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1.
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
2.
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
3.
Int J Qual Health Care ; 33(1)2021 Feb 20.
Artículo en Inglés | MEDLINE | ID: covidwho-1093551

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has forced health-care providers to find creative ways to allow continuity of care in times of lockdown. Telemedicine enables provision of care when in-person visits are not possible. Sheba Medical Center made a rapid transition of outpatient clinics to video consultations (VC) during the first wave of COVID-19 in Israel. OBJECTIVE: Results of a survey of patient and clinician user experience with VC are reported. METHODS: Satisfaction surveys were sent by text messages to patients, clinicians who practice VC (users) and clinicians who do not practice VC (non-users). Questions referred to general satisfaction, ease of use, technical issues and medical and communication quality. Questions and scales were based on surveys used regularly in outpatient clinics of Sheba Medical Center. RESULTS: More than 1200 clinicians (physicians, psychologists, nurses, social workers, dietitians, speech therapists, genetic consultants and others) provided VC during the study period. Five hundred and forty patients, 162 clinicians who were users and 50 clinicians who were non-users completed the survey. High level of satisfaction was reported by 89.8% of patients and 37.7% of clinician users. Technical problems were experienced by 21% of patients and 80% of clinician users. Almost 70% of patients but only 23.5% of clinicians found the platform very simple to use. Over 90% of patients were very satisfied with clinician's courtesy, expressed a high sense of trust, thought that clinician's explanations and recommendations were clear and estimated that the clinician understood their problems and 86.5% of them would recommend VC to family and friends. Eighty-seven percent of clinician users recognize the benefit of VC for patients during the COVID-19 pandemic but only 68% supported continuation of the service after the pandemic. CONCLUSION: Our study reports high levels of patient satisfaction from outpatient clinics VC during the COVID-19 pandemic. Lower levels of clinician satisfaction can mostly be attributed to technical and administrative challenges related to the newly implemented telemedicine platform. Our findings support the continued future use of VC as a means of providing patient-centered care. Future steps need to be taken to continuously improve the clinical and administrative application of telemedicine services.


Asunto(s)
Actitud del Personal de Salud , Satisfacción del Paciente , Neumonía Viral/epidemiología , Consulta Remota , Control de Enfermedades Transmisibles , Femenino , Humanos , Israel/epidemiología , Masculino , Pandemias , Neumonía Viral/virología , Encuestas y Cuestionarios
4.
Medicine (Baltimore) ; 100(7): e24668, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1091183

RESUMEN

ABSTRACT: We aimed to retrospectively analyze the clinical and computed tomography (CT) characteristics of young adults with Coronavirus Disease 2019 (COVID-19) pneumonia who were critically ill and to identify the features associated with non-survival.Thirty-eight COVID-19 patients (20-45 years old, 28 men) who had been admitted in the intensive care unit were included, including 18 non-survivors (group 1) and 20 survivors (group 2). Their clinical characteristics and initial and follow-up CT were compared between groups.In group 1, the days from illness onset to death were 21.1 ±â€Š10.3 days; 7 patients had underlying comorbidities. At admission, group 1 exhibited higher serum ferritin and interleukin-6 (IL-6) levels (1142.6 ±â€Š242.4 mg/L and 33.8 ±â€Š18.6 mmol/L) compared with group 2 (728.3 ±â€Š150.9 mg/L and 15.2 ±â€Š6.9 mmol/L, P < .01). Group 1 exhibited more rapidly progressive opacities and consolidation in follow-up CT (16.7 ±â€Š3.1 scores, 15.7 ±â€Š3.1 segments) than group 2 (11.4 ±â€Š4.0 scores, 10.3 ±â€Š4.6 segments, P < .01). The oxygenation index was lower (87.6 ±â€Š19.2 vs 99.1 ±â€Š20.4 mm Hg) and the mechanical ventilation duration was longer (14.7 ±â€Š6.9 vs 9.7 ±â€Š3.7 days) in group 1 compare with group 2 (P < .01).Compared with the survivors, the non-survivors showed higher serum ferritin and IL-6 levels, more rapidly progressive opacities in CT, lower oxygenation index, and longer mechanical ventilation durations. Special attention to ferritin/IL-6 levels and oxygenation index as well as early CT application and timely reexaminations are important to identify the individuals who may be at risk of becoming critically ill.


