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1.
Hu Li Za Zhi ; 68(1): 43-53, 2021 Feb.
Artículo en Chino | MEDLINE | ID: covidwho-1100322

RESUMEN

BACKGROUND: Because of the COVID-19 epidemic, people are mostly isolated at home and must seek medical advice over the internet. In addition, government authorities are currently investing greater efforts in developing internet hospitals. PURPOSE: The purpose of this essay was to assess how outpatients feel about online outpatient clinics and to analyze the factors that affect their satisfaction and willingness to return to these clinics. The results provide advice regarding how to more effectively encourage patients to use online outpatient clinics. METHODS: A self-developed questionnaire was used to survey 191 patients who had visited the online outpatient clinic of a tertiary hospital in Sichuan Province from January to July 2019. A descriptive analysis was conducted on the collected data, and factors influencing satisfaction were identified. RESULTS: The majority of the surveyed patients were young or middle-aged (92.7%) and 42.9% held a college degree or higher. Nearly three-quarters (72.2%) expressed feeling satisfied or better with the online outpatient clinic, with 31.4% of these expressing feeling very satisfied. Nearly all (91.1%) expressed the opinion that the online outpatient clinic had improved their awareness of health self-management . Furthermore, 176 (92.1%) were willing to use the online outpatient clinic again. The results of univariate analysis showed that the main factors negatively influencing re-use of the online outpatient clinic were: failure to solve the problem in a timely manner (χ2 = 8.603, p = .045), the complicated process of online registration (χ2 = 8.322, p = .016), the failure of the online physical examination (χ2 = 8.958, p = .015), and unreliable quality (χ2 = 15.373, p = .004). CONCLUSIONS: The participants surveyed in this study reported a lower satisfaction for their online outpatient clinic experience than reported in similar surveys of traditional outpatient services. However, many reported that their health-related self-management awareness had improved after use, indicating that they feel better about the online outpatient clinic. The factors that affected willingness to reuse to the online outpatient clinic related mainly to imperfections related to the clinic and its inability to adequately meet patient needs. Online outpatient clinics should simplify the process of registration, improve functions, and increase service functions such as online examination appointments and follow-up visits to improve patient satisfaction.


Asunto(s)
Anciano , Instituciones de Atención Ambulatoria , Humanos , Persona de Mediana Edad , Satisfacción del Paciente , Retratamiento , Encuestas y Cuestionarios
2.
Epidemiol Health ; 43: e2021007, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1094290

RESUMEN

OBJECTIVES: This study explored socioeconomic disparities in Korea using health insurance type as a proxy during the ongoing coronavirus disease 2019 (COVID-19) pandemic. METHODS: We conducted a retrospective cohort study using Korea's nationwide healthcare database, which contained all individuals who received a diagnostic test for COVID-19 (n=232,390) as of May 15, 2020. We classified our cohort by health insurance type into beneficiaries of the National Health Insurance (NHI) or Medicaid programs. Our study outcomes were infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19-related outcomes, a composite of all-cause death, intensive care unit admission, and mechanical ventilation use. We estimated age-, sex-, and Charlson comorbidity index score-adjusted odds ratios (aORs) with 95% confidence intervals (CIs) using a multivariable logistic regression analysis. RESULTS: Of the 218,070 NHI and 14,320 Medicaid beneficiaries who received COVID-19 tests, 7,777 and 738 tested positive, respectively. The Medicaid beneficiaries were older (mean age, 57.5 vs. 47.8 years), more likely to be males (47.2 vs. 40.2%), and had a higher comorbidity burden (mean CCI, 2.0 vs. 1.7) than NHI beneficiaries. Compared to NHI beneficiaries, Medicaid beneficiaries had a 22% increased risk of SARS-CoV-2 infection (aOR, 1.22; 95% CI, 1.09 to 1.38), but had no significantly elevated risk of COVID-19-related outcomes (aOR 1.10, 95% CI 0.77 to 1.57); the individual events of the composite outcome yielded similar findings. CONCLUSIONS: As socioeconomic factors, with health insurance as a proxy, could serve as determinants during the current pandemic, pre-emptive support is needed for high-risk groups to slow its spread.


