalidade dos indivíduos que passaram por internação hospitalar, além de alterar o desempenho profissional e dificultar a interação social, com possibilidade de aumento de fatores de risco para doenças crônicas não transmissíveis.8 Nesse sentido, o PTS realizado por uma equipe multiprofissional, como no programa relatado, é um dispositivo de cuidado que visa a resolutividade dos casos complexos por meio da corresponsabilização e utilização dos recursos de todos os envolvidos, por meio do desenvolvimento de ações terapêuticas a partir de uma reflexão sistematizada. Para isso, o PTS deve ser abordado em duas perspectivas, uma delas centrada na clínica ampliada e outra na recuperação da autonomia da vida afetiva do sujeito, tal como preconizado no SUS.9 Em ambas as perspectivas sempre são considerados o sujeito, as equipes de saúde, o território e a família onde o PTS é desenvolvido.10 A utilização do PTS no âmbito da saúde pública melhora não só o processo de trabalho como o vínculo entre todos os envolvidos ­ profissionais de saúde e pacientes, potencializando assim a assistência integral à saúde na produção do cuidado, em função da troca de saberes no âmbito multiprofissional.11-13 Nota-se, portanto, que o processo de tratamento dos pacientes com COVID-19 é fundamental não apenas durante a fase hospitalar, mas também após alta melhorada. Dentre as estratégias disponíveis para atender os pacientes na rede pública de saúde, o desenvolvimento de programas de reabilitação funcional, por meio de PTS e intervenções multiprofissionais, pode garantir a continuidade do acompanhamento, promovendo a recuperação de implicações provocadas pela doença, proporcionando mais qualidade de vida às pessoas no período pós-internação.


Subject(s)
Humans , Male , Female , Patients , Rehabilitation , COVID-19
8.
PLoS One ; 16(5): e0251410, 2021.
Article in English | MEDLINE | ID: covidwho-1604261

ABSTRACT

The objective of this study was to explore the impact of the coronavirus disease 2019 epidemic on ongoing and upcoming drug clinical trials. Qualitative semi-structured interviews were conducted with clinical trial staff and clinical trial subjects were surveyed by questionnaire in this study. The results of interviews and questionnaire showed that coronavirus disease 2019 pandemic has led to many changes in the implementation of drug clinical trials, including: a variety of meetings being held online webinars using various platforms, telemedicine and follow-up by video, A large number of deviations from protocol and losses of follow-up, delivery of clinical trial drugs by express, additional workload caused by screening for coronavirus, and anxiety of subjects. These results suggest that the coronavirus disease 2019 outbreak has hindered the progress and damaged the quality of clinical trials. The online meeting, remote follow-up, express delivery of drugs and remote monitoring in the epidemic environment can ensure the progress of clinical trials to a certain extent, but they cannot fully guarantee the quality as before.


Subject(s)
COVID-19/pathology , Clinical Trials as Topic , Adult , Antiviral Agents/therapeutic use , Anxiety/etiology , COVID-19/drug therapy , COVID-19/epidemiology , COVID-19/virology , Humans , Interviews as Topic , Middle Aged , Pandemics , Patients/psychology , Research Personnel/psychology , SARS-CoV-2/isolation & purification , Surveys and Questionnaires , Telemedicine , Young Adult
9.
Rinsho Shinkeigaku ; 62(1): 8-14, 2022 Jan 28.
Article in Japanese | MEDLINE | ID: covidwho-1579997

ABSTRACT

We conducted the multicenter questionnaire survey targeting patients with Parkinson's disease (PD) in order to investigate the impacts on their daily lives and their requests to hospitals in the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mainly using open-ended questionnaire, we asked their anxiety, troubles they are facing, and requests toward hospitals in the pandemic of SARS-CoV-2. Two hundred fifth-eight PD patients answered the questionnaire. There were various opinions about anxiety such as "PD patients are susceptible and vulnerable to SARS-CoV-2" (36.8%). Concerning the troubles in the pandemic, the most frequent answer was that they couldn't participate in the rehabilitation and elderly day care (38.4%). Relatively many PD patients requested telemedicine (29.5%), whereas some people hoped face-to-face medical care (8.1%). There were demands about the delivery of medications (50.0%), the establishment of telephone consultations (43.8%), resources for rehabilitation at home (43.8%). The medical care adapted to the anxiety, trouble and requests of PD patients will be required in the era when we have to live with SARS-CoV-2.


