共检索245条数据Total:245
2021-12-19
Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Australia. Electronic address: a.kavanagh@unimelb.edu.au.; Dept of Social Care and Social Work, Manchester Metropolitan University, UK.; Centre for Disability Research and Policy, Faculty of Health and Medicine, University of Sydney, Australia.; Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Australia.; Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Australia.; Faculty of Social Sciences, University of Warwick, UK.; Division of Psychiatry, University College London, UK.; Centre for Disability Research and Policy, Faculty of Health and Medicine, University of Sydney, Australia.; Dept of Social Care and Social Work, Manchester Metropolitan University, UK; Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, UK.
BACKGROUND: While emerging evidence shows increased mortality from COVID-19 among people with disability, evidence regarding whether there are disability-related inequalities in health during the pandemic is lacking. OBJECTIVE: This study compares access to COVID-19 and non-COVID-19 related health care and mental health of people with and without disability. METHODS: Longitudinal analysis of 12,703 adults (16-64 years) who participated in W9 (2017-2019) and the April and/or May COVID-19 special surveys of the UK Understanding Society study. Descriptive analyses and Poisson regression (adjusted for age, gender, ethnicity and financial stress) were conducted to estimate associations between disability (measured at Wave 9) and a number of different COVID-19-related health and health care outcomes (COVID-19 symptoms, testing and hospitalisation), mental health and loneliness, and non-COVID-19 related health care (e.g. outpatient and inpatient hospital care, prescription medications).
2021-12-07
Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine of Brown University, Providence, RI, USA; Women and Infants' Hospital of Rhode Island, Providence, RI, USA. Electronic address: micheline_anderson@brown.edu.; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine of Brown University, Providence, RI, USA; Women and Infants' Hospital of Rhode Island, Providence, RI, USA; School of Nursing, Virginia Commonwealth University, Richmond, VA, USA.; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA.; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA.; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine of Brown University, Providence, RI, USA; Women and Infants' Hospital of Rhode Island, Providence, RI, USA; Butler Hospital, Providence, RI, USA.
BACKGROUND: Research on perinatal mental health during the COVID-19 pandemic has largely focused on data from community samples. This study sought to understand the experiences of pregnant and postpartum women with histories of clinically elevated symptoms of depression. METHODS: Participants included 60 perinatal women who participated in wellness intervention trials for women with antenatal depression. We used a mixed methods approach, assessing depression, anxiety, stressors and coping behaviors, along with narrative responses to questions regarding COVID-specific effects on mental health. RESULTS: Over three-fourths of the sample indicated a worsening of mental health during the pandemic, with 31.7% of women endorsing clinically elevated depression symptoms and 36.7% screening positive for anxiety. Women reported negative impacts on their emotional wellbeing, especially a resurgence of mental health symptoms. Participants also articulated positive experiences during the pandemic
2021-12-05
Department of Obstetrics and Gynecology, Mount Sinai West, 1000 10th Avenue, New York, NY, 10019, USA.; Department of Obstetrics, Gynecology, & Reproductive Medicine, Division of Gynecologic Oncology, Mount Sinai Hospital/Icahn School of Medicine, 1176 Fifth Avenue, New York, NY, 10029, USA.; Department of Obstetrics, Gynecology, & Reproductive Medicine, Division of Gynecologic Oncology, Mount Sinai Hospital/Icahn School of Medicine, 1176 Fifth Avenue, New York, NY, 10029, USA. Kristen.Zeligs@mountsinai.org.; Department of Obstetrics, Gynecology, & Reproductive Medicine, Division of Gynecologic Oncology, Mount Sinai Hospital/Icahn School of Medicine, 1176 Fifth Avenue, New York, NY, 10029, USA.