Asunto(s)
/estadística & datos numéricos , Disparidades en Atención de Salud/economía , Seguro de Salud/estadística & datos numéricos , Pandemias , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos Factuales , Femenino , Humanos , Revisión de Utilización de Seguros , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Estudios Retrospectivos , Factores Socioeconómicos , Adulto Joven
3.
BMC Surg ; 21(1): 97, 2021 Feb 22.
Artículo en Inglés | MEDLINE | ID: covidwho-1094031

RESUMEN

BACKGROUND: In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. CASE PRESENTATION: We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. CONCLUSIONS: Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.


Asunto(s)
Enfermedades Intestinales , Anciano , /terapia , Humanos , Enfermedades Intestinales/patología , Enfermedades Intestinales/virología , Masculino , Necrosis , Índice de Severidad de la Enfermedad
5.
BMC Psychiatry ; 21(1): 112, 2021 02 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1090679

RESUMEN

BACKGROUND: The COVID-19 pandemic and subsequent suppression measures have had health and social implications for billions of individuals. The aim of this paper is to investigate the risk of psychological distress associated with the COVID-19 pandemic and suppression measures during the early days of the lockdown. We compared the level of psychological distress at the beginning of that period with a pre-pandemic health survey and assessed the psychological effects of exposure to the COVID-19 pandemic and changes in social activity and support. METHODS: An online survey was distributed to the general population in Belgium 3 days after the beginning of the lockdown. 20,792 respondents participated. The psychological distress of the population was measured using the GHQ-12 scale. Social activities and support were assessed using the Social Participation Measure, the Short Loneliness Scale, and the Oslo Social Support Scale. An index of subjective exposure to the COVID-19 pandemic was constructed, as well as a measure of change in occupational status. Measurements were compared to a representative sample of individuals extracted from the Belgian Health Interview Survey of 2018. Bootstrapping was performed and analyses were reweighted to match the Belgian population in order to control for survey selection bias. RESULTS: Half of the respondents reported psychological distress in the early days of the lockdown. A longer period of confinement was associated with higher risk of distress. Women and younger age groups were more at risk than men and older age groups, as were respondents who had been exposed to COVID-19. Changes in occupational status and a decrease in social activity and support also increased the risk of psychological distress. Comparing the results with those of the 2018 Belgian Health Interview shows that the early period of the lockdown corresponded to a 2.3-fold increase in psychological distress (95% CI: 2.16-2.45). CONCLUSIONS: Psychological distress is associated with the consequences of the COVID-19 pandemic and suppression measures. The association is measurable from the very earliest days of confinement and it affected specific at-risk groups. Authorities should consider ways of limiting the effect of confinement on the mental and social health of the population and developing strategies to mitigate the adverse consequences of suppression measures.


Asunto(s)
Pandemias , Anciano , Bélgica/epidemiología , Control de Enfermedades Transmisibles , Femenino , Humanos , Masculino , Distrés Psicológico
6.
Crit Care ; 25(1): 72, 2021 02 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1090630

