pandemic (COVID-19)

大流行 ( COVID - 19 )
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    印度医学研究委员会(ICMR)在简化测试和诊断方面发挥了至关重要的作用,制定指导方针,并在COVID-19大流行期间制定管理策略。此外,ICMR设计并开发了一个全面的数据管理工具,用于以标准化格式从全国所有实验室收集测试数据。本报告是对ICMR生成的测试数据的回顾性分析。该研究的主要目标是了解一个人在最初的阳性测试后根据其年龄测试为阴性的可能性,并评估该疾病在不同年龄段和性别人群中的不同影响和持续时间。
    分析了COVID测试的匿名数据。P到P是患者的两个连续阳性测试之间的最长时间间隔,而阳性之间没有任何阴性测试。P-to-Plast是第一个阳性测试和最后一个阳性测试之间的时间,而不是P-to-P,在这里,我们看到的是可能连续或不连续的第一个和最后一个阳性测试。P-N间隔是患者的第一次阳性和第一次阴性测试之间的时间。
    印度在研究期间进行了170,914,170次测试(直到2020年12月29日)。排除无效测试结果和重复项后,对150,086,257名独特个体进行了11,101,603名(6.5%)阳性和156,542,352名(93.5%)阴性测试结果.阳性测试后的阴性报告为12.69%。近四分之三的病例(78.29%)属于工作年龄组(18-60岁)。>50岁的患者比例从26.06%上升到35.03%,在2020年9月之后急剧上升。阳性中的性别比例为1.73:1,在<7天(年龄)的新生儿中是中性的。在最初的几个月中,性别比例偏向男性,此后趋势相反,并且随着患者年龄的增加。平均P对P,P-to-Plast,P-P持续时间为1-4周的个体的P-N持续时间分别为12.7+4.3、13.3+4.6和14.2+4.9天。在第一次阳性测试后14天和21天,测试阴性的概率分别为82%和85%,没有性别偏见。
    当前的研究强调了印度COVID-19流行病学的一些重要方面。在缺乏关于新病毒和疾病本身的预先存在的信息的情况下,这项研究将增加对病毒的当前理解。
    UNASSIGNED: The Indian Council of Medical Research (ICMR) played a crucial role in streamlining testing and diagnosis, formulating guidelines, and devising management strategies during the COVID-19 pandemic. Additionally, ICMR designed and developed a comprehensive data management tool for collecting testing data in a standardized format from all laboratories across the country. The current report is a retrospective analysis of the testing data generated by the ICMR. The study\'s main objectives are to understand the probability of a person testing negative based on their age after an initial positive test and to assess the varied impact and duration of the disease in people of different age groups and genders.
    UNASSIGNED: Anonymized data on the testing for COVID were analyzed. The P-to-P is the longest time interval between two consecutive positive tests for a patient without any negative test in between the positives. P-to-Plast is the time between the first positive and last positive test, as opposed to P-to-P, here we are looking at the first and last positive tests that might or might not be consecutive. P-to-N intervals is the time between the first positive and first negative test of a patient.
    UNASSIGNED: India conducted 170,914,170 tests during the study-period (until December 29, 2020). After excluding invalid test results and duplicates, there were 11,101,603 (6.5%) positive and 156,542,352 (93.5%) negative test-results performed upon 150,086,257 unique individuals. A negative-report following a positive-test was available in 12.69%. Nearly three-fourths of the cases (78.29%) belonged to the working-age group (18-60 years). The proportion of patients >50 years old has risen from 26.06 to 35.03%, with a steep rise beyond September 2020. Gender-ratio among the positives was 1.73:1 which was neutral in neonates < 7-days (age). The gender ratio was skewed in-favor-of males in the initial months with a reverse trend thereafter and with increasing age of patients. The mean P-to-P, P-to-Plast, and P-to-N durations were 12.7 + 4.3, 13.3 + 4.6, and 14.2 + 4.9 days for individuals with P-to-P duration of 1-4 weeks. The probability of testing negative was 82 & 85% at 14 & 21 days after the first-positive-test respectively with no gender bias.
    UNASSIGNED: The current study has highlighted some vital aspects of COVID-19 epidemiology in India. This study will add to the current understanding of the virus in the absence of pre- existing information on the novel virus and the disease per se.
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  • 文章类型: Observational Study
    COVID-19大流行带来了护理使用模式的变化。预计紧急情况的数量将大大增加。然而,在全球范围内观察到显著下降。
    观测,对波尔图大学医院中心急诊服务机构(2018-2022年)收治的18岁或以上患者的所有急诊事件记录进行了分析和横断面研究.
    在大流行期间,紧急情况入院人数显著减少(封锁期间高达40%),增加应急服务,并观察到传染病和内科的放电。全科医学和全科医学和家庭医学的出院都是残留的。
    在COVID-19大流行期间,紧急服务的使用率和使用类型较低,对疾病负担产生了负面影响。可以通过制定战略以提高对使用卫生资源的信心并建立虚拟援助的应急计划,在未来的流行病中预防这种情况。
    The COVID-19 pandemic brought changes in the pattern of care use. A significant increase in the volume of emergencies was expected. However, a significant decrease was observed worldwide.