Subject(s)
COVID-19 , Health Care Surveys , Health Surveys , Pandemics , Parkinson Disease/psychology , Parkinson Disease/therapy , Patients/psychology , Aged , Anxiety , COVID-19/epidemiology , Humans , Parkinson Disease/rehabilitation , Telemedicine
10.
rev. colomb. cienc. soc ; 12(2): 778-804, 2021.
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1573042

ABSTRACT

El objetivo de este trabajo fue realizar una aproximación conceptual y análisis de prácticas que permitan problematizar la inclusión de estrategias comunitarias en abordajes integrales de salud mental. Desde una perspectiva cualitativa, este escrito es producto de un proceso de articulación conceptual y sistematización derivado de un análisis reflexivo sobre prácticas de salud mental desarrolladas en el primer nivel de atención en la ciudad y provincia de Buenos Aires desde el año 2010. Se reconoce la fragilización de redes comunitarias como una problemática colectiva en salud mental, y se propone a la promoción en salud mental como estrategia central que permite, desde una perceptiva no normativa e integral, el desarrollo de acciones participativas y el fortalecimiento de lazos comunitarios solidarios como recursos colectivos para el cuidado de la salud mental. Se abordan ejes problemáticos relevados en la implementación de dichas prácticas y su relación con una vigente tensión entre los modelos biomédico e integral de atención. Se articulan reflexiones relacionadas a la pandemia por COVID-19, evidenciando una necesidad actual de profundizar el desarrollo de estrategias comunitarias en salud mental.


The objective of this work was to carry out a conceptual approach and analysis of practices that allow problematizing the inclusion of community strategies in comprehensive mental health approaches. From a qualitative perspective, this paper is the result of a process of conceptual articulation and systematization derived from a reflexive analysis of mental health practices developed in the first level of care in the City and Province of Buenos Aires since 2010. The fragilization of community networks is recognized as a collective mental health problem, and mental health promotion is proposed as a central strategy that allows, from a non-normative and comprehensive perspective, the development of participatory actions and the strengthening of supportive community bonds, as collective resources for mental health care. It addresses problematic axes revealed in the implementation of such practices and their relationship with a current tension between the biomedical and integral models of care. Reflections related to the COVID-19 pandemic are articulated, evidencing a current need to deepen the development of community strategies in mental health.


Subject(s)
Humans , Patients/psychology , Psychology, Social , Community Participation/methods , Patient Care
11.
West J Emerg Med ; 22(4): 1000-1009, 2021 Jul 15.
Article in English | MEDLINE | ID: covidwho-1572898

ABSTRACT

INTRODUCTION: Voters facing illness or disability are disproportionately under-represented in terms of voter turnout. Earlier research has indicated that enfranchisement of these populations may reinforce the implementation of policies improving health outcomes and equity. Due to the confluence of the coronavirus 2019 (COVID-19) pandemic and the 2020 election, we aimed to assess emergency absentee voting processes, which allow voters hospitalized after regular absentee deadlines to still obtain an absentee ballot, and election changes due to COVID-19 in all 50 states. METHODS: We performed a cross-sectional study collecting 34 variables pertaining to emergency voting processes and COVID-19-related election changes, including deadlines, methods of submission for applications and ballots, and specialized services for patients. Data were obtained from, in order of priority, state boards of elections websites, poll worker manuals, application forms, and state legislation. We verified all data through direct correspondence with state boards of elections. RESULTS: Emergency absentee voting processes are in place in 39 states, with the remaining states having universal vote-by-mail (n = 5) or extended regular absentee voting deadlines (n = 6). The emergency absentee period most commonly began within 24 hours following the normal absentee application deadline, which was often seven days before an election (n = 11). Unique aspects of emergency voting processes included patients designating an "authorized agent" to deliver their applications and ballots (n = 38), electronic ballot delivery (n = 5), and in-person teams that deliver ballots directly to patients (n = 18). Documented barriers in these processes nationwide include unavailable online information (n = 11), restrictions mandating agents to be family members (n = 7), physician affidavits or signatures (n = 9), and notary or witness signature requirements (n = 15). For the November 2020 presidential election, 12 states expanded absentee eligibility to allow COVID-19 as a reason to request an absentee ballot, and 18 states mailed absentee ballot applications or absentee ballots to all registered voters. CONCLUSION: While 39 states operate emergency absentee voting processes for hospitalized voters, there are considerable areas for improvement and heterogeneity in guidelines for these protocols. For future election cycles, information on emergency voting and broader election reforms due to COVID-19 may be useful for emergency providers and patients alike to improve the democratic participation of voters experiencing illness.


