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Kim EJ, Byun M. Factors Affecting Adherence to Social Distancing among Adults Aged 19-44 Years: Insights from a Nationwide Survey during COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:827. [PMID: 38793010 PMCID: PMC11122991 DOI: 10.3390/medicina60050827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/09/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Before COVID-19 vaccinations became available, adhering to non-pharmaceutical interventions (NPIs), like social distancing (SD), wearing masks, and hand hygiene, were crucial to mitigating viral spread. Many studies reported that younger individuals were more reluctant to follow these measures compared with older ones. We hypothesized that it would be worthwhile to find factors that influenced SD compliance among young people during the pre-vaccination phase of a pandemic. Materials and Methods: We analyzed data of adults aged 19-44 from the 2020 South Korean Community Health Survey and compared socio-demographic, health-related behavioral, and psychological factors between compliant and non-compliant cohorts. Results: A total of 59,943 participants were enrolled and we found that older age groups (30-39 and 40-44) and safety concerns (such as viral infection, virus-related death, economic damage, and transmitting virus to vulnerable people) were significantly associated with adherence to SD. Conversely, participants who were not living with a spouse, were unable to stay at home despite symptoms, smoked, drank, and had a negative attitude toward government policy statistically correlated with non-compliance. Conclusions: In times when NPIs were the primary defense against the pandemic, it is essential to identify factors that positively or negatively affect individual compliance with them, especially among young people. Using a large-scale, well-designed national survey, we could gain insights into the early recognition of risk factors for non-compliance and appropriate follow-up interventions (i.e., education campaigns, clear communication of public guidelines, and implementation of guidelines), which will help people to avoid suffering from other waves of future infectious diseases.
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Affiliation(s)
- Eun Jung Kim
- Department of Nursing, Seoil College, Seoul 02192, Republic of Korea;
| | - Mikyong Byun
- Department of Nursing, Deajeon University, 62, Daehak-ro, Dong-gu, Daejeon 300716, Republic of Korea
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Hurtado DA, Greenspan SA, Alley L, Hammer LB, Furnari M, Lenhart A. Safety Responsiveness and Psychological Distress Among Health Care Workers During COVID-19 (2020-2022) in the Pacific Northwest. Am J Public Health 2024; 114:204-212. [PMID: 38354349 PMCID: PMC10916732 DOI: 10.2105/ajph.2024.307582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/16/2024]
Abstract
Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n = 3468). Psychological distress was measured with the Well-being Index (range: -2 to 7 points). Safety response was scored on the basis of participants' ratings (on a 1-5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b = -0.54; 95% confidence interval [CI] = -0.67, -0.41) and the unit level (b = -0.73; 95% CI = -1.46, -0.01). The cross-level interaction was also statistically significant (b = -0.46; 95% CI = -0.87, -0.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. (Am J Public Health. 2024;114(S2):S204-S212. https://doi.org/10.2105/AJPH.2024.307582).