RESUMEN

BACKGROUND: The COVID-19 pandemic is responsible for many hospitalizations in intensive care units (ICU), with widespread use of invasive mechanical ventilation (IMV) which exposes patients to the risk of ventilator-associated pneumonia (VAP). The characteristics of VAP in COVID-19 patients remain unclear. METHODS: We retrospectively collected data on all patients hospitalized for COVID-19 during the first phase of the epidemic in one of the seven ICUs of the Pays-de-Loire region (North-West France) and who were on invasive mechanical ventilation for more than 48 h. We studied the characteristics of VAP in these patients. VAP was diagnosed based on official recommendations, and we included only cases of VAP that were confirmed by a quantitative microbiological culture. FINDINGS: We analyzed data from 188 patients. Of these patients, 48.9% had VAP and 19.7% experienced multiple episodes. Our study showed an incidence of 39.0 VAP per 1000 days of IMV (until the first VAP episode) and an incidence of 33.7 VAP per 1000 days of IMV (including all 141 episodes of VAP). Multi-microbial VAP accounted for 39.0% of all VAP, and 205 pathogens were identified. Enterobacteria accounted for 49.8% of all the isolated pathogens. Bacteremia was associated in 15 (10.6%) cases of VAP. Pneumonia was complicated by thoracic empyema in five cases (3.5%) and by pulmonary abscess in two cases (1.4%). Males were associated with a higher risk of VAP (sHR 2.24 CI95% [1.18; 4.26] p = 0.013). INTERPRETATION: Our study showed an unusually high incidence of VAP in patients admitted to the ICU for severe COVID-19, even though our services were not inundated during the first wave of the epidemic. We also noted a significant proportion of enterobacteria. VAP-associated complications (abscess, empyema) were not exceptional. REGISTRATION: As an observational study, this study has not been registered.


Asunto(s)
/terapia , Neumonía Asociada al Ventilador/epidemiología , Neumonía Asociada al Ventilador/microbiología , Respiración Artificial/efectos adversos , Anciano , Femenino , Francia/epidemiología , Hospitalización , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
7.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200576, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-1090510

RESUMEN

OBJECTIVE: Reflect, in the light of the Health Belief Model, on the adoption of behavioral measures in the context of COVID-19. METHODS: Theoretical-reflective essay, based on the Health Belief Model, to reflect on adherence to preventive behaviors in the pandemic of COVID-19. RESULTS: Adherence to preventive behaviors is strongly influenced by socioeconomic, territorial, political and individual factors in the face of critical health situations. In addition, the spread of false news modulates the thinking and execution of behavioral actions in the population. FINAL CONSIDERATIONS: It is necessary to understand the importance of health communication processes and the use of tools aimed at responsible human behavior and engaged in the adoption of a preventive posture.


Asunto(s)
Actitud Frente a la Salud , /psicología , Adhesión a Directriz/estadística & datos numéricos , Conductas Relacionadas con la Salud , Pandemias/prevención & control , Participación del Paciente/psicología , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
8.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200602, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-1090509

RESUMEN

OBJECTIVE: To report the experience of a Virtual Culture Circle with Brazilian families about coping with COVID-19, as a space that promotes health during the pandemic. METHOD: Experience resulting from an extension action, the Virtual Culture Circle was held based on Paulo Freire's Research Itinerary. It counted with the participation of seven families from different locations in Brazil. During the dialogues, a house was built: the foundation represented the thematic research; walls and roof, coding and decoding; doors and windows, the critical unveiling. RESULTS: The action-reflection-action process favored the approach and integration of the participants of the Culture Circle; despite the geographical distance, it is an innovative strategy for empowerment and health promotion. FINAL CONSIDERATIONS: The Virtual Culture Circle constituted a soft technology for health care and can be explored as a tool for promoting health, especially in scenarios where face-to-face meetings are an impossibility.


Asunto(s)
Adaptación Psicológica , Promoción de la Salud/métodos , Educación del Paciente como Asunto/métodos , Realidad Virtual , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa
9.
JSLS ; 24(4)2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1090243

RESUMEN

Objective: To evaluate the use of social media platforms by medical students, surgical trainees, and practicing surgeons for surgical education during the Covid-19 pandemic. Methods: An online, 15-question survey was developed and posted on Facebook and WhatsApp closed surgeon groups. Results: The online survey was completed by 219 participants from South America (87%), North America (7%), Europe (5%), Central America, and Asia. Respondents included medical students (6.4%), surgical residents/fellows (24.2%), and practicing surgeons (69.4%). The most common age group was 35-44 years. When asked which social media platforms they preferred, the video sharing site YouTube (33.3%), the messaging app WhatsApp (21%), and "other" (including videoconferencing sites) (22.3%) were most popular. Respondents reported using social media for surgical education either daily (38.4%) or weekly (45.2%), for an average of 1-5 hours/week. Most (85%) opined that surgical conferences that were cancelled during the pandemic should be made available online, with live discussions. Conclusion: Social media use for surgical education during Covid-19 appears to be increasing and evolving.


