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1.
Health Aff (Millwood) ; 39(10): 1792-1798, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1177766

RESUMEN

Motor vehicle crashes remain the leading cause of adolescent mortality and injury in the United States. For young drivers, crash risk peaks immediately after licensure and declines during the next two years, making the point of licensure an important safety intervention opportunity. Legislation in Ohio established a unique health-transportation partnership among the State of Ohio, Children's Hospital of Philadelphia, and Diagnostic Driving, Inc., to identify underprepared driver license applicants through a virtual driving assessment system. The system, a computer-based virtual driving test, exposes drivers to common serious crash scenarios to identify critical skill deficits and is delivered in testing centers immediately before the on-road examination. A pilot study of license applicants who completed it showed that the virtual driving assessment system accurately predicted which drivers would fail the on-road examination and provided automated feedback that informed drivers on their skill deficits. At this time, the partnership's work is informing policy changes around integrating the virtual driving assessment system into licensing and driver training with the aim of reducing crashes in the first months of independent driving. The system can be developed to identify deficits in safety-critical skills that lead to crashes in new drivers and to address challenges that the coronavirus disease 2019 pandemic has introduced to driver testing and training.


Asunto(s)
Conducción de Automóvil/legislación & jurisprudencia , Infecciones por Coronavirus/prevención & control , Concesión de Licencias/legislación & jurisprudencia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Administración de la Seguridad/organización & administración , Interfaz Usuario-Computador , Adolescente , Infecciones por Coronavirus/epidemiología , Estudios de Factibilidad , Femenino , Humanos , Masculino , Vehículos a Motor/estadística & datos numéricos , Ohio , Pandemias/estadística & datos numéricos , Philadelphia , Proyectos Piloto , Neumonía Viral/epidemiología , Transportes/métodos , Adulto Joven
2.
JMIR Public Health Surveill ; 6(3): e19969, 2020 07 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1172934

RESUMEN

BACKGROUND: In the absence of vaccines and established treatments, nonpharmaceutical interventions (NPIs) are fundamental tools to control coronavirus disease (COVID-19) transmission. NPIs require public interest to be successful. In the United States, there is a lack of published research on the factors that influence public interest in COVID-19. Using Google Trends, we examined the US level of public interest in COVID-19 and how it correlated to testing and with other countries. OBJECTIVE: The aim of this study was to determine how public interest in COVID-19 in the United States changed over time and the key factors that drove this change, such as testing. US public interest in COVID-19 was compared to that in countries that have been more successful in their containment and mitigation strategies. METHODS: In this retrospective study, Google Trends was used to analyze the volume of internet searches within the United States relating to COVID-19, focusing on dates between December 31, 2019, and March 24, 2020. The volume of internet searches related to COVID-19 was compared to that in other countries. RESULTS: Throughout January and February 2020, there was limited search interest in COVID-19 within the United States. Interest declined for the first 21 days of February. A similar decline was seen in geographical regions that were later found to be experiencing undetected community transmission in February. Between March 9 and March 12, 2020, there was a rapid rise in search interest. This rise in search interest was positively correlated with the rise of positive tests for SARS-CoV-2 (6.3, 95% CI -2.9 to 9.7; P<.001). Within the United States, it took 52 days for search interest to rise substantially after the first positive case; in countries with more successful outbreak control, search interest rose in less than 15 days. CONCLUSIONS: Containment and mitigation strategies require public interest to be successful. The initial level of COVID-19 public interest in the United States was limited and even decreased during a time when containment and mitigation strategies were being established. A lack of public interest in COVID-19 existed in the United States when containment and mitigation policies were in place. Based on our analysis, it is clear that US policy makers need to develop novel methods of communicating COVID-19 public health initiatives.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Opinión Pública , Motor de Búsqueda/tendencias , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Comparación Transcultural , Humanos , Neumonía Viral/epidemiología , Estudios Retrospectivos , Estados Unidos/epidemiología
3.
JMIR Public Health Surveill ; 6(3): e19831, 2020 07 30.
Artículo en Inglés | MEDLINE | ID: covidwho-1172930