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Affiliation(s)
- David A Hurtado
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Samuel A Greenspan
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Lindsey Alley
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Leslie B Hammer
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Megan Furnari
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Abigail Lenhart
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
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Chasinga TB, Cikwanine JPB, Kribi S, Yoyu JT, Hofmann N, Grossegesse M, Nitsche A, Tomczyk S, Vietor AC, Leendertz FH, Eckmanns T, Kusinza AB, Munguakonkwa E, Kalk A, Raha M, Kambale NS, Ayagirwe RB, Schubert G, Mukwege D. Seroprevalence of anti-SARS-CoV-2 antibodies and risk of viral exposure among healthcare workers in the South Kivu province, eastern Democratic Republic of the Congo: a cross-sectional study. BMJ Open 2024; 14:e072212. [PMID: 38176860 PMCID: PMC10773362 DOI: 10.1136/bmjopen-2023-072212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
OBJECTIVES Healthcare workers (HCWs) are on the frontline of combating COVID-19, hence are at elevated risk of contracting an infection with SARS-CoV-2. The present study aims to measure the impact of SARS-CoV-2 on HCWs in central sub-Saharan Africa. SETTING A cross-sectional serological study was conducted at six urban and five rural hospitals during the first pandemic wave in the South Kivu province, Democratic Republic of the Congo (DRC). PARTICIPANTS Serum specimens from 1029 HCWs employed during the first pandemic wave were collected between August and October 2020, and data on demographics and work-related factors were recorded during structured interviews. PRIMARY AND SECONDARY OUTCOME MEASURES The presence of IgG antibodies against SARS-CoV-2 was examined by ELISA. Positive specimens were further tested using a micro-neutralisation assay. Factors driving SARS-CoV-2 seropositivity were assessed by multivariable analysis. RESULTS Overall SARS-CoV-2 seroprevalence was high among HCWs (33.1%), and significantly higher in urban (41.5%) compared with rural (19.8%) hospitals. Having had presented with COVID-19-like symptoms before was a strong predictor of seropositivity (31.5%). Personal protective equipment (PPE, 88.1% and 11.9%) and alcohol-based hand sanitizer (71.1% and 28.9%) were more often available, and hand hygiene was more often reported after patient contact (63.0% and 37.0%) in urban compared with rural hospitals, respectively. This may suggest that higher exposure during non-work times in high incidence urban areas counteracts higher work protection levels of HCWs. CONCLUSIONS High SARS-CoV-2 seropositivity indicates widespread transmission of the virus in this region of DRC. Given the absence of publicly reported cases during the same time period at the rural sites, serological studies are very relevant in revealing infection dynamics especially in regions with low diagnostic capacities. This, and discrepancies in the application of PPE between urban and rural sites, should be considered in future pandemic response programmes.
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Affiliation(s)
- Tshass B Chasinga
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Jean-Paul Buhendwa Cikwanine
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | | | - Jonathan Tunangoya Yoyu
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Département des Œuvres et Recherches Médicales, ECC-NK, Goma, Congo (the Democratic Republic of the)
| | | | | | | | | | | | - Fabian H Leendertz
- Robert Koch Institute, Berlin, Germany
- Helmholtz Institute for One Health, Greifswald, Germany
| | | | - Aline B Kusinza
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Eric Munguakonkwa
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Andreas Kalk
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Kinshasa, Congo (the Democratic Republic of the)
| | - Maroyi Raha
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Nelson S Kambale
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Département des Œuvres et Recherches Médicales, ECC-NK, Goma, Congo (the Democratic Republic of the)
| | - Rodrigue B Ayagirwe
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
| | | | - Denis Mukwege
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
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Doos D, Hughes AM, Pham T, Barach P, Bona A, Falvo L, Moore M, Cooper DD, Ahmed R. Front-Line Health Care Workers' COVID-19 Infection Contamination Risks: A Human Factors and Risk Analysis Study of Personal Protective Equipment. Am J Med Qual 2024; 39:4-13. [PMID: 38127677 DOI: 10.1097/jmq.0000000000000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Infectious risks escalate with complex donning and doffing personal protective equipment (PPE) protocols. Recent studies suggest that PPE donning and doffing behaviors that deviate from protocol during PPE reuse compounded the risks of health care worker (HCW) self-contamination. This study quantified the occurrence of behaviors associated with known risks in PPE use and reuse. We conducted a prospective study of emergency department HCWs and video-recorded PPE donning and doffing 5 times in simulated patient encounters. Trained coders recorded HCW behaviors according to an evidence-based guide. All 28 participants deviated from the Centers for Disease Control and Prevention (CDC) sanctioned donning and doffing protocol order, and most were documented to have (92.85%) self-contaminated at least once during each simulated clinical encounter. Behaviors that compounded self-contamination due to PPE reuse were also observed. Wide variation in PPE donning and doffing behaviors was found among front-line, experienced HCWs. Future work is needed to determine which deviations put HCWs at increased risk for accidental self-contamination and what changes are needed to the CDC protocol for protecting HCW from infections.