Asunto(s)
Educación a Distancia/métodos , Educación Médica/métodos , Cirugía General/educación , Medios de Comunicación Sociales/tendencias , Adolescente , Adulto , Anciano , Américas/epidemiología , Asia/epidemiología , /prevención & control , Estudios Transversales , Educación a Distancia/estadística & datos numéricos , Educación Médica/tendencias , Europa (Continente)/epidemiología , Femenino , Cirugía General/tendencias , Salud Global , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Encuestas y Cuestionarios , Adulto Joven
10.
Wiad Lek ; 73(12 cz 2): 2743-2751, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1089582

RESUMEN

OBJECTIVE: The aim: This article aims to analyze the rates of suicide as an indicator of public mental health, to consider the suicidal map of the territory of Ukraine (including to check the manifestation of such a territorial characteristic as the Albanian paradox); calculate the price of suicide for the socio-economic development of the Ukrainian state, consider the risks of suicide that have arisen as social and criminological consequences of the COVID-19 pandemic. PATIENTS AND METHODS: Materials and methods: The study is based on the analytical materials of the Ministry of Health of Ukraine and the WHO; the information and analytical data of the GeneralProsecutor's Office of Ukraine, the State Statistics Service of Ukraine and sectoral statistics for the period of 2015-2019, etc. The article is based on dialectical, analytical, synthetic, comparative, statistical, cartographic, and sociological methods of research and the method of potential demography. The theoretical basis of the article is specialized literature on medicine, suicidology, law, sociology, and cartography. RESULTS: Results: In Ukraine, the death rate from suicide in recent years averages 1.1% of the total number of deaths. The rate of suicide decline in Ukraine has slowed significantly over the past five years, which is an alarming symptom. There are almost strict proportions between male and female suicide (men commit four out of five suicides). The level of self-harm per 100,000 population of Ukraine remains almost stable, indicating a severe demographic crisis in Ukraine. Women in Ukraine are less likely to commit suicide than in European countries. In Ukraine in recent years, contrary to European trends, suicide has dominated among the elderly aged 65+. The number of years of potential life loss for male and female suicides in Ukraine is 103 thousand, and the number of working years is almost 100 thousand. The losses for Ukraine from the unlived life of those who died as a result of suicide in 2019 are almost USD 341 billion. CONCLUSION: Conclusions: In 2019, suicides accounted for almost 21% of deaths from external causes among Ukraine's population. The most intense suicidal situation is observed in the central part of the country's geographical map along the imaginary vertical axis "North-South" (Kherson, Chernihiv, Cherkasy, Vinnytsia, Zaporizhia, Kirovohrad, Sumy, Poltava, Dnipropetrovsk, Mykolaiv regions). During the COVID-19 pandemic, many additional factors increase the risk of suicide among individuals who are at heightened risk of suicide or are actively suicidal, and among the general population.