Asunto(s)
/diagnóstico , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Neumonía Viral/mortalidad , Tomografía Computarizada por Rayos X/métodos , Adulto , Enfermedad Crítica , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Neumonía Viral/virología , Estudios Retrospectivos , Análisis de Supervivencia
5.
Medicine (Baltimore) ; 100(7): e24720, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1091182

RESUMEN

ABSTRACT: The purpose of this study was to explore the management experience of outpatient with totally implantable central venous access Ports (TIVAPs, Ports) during the epidemic, including whether the extension of the irrigation interval will affect the incidence of catheter occlusion, the reasons for the port removal rate, and the corresponding protective treatment strategies during the COVID-19 epidemic.We retrospectively analyzed the Ports evaluation and flushing procedure data between February 3, 2020 and April 3, 2020; the cases were divided into the normal group and delayed group according to the critical point of the maintenance interval of 28 days (4 weeks). We compared the incidence of catheter obstruction between the 2 groups, analyzed the causes of catheter removal events in the 2 groups, and proposed corresponding protective treatment recommendations.During the period, 329 cases were included in the study. There was no significant difference in the incidence of catheter obstruction between the 2 groups. There were 15 patients with catheter removal, 8 cases of infection, 5 cases of catheter obstruction, and 1 case of an ectopic catheter, as well as 1 case of an overturned port. During the epidemic, no hospital infections related to the Ports flushing procedure occurred.The interval of Ports flushing procedures for patients without clinical symptoms can be appropriately extended during the COVID-19 epidemic. However, once the local infection symptoms or other sources of discomfort appear, Ports assessment needs to be performed as soon as possible. Take enhanced protected and isolation measures did not increase cross-infection during outpatient's flushing procedure at non-COVID-19-designated diagnosis and treatment hospitals.


Asunto(s)
/epidemiología , Cateterismo Venoso Central , Pacientes Ambulatorios , Remoción de Dispositivos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
6.
Medicine (Baltimore) ; 100(7): e24821, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1091181

RESUMEN

ABSTRACT: The COVID-19 pandemic has disrupted teaching in a variety of institutions, especially in medical schools. Electronic learning (e-learning) became the core method of teaching the curriculum during the pandemic. After 8 weeks of only online learning, a survey was conducted to investigate perception of this type of learning among medical students.A survey was conducted by distributing an online questionnaire to Polish medical students. Data gathered from the survey were analyzed with routine statistical software.Eight hundred four students answered the questionnaire. According to respondents' answers, the main advantages of online learning were the ability to stay at home (69%), continuous access to online materials (69%), learning at your own pace (64%), and comfortable surroundings (54%). The majority of respondents chose lack of interactions with patients (70%) and technical problems with IT equipment (54%) as the main disadvantages. There was no statistical difference between face-to-face and online learning in terms of opinions on the ability of the learning method to increase knowledge (P = .46). E-learning was considered less effective than face-to-face learning in terms of increasing skills (P < .001) and social competences (P < .001). Students assessed that they were less active during online classes compared to traditional classes (P < .001). E-learning was rated as enjoyable by 73% of respondents.E-learning is a powerful tool for teaching medical students. However, successful implementation of online learning into the curriculum requires a well thought-out strategy and a more active approach.


Asunto(s)
/epidemiología , Educación a Distancia/métodos , Educación de Pregrado en Medicina/métodos , Estudiantes de Medicina/psicología , Adulto , Femenino , Humanos , Masculino , Pandemias , Polonia/epidemiología , Encuestas y Cuestionarios
7.
BMC Infect Dis ; 21(1): 192, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1090689

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused a global pandemic that has raised worldwide concern. This study aims to investigate the correlation between the extent of lung infection and relevant clinical laboratory testing indicators in COVID-19 and to analyse its underlying mechanism. METHODS: Chest high-resolution computer tomography (CT) images and laboratory examination data of 31 patients with COVID-19 were extracted, and the lesion areas in CT images were quantitatively segmented and calculated using a deep learning (DL) system. A cross-sectional study method was carried out to explore the differences among the proportions of lung lobe infection and to correlate the percentage of infection (POI) of the whole lung in all patients with clinical laboratory examination values. RESULTS: No significant difference in the proportion of infection was noted among various lung lobes (P > 0.05). The POI of total lung was negatively correlated with the peripheral blood lymphocyte percentage (L%) (r = - 0.633, P < 0.001) and lymphocyte (LY) count (r = - 0.555, P = 0.001) but positively correlated with the neutrophil percentage (N%) (r = 0.565, P = 0.001). Otherwise, the POI was not significantly correlated with the peripheral blood white blood cell (WBC) count, monocyte percentage (M%) or haemoglobin (HGB) content. In some patients, as the infection progressed, the L% and LY count decreased progressively accompanied by a continuous increase in the N%. CONCLUSIONS: Lung lesions in COVID-19 patients are significantly correlated with the peripheral blood lymphocyte and neutrophil levels, both of which could serve as prognostic indicators that provide warning implications, and contribute to clinical interventions in patients.


