RESUMO
This scoping study reports on the experiences of 41 female self-employed psychologists (or psychologists in private practice) during the first Covid-19 lockdown in the UK. Psychologists are more likely to be female, and unlike employed people, self-employed female psychologists were more likely to be working in lone contexts, and they were unlikely to have had broader organisational and government support available to them. Yet, self-employed female psychologists still made a significant contribution to the UK's response to the Covid-19 pandemic. In addition to supporting children and adults, they have played an important role in shaping government policy, and in the delivery of mass media campaigns and public health messaging. In view of this, the current scoping study focused on how self-employed female psychologists were fairing during the unprecedented circumstances. How were their needs being met? Responses to open-ended survey questions were qualitatively examined using a thematic analysis approach. Overall, the findings suggest that lockdown has afforded some positive opportunities for self-employed female psychologists in the UK. However, for many, it has also had a detrimental impact on their family relationships, and on their own mental health and wellbeing. The findings indicate that self-employed female psychologists may need a more nuanced approach to mitigate against any long-term negative effects of Covid-19.
RESUMO
OBJECTIVES: A network approach to transfer ST-segment elevation myocardial infarction (STEMI) patients can achieve durable first door-to-balloon times (1st D2B) for percutaneous coronary intervention (PCI) within 90 min. BACKGROUND: Nationally, a minority of STEMI patients from referral centers obtain 1st D2B in <2 h and even fewer in <90 min. METHODS: Included were transfer STEMI patients from 9 network hospitals treated in 2007 compared with 2008 to 2011 after installing the following initiatives: 1) established hospital referral system; 2) goal-oriented performance protocols; 3) expedited transport by ground or air; 4) first hospital activation of the PCI hospital catheterization laboratory; and 5) outreach coordinator and patient-level web-based feedback to the referring hospital. RESULTS: A total of 101 STEMI patients transported in 2007 were compared with 442 STEMI patients transferred after starting these initiatives for STEMI from 2008 to 2011, with the median door-in to door-out time decreased from 44 to 35 min (p < 0.0001), the median 1st D2B decreasing from 109.5 to 88.0 min (p < 0.0001), and the percentage under 90 min increased from 22.8% to 55.9% (p < 0.0001). Overall, throughout the study period (2007 to 2011), the transport times remained consistent (median 36.5 vs. 36.0 min, p = 0.98), whereas the PCI hospital D2B decreased from 20.0 to 16.0 min (p < 0.0001). Length of stay and in-hospital mortality remained low at 3.0 days and under 4%, respectively. CONCLUSIONS: A system-wide network program can achieve sustained (over 4 years) 1st D2B times of <90 min.