Asunto(s)
Suicidio , Anciano , Europa (Continente) , Femenino , Humanos , Masculino , Salud Mental , Pandemias , Ucrania/epidemiología
11.
MMWR Morb Mortal Wkly Rep ; 70(7): 245-249, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1089243

RESUMEN

On March 13, 2020, the United States declared a national emergency concerning the novel coronavirus disease 2019 (COVID-19) outbreak (1). In response, many state and local governments issued shelter-in-place or stay-at-home orders, restricting nonessential activities outside residents' homes (2). CDC initially issued guidance recommending postponing routine adult vaccinations, which was later revised to recommend continuing to administer routine adult vaccines (3). In addition, factors such as disrupted operations of health care facilities and safety concerns regarding exposure to SARS-CoV-2, the virus that causes COVID-19, resulted in delay or avoidance of routine medical care (4), likely further affecting delivery of routine adult vaccinations. Medicare enrollment and claims data of Parts A (hospital insurance), B (medical insurance), and D (prescription drug insurance) were examined to assess the change in receipt of routine adult vaccines during the pandemic. Weekly receipt of four vaccines (13-valent pneumococcal conjugate vaccine [PCV13], 23-valent pneumococcal polysaccharide vaccine [PPSV23], tetanus-diphtheria or tetanus-diphtheria-acellular pertussis vaccine [Td/Tdap], and recombinant zoster vaccine [RZV]) by Medicare beneficiaries aged ≥65 years during January 5-July 18, 2020, was compared with that during January 6-July 20, 2019, for the total study sample and by race and ethnicity. Overall, weekly administration rates of the four examined vaccines declined by up to 89% after the national emergency declaration in mid-March (1) compared with those during the corresponding period in 2019. During the first week following the national emergency declaration, the weekly vaccination rates were 25%-62% lower than those during the corresponding week in 2019. After reaching their nadirs of 70%-89% below 2019 rates in the second to third week of April 2020, weekly vaccination rates gradually began to recover through mid-July, but by the last study week were still lower than were those during the corresponding period in 2019, with the exception of PPSV23. Vaccination declined sharply for all vaccines studied, overall and across all racial and ethnic groups. While the pandemic continues, vaccination providers should emphasize to patients the importance of continuing to receive routine vaccinations and provide reassurance by explaining the procedures in place to ensure patient safety (3).


Asunto(s)
/epidemiología , Medicare/estadística & datos numéricos , Pandemias , Vacunación/estadística & datos numéricos , Vacunas/administración & dosificación , Anciano , Humanos , Estados Unidos/epidemiología
12.
Crit Care ; 25(1): 70, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088611

RESUMEN

BACKGROUND: The early months of the COVID-19 pandemic were fraught with much uncertainty and some resource constraint. We assessed the change in survival to hospital discharge over time for intensive care unit patients with COVID-19 during the first 3 months of the pandemic and the presence of any surge effects on patient outcomes. METHODS: Retrospective cohort study using electronic medical record data for all patients with laboratory-confirmed COVID-19 admitted to intensive care units from February 25, 2020, to May 15, 2020, at one of 26 hospitals within an integrated delivery system in the Western USA. Patient demographics, comorbidities, and severity of illness were measured along with medical therapies and hospital outcomes over time. Multivariable logistic regression models were constructed to assess temporal changes in survival to hospital discharge during the study period. RESULTS: Of 620 patients with COVID-19 admitted to the ICU [mean age 63.5 years (SD 15.7) and 69% male], 403 (65%) survived to hospital discharge and 217 (35%) died in the hospital. Survival to hospital discharge increased over time, from 60.0% in the first 2 weeks of the study period to 67.6% in the last 2 weeks. In a multivariable logistic regression analysis, the risk-adjusted odds of survival to hospital discharge increased over time (biweekly change, adjusted odds ratio [aOR] 1.22, 95% CI 1.04-1.40, P = 0.02). Additionally, an a priori-defined explanatory model showed that after adjusting for both hospital occupancy and percent hospital capacity by COVID-19-positive individuals and persons under investigation (PUI), the temporal trend in risk-adjusted patient survival to hospital discharge remained the same (biweekly change, aOR 1.18, 95% CI 1.00-1.38, P = 0.04). The presence of greater rates of COVID-19 positive/PUI as a percentage of hospital capacity was, however, significantly and inversely associated with survival to hospital discharge (aOR 0.95, 95% CI 0.92-0.98, P < 0.01). CONCLUSIONS: During the early COVID-19 pandemic, risk-adjusted survival to hospital discharge increased over time for critical care patients. An association was also seen between a greater COVID-19-positive/PUI percentage of hospital capacity and a lower survival rate to hospital discharge.


