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1.
Ann Med ; 54(1): 2875-2884, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-2106904

RESUMEN

BACKGROUND: Since the emergence of the novel corona virus (SARS-Cov-2) in the late 2019 and not only the endoscopy practice and training but also the health care systems around the globe suffers. This systematic review focused the impact of Corona Virus Disease (COVID-19) on the endoscopy practice. METHODS: A web search of different databases combining different search terms describing the endoscopy practice and the COVID-19 pandemic was done. Articles were screened for selection of relevant articles in two steps: title and abstract step and full-text screening step, by two independent reviewers and any debate was solved by a third reviewer. RESULTS: Final studies included in qualitative synthesis were 47. The data shown in the relevant articles were evident for marked reduction in the volume of endoscopy, marked affection of colorectal cancer screening, impairments in the workflow, deficiency in personal protective equipment (PPE) and increased likelihood of catching the infection among both the staff and the patients. CONCLUSION: The main outcomes from this review are rescheduling of endoscopy procedures to be suitable with the situation of COVID-19 pandemic in each Country. Also, the endorsement of the importance of PPE use for health care workers and screening of COVID-19 infection pre-procedure.Key messagesThe data focussing Gastrointestinal Endoscopy and COVID-19 emerged from different areas around the globe. The data presented on the published studies were heterogeneous. However, there were remarkable reductions in the volume of GI endoscopy worldwideStaff reallocation added a burden to endoscopy practiceThere was a real risk for COVID-19 spread among both the staff and the patients.


Asunto(s)
COVID-19 , Pandemias , Humanos , Pandemias/prevención & control , SARS-CoV-2 , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/prevención & control , Control de Infecciones , Endoscopía Gastrointestinal
2.
Am J Speech Lang Pathol ; 31(6): 2825-2834, 2022 Nov 16.
Artículo en Inglés | MEDLINE | ID: covidwho-2106540

RESUMEN

PURPOSE: During the COVID-19 pandemic, clinicians and researchers have increasingly used remote online assessments to pursue their activities, but mostly with tests not validated for videoconference administration. This study aims to validate the remote online administration of picture description in Canadian French neurotypical speakers and to explore the thematic unit (TU) checklist recently developed. METHOD: Spoken discourse elicited through the picture description task of the Western Aphasia Battery-Revised (WAB-R) was collected from Canadian French neurotypical speakers from Québec aged between 50 and 79 years old. Forty-seven participants completed the task in person, and 49 participants completed the task by videoconference. Videos of each discourse sample were transcribed using CHAT conventions. Microstructural variables were extracted using the CLAN (Computerized Language ANalysis) program, whereas thematic informativeness was scored for each sample using TUs. Chi-square tests were conducted to compare both groups on each TU; t tests were also performed on the total score of TUs and microstructural variables. RESULTS: Groups were matched on sex, age, and education variables. The t tests revealed no intergroup difference for the total TU score and for the microstructural variables (e.g., mean length of utterances and number of words per minute). Chi-square tests showed no significant intergroup difference for all 16 TUs. CONCLUSIONS: These findings support remote online assessment of the picnic scene of the WAB-R picture description in Canadian French neurotypical speakers. These results also validate the 16 TUs most consistently produced. The use of videoconference could promote and improve the recruitment of participants who are usually less accessible, such as people using assistive mobility technologies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21476961.


Asunto(s)
Afasia , COVID-19 , Humanos , Persona de Mediana Edad , Anciano , Lenguaje , Pandemias , Canadá , Comunicación por Videoconferencia
3.
Prim Health Care Res Dev ; 23: e67, 2022 Nov 04.
Artículo en Inglés | MEDLINE | ID: covidwho-2106285