COVID-19 has transformed the care we provide to gynecologic oncology patients. In addition to directly impacting the diagnosis and treatment of women with gynecologic cancer, it has affected our patient's ability to undergo recommended surveillance and has made an impact on every caregiver providing care during this time. Herein we review the current literature on the impact of COVID-19 on gynecologic oncology and highlight new approaches and innovations that have resulted in gynecologic cancer care as a result of the pandemic. The impact of COVID-19 on the field of gynecologic oncology has been profound. In addition to directly impacting the diagnosis and treatment of women with cancer, it has also challenged the very ethics with which we practice medicine. The equitable distribution of resources is paramount to upholding the Hippocratic Oath which we all invoke. The COVID-19 pandemic has stripped this oath down to its very core, forcing all medical practitioners to scrutinize who
2021-10-26
Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI.; Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI.; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI; Department of Infection Prevention and Epidemiology, Michigan Medicine, Ann Arbor, MI.; Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI.; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI; Division of Infectious Diseases, Department of Internal Medicine, Veterans Affairs, Ann Arbor Healthcare System, Ann Arbor, MI.; Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI.; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI.; Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI.; Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI; Geriatrics Research Education and Clinical Center (GRECC), Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI. Electronic address: lonamody@umich.edu.
BACKGROUND: Nursing home (NH) populations have borne the brunt of morbidity and mortality of COVID-19. We surveyed Michigan NHs to evaluate preparedness, staffing, testing, and adaptations to these challenges. METHODS: Interpandemic survey responses were collected May 1-12, 2020. We used Pearson's Chi-squared test, Fisher's exact test, and logistic regression to evaluate relationships. RESULTS: Of 452 Michigan NHs contacted via e-mail, 145 (32.1%) opened the survey and of these, 143 (98.6%) responded. Sixty-eight percent of respondents indicated their response plan addressed most issues. NHs reported receiving rapidly changing guidance from many sources. Two-thirds reported shortages of personal protective equipment and other supplies. Half (50%) lacked sufficient testing resources with only 36% able to test residents and staff with suspected COVID-19. A majority (55%) experienced staffing shortages. Sixty-three percent experienced resignations, with front-line clinical staff more
2021-10-19
Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. ernesto.maddaloni@uniroma1.it.; Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.; Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.; Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.; Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.; Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.; Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.; Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.; Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
Contrasting data have been published about the impact of cardiovascular disease on Covid-19. A comprehensive synthesis and pooled analysis of the available evidence is needed to guide prioritization of prevention strategies. To clarify the association of cardiovascular disease with Covid-19 outcomes, we searched PubMed up to 26 October 2020, for studies reporting the prevalence of cardiovascular disease among inpatients with Covid-19 in relation to their outcomes. Pooled odds-ratios (OR) for death, for mechanical ventilation or admission in an intensive care unit (ICU) and for composite outcomes were calculated using random effect models overall and in the subgroup of people with comorbid diabetes. Thirty-three studies enrolling 52,857 inpatients were included. Cardiovascular disease was associated with a higher risk of death both overall (OR 2.58, 95% confidence intervals, CI 2.12-3.14, p < 0.001, number of studies 24) and in the subgroup of people with diabetes (OR 2.91, 95% CI 2.13
2021-10-19
Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy. alice.gianstefani@aosp.bo.it.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.; Respiratory Disease Clinic, Sant'Orsola-Malpighi Hospital of the University of Bologna, Bologna, Italy.; Emergency Department, University of Bologna Hospital of Bologna Sant'Orsola-Malpighi, via Albertoni 10, 40138, Bologna, Italy.