Asunto(s)
/epidemiología , Pandemias , Alta del Paciente/estadística & datos numéricos , Anciano , Cuidados Críticos , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia , Estados Unidos/epidemiología
15.
J Transl Med ; 19(1): 79, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088601

RESUMEN

BACKGROUND: The Sars-CoV-2 can cause severe pneumonia with multiorgan disease; thus, the identification of clinical and laboratory predictors of the progression towards severe and fatal forms of this illness is needed. Here, we retrospectively evaluated and integrated laboratory parameters of 45 elderly subjects from a long-term care facility with Sars-CoV-2 outbreak and spread, to identify potential common patterns of systemic response able to better stratify patients' clinical course and outcome. METHODS: Baseline white blood cells, granulocytes', lymphocytes', and platelets' counts, hemoglobin, total iron, ferritin, D-dimer, and interleukin-6 concentration were used to generate a principal component analysis. Statistical analysis was performed by using R statistical package version 4.0. RESULTS: We identified 3 laboratory patterns of response, renamed as low-risk, intermediate-risk, and high-risk, strongly associated with patients' survival (p < 0.01). D-dimer, iron status, lymphocyte/monocyte count represented the main markers discriminating high- and low-risk groups. Patients belonging to the high-risk group presented a significantly longer time to ferritin decrease (p: 0.047). Iron-to-ferritin-ratio (IFR) significantly segregated recovered and dead patients in the intermediate-risk group (p: 0.012). CONCLUSIONS: Our data suggest that a combination of few laboratory parameters, i.e. iron status, D-dimer and lymphocyte/monocyte count at admission and during the hospital stay, can predict clinical progression in COVID-19.


Asunto(s)
/diagnóstico , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Hierro/sangre , Linfocitos/patología , Monocitos/patología , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , /mortalidad , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Humanos , Recuento de Leucocitos , Cuidados a Largo Plazo , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento
16.
BMC Health Serv Res ; 21(1): 153, 2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088592

RESUMEN

BACKGROUND: The COVID-19 pandemic halted non-emergency surgery across Scotland. Measures to mitigate the risks of transmitting COVID-19 are creating significant challenges to restarting all surgical services safely. We describe the development of a risk stratification tool to prioritise patients for cataract surgery taking account both specific risk factors for poor outcome from COVID-19 infection as well as surgical 'need'. In addition we report the demographics and comorbidities of patients on our waiting list. METHODS: A prospective case review of electronic records was performed. A risk stratification tool was developed based on review of available literature on systemic risk factors for poor outcome from COVID-19 infection as well as a surgical 'need' score. Scores derived from the tool were used to generate 6 risk profile groups to allow prioritised allocation of surgery. RESULTS: There were 744 patients awaiting cataract surgery of which 66 (8.9 %) patients were 'shielding'. One hundred and thirty-two (19.5 %) patients had no systemic comorbidities, 218 (32.1 %) patients had 1 relevant systemic comorbidity and 316 (46.5 %) patients had 2 or more comorbidities. Five hundred and ninety patients (88.7 %) did not have significant ocular comorbidities. Using the risk stratification tool, 171 (23 %) patients were allocated in the highest 3 priority stages. Given an aging cohort with associated increase in number of systemic comorbidities, the majority of patients were in the lower priority stages 4 to 6. CONCLUSIONS: COVID-19 has created an urgent challenge to deal safely with cataract surgery waiting lists. This has driven the need for a prompt and pragmatic change to the way we assess risks and benefits of a previously regarded as low-risk intervention. This is further complicated by the majority of patients awaiting cataract surgery being elderly with comorbidities and at higher risk of mortality related to COVID-19. We present a pragmatic method of risk stratifying patients on waiting lists, blending an evidence-based objective assessment of risk and patient need combined with an element of shared decision-making. This has facilitated safe and successful restarting of our cataract service.