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) has spread rapidly around the world since the initial outbreak in Wuhan, China. With the emergence of the Omicron variant, South Africa is presently the epicentre of the COVID-19 pandemic in sub-Saharan Africa. Healthcare workers have been at the forefront of the pandemic in terms of screening, early detection and clinical management of suspected and confirmed COVID-19 cases. Since the beginning of the outbreak, little has been reported on how healthcare workers have experienced the COVID-19 pandemic in South Africa, particularly within a low-income, rural primary care context. METHODS: The purpose of the present qualitative study design was to explore primary healthcare practitioners' experiences regarding the COVID-19 pandemic at two selected primary healthcare facilities within a low-income rural context in KwaZulu-Natal, South Africa. Data were collected from a purposive sample of 15 participants, which consisted of nurses, physiotherapists, pharmacists, community caregivers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. Audio recordings were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis. RESULTS: Participants reported personal, occupational and community-related experiences related to the COVID-19 pandemic in South Africa. Personal experiences of COVID-19 yielded superordinate themes of psychological distress, self-stigma, disruption of the social norm, Epiphany and conflict of interest. Occupational experiences yielded superordinate themes of staff infections, COVID-19-related courtesy stigma, resource constraints and poor dissemination of information. Community-related experiences were related to struggles with societal issues, clinician-patient relations and COVID-19 mismanagement of patients. CONCLUSION: The findings of this study suggest that primary healthcare practitioners' experiences around COVID-19 are attributed to the catastrophic effects of the COVID-19 pandemic with the multitude of psychosocial consequences forming the essence of these experiences. Ensuring availability of reliable sources of information regarding the pandemic as well as psychosocial support could be valuable in helping healthcare workers cope with living and working during the pandemic.


Asunto(s)
COVID-19 , Pandemias , Masculino , Humanos , Femenino , Pandemias/prevención & control , COVID-19/epidemiología , Sudáfrica/epidemiología , SARS-CoV-2 , Personal de Salud/psicología , Investigación Cualitativa , Atención Primaria de Salud
4.
Prim Health Care Res Dev ; 23: e56, 2022 09 12.
Artículo en Inglés | MEDLINE | ID: covidwho-2106284

RESUMEN

INTRODUCTION: The coronavirus (COVID-19) pandemic has impacted healthcare worldwide. It has altered service delivery and posed challenges to practitioners in relation to workload, well-being and support. Within primary care, changes in physicians' activities have been identified and innovative work solutions implemented. However, evidence is lacking regarding the impact of the pandemic on pharmacy personnel who work in primary care. AIM: To explore the impact of the pandemic on the working practice (including the type of services provided) and job satisfaction of pharmacists and pharmacy technicians within Scottish general practice. Due to the stressful nature of the pandemic, we hypothesise that job satisfaction will have been negatively affected. METHODS: An online questionnaire was distributed in May-July 2021, approximately 15 months since initial lockdown measures in the UK. The questionnaire was informed by previous literature and underwent expert review and piloting. Analysis involved descriptive statistics, non-parametric statistical tests and thematic analysis. RESULTS: 180 participants responded (approximated 16.1% response rate): 134 pharmacists (74.4%) and 46 technicians (25.6%). Responses indicated greater involvement with administrative tasks and a reduction in the provision of clinical services, which was negatively perceived by pharmacists. There was an increase in remote working, although most participants continued to have a physical presence within general practices. Face-to-face interactions with patients reduced, which was negatively perceived by participants, and telephone consults were considered efficient yet less effective. Professional development activities were challenged by increased workloads and reduced support available. Although workplace stress was apparent, there was no indication of widespread job dissatisfaction. CONCLUSION: The pandemic has impacted pharmacists and technicians, but it is unknown if changes will be permanent, and there is a need to understand which changes should continue. Future research should explore the impact of altered service delivery, including remote working, on patient care.


Asunto(s)
COVID-19 , Farmacia , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Humanos , Pandemias , Atención Primaria de Salud
5.
Vaccine ; 40(46): 6575-6580, 2022 Nov 02.
Artículo en Inglés | MEDLINE | ID: covidwho-2106122

RESUMEN

BACKGROUND: We sought to evaluate the trends of HPV vaccination between 03/2019-09/2021 and whether the impact of the COVID pandemic on HPV vaccination varied by race/ethnicity and neighborhood deprivation index (NDI). METHODS: Electronic medical records at Kaiser Permanente Southern California were used to assess monthly volume of HPV vaccine doses administered among children aged 9-12.9yrs, and up-to-date coverage (% vaccinated) by age 13 between 03/2019-09/2021. Modified Poisson models were used to evaluate the interactions between race/ethnicity, NDI and the pandemic periods on HPV vaccine coverage. RESULTS: HPV vaccine doses administered in 2020/2021 have returned to the 2019 level after the initial drop. The average up-to-date coverage in 05/2021-09/2021 (54.8%) remained lower than the pre-pandemic level (58.5%). The associations between race/ethnicity, NDI and HPV vaccine coverage did not vary due to the pandemic. CONCLUSION: HPV vaccine promotion efforts are needed to address COVID-19 pandemic's lasting impact on HPV vaccination coverage.