Asunto(s)
/diagnóstico por imagen , Pulmón/patología , Aprendizaje Automático , Adulto , Técnicas de Laboratorio Clínico , Estudios Transversales , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/virología , Recuento de Linfocitos , Linfocitos/citología , Masculino , Persona de Mediana Edad , Neutrófilos/citología , Pandemias , Pronóstico , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
8.
BMC Infect Dis ; 21(1): 187, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1090687

RESUMEN

BACKGROUND: Thresholds for SARS-CoV-2 antibody assays have typically been determined using samples from symptomatic, often hospitalised, patients. In this setting the sensitivity and specificity of the best performing assays can both exceed 98%. However, antibody assay performance following mild infection is less clear. METHODS: We assessed quantitative IgG responses in a cohort of healthcare workers in Oxford, UK, with a high pre-test probability of Covid-19, in particular the 991/11,475(8.6%) who reported loss of smell/taste. We use anosmia/ageusia and other risk factors as probes for Covid-19 infection potentially undiagnosed by immunoassays by investigating their relationship with antibody readings either side of assay thresholds. RESULTS: The proportion of healthcare workers reporting anosmia/ageusia increased at antibody readings below diagnostic thresholds using an in-house ELISA (n = 9324) and the Abbott Architect chemiluminescent microparticle immunoassay (CMIA; n = 11,324): 426/906 (47%) reported anosmia/ageusia with a positive ELISA, 59/449 (13.1%) with high-negative and 326/7969 (4.1%) with low-negative readings. Similarly, by CMIA, 518/1093 (47.4%) with a positive result reported anosmia/ageusia, 106/686 (15.5%) with a high-negative and 358/9563 (3.7%) with a low-negative result. Adjusting for the proportion of staff reporting anosmia/ageusia suggests the sensitivity of both assays in mild infection is lower than previously reported: Oxford ELISA 89.8% (95%CI 86.6-92.8%) and Abbott CMIA 79.3% (75.9-82.7%). CONCLUSION: Following mild SARS-CoV-2 infection 10-30% of individuals may have negative immunoassay results. While lowered diagnostic thresholds may result in unacceptable specificity, our findings have implications for epidemiological analyses and result interpretation in individuals with a high pre-test probability. Samples from mild PCR-confirmed infections should be included in SARS-CoV-2 immunoassay evaluations.


Asunto(s)
Anticuerpos Antivirales/análisis , /diagnóstico , Inmunoglobulina G/análisis , Adulto , Ageusia/virología , Infecciones Asintomáticas , Ensayo de Inmunoadsorción Enzimática/normas , Femenino , Personal de Salud , Humanos , Inmunoensayo/normas , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Enfermedades no Diagnosticadas , Reino Unido
9.
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
10.
Malar J ; 20(1): 88, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1090664