    An observational, analytical and cross-sectional study of all records of emergency episodes of patients aged 18 years or older admitted to the emergency services of the University of Porto Hospital Centre (2018-2022) were analysed.
    During the pandemic, a significant reduction in emergency episode admissions (up to 40% during lockdowns), an increase in pre-emergency services, and discharges from Infectious Diseases and Internal Medicine was observed. The discharges from General Practice and General Practice and Family Medicine were residual.
    The lower use and type of use of emergency services during the COVID-19 pandemic had a negative impact on the disease burden. This could be prevented in future pandemics through the development of strategies to promote confidence in the use of health resources and establishing contingency plans for virtual assistance.
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  • 文章类型: Journal Article
    围绕COVID-19大流行的不确定性导致出现上呼吸道感染(URTI)症状的非紧急急诊科(ED)就诊人数激增。这些非紧急访问,在初级保健中通常是可控的,加剧了ED的过度拥挤,这可能会损害ED服务的质量。了解患者的期望和这些ED就诊的原因对于缓解ED过度拥挤的问题至关重要。因此,我们评估了影响患者在大流行不同阶段对无并发症URTI进行ED访视期间对诊断性检查期望的因素.
    我们对2021年3月至2022年3月期间在新加坡的四个公共ED上寻求治疗的患有URTI症状的成年人进行了横断面研究。我们将研究期间分为三个COVID-19大流行阶段-遏制,过渡,和缓解。结果变量是患者是否期望(1)COVID-19特异性诊断测试,(2)非COVID-19特异性诊断测试,(3)COVID-19特异性和非COVID-19特异性诊断测试,或(4)没有诊断测试。我们建立了一个向后逐步选择的多项回归模型,并根据Andersen的医疗保健利用模型对研究结果进行了分类。
    参与者的平均年龄为34.5(12.7)岁。影响ED中COVID-19特异性诊断测试预期的因素(调整后比值比[95%置信区间])包括年龄较小{21-40岁:(2.98[1.04-8.55])},没有事先的临床咨询(2.10[1.13-3.89]),遵守雇主的卫生政策(3.70[1.79-7.67]),感知的非疾病严重程度(2.50[1.39-4.55]),担心感染COVID-19(2.29[1.11-4.69]),在大流行的过渡阶段(2.29[1.15-4.56])。未就业影响了对非COVID-19特异性诊断测试的期望(3.83[1.26-11.66])。影响COVID-19特异性和非COVID-19特异性测试预期的因素包括年龄{21-40岁:(3.61[1.26-10.38]);41-60岁:(4.49[1.43-14.13])},遵守雇主的卫生政策(2.94[1.41-6.14]),担心感染COVID-19(2.95[1.45-5.99]),以及在大流行的过渡(2.03[1.02-4.06])和缓解(2.02[1.03-3.97])阶段。
    在COVID-19大流行阶段,患者在急诊就诊期间对诊断测试的期望是动态的。在年轻人和担心在COVID-19大流行期间感染COVID-19的人中,对COVID-19特异性诊断测试对不复杂的URTI的ED访问的期望更高。未来的研究需要加强关于初级保健诊断服务可用性的公共沟通,以及关于新冠肺炎等新发传染病自我管理的公共教育。
    The uncertainties surrounding the COVID-19 pandemic led to a surge in non-urgent emergency department (ED) attendance among people presenting with upper respiratory tract infection (URTI) symptoms. These non-urgent visits, often manageable in primary care, exacerbated ED overcrowding, which could compromise the quality of ED services. Understanding patients\' expectations and the reasons for these ED visits is imperative to mitigate the problem of ED overcrowding. Hence, we assessed the factors influencing patients\' expectations for diagnostic tests during their ED visits for uncomplicated URTI during different phases of the pandemic.
    We conducted a cross-sectional study on adults with URTI symptoms seeking care at four public EDs in Singapore between March 2021 and March 2022. We segmented the study period into three COVID-19 pandemic phases-containment, transition, and mitigation. The outcome variables are whether patients expected (1) a COVID-19-specific diagnostic test, (2) a non-COVID-19-specific diagnostic test, (3) both COVID-19-specific and non-COVID-19-specific diagnostic tests, or (4) no diagnostic test. We built a multinomial regression model with backward stepwise selection and classified the findings according to Andersen\'s healthcare utilization model.