Asunto(s)
/epidemiología , Extracción de Catarata , Catarata/epidemiología , Pandemias , Listas de Espera , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Humanos , Masculino , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Escocia/epidemiología
17.
BMC Psychiatry ; 21(1): 99, 2021 02 16.
Artículo en Inglés | MEDLINE | ID: covidwho-1088585

RESUMEN

BACKGROUND: The COVID-19 pandemic have caused mental and psychological problems on the general population, patients, and related workers. Our study is to determine the impact of mental and psychological symptoms among population in quarantine for 2 weeks during COVID-19 pandemic. METHODS: A case-controlled study design have conducted at department of psychiatry of Shenzhen Longgang Center for Chronic Disease Control in Shenzhen, China mainland from 7th April to 15th June 2020.1674 participants (aged 18 to 65 years) in quarantine for 2 weeks and 1743 age-sex matched controls living in Shenzhen were recruited between 7th April 2020 and 15th June 2020. The assessment of depressive, anxiety, and insomnia symptoms were determined by self-reported questionnaires PHQ-9, GAD-7, and ISI, respectively. RESULTS: A total of 1674 participants in quarantine for 2 weeks and 1743 age-sex matched controls (32.6 ± 9.3 years vs. 32.7 ± 10.7 years, 49.8% vs. 47.8% females) were recruited. Population in quarantine had higher score on PHQ-9 (6.1 ± 5.5 vs. 3.0 ± 3.7, p < 0.001), GAD-7 (4.2 ± 4.7 vs. 1.9 ± 3.7, p < 0·001), and ISI (5.5 ± 5.8 vs. 3.1 ± 5.0%, p < 0.001) compared to general population. Population in quarantine showed significantly higher risks of depression (OR: 4.55, 95% CI: 3.82-5.41), anxiety (OR: 2.92, 95% CI: 2.43-3.51), and insomnia (OR: 2.40, 95% CI: 2.02-2.89), when compared to the general population. Younger, more education, non-married and lower household income showed higher risks of mental health problems. CONCLUSIONS: Population in quarantine had a higher level of depressive, anxiety, and insomnia symptoms than controls. Specifically, they were at a higher risk prevalence of depression, anxiety, and insomnia, especially the severity of depression, when compared to controls. Younger, more education, non-married, and lower income population in quarantine were at higher risks of mental health problems. Mental health professionals should pay attention to the mental and psychological symptoms for population in quarantine.


Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño , Adolescente , Adulto , Anciano , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Cuarentena , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Adulto Joven
18.
BMC Geriatr ; 21(1): 128, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088582

RESUMEN

BACKGROUND: Middle-aged and older adults are more vulnerable to hospitalization and mortality if they are infected with the COVID-19 virus. The present study investigates the longitudinal effects of subjective successful aging on middle-aged and older adults' emotional and coping responses to the COVID-19 pandemic, and explores an underlying mechanism through perceived time limitation during the pandemic. METHODS: A sample of 311 Hong Kong Chinese middle-aged and older adults (Mage = 64.58, SD = 10.14, Range = 45-90 years) were recruited from an Adult Development and Aging Project and participated in a questionnaire study via an online platform or phone interview. Their levels of subjective successful aging, perceived time limitation, and emotional and coping responses to the pandemic were measured. RESULTS: The respondents who perceived themselves as more successful in aging process reported more positive and fewer negative emotions compared with their counterparts with lower levels of subjective successful aging. The mediation analysis showed that perceived time limitation could partially account for the effects of subjective successful aging on emotional and coping responses. CONCLUSIONS: Findings of this study unveil the beneficial effects of subjective views of successful aging on emotional and coping responses to the pandemic through alleviating their perception of time limitation.