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Affiliation(s)
- Devin Doos
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Ashley M Hughes
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL
- Center of Innovation for Chronic Complex Health (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL
| | - Trang Pham
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL
| | - Paul Barach
- Department of Anesthesiology and City of Philadelphia, Jefferson College of Population Health, Thomas Jefferson School of Medicine, PA
- Department of Anesthesiology, Brisbane Queensland, University of Queensland, Australia
| | - Anna Bona
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Lauren Falvo
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Malia Moore
- Simulation Medicine, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Dylan D Cooper
- Clinical Emergency Medicine, Simulation Education, Department of Emergency Medicine, Simulation Center at Fairbanks Hall, Indiana University School of Medicine, Indianapolis, IN
| | - Rami Ahmed
- Division of Simulation, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
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De Maria L, Delvecchio G, Sponselli S, Cafaro F, Caputi A, Giannelli G, Stefanizzi P, Bianchi FP, Stufano A, Tafuri S, Lovreglio P, Boffetta P, Vimercati L. SARS-CoV-2 Infections, Re-Infections and Clinical Characteristics: A Two-Year Retrospective Study in a Large University Hospital Cohort of Vaccinated Healthcare Workers. J Clin Med 2023; 12:6800. [PMID: 37959268 PMCID: PMC10647276 DOI: 10.3390/jcm12216800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
At the University Hospital of Bari, during the first year after the start of the mandatory vaccination campaign with BNT162b2 mRNA COVID-19 vaccine, the preliminary results of an observational study showed a significant prevalence of SARS-CoV-2 breakthrough infections (BIs) among healthcare workers (HCWs), but no hospitalization or deaths. In the present study, we extended the observation period (January 2021-January 2023) with the aim of determining the incidence, characteristics and clinical course of SARS-CoV-2 BIs among 6213 HCWs. All HCWs were regularly monitored and screened. To allow return to work after BI, the protocol required one negative nasopharyngeal swab test followed by a medical examination certifying complete clinical recovery. We observed an overall incidence rate of SARS-CoV-2 BIs of 20.2%. Females were most affected, especially in the nurse group compared with doctors and other HCWs (p < 0.0001). Cardiovascular diseases were the most frequent comorbidity (n = 140; 11.4%). The source of infection was non-occupational in 52.4% of cases. Most cases (96.9%) showed minor symptoms and only two cases of hospitalization (one in intensive care unit), 13 cases of re-infection and no deaths were recorded. Our results confirm that SARS-CoV-2 infection can break vaccination protection but the clinical course is favorable.
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Affiliation(s)
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Francesco Cafaro
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | | | - Angela Stufano
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA;
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
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Kraus M, Stegner C, Reiss M, Riedel M, Børsch AS, Vrangbaek K, Michel M, Turmaine K, Cseh B, Dózsa CL, Dandi R, Mori AR, Czypionka T. The role of primary care during the pandemic: shared experiences from providers in five European countries. BMC Health Serv Res 2023; 23:1054. [PMID: 37784101 PMCID: PMC10546726 DOI: 10.1186/s12913-023-09998-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic necessitated wide-ranging adaptations to the organisation of health systems, and primary care is no exception. This article aims to collate insights on the role of primary care during the pandemic. The gained knowledge helps to increase pandemic preparedness and resilience. METHODS The role of primary care during the pandemic in five European countries (Austria, Denmark, France, Hungary, Italy) was investigated using a qualitative approach, namely case study, based on document analysis and semi-structured interviews. In total, 31 interviews were conducted with primary care providers between June and August 2022. The five country case studies were subjected to an overarching analysis focusing on successful strategies as well as gaps and failures regarding pandemic management in primary care. RESULTS Primary care providers identified disruptions to service delivery as a major challenge emerging from the pandemic which led to a widespread adoption of telehealth. Despite the rapid increase in telehealth usage and efforts of primary care providers to organise face-to-face care delivery in a safe way, some patient groups were particularly affected by disruptions in service delivery. Moreover, primary care providers perceived a substantial propagation of misinformation about COVID-19 and vaccines among the population, which also threatened patient-physician relationships. At the same time, primary care providers faced an increased workload, had to work with insufficient personal protective equipment and were provided incongruous guidelines from public authorities. There was a consensus among primary care providers that they were mostly sidelined by public health policy in the context of pandemic management. Primary care providers tackled these problems through a diverse set of measures including home visits, implementing infection control measures, refurbishing used masks, holding internal meetings and relying on their own experiences as well as information shared by colleagues. CONCLUSION Primary care providers were neither well prepared nor the focus of initial policy making. However, they implemented creative solutions to the problems they faced and applying the learnings from the pandemic could help in increasing the resilience of primary care. Attributes of an integrated health system with a strong primary care component proved beneficial in addressing immediate effects of the pandemic.