Asunto(s)
COVID-19 , Prestación Integrada de Atención de Salud , Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Niño , Humanos , Pandemias , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Etnicidad , COVID-19/epidemiología , COVID-19/prevención & control , Vacunación , Clase Social , California/epidemiología
6.
Vaccine ; 40(46): 6649-6657, 2022 Nov 02.
Artículo en Inglés | MEDLINE | ID: covidwho-2106118

RESUMEN

INTRODUCTION: Vaccine hesitancy in the wake of the COVID-19 pandemic is a major public health concern in the US. Cancer patients are especially vulnerable to adverse COVID-19 outcomes and require targeted prevention efforts against COVID-19. METHODS: We used longitudinal survey data from patients seen at Moffitt Cancer Center to identify attitudes, beliefs, and sociodemographic factors associated with COVID-19 vaccination acceptance among cancer patients. Patients with confirmed invasive cancer diagnosis through Cancer Registry data were asked about vaccine acceptance through the question "Now that a COVID-19 vaccine is available, are you likely to get it?" and dichotomized into high accepters (already received it, would get it when available) and low accepters (waiting for a doctor to recommend it, waiting until more people received it, not likely to get it). RESULTS: Most patients (86.8% of 5,814) were high accepters of the COVID-19 vaccine. High accepters had more confidence in the effectiveness and safety of the vaccine than low accepters. Multivariable logistic regression showed older individuals (70-89 vs.18-49: OR:2.57, 95% CI:1.33-4.86), those with greater perceived severity of COVID-19 infection (very serious vs. not at all serious: OR:2.55, 95% CI:1.76-3.70), practicing more risk mitigation behaviors (per one standard deviation OR:1.75, 95% CI:1.57-1.95), and history of receiving the flu shot versus not (OR:6.56, 95% CI:5.25-8.20) had higher odds of vaccine acceptance. Individuals living with more than one other person (vs. alone: OR: 0.53, 95% CI: 0.35, 0.79) and those who were more socioeconomically disadvantaged (per 10 percentile points: OR: 0.89, 95 %CI: 0.85, 0.93) had lower odds of reporting vaccine acceptance. CONCLUSION: Most patients with cancer have or would receive the COVID-19 vaccine. Those who are less likely to accept the vaccine have more concerns regarding effectiveness and side effects, are younger, more socioeconomically disadvantaged, and have lower perceptions of COVID-19 severity.


Asunto(s)
COVID-19 , Neoplasias , Humanos , Vacunas contra la COVID-19/uso terapéutico , COVID-19/prevención & control , Pandemias/prevención & control , Aceptación de la Atención de Salud , Estudios Transversales , Vacunación
7.
Prim Care ; 49(4): 609-619, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-2105732

RESUMEN

During the COVID-19 pandemic, providers and patients explored the use of telehealth on a wide and rapid scale. Reflecting on how prenatal providers and pregnant patients used telehealth during the pandemic and afterward, we review existing and new lessons learned from the pandemic. This article summarizes international and national guidelines on prenatal care, presents practice examples on how telehealth and remote patient monitoring were used during the COVID-19 pandemic, and offers lessons learned and suggestions for future care.


Asunto(s)
COVID-19 , Telemedicina , Embarazo , Femenino , Humanos , Pandemias , Atención Prenatal , SARS-CoV-2
8.
Pediatr Clin North Am ; 69(5): 847-864, 2022 10.
Artículo en Inglés | MEDLINE | ID: covidwho-2105693

RESUMEN

Adolescent Medicine addresses the health care of adolescents, young adults, and their families. Adolescent psychology constitutes an important part. The COVID-19 pandemic has given insight into adolescent needs, bringing the focus on prevention rather than mere correction. One needs to factor in the unique aspects of adolescence, their need to impress peers and gain acceptance, and their unique information processing, not calculating trade-offs between risk and reward the way adults might, in a linear, rational, logical, and verbal manner. The article focuses on the need for collaborative training among the various stakeholders in Child and Adolescent Mental Health.


Asunto(s)
Medicina del Adolescente , COVID-19 , Adolescente , COVID-19/epidemiología , Niño , Humanos , Internacionalidad , Pandemias , Psicología del Adolescente , Adulto Joven
9.
Pediatr Clin North Am ; 69(3): 547-571, 2022 06.
Artículo en Inglés | MEDLINE | ID: covidwho-2105692

RESUMEN

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. More than 5 million children have been infected in the United States. Risk factors for more severe disease progression include obesity, pulmonary disease, gastrointestinal disorders, and neurologic comorbidities. Children with COVID-19 are admitted to the pediatric intensive care unit because of severe acute COVID-19 illness or COVID-19-associated multisystem inflammatory syndrome in children. The delta surge of 2021 was responsible for an increased disease burden in children and points to the key role of vaccinating children against this sometimes-deadly disease.