RESUMEN

Before the coronavirus disease (COVID-19), 1 in 3 women and girls, globally, were victimized by an abusive partner in intimate relationships. However, the current pandemic has amplified cases of domestic violence (DV) against women and girls, with up to thrice the prevalence in DV cases compared to the same time last year. Evidence of the adverse effects of the pandemic on DV is still emerging, even as violence prevention strategies are iteratively being refined by service providers, advocacy agencies, and survivors to meet stay-at-home mandates. Emotional and material support for survivors is a critical resource increasingly delivered using digital and technology-based modalities, which offer several advantages and challenges. This paper rapidly describes current DV mitigation approaches using digital solutions, signaling emerging best practices to support survivors, their children, and abusers during stay-at-home advisories. Some examples of technology-based strategies and solutions are presented. An immediate priority is mapping out current digital solutions in response to COVID-19-related DV and outlining issues with uptake, coverage, and meaningful use of digital solutions.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Violencia Doméstica/prevención & control , Violencia de Pareja/prevención & control , Pandemias , Neumonía Viral/epidemiología , Telemedicina/métodos , Infecciones por Coronavirus/prevención & control , Violencia Doméstica/estadística & datos numéricos , Femenino , Salud Global/estadística & datos numéricos , Humanos , Violencia de Pareja/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Prevalencia , Apoyo Social , Sobrevivientes/psicología
7.
West J Emerg Med ; 21(6): 83-87, 2020 Sep 24.
Artículo en Inglés | MEDLINE | ID: covidwho-1159496

RESUMEN

INTRODUCTION: We are currently in the midst of the coronavirus disease 2019 (COVID-19) pandemic. Research into previous infectious disease outbreaks has shown that healthcare workers are at increased risk for burnout during these dire times, with those on the front lines at greatest risk. The purpose of this prospective study was to determine the effect that the COVID-19 pandemic has had on the wellness of emergency physicians (EP). METHODS: A survey was sent to 137 EPs in a multi-hospital network in eastern Pennsylvania. We compared 10 primary and two supplemental questions based on how the physicians had been feeling in the prior 2-3 weeks (COVID-19 period) to the same questions based on how they were feeling in the prior 4-6 months (pre-COVID-19 period). RESULTS: We received 55 responses to the survey (40.1% response rate). The study found that during the pandemic, EPs felt less in control (p-value = 0.001); felt decreased happiness while at work (p-value 0.001); had more trouble falling asleep (p-value = 0.001); had an increased sense of dread when thinking of work needing to be done (p-value = 0.04); felt more stress on days not at work (p-value <0.0001); and were more concerned about their own health (p-value <0.0001) and the health of their families and loved ones (p-value <0.0001). CONCLUSION: This study showed a statistically significant decrease in EP wellness during the COVID-19 pandemic when compared to the pre-pandemic period. We need to be aware of evidence-based recommendations to help mitigate the risks and prevent physician burnout.


Asunto(s)
Agotamiento Profesional/prevención & control , Infecciones por Coronavirus/epidemiología , Salud Laboral , Estrés Laboral/epidemiología , Médicos/psicología , Neumonía Viral/epidemiología , Adulto , Agotamiento Profesional/epidemiología , Infecciones por Coronavirus/prevención & control , Medicina de Emergencia/estadística & datos numéricos , Servicio de Urgencia en Hospital/organización & administración , Femenino , Humanos , Masculino , Pandemias/prevención & control , Pennsylvania , Neumonía Viral/prevención & control , Estudios Prospectivos , Encuestas y Cuestionarios
9.
J Glob Health ; 10(2): 020507, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-1154782

RESUMEN

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide. Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, <100). Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P < 0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries. Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions. Study registration: Registered in ClinicalTrials.gov: NCT04344197.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Control de Infecciones/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Pautas de la Práctica en Medicina/estadística & datos numéricos , Procedimientos Quirúrgicos Operativos/normas , Betacoronavirus , Infecciones por Coronavirus/transmisión , Infección Hospitalaria/virología , Estudios Transversales , Hospitales/normas , Hospitales/estadística & datos numéricos , Humanos , Control de Infecciones/normas , Tamizaje Masivo/normas , Neumonía Viral/transmisión , Políticas , Pautas de la Práctica en Medicina/normas , Procedimientos Quirúrgicos Operativos/efectos adversos , Encuestas y Cuestionarios
11.
Aging Clin Exp Res ; 32(7): 1195-1198, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-1152155