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Affiliation(s)
- Markus Kraus
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria.
| | - Christoph Stegner
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
| | - Miriam Reiss
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
| | - Monika Riedel
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
| | - Anne Sofie Børsch
- University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1353, Denmark
| | - Karsten Vrangbaek
- University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1353, Denmark
| | - Morgane Michel
- Université Paris Cité, ECEVE, UMR 1123, 10 avenue de Verdun, Inserm, Paris, 75010, France
- Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, 48 boulevard Sérurier, Paris, 75019, France
| | - Kathleen Turmaine
- Université Paris Cité, ECEVE, UMR 1123, 10 avenue de Verdun, Inserm, Paris, 75010, France
| | - Borbála Cseh
- University of Miskolc, Egyetem út 1, Miskolc-Egyetemváros, 3515, Hungary
| | - Csaba László Dózsa
- University of Miskolc, Egyetem út 1, Miskolc-Egyetemváros, 3515, Hungary
| | - Roberto Dandi
- Luiss Business School, Via Nomentana 216, Roma, 00162, RM, Italy
| | - Angelo Rossi Mori
- Institute for Research on Population and Social Policies, Via Palestro 32, Roma, 00185, Italy
| | - Thomas Czypionka
- Institute for Advanced Studies (IHS), Josefstädter Straße 39, Vienna, 1080, Austria
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Smith A, Kardos P, Pfaar O, Randerath W, Estrada Riolobos G, Braido F, Sadofsky L. The treatment of mild upper respiratory tract infections - a position paper with recommendations for best practice. Drugs Context 2023; 12:2023-4-2. [PMID: 37521107 PMCID: PMC10379023 DOI: 10.7573/dic.2023-4-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/31/2023] [Indexed: 08/01/2023] Open
Abstract
Following the waning severity of COVID-19 due to vaccination and the development of immunity, the current variants of SARS-CoV-2 often lead to mild upper respiratory tract infections (MURTIs), suggesting it is an appropriate time to review the pathogenesis and treatment of such illnesses. The present article reviews the diverse causes of MURTIs and the mechanisms leading to symptomatic illness. Different symptoms of MURTIs develop in a staggered manner and require targeted symptomatic treatment. A wide variety of remedies for home treatment is available, including over-the-counter drugs and plant-derived substances. Recent pharmacological research has increased the understanding of molecular effects, and clinical studies have shown the efficacy of certain herbal remedies. However, the use of subjective endpoints in these clinical studies may suggest limited validity of the results. In this position paper, the importance of patient-centric outcomes, including a subjective perception of improved well-being, is emphasized. A best practice approach for the management of MURTIs, in which pharmacists and physicians create an improved multi-professional healthcare setting and provide healthcare education to patients, is proposed. Pharmacists act as first-line consultants and provide patients with remedies, considering the individual patient's preferences towards chemical or plant-derived drugs and providing advice for self-monitoring. Physicians act as second-line consultants if symptoms worsen and subsequently initiate appropriate therapies. In conclusion, general awareness of MURTIs should be increased amongst medical professionals and patients, thus improving their management.
