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Journal of Clinical Urology ; : 20514158221086137, 2022.
Article Dans Anglais | Sage | ID: covidwho-1910212


Background:Although the technology has been available and several pilot studies have shown success, use of telemedicine has previously been limited in the United States, especially among surgeons. This study aimed to investigate the benefits and obstacles for successful implementation of telemedicine visits in paediatric surgical subspecialties amid the COVID-19 pandemic.Methods:We analysed survey data from telemedicine visits with paediatric surgical subspecialists from May 1 through June 30, 2020 at our paediatric surgery subspecialty clinics. Univariate logistic regression was used to determine associations in survey responses and various demographic factors.Results:There were 164 respondents to the survey. The most frequently cited barrier to care was ability to get time off work (46.3%). Overall satisfaction with the telemedicine visit was 93.8%, and 55.6% responded that they would choose video telemedicine rather than an in-person or telephone visit. Those living at least 25 miles from the hospital had increased odds of indicating interest in using telemedicine for future visits (OR = 2.56, 95% CI = 1.12?5.86, p = 0.026). The average respondent saved between 30 minutes and 1 hour, and 45 minutes using telemedicine.Conclusions:The implementation of telemedicine at our institution in the paediatric surgical subspecialties has proven to be effective and well-received. Given the benefits of time and money saved for families, paired with high satisfaction rates and continued interest, paediatric surgical subspecialists should work to incorporate virtual visits into regular patient care, even well after the COVID-19 pandemic.Level of Evidence:Level IV

Preprint Dans Anglais | medRxiv | ID: ppmedrxiv-21266195


BackgroundInformation on the occupational distribution of COVID-19 mortality is limited. ObjectiveTo characterize COVID-19 fatalities among working Californians. DesignRetrospective study of laboratory-confirmed COVID-19 fatalities with dates of death from January 1 to December 31, 2020. SettingCalifornia. ParticipantsCOVID-19 accounted for 8,050 (9.9%) of 81,468 fatalities among Californians 18-64 years old. Of these decedents, 2,486 (30.9%) were matched to state employment records and classified as "confirmed working." The remainder were classified as "likely working" (n=4,121 [51.2%]) or "not working" (n=1,443 [17.9%]) using death certificate and case registry data. MeasurementsWe calculated age-adjusted overall and occupation-specific COVID-19 mortality rates using 2019 American Community Survey denominators. ResultsConfirmed and likely working COVID-19 decedents were predominantly male (76.3%), Latino (68.7%), and foreign-born (59.6%), with high school or less education (67.9%); 7.8% were Black. The overall age-adjusted COVID-19 mortality rate was 30.0 per 100,000 workers (95% confidence interval [CI], 29.3-30.8). Workers in nine occupational groups had mortality rates higher than this overall rate, including those in farming (78.0; 95% CI, 68.7-88.2); material moving (77.8; 95% CI, 70.2-85.9); construction (62.4; 95% CI, 57.7-67.4); production (60.2; 95% CI, 55.7-65.0); and transportation (57.2; 95% CI, 52.2-62.5) occupations. While occupational differences in mortality were evident across demographic groups, mortality rates were three-fold higher for male compared with female workers and three- to seven-fold higher for Latino and Black workers compared with Asian and White workers. LimitationsThe requirement that fatalities be laboratory-confirmed and the use of 2019 denominator data may underestimate the occupational burden of COVID-19 mortality. ConclusionCalifornians in manual labor and in-person service occupations experienced disproportionate COVID-19 mortality, with the highest rates observed among male, Latino, and Black workers.

Sustainability ; 13(16):9010, 2021.
Article Dans Anglais | MDPI | ID: covidwho-1355038


COVID-19 is a terrible virus that has impacted human health and the economy on a global scale. The detection and control of the pandemic have become necessities that require appropriate monitoring strategies. One of these strategies involves measuring and quantifying the virus in water at different stages of the Urban Water Cycle (UWC). This article presents a comprehensive literature review of the analyses and quantifications of SARS-CoV-2 in multiple UWC components from 2020 to June 2021. More than 140 studies worldwide with a focus on industrialized nations were identified, mainly in the USA, Australia, and Asia and the European Union. Wastewater treatment plants were the focus of most of these studies, followed by city sewerage systems and hospital effluents. The fewest studies examined the presence of this virus in bodies of water. Most of the studies were conducted for epidemiological purposes. However, a few focused on viral load and its removal using various treatment strategies or modelling and developing strategies to control the disease. Others compared methodologies for determining if SARS-CoV-2 was present or included risk assessments. This is the first study to emphasize the importance of the various individual components of the UWC and their potential impacts on viral transmission from the source to the public.

Preprint Dans Anglais | medRxiv | ID: ppmedrxiv-20248203


BackgroundAfter eight months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia. MethodsWe conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from March 2nd to October 26th, 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the hazard risk ratio (HR) by age groups, sex, ethnicity, type of health insurance, area of residence, and socioeconomic strata. ResultsThere were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between March 2nd and October 26th. The risk of dying for COVID-19 among confirmed cases was higher in males (HR=1.68 95% CI: 1.64-1.72), in people older than 60 years (HR=296.58 95% CI: 199.22-441.51), in indigenous people (HR=1.20 95% CI: 1.08-1.33), in people with subsidized health insurance regime (HR=1.89 95% CI: 1.83-1.96), and in people living in the very low socioeconomic strata (HR=1.44 95% CI: 1.24-1.68). ConclusionOur study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regime, and socioeconomic status.

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