Asunto(s)
COVID-19 , COVID-19/complicaciones , COVID-19/epidemiología , Niño , Humanos , Unidades de Cuidado Intensivo Pediátrico , Pandemias , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria Sistémica , Estados Unidos/epidemiología
10.
Nurs Clin North Am ; 57(4): 551-562, 2022 12.
Artículo en Inglés | MEDLINE | ID: covidwho-2104622

RESUMEN

Despite the unprecedented obstacles created by the COVID-19 pandemic, nursing professional development practitioners and nurse educators successfully harnessed educational technology to disseminate an extraordinary amount of vital information needed to provide care to a society in crisis. The agile adoption of educational technology allowed rapid access and dissemination of information that carried institutions through the uncharted waters of the pandemic and created a roadmap for mass education techniques to guide not only future disaster preparedness and crisis intervention but also application of nursing education in all arenas.


Asunto(s)
COVID-19 , Educación en Enfermería , Humanos , Pandemias , Docentes de Enfermería , Tecnología
11.
Crit Care Nurs Clin North Am ; 34(4): 481-490, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-2104621

RESUMEN

The COVID-19 pandemic disproportionately affected individuals with kidney disease causing significant morbidity and mortality worldwide. Sars-coV-2 infection has been linked to the development of acute kidney injury and worsening of underlying kidney function. Multiple challenges were encountered during the COVID-19 pandemic resulting in valuable lessons learned for future pandemics, public health emergencies, and disasters related to the care of individuals with kidney disease. The COVID-19 pandemic has further exposed the extensive need for more nurses to be knowledgeable about the care of kidney disease and able to provide specialized nephrology care.


Asunto(s)
Lesión Renal Aguda , COVID-19 , Humanos , Pandemias , SARS-CoV-2
12.
Health Promot Int ; 36(5): 1324-1333, 2021 Oct 13.
Artículo | MEDLINE | ID: covidwho-2107483

RESUMEN

Global shifts toward a disease-oriented, vertical approach to health has involved limiting the right for communities to participate in decision-making. Ecuador's authoritarian legacy has forced civil society and social organizations to adopt 'coping strategies', while large protests recently derived into violent struggles. The country has been severely hit by the COVID-19 pandemic amid corruption scandals involving hospital and food purchases by government during the response. This study critically examines how Ecuador's government took into consideration 'community participation' as a value and tenet of health promotion. Our systematic textual analysis focuses on 53 consecutive resolutions by the National Emergency Operations Committee (EOC) leading the decision-making processes, which, explicitly requires community participation. Results show that the 'lifecycle' of the central government's evolving policy framing centered on law enforcement and the private sector, followed by the social sector. Further, there is no evidence of stakeholders from civil society or organizations taking part in decision-making. Having legitimized the exclusion of community participation in Ecuador's response to the COVID-19 pandemic, it is possible that the government will fail to consider the wider social implications of its impact. In particular, the limits to local governments becoming informed and making decisions without mediation by the National EOC will further impede community participation in health decision-making in the future. This implies that local knowledge and experiences will also not inform health policy.


Asunto(s)
COVID-19 , Participación de la Comunidad , Ecuador , Política de Salud , Humanos , Pandemias , SARS-CoV-2
14.
Lancet ; 396(10250): 535-544, 2020 08 22.
Artículo en Inglés | MEDLINE | ID: covidwho-2106188

RESUMEN

BACKGROUND: Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. METHODS: 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). FINDINGS: Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. INTERPRETATION: The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. FUNDING: Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Adulto , Anciano , Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , COVID-19 , Niño , Preescolar , Femenino , Humanos , Inmunoensayo , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Pruebas en el Punto de Atención , Prevalencia , Factores de Riesgo , SARS-CoV-2 , Estudios Seroepidemiológicos , España/epidemiología , Adulto Joven
15.
Top Antivir Med ; 30(3): 490-521, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-2101976