    The mean age of participants was 34.5 (12.7) years. Factors (adjusted odds ratio [95% confidence interval]) influencing expectations for a COVID-19-specific diagnostic test in the ED include younger age {21-40 years: (2.98 [1.04-8.55])}, no prior clinical consultation (2.10 [1.13-3.89]), adherence to employer\'s health policy (3.70 [1.79-7.67]), perceived non-severity of illness (2.50 [1.39-4.55]), being worried about contracting COVID-19 (2.29 [1.11-4.69]), and during the transition phase of the pandemic (2.29 [1.15-4.56]). Being non-employed influenced the expectation for non-COVID-19-specific diagnostic tests (3.83 [1.26-11.66]). Factors influencing expectations for both COVID-19-specific and non-COVID-19-specific tests include younger age {21-40 years: (3.61 [1.26-10.38]); 41-60 years: (4.49 [1.43-14.13])}, adherence to employer\'s health policy (2.94 [1.41-6.14]), being worried about contracting COVID-19 (2.95 [1.45- 5.99]), and during the transition (2.03 [1.02-4.06]) and mitigation (2.02 [1.03-3.97]) phases of the pandemic.
    Patients\' expectations for diagnostic tests during ED visits for uncomplicated URTI were dynamic across the COVID-19 pandemic phases. Expectations for COVID-19-specific diagnostic tests for ED visits for uncomplicated URTI were higher among younger individuals and those worried about contracting COVID-19 during the COVID-19 pandemic. Future studies are required to enhance public communications on the availability of diagnostic services in primary care and public education on self-management of emerging infectious diseases such as COVID-19.
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  • 文章类型: Editorial
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  • 文章类型: Editorial
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    自2020年3月全球开始严格限制以来,由于COVID-19大流行对我们生活的巨大影响,人们对提供视频会议心理治疗(VCP)的兴趣与日俱增。科学文献提供了关于向远程会议过渡及其影响的有趣结果,考虑不同的心理治疗取向。关于VCP是否以及如何影响心理动力学心理治疗方法的了解较少,并且关于诸如严重人格障碍之类的严重和复杂的心理健康问题的远程工作的报道仍然很少。这项研究的目的是检查心理动力学心理治疗师的经验,主要提供以移情为中心的心理治疗(TFP),随着第一波COVID-19大流行期间VCP的过渡和递送。在大流行的高峰期,四百七十九名有执照的心理治疗师完成了一项在线调查。采用定性分析方法对调查数据进行分析。提出并讨论了有关获得心理治疗的利弊的结果,在线视频设置的特殊性,身体方面,治疗关系的质量,治疗过程包括技术方面和治疗师的经验。此外,我们分析并讨论了有关转移和反转移反应的陈述,将高级别临界和神经症患者与低水平临界患者区分开来。我们的结果支持识别可能受益于VCP的患者的重要性。需要进一步的研究,包括更多的前瞻性随机对照试验,以调查研究结果的治疗意义。
    There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist\'s experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings.
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  • 文章类型: Journal Article
    医护人员已被确定为有职业性语音障碍的风险。其中,在重症监护病房(ICU)工作的护士由于暴露于高水平噪音的风险因素而特别脆弱.因此,本研究旨在确定ICU护士的嗓音障碍患病率.
    对来自中国四家医院的100名ICU护士进行了问卷调查。问卷评估了声带相关症状,感知到的语音障碍,经常听到的噪声源,以及通信质量。
    结果表明,最常报告的声音症状是\“声音疲倦\”和\“无声\”。每周工作超过50小时的护士比每周工作40-50小时的护士更频繁地出现声音症状。感觉到的嗓音障碍评分(VHI-30)的中值为23,表明轻度的嗓音障碍,而24%的护士报告严重的嗓音障碍。更长的工作时间和在患者病房工作与更高的VHI-30得分显着相关。护士还报告说,在COVID-19大流行期间,与患者和同事的口头交流质量和语音问题恶化。
    超过20%的护士报告严重的嗓音障碍,然而,ICU护士的嗓音障碍并没有出现在所有护士中。需要进一步的研究来确定与语音障碍相关的危险因素以及ICU护士之间这种异质性背后的机制。
    Healthcare workers have been identified as being at risk of occupational voice disorders. Among them, nurses working in intensive care units (ICUs) are particularly vulnerable due to the risk factors that are associated with their exposure to high levels of noise. Thus, this study aimed to determine the prevalence of voice disorders among ICU nurses.
    A questionnaire was administered to 100 ICU nurses from four hospitals in China. The questionnaire assessed vocal-related symptoms, perceived voice handicap, frequently heard noise sources, and the quality of communications.
    Results indicate that the most frequently reported voice symptoms were \'voice tiredness\' and \'voiceless\'. Nurses working more than 50 h per week experienced voice symptoms more frequently than nurses working for 40-50 h per week. The median value of the perceived voice handicap score (VHI-30) was 23, indicating mild voice handicap, while 24% of the nurses reported severe voice handicap. Longer working hours and working at patient wards were significantly associated with higher VHI-30 scores. The nurses also reported that the quality of verbal communication with patients and colleagues and voice problems worsened during the COVID-19 pandemic.
    More than 20% of nurses reported severe voice handicap, however, voice handicap among ICU nurses did not appear universally to all nurses. Further research is necessary to identify the risk factors associated with voice disorders and the mechanism behind such heterogeneity among ICU nurses.
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