RESUMEN

BACKGROUND: Malaria remains a serious health threat in the Amazonas Region of Peru and approximately 95% of the cases, mainly Plasmodium vivax, are found in native communities of The Rio Santiago District, Condorcanqui Province. In 2019, more than one thousand malaria cases were reported, with an unusual number of Plasmodium falciparum autochthonous cases. The present study aims to report this P. falciparum outbreak while describing the epidemiology of malaria and the risk factors associated in the native communities of Amazonas, Peru. METHODS: The DIRESA-Amazonas in collaboration with the Condorcanqui Health Network and the Institute of Tropical Diseases of the UNTRM carried out a malaria Active Case Detection (ACD III) between January 31st and February 10th of 2020. A total of 2718 (47.4%) individuals from 21 native communities grouped in eight sanitary districts, were screened for malaria infections. Each participant was screened for malaria using microscopy. Follow-up surveys were conducted for all malaria positive individuals to collect socio-demographic data. Spatial clustering of infection risk was calculated using a generalized linear model (GLM). Analysis of risk considered factors such as gender, age, type of infection, symptomatology, and parasitaemia. RESULTS: The study suggests that the P. falciparum index case was imported from Loreto and later spread to other communities of Rio Santiago during 2019. The ACD III reported 220 (8.1%) malaria cases, 46 P. falciparum, 168 P. vivax and 6 mixed infections. SaTScan analysis detected a cluster of high infection risk in Middle Rio Santiago and a particular high P. falciparum infection risk cluster in Upper Rio Santiago. Interestingly, the evaluation of different risk factors showed significant associations between low parasitaemia and P. falciparum asymptomatic cases. CONCLUSION: This is the first report of a P. falciparum outbreak in native communities of Condorcanqui, Amazonas. Timely identification and treatment of symptomatic and asymptomatic cases are critical to achieve malaria control and possible elimination in this area. However, the current malaria situation in Condorcanqui is uncertain, given that malaria ACD activities have been postponed due to COVID-19.


Asunto(s)
Brotes de Enfermedades , Malaria Falciparum/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Población Rural , Adulto Joven
11.
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
12.
Rev Bras Enferm ; 74Suppl 1(Suppl 1): e20200281, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-1090511

RESUMEN

OBJECTIVE: to report the experience of professors and students of a graduate course on nursing care in coping with the new coronavirus (COVID-19) based on Self-Care Theory. METHOD: the active methodologies used were a literature search and seminar presentations, with an understanding of Orem's theoretical concepts: health; man; self-care; universal, developmental and health deviation requirements; self-care activities; self-care deficits; the required therapeutic demand; nursing systems. The pandemic was considered a health deviation that requires critical thinking and nursing care planning. Methodological frameworks to classify nursing diagnoses, interventions, and outcomes were used. RESULTS: for each health deviation, nursing systems were identified; self-care deficits, diagnoses; actions, interventions; and the form of assessment, outcomes. FINAL CONSIDERATIONS: theoretical-practical reflections of the academic context support nursing care planning.


Asunto(s)
/diagnóstico , Educación de Postgrado en Enfermería/organización & administración , Atención de Enfermería/normas , Técnicas de Planificación , Guías de Práctica Clínica como Asunto , Adulto , Brasil , Curriculum , Femenino , Política de Salud , Humanos , Masculino , Teoría de Enfermería , Adulto Joven
13.
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
14.
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
15.
Rev Soc Bras Med Trop ; 54: e07792020, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1090506

RESUMEN

INTRODUCTION: Rio de Janeiro has hardly experienced coronavirus disease. METHODS: Here, 87,442 reverse transcription polymerase chain reaction (RT-PCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported among Rio de Janeiro residents (March to September 2020). RESULTS: Overall, RT-PCR positivity of 44.6% decreased over time towards 20%. Positivity was greater among males (OR=1.22; 95%CI:1.19-1.26); Black (OR=1.10; 95%CI:1.02-1.19), Brown (OR=1.16; 95%CI:1.10-1.22), and indigenous people (OR=2.11; 95%CI:0.88-5.03) compared to Whites and increased with age; with epidemic spread from the capital to inland regions. CONCLUSIONS: SARS-CoV-2 keeps spreading in Rio de Janeiro, and reopening of activities may fuel the epidemic.


Asunto(s)
Brasil/epidemiología , Humanos , Incidencia , Masculino , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
16.
Int J Environ Res Public Health ; 18(4)2021 02 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1090353

RESUMEN

BACKGROUND: COVID-19 containment measures and the uncertainties associated with the pandemic may have contributed to changes in mental health risks and mental health problems in university students. Due to the high burden of the disease, depression is of particular concern. However, knowledge about the prevalence of depressive symptoms in Swiss university students during the pandemic is limited. We therefore assessed the prevalence of depressive symptoms and their change during the COVID-19 pandemic in a large sample of Swiss university students. METHODS: We assessed depressive symptoms in two cross-sectional cohorts of university students (n = 3571) in spring and autumn 2020 during the COVID-19 pandemic and compared them with a matched sample of the Swiss national population (n = 2328). Binary logistic regression models estimated prevalence with corresponding 95% confidence intervals (95% CI). RESULTS: Adjusted prevalence of depressive symptoms in female (30.8% (95% CI: 28.6-33.0)) and male students (24.8% (95% CI: 21.7-28.1)) was substantially higher than in the matching female (10.9% (95% CI: 8.9-13.2)) and male (8.5% (6.6-11.0)) pre-pandemic national population. Depressive symptoms in the two consecutive student cohorts did not significantly differ. CONCLUSIONS: More than a quarter of Swiss university students reported depressive symptoms during the COVID-19 pandemic, which was substantially higher as compared to the matched general population. Universities should introduce measures to support students in such times of crisis and gain an understanding of the factors impacting mental health positively or negatively and related to university structures and procedures.