Subject(s)
COVID-19 , Cross-Sectional Studies , Humans , Patients , Politics
12.
Sci Rep ; 11(1): 23713, 2021 12 09.
Article in English | MEDLINE | ID: covidwho-1565736

ABSTRACT

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many vaccine trials have been initiated. An important goal of vaccination is the development of neutralizing antibody (Ab) against SARS-CoV-2. However, the possible induction of antibody-dependent enhancement (ADE) of infection, which is known for other coronaviruses and dengue virus infections, is a particular concern in vaccine development. Here, we demonstrated that human iPS cell-derived, immortalized, and ACE2- and TMPRSS2-expressing myeloid cell lines are useful as host cells for SARS-CoV-2 infection. The established cell lines were cloned and screened based on their function in terms of susceptibility to SARS-CoV-2-infection or IL-6 productivity. Using the resulting K-ML2 (AT) clone 35 for SARS-CoV-2-infection or its subclone 35-40 for IL-6 productivity, it was possible to evaluate the potential of sera from severe COVID-19 patients to cause ADE and to stimulate IL-6 production upon infection with SARS-CoV-2.


Subject(s)
Antibody-Dependent Enhancement , COVID-19/immunology , COVID-19/metabolism , Interleukin-6/metabolism , SARS-CoV-2/immunology , Angiotensin-Converting Enzyme 2/metabolism , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Cell Line , Humans , Myeloid Cells/immunology , Myeloid Cells/metabolism , Patients , Serine Endopeptidases/metabolism
13.
Sci Rep ; 11(1): 23711, 2021 12 09.
Article in English | MEDLINE | ID: covidwho-1565733

ABSTRACT

Since the beginning of the COVID-19 pandemic, evidence shows the negative psychological impact of lockdown measures in the general population. It is also important to identify predictors of psychological distress in vulnerable people, particularly patients with history of depressive episodes (the most prevalent psychiatric disorder), in order to adapt mental health strategies for future lockdown measures. This study aim was to (1) compare in 69 healthy controls (HC) and 346 patients with a major depressive episode in the two previous years (PP) self-reported psychological symptoms (depression, anxiety, insomnia, suicidal ideation, traumatic stress, anger) and living conditions during the first national French lockdown, and (2) identify predictors of significant psychological distress in PP. The levels of psychological symptoms were very low in HC compared with PP, independently of the living conditions. Half of PP had no psychiatric contact during the lockdown. Loneliness and boredom were independent predictors of depression, anxiety and insomnia, whereas daily physical activity was a protective factor. Virtual contacts protected against suicidal ideation. Our results highlight the need of specific strategies to target loneliness and boredom and to improve care access, including telepsychiatry. Longitudinal studies must investigate the COVID-19 pandemic psychological impact in clinical samples.


Subject(s)
COVID-19 , Depressive Disorder, Major/psychology , Mood Disorders/psychology , Patients/psychology , Quarantine/psychology , Adaptation, Psychological , Adolescent , Adult , Aged , Anger , Anxiety/psychology , Boredom , Female , France , Health Services Accessibility , Humans , Loneliness/psychology , Male , Mental Health/statistics & numerical data , Middle Aged , Patients/statistics & numerical data , Psychological Distress , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/psychology , Social Conditions/statistics & numerical data , Social Determinants of Health , Stress Disorders, Traumatic/psychology , Suicidal Ideation , Telemedicine , Young Adult
15.
Ophthalmology ; 129(3): 258-266, 2022 03.
Article in English | MEDLINE | ID: covidwho-1540882