RESUMEN

The 2022 Conference on Retroviruses and Opportunistic Infections provided a rich source of new data and comprehensive reviews on antiviral therapy. For COVID-19, intramuscular sotrovimab was noninferior to intravenous sotrovimab, serostatus did not predict the efficacy of sotrovimab, and molnupiravir appeared safe and modestly effective in decreasing hospitalization rates. Trials from low- and middle-income countries provided data to support transitioning those on first-line therapy with or without virologic suppression and those virologically suppressed on second-line therapy to dolutegravir-based regimens. Additional data supported the use of lenacapavir as a long-acting antiretroviral drug. Data across the United States demonstrate the negative impact of the COVID-19 pandemic on the HIV care continuum, although enhanced outreach efforts and decentralization of antiretroviral therapy delivery were associated with improvements in care engagement outcomes. Researchers described potential mechanisms for the emergence of integrase strand transfer inhibitor resistance. Studies on proviral genotyping high-lighted the limitations of its use in predicting clinically significant resistance. Several studies looked at the epidemiology and treatment of hepatitis C and B and the status of current hepatitis C virus elimination efforts. Data presented on HIV, COVID-19, and maternal and pediatric health included 2-year virologic outcome data of very early antiretroviral therapy in potentially reducing the latent HIV reservoir in infants with HIV. Data presented on COVID-19 and HIV therapeutics in children included SARS-CoV-2-neutralizing monoclonal antibodies in children younger than 12 years of age, remdesivir in hospitalized infants and children, and long-acting therapies for HIV treatment in children.


Asunto(s)
COVID-19 , Infecciones por VIH , VIH-1 , Hepatitis Viral Humana , Niño , Humanos , Estados Unidos/epidemiología , Infecciones por VIH/tratamiento farmacológico , COVID-19/tratamiento farmacológico , Pandemias , SARS-CoV-2 , Latencia del Virus , Antirretrovirales/uso terapéutico
16.
Psychopharmacol Bull ; 52(4): 8-30, 2022 Oct 27.
Artículo en Inglés | MEDLINE | ID: covidwho-2101824

RESUMEN

Objective: In a phase 2 study, pimavanserin demonstrated efficacy as adjunctive treatment for major depressive disorder (MDD). Subsequently, two phase 3 studies (NCT03968159 in the US; NCT03999918 in Europe) were initiated to examine the efficacy and safety of adjunctive pimavanserin in subjects with MDD and inadequate response to antidepressant treatment. Studies were combined with a prespecified statistical analysis plan owing to recruitment challenges related to the COVID-19 pandemic. Experimental design: The randomized, double-blind studies enrolled 298 patients with MDD and inadequate response to current antidepressants. Patients were randomly assigned 1:1 to pimavanserin or placebo added to current antidepressant for 6 weeks. Primary endpoint was change from baseline to week 5 in the Hamilton Rating Scale for Depression, 17-item version (HAM-D-17). Principal observations: There was no effect of pimavanserin in change from baseline to week 5 in the HAM-D-17 (pimavanserin [n = 138]: least-squares mean [LSM] [standard error {SE}], -9.0 [0.58]; placebo [n = 135]: -8.1 [0.58]; mixed-effects model for repeated measures LSM [SE] difference, -0.9 [0.82], P = 0.2956). Nominal improvement with pimavanserin was observed on 2 secondary endpoints: Clinical Global Impressions-Severity scale, Karolinska Sleepiness Scale. Treatment-emergent adverse events occurred in 58.1% of pimavanserin-treated and 54.7% of placebo-treated patients. Conclusions: Adjunctive pimavanserin did not significantly improve depressive symptoms, although pimavanserin was well tolerated.


Asunto(s)
COVID-19 , Trastorno Depresivo Mayor , Humanos , Trastorno Depresivo Mayor/tratamiento farmacológico , Método Doble Ciego , Pandemias , Antidepresivos/efectos adversos , Resultado del Tratamiento
17.
J Neurol ; 269(9): 5022-5037, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-1820660

RESUMEN

OBJECTIVE: To identify factors that patients consider when choosing between future in-person, video, or telephone visits. BACKGROUND: Telemedicine has been rapidly integrated into ambulatory neurology in response to the COVID-19 pandemic. METHODS: Ambulatory neurology patients at a single center were contacted via telephone to complete: (1) a survey quantifying likelihood of scheduling a future telemedicine visit, and (2) a semi-structured qualitative interview following their visit in March 2021. Data were processed using the principles of thematic analysis. RESULTS: Of 2493 visits, 39% assented to post-visit feedback; 74% were in-person visits and 13% video and telephone. Patients with in-person visits were less likely than those with video and telephone visits to "definitely" consider a future telemedicine visit (36 vs. 59 and 62%, respectively; p < 0.001). Patients considered five key factors when scheduling future visits: "Pros of Visit Type," "Barriers to Telemedicine," "Situational Context," "Inherent Beliefs," and "Extrinsic Variables." Patients with telemedicine visits considered convenience as a pro, while those with in-person visits cited improved quality of care. Accessibility and user familiarity were considered barriers to telemedicine by patients with in-person and telephone visits, whereas system limitations were prevalent among patients with video visits. Patients agreed that stable conditions can be monitored via telemedicine, whereas physical examination warrants an in-person visit. Telemedicine was inherently considered equivalent to in-person care by patients with telephone visits. Awareness of telemedicine must be improved for patients with in-person visits. CONCLUSION: Across visit types, patients agree that telemedicine is convenient and effective in many circumstances. Future care delivery models should incorporate the patient perspective to implement hybrid models where telemedicine is an adjunct to in-person visits in ambulatory neurology.