Asunto(s)
Pandemias , Adaptación Psicológica , Anciano , Anciano de 80 o más Años , Envejecimiento , Emociones , Hong Kong/epidemiología , Humanos , Persona de Mediana Edad
19.
J Prim Care Community Health ; 12: 2150132721995451, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1088493

RESUMEN

The purpose of this study was to describe knowledge and beliefs about SARS-CoV2 and COVID-19 and explore the gaps between current media coverage of health risks and what the general public knows about the virus and its outcome. A 37-question survey was developed and administered to a community collaborative group in a Midwestern state in the United States. Fifty-three participants completed the survey. When asked where participants found their information, a majority reported the internet (33.9%, n = 18/53) and radio and/or tv (28.3%, n = 15/53). Most participants showed a basic level of COVID-19 knowledge, but few could identify the 3 most frequent symptoms of COVID-19 (7.5%, n = 4/53). The results from this study highlight the continued need for increased public health communication. Educational efforts should focus on social media and internet outlets to address COVID-19 misinformation, strategies to address vaccine hesitancy, and the associated communication gap to help address related health disparities.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Información de Salud al Consumidor , Femenino , Humanos , Conducta en la Búsqueda de Información , Kansas/epidemiología , Masculino , Medios de Comunicación de Masas , Persona de Mediana Edad , Medición de Riesgo , Encuestas y Cuestionarios , Adulto Joven
20.
BMJ ; 372: n334, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1088219

RESUMEN

OBJECTIVE: To directly measure the fatal impact of coronavirus disease 2019 (covid-19) in an urban African population. DESIGN: Prospective systematic postmortem surveillance study. SETTING: Zambia's largest tertiary care referral hospital. PARTICIPANTS: Deceased people of all ages at the University Teaching Hospital morgue in Lusaka, Zambia, enrolled within 48 hours of death. MAIN OUTCOME MEASURE: Postmortem nasopharyngeal swabs were tested via reverse transcriptase quantitative polymerase chain reaction (PCR) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Deaths were stratified by covis-19 status, location, age, sex, and underlying risk factors. RESULTS: 372 participants were enrolled between June and September 2020; PCR results were available for 364 (97.8%). SARS-CoV-2 was detected in 58/364 (15.9%) according to the recommended cycle threshold value of <40 and in 70/364 (19.2%) when expanded to any level of PCR detection. The median age at death among people with a positive test for SARS-CoV-2 was 48 (interquartile range 36-72) years, and 69% (n=48) were male. Most deaths in people with covid-19 (51/70; 73%) occurred in the community; none had been tested for SARS-CoV-2 before death. Among the 19/70 people who died in hospital, six were tested before death. Among the 52/70 people with data on symptoms, 44/52 had typical symptoms of covid-19 (cough, fever, shortness of breath), of whom only five were tested before death. Covid-19 was identified in seven children, only one of whom had been tested before death. The proportion of deaths with covid-19 increased with age, but 76% (n=53) of people who died were aged under 60 years. The five most common comorbidities among people who died with covid-19 were tuberculosis (22; 31%), hypertension (19; 27%), HIV/AIDS (16; 23%), alcohol misuse (12; 17%), and diabetes (9; 13%). CONCLUSIONS: Contrary to expectations, deaths with covid-19 were common in Lusaka. Most occurred in the community, where testing capacity is lacking. However, few people who died at facilities were tested, despite presenting with typical symptoms of covid-19. Therefore, cases of covid-19 were under-reported because testing was rarely done not because covid-19 was rare. If these data are generalizable, the impact of covid-19 in Africa has been vastly underestimated.


Asunto(s)
/mortalidad , /aislamiento & purificación , Adulto , Distribución por Edad , Factores de Edad , Anciano , Autopsia , /virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Población Urbana/estadística & datos numéricos , Zambia/epidemiología
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