During the first outbreak of Coronavirus disease 2019 (COVID-19) Emergency Departments (EDs) were overcrowded. Hence, the need for a rapid and simple tool to support clinical decisions, such as the ROX index (Respiratory rate - OXygenation), defined as the ratio of peripheral oxygen saturation and fraction of inspired oxygen, to respiratory rate. The aim of the study was to evaluate the accuracy of the ROX index in predicting hospitalization and mortality in patients with a diagnosis of COVID-19 in the ED. The secondary outcomes were to assess the number of readmissions and the variations in the ROX index between the first and the second admission. This was an observational prospective monocentric study, carried out in the ED of Sant'Orsola-Malpighi Hospital in Bologna, Italy. Five hundred and fifty-four consecutive patients with COVID-19 were enrolled and the ROX index was calculated. Patients were followed until hospital discharge or death. A ROX index value < 25.7 was associated
2021-10-19
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.; Immunization Unit, Robert Koch Institute, Berlin, Germany.; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.; Institute for Medical Epidemiology, Biostatistics and Informatics, University of Halle, Halle, Germany.; Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany.; German Center for Infection Research, Hannover-Braunschweig site, Brunswick, Germany.; Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hanover, Germany.; Biomedical Research in End-Stage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hanover, Germany.; Faculty of Medicine, University of Halle, Halle, Germany.; Institute for Medical Epidemiology, Biostatistics and Informatics, University of Halle, Halle, Germany.; Institute for Medical Epidemiology, Biostatistics and Informatics, University of Halle, Halle, Germany.; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany. veronika.jaeger@ukmuenster.de.; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
BACKGROUND: The effect of contact reduction measures on infectious disease transmission can only be assessed indirectly and with considerable delay. However, individual social contact data and population mobility data can offer near real-time proxy information. The aim of this study is to compare social contact data and population mobility data with respect to their ability to reflect transmission dynamics during the first wave of the SARS-CoV-2 pandemic in Germany. METHODS: We quantified the change in social contact patterns derived from self-reported contact survey data collected by the German COVIMOD study from 04/2020 to 06/2020 (compared to the pre-pandemic period from previous studies) and estimated the percentage mean reduction over time. We compared these results as well as the percentage mean reduction in population mobility data (corrected for pre-pandemic mobility) with and without the introduction of scaling factors and specific weights for different types of contacts and
2021-10-18
Pharmaceutical Department, USL Umbria 1, Perugia, Italy. antonio.vitiello2@uslumbria1.it.; Pharmaceutical Department, USL Umbria 1, Perugia, Italy.; Pathology Department, ASUR Marche, Area Vasta 1, Urbino, Italy.; Pathology Department, ASUR Marche, Area Vasta 1, Urbino, Italy.
A massive COVID-19 vaccination campaign is underway worldwide. Epidemiological data from studies indicate excellent efficacy and safety profile for COVID-19 vaccines. However, there are few data from studies on the effect of decreasing the probability of infection of vaccinated subjects compared to unvaccinated subjects. In this short communication, we describe some evidence on this important and current topic providing useful personal reflections.CI - © 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
2021-10-14
McMaster University, 1280 Main Street W., Hamilton, Ontario, 835 King St. West, Kitchener, ON, Canada. Christopher.dainton@gmail.com.; Grand River Hospital, 835 King St. West, Kitchener, Ontario, N2G 1G3, Canada. Christopher.dainton@gmail.com.; Grand River Hospital, 835 King St. West, Kitchener, Ontario, N2G 1G3, Canada.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street Suite 130, Toronto, ON, M5T 1P8, Canada.; Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, Ontario, M5G 2A2, Canada.
BACKGROUND: The COVID-19 pandemic and subsequent lockdown measures have led to increasing mental health concerns in the general population. We aimed to assess the short-term impact of the pandemic lockdown on mental health emergency services use in the Kitchener-Waterloo region of Ontario, Canada. METHODS: We conducted an observational study during the 6-month period between March 5 and September 5, 2020 using National Ambulatory Care Reporting System metadata from mental health visits to three regional Emergency Departments (ED); mental health and substance related police calls; and calls to a regional mental health crisis telephone line, comparing volumes during the pandemic lockdown with the same period in 2019. Quasi-Poisson regressions were used to determine significant differences between numbers of each visit or call type during the lockdown period versus the previous year. Significant changes in ED visits, mental health diagnoses, police responses, and calls to the crisis line
2021-09-30
Department of Pediatrics, Children's Hospital of Michigan, 3901, Beaubien Boulevard, Detroit, MI 48201, USA. Electronic address: pezaddoctor@gmail.com.; Department of Pediatrics, UT Health Science Center, UT Health San Antonio, San Antonio, TX 78229, USA.; Department of Pediatrics, Wayne State University School of Medicine, 540E Canfield Street, Detroit, Michigan 48201, USA.
COVID-19 has afflicted the health of children and women across all age groups. Since the outbreak of the pandemic in December 2019, various epidemiologic, immunologic, clinical, and pharmaceutical studies have been conducted to understand its infectious characteristics, pathogenesis, and clinical profile. COVID-19 affects pregnant women more seriously than nonpregnant women, endangering the health of the newborn. Changes have been implemented to guidelines for antenatal care of pregnant women, delivery, and newborn care. We highlight the current trends of clinical care in pregnant women and newborns during the COVID-19 pandemic.CI - Copyright © 2021 Elsevier Inc. All rights reserved.