RESUMEN

WHO declared SARS-CoV-2 a global pandemic. The present aim was to propose an hypothesis that there is a potential association between mean levels of vitamin D in various countries with cases and mortality caused by COVID-19. The mean levels of vitamin D for 20 European countries and morbidity and mortality caused by COVID-19 were acquired. Negative correlations between mean levels of vitamin D (average 56 mmol/L, STDEV 10.61) in each country and the number of COVID-19 cases/1 M (mean 295.95, STDEV 298.7, and mortality/1 M (mean 5.96, STDEV 15.13) were observed. Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of the population in relation to COVID-19. It should be advisable to perform dedicated studies about vitamin D levels in COVID-19 patients with different degrees of disease severity.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Deficiencia de Vitamina D/epidemiología , Betacoronavirus , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/prevención & control , Humanos , Italia/epidemiología , Pandemias/prevención & control , Neumonía Viral/etiología , Neumonía Viral/prevención & control , España/epidemiología , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones
13.
BMC Anesthesiol ; 20(1): 232, 2020 09 14.
Artículo en Inglés | MEDLINE | ID: covidwho-757603

RESUMEN

BACKGROUND: The challenges posed by the spread of COVID-19 disease through aerosols have compelled anesthesiologists to modify their airway management practices. Devices such as barrier boxes are being considered as potential adjuncts to full PPE's to limit the aerosol spread. Usage of the barrier box raises concerns of delay in time to intubate (TTI). We designed our study to determine if using a barrier box with glidescope delays TTI within acceptable parameters to make relevant clinical conclusions. METHODS: Seventy-eight patients were enrolled in this prospective non-inferiority controlled trial and were randomly allocated to either group C (without the barrier box) or the study group BB (using barrier box). The primary measured endpoint is time to intubate (TTI), which is defined as time taken from loss of twitches confirmed with a peripheral nerve stimulator to confirmation of end-tidal CO 2. 15 s was used as non-inferiority margin for the purpose of the study. We used an unpaired two-sample single-sided t-test to test our non- inferiority hypothesis (H 0: Mean TTI diff ≥15 s, H A: Mean TTI diff < 15 s). Secondary endpoints include the number of attempts at intubation, lowest oxygen saturation during induction, and the need for bag-mask ventilation. RESULTS: Mean TTI in group C was 42 s (CI 19.2 to 64.8) vs. 52.1 s (CI 26.1 to 78) in group BB. The difference in mean TTI was 10.1 s (CI -∞ to 14.9). We rejected the null hypothesis and concluded with 95% confidence that the difference of the mean TTI between the groups is less than < 15 s (95% CI -∞ to 14.9,p = 0.0461). Our induction times were comparable (67.7 vs. 65.9 s).100% of our patients were intubated on the first attempt in both groups. None of our patients needed rescue breaths. CONCLUSIONS: We conclude that in patients with normal airway exam, scheduled for elective surgeries, our barrier box did not cause any clinically significant delay in TTI when airway manipulation is performed by well-trained providers. The study was retrospectively registered at clinicaltrials.gov (NCT04411056) on May 27, 2020.


Asunto(s)
Manejo de la Vía Aérea/métodos , Anestesiología/métodos , Infecciones por Coronavirus/terapia , Intubación Intratraqueal/métodos , Neumonía Viral/terapia , Adulto , Aerosoles , Anciano , Manejo de la Vía Aérea/instrumentación , Anestesiólogos/organización & administración , Anestesiología/instrumentación , Infecciones por Coronavirus/prevención & control , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Humanos , Intubación Intratraqueal/instrumentación , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Estudios Prospectivos , Respiración Artificial/métodos , Factores de Tiempo
16.
Cytometry A ; 97(9): 882-886, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-790373

RESUMEN

Operating shared resource laboratories (SRLs) in times of pandemic is a challenge for research institutions. In a multiuser, high-turnover working space, the transmission of infectious agents is difficult to control. To address this challenge, imaging core facility managers being members of German BioImaging discussed how shared microscopes could be operated with minimal risk of spreading SARS-CoV-2 between users and staff. Here, we describe the resulting guidelines and explain their rationale, with a focus on separating users in space and time, protective face masks, and keeping surfaces virus-free. These recommendations may prove useful for other types of SRLs. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals LLC. on behalf of International Society for Advancement of Cytometry.


Asunto(s)
Betacoronavirus/patogenicidad , Investigación Biomédica/organización & administración , Infecciones por Coronavirus/prevención & control , Control de Infecciones , Laboratorios/organización & administración , Microscopía , Salud Laboral , Pandemias/prevención & control , Neumonía Viral/prevención & control , Conducta Cooperativa , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Descontaminación , Contaminación de Equipos/prevención & control , Alemania , Humanos , Exposición Profesional/prevención & control , Equipo de Protección Personal , Neumonía Viral/transmisión , Neumonía Viral/virología , Factores Protectores , Investigadores/organización & administración , Medición de Riesgo , Factores de Riesgo , Flujo de Trabajo
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