Asunto(s)
COVID-19 , Neurología , Telemedicina , Atención a la Salud , Humanos , Pandemias
18.
Nurs Clin North Am ; 57(2): 245-258, 2022 06.
Artículo en Inglés | MEDLINE | ID: covidwho-1819287

RESUMEN

This article highlights the critical role of advanced practice registered nurses in the care of older adults living in nursing homes. This population is one of the frailest, marginalized, and often neglected in the United States. The COVID-19 pandemic impact on nursing homes resulted in a stunning number of infections and subsequent resident deaths. This is a shameful reminder of the many challenges and gaps in the nursing home industry including inadequate staffing, high staff turnover, improper isolation technique, and lack of fundamental knowledge of how to adequately implement infection prevention and control processes. Strong advanced practice registered nurse leadership may have mitigated some of these factors.


Asunto(s)
COVID-19 , Enfermeras y Enfermeros , Anciano , Humanos , Liderazgo , Casas de Salud , Pandemias , Estados Unidos
19.
BMC Bioinformatics ; 22(Suppl 15): 625, 2022 Apr 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1798449

RESUMEN

BACKGROUND: Being able to efficiently call variants from the increasing amount of sequencing data daily produced from multiple viral strains is of the utmost importance, as demonstrated during the COVID-19 pandemic, in order to track the spread of the viral strains across the globe. RESULTS: We present MALVIRUS, an easy-to-install and easy-to-use application that assists users in multiple tasks required for the analysis of a viral population, such as the SARS-CoV-2. MALVIRUS allows to: (1) construct a variant catalog consisting in a set of variations (SNPs/indels) from the population sequences, (2) efficiently genotype and annotate variants of the catalog supported by a read sample, and (3) when the considered viral species is the SARS-CoV-2, assign the input sample to the most likely Pango lineages using the genotyped variations. CONCLUSIONS: Tests on Illumina and Nanopore samples proved the efficiency and the effectiveness of MALVIRUS in analyzing SARS-CoV-2 strain samples with respect to publicly available data provided by NCBI and the more complete dataset provided by GISAID. A comparison with state-of-the-art tools showed that MALVIRUS is always more precise and often have a better recall.


Asunto(s)
COVID-19 , Genoma Viral , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Mutación , Pandemias , Filogenia , SARS-CoV-2/genética
20.
BMC Med Educ ; 22(1): 302, 2022 Apr 21.
Artículo en Inglés | MEDLINE | ID: covidwho-1798406

RESUMEN

BACKGROUND: Medical humanities courses that incorporate the visual arts traditionally require in-person instruction and visits to museums. The COVID-19 pandemic afforded medical educators a unique opportunity to implement and evaluate virtual visual arts programming. METHODS: A two-week, 7-module visual arts and medicine elective course for third and fourth-year medical students was conducted virtually in the Spring of 2021. The course included traditional didactic components as well as a range of hands-on creative art activities including painting, graphic medicine, photovoice, and Kintsugi (Japanese craft). Digital tools including Canvas, Google Jamboard, and Zoom facilitated student engagement. Student feedback was collected through anonymous post-course surveys. RESULTS: We successfully conducted a virtual visual arts and medicine elective which integrated hands-on creative art activities. Most students "strongly agreed" that remote instruction was sufficient to meet course objectives. However, all students also "agreed" that in-person instruction may promote more in-depth engagement with the visual arts. The hands-on creative art activities were appreciated by all students. CONCLUSION: Visual arts-based medical humanities courses can be delivered virtually and can include hands-on creative art activities such as painting. Future visual arts and medicine courses may benefit from incorporating a range of pedagogical methodologies, digital tools, control groups, and pre-/post-course assessments.


Asunto(s)
COVID-19 , Estudiantes de Medicina , Curriculum , Humanidades/educación , Humanos , Pandemias
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