Asunto(s)
/psicología , Depresión/epidemiología , Pandemias , Estudiantes/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Suiza/epidemiología , Universidades
17.
Int J Environ Res Public Health ; 18(4)2021 02 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1090352

RESUMEN

The study was carried out to examine the situation of university students from one month after the beginning of a very strict confinement process in Spain during the COVID-19 pandemic. Students responded to a survey which included the 7-item Generalized Anxiety Disorder Scale (GAD-7) together with other questions relating to their general well-being from the European Quality of Life Survey (EQLS). A total of 198 university students answered the web-based survey. The questionnaire was generated using Microsoft Forms and was explained and distributed online. The results indicated that around 18.7% of students were suffering from severe anxiety and 70.2% were suffering either mild or moderate anxiety at this point of the strict confinement process. The findings show that when emotional well-being (quality of sleep, the perception of feeling fear, death of a relative) is reduced and material well-being is negatively affected (income level) anxiety levels are increased. On the other hand, the results show that having good interpersonal relationships with family members and taking care of personal development (routines and habits that make them feel good) help reduce anxiety levels. The female students in the sample also suffered higher levels of anxiety than males during strict confinement.


Asunto(s)
Ansiedad/epidemiología , Pandemias , Estudiantes/psicología , Femenino , Humanos , Relaciones Interpersonales , Masculino , Calidad de Vida , España/epidemiología , Universidades
18.
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
19.
J Glob Health ; 11: 05001, 2021 Jan 16.
Artículo en Inglés | MEDLINE | ID: covidwho-1090198

RESUMEN

Background: On 12 June 2020, Brazil reached the second position worldwide in the number of COVID-19 cases. Authorities increased the number of tests performed, including the identification of antibodies to SARS-CoV-2 (IgG, IgA, and IgM). There was an overflooding of the market with several tests, and the presence of possible false-positive results became a challenge. The purpose of this study was to describe the seroprevalence and immunoglobulin blood levels in a group of asymptomatic individuals using the reference levels provided by the manufacturer. Methods: Levels of IgG and IgA antibodies to SARS-CoV-2 were determined in blood serum by the same ELISA (enzyme-linked immunoassay) test. Patients must be free of symptoms. Results: From 20 to 22 May 2020, 938 individuals were tested. There were 441 (47%) men, age 53 years (interquartile range (IQR) = 39-63.2). The sample included 335 (35.7%) subjects aged ≥60 years old. Subjects with a positive test were 54 (5.8%) for IgG and 96 (10.2%) for IgA and 42 (4.5%) for both IgG and IgA. The prevalence of IgG and IgA positive test was not different in men and women and not different in individuals under 60 and over 60 years of age. Conversely, analysing only individuals with positive tests, the levels of IgG in positive subjects were significantly higher than those with an IgA positive test, 3.00 (IQR = 1.68-5.65), and 1.95 (IQR = 1.40-3.38), respectively; P = 0.017. Additionally, individuals with isolated IgA positive tests had significantly lower levels of IgA than those with both IgA and IgG positive tests: 1.95 (IQR = 1.60-2.40) and 3.15 (IQR = 2.20-3.90), respectively, P = 0.005. These latter data suggest that IgA shows a deviation of the distribution to the left in comparison to IgG distribution data. Indeed, many subjects reported as IgA positive had immunoglobulin levels slightly elevated. Conclusions: In conclusion, we strongly suggest caution in the interpretation of IgA test results. This recommendation is more important for those with positive IgA just above the reference level.


Asunto(s)
Anticuerpos Antivirales/sangre , Reacciones Falso Positivas , Inmunoglobulina A/sangre , /inmunología , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Valores de Referencia , Estudios Seroepidemiológicos
20.
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
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