ABSTRACT

PURPOSE: Emerging evidence suggests that the coronavirus disease 2019 (COVID-19) pandemic is disrupting health behaviors such as medication adherence. The objective of this study was to determine whether adherence to ocular hypotensive medication was affected by the pandemic and to identify factors associated with this change. DESIGN: In this cohort study, we used a controlled interrupted time series design in which the interruption was the declaration of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day monitoring period, which evenly bracketed this declaration, started on October 16, 2019, and ended on August 10, 2020. PARTICIPANTS: Patients with primary open-angle glaucoma enrolled in an ongoing longitudinal National Institutes of Health-funded study initiated before the onset of the pandemic were selected if they were prescribed ocular hypotensive medication and had adherence data spanning the 300-day period. METHODS: We applied segmented regression analysis using a "slope change following a lag" impact model to obtain the adherence slopes in the periods before and after the segmentation. We compared the 2 slopes using the Davies test. MAIN OUTCOME MEASURES: The main outcome measure was daily adherence to ocular hypotensive medication, defined as the number of doses taken divided by the number of doses prescribed, expressed in percent. Adherence was measured objectively using Medication Event Monitoring System caps. We assessed the associations between change in adherence and demographic, clinical, and psychosocial factors. RESULTS: The sample included 79 patients (mean age, 71 years [standard deviation, 8 years]). Segmented regression identified a breakpoint at day 28 after the declaration of the pandemic. The slope in the period after the breakpoint (-0.04%/day) was significantly different from zero (P < 0.001) and from the slope in the period before the breakpoint (0.006%/day; P < 0.001). Mean adherence in the period before the segmentation breakpoint was significantly worse in Black patients (median, IQR: 80.6%, 36.2%) compared with White patients (median, IQR: 97.2%, 8.7%; chi-square, 15.4; P = 0.0004). A significant positive association was observed between the Connor-Davidson resilience score and the change in slope between the periods before and after the breakpoint (P = 0.002). CONCLUSIONS: Adherence to ocular hypotensive medication worsened during the COVID-19 pandemic and seems to be related to patient resilience. This collateral consequence of the pandemic may translate into vision loss that may manifest beyond its containment.


Subject(s)
Antihypertensive Agents/therapeutic use , COVID-19/epidemiology , Glaucoma, Open-Angle/drug therapy , Medication Adherence/statistics & numerical data , SARS-CoV-2 , Aged , Cohort Studies , Drug Prescriptions/statistics & numerical data , Female , Humans , Intraocular Pressure , Male , Middle Aged , Ophthalmic Solutions , Patients/psychology , Psychology , Resilience, Psychological , United States/epidemiology
16.
Am J Trop Med Hyg ; 106(1): 15-16, 2021 11 22.
Article in English | MEDLINE | ID: covidwho-1528970

ABSTRACT

A 3-year analysis released in August 2021 by the WHO indicated that more than 700 healthcare workers and patients have died (2,000 injured) as a result of attacks against health facilities since 2017. The COVID-19 pandemic has made the risks even worse for doctors, nurses, and support staff, unfortunately. According to the latest figures from the International Committee of the Red Cross, 848 COVID-19-related violent incidents were recorded in 2020, and this is likely an underrepresentation of a much more widespread phenomenon. In response to rises in COVID-19-related attacks against healthcare, some countries have taken action. In Algeria, for instance, the penal code was amended to increase protection for healthcare workers against attacks and to punish individuals who damage health facilities. In the United Kingdom, the police, crime, sentencing, and courts bill proposed increased the maximum penalty from 12 months to 2 years in prison for anyone who assaults an emergency worker. Measures taken by countries represent a good practical way to counteract this crisis within COVID-19. However, we stress the importance of primary prevention with the use of communication: social media and other communication channels are fundamentally important to combat violence against health professionals, both to inform the population with quality data and to disseminate campaigns to prevent these acts.


Subject(s)
Delivery of Health Care/trends , Violence , Health Personnel , Humans , Patients , Risk Factors , Violence/prevention & control , Violence/statistics & numerical data
17.
Ann Surg ; 274(6): e829-e830, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1522435
18.
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