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Affiliation(s)
- Andrew Smith
- School of Psychology, Cardiff University, Cardiff, UK
| | - Peter Kardos
- Centre of Allergy, Respiratory and Sleep Medicine, Maingau Clinic of the Red Cross, Frankfurt am Main, Germany
| | - Oliver Pfaar
- Department of Otorhinolaryngology, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Winfried Randerath
- Institute of Pneumology, University of Cologne, Cologne, Germany
- Bethanien Hospital, Clinic of Pneumology and Allergology, Centre for Sleep Medicine and Respiratory Care, Solingen, Germany
| | | | - Fulvio Braido
- Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy
- Università di Genova, (DIMI), Genova, Italy
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McKay VR, Kwon JH. Identifying, deconstructing, and deimplementing low-value infection control and prevention interventions. Infect Control Hosp Epidemiol 2023:1-2. [PMID: 37183993 DOI: 10.1017/ice.2023.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Virginia R McKay
- Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Jennie H Kwon
- Department of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
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9
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Hu GY, Liang CA, Lin PC, Lin CY. Ivermectin's Role in the Prevention of COVID-19: A Systematic Review and Meta-Analysis. J Clin Pharmacol 2023; 63:288-297. [PMID: 36399336 DOI: 10.1002/jcph.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022]
Abstract
This systematic review was performed to determine the population that benefited from prophylactic ivermectin. Seven databases of health-related studies were searched for eligible trials without language restrictions. Randomized controlled trials (RCTs) and cohort studies investigating ivermectin for coronavirus disease 2019 (COVID-19) prevention were included. Data were pooled using a random-effects model, and subgroups were analyzed by study type and the pre- or postexposure population. The certainty of the evidence was determined by the Grading of Recommendations Assessment, Development, and Evaluation approach. Furthermore, 4 RCTs and 4 cohort studies with a moderate to high risk of bias were included in the analysis. The prophylactic use of ivermectin significantly decreased the overall incidence of COVID-19 (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.16-0.44). Nevertheless, the positive result was not supported by the RCT. Ivermectin was associated with a lower risk of COVID-19 (OR, 0.22; 95% CI, 0.12-0.40) in the preexposure population, whereas no protective effect was observed in the postexposure population (OR, 0.39; 95% CI, 0.09-1.67). In summary, prophylactic ivermectin did not prevent COVID-19 in the postexposure population. Although the protective effect of ivermectin was shown in the overall and preexposure populations, the results were unreliable owing to poor-quality evidence.
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Affiliation(s)
- Gong-Yi Hu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-An Liang
- Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Pei-Chin Lin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Yang Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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A Snapshot of the Experience of Dietitians during the COVID-19 Crisis in Five Arab Countries: Findings from a Regional Cross-Sectional Study. Nutrients 2022; 14:nu14224904. [PMID: 36432590 PMCID: PMC9695406 DOI: 10.3390/nu14224904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
COVID-19's intimidating spread has challenged the resilience of the global health systems, causing shifts in the practices of healthcare workers, including dietitians. The current study aimed to assess the change in dietitians' practices and duties in hospitals/clinics after the commencement of COVID-19 pandemic. This cross-sectional study was conducted in five Arab countries between November 2020 and January 2021. A convenient sample of 903 dietitians filled an online self-administered questionnaire to meet the study aims. Nearly 40.0% of the dietitians experienced a change in their workload and caseload during the pandemic. Besides, 18.7% of the dietitians had been assigned additional tasks in their facilities. Nearly half the dietitians (46.9%) had started giving remote nutrition consultations, associated with a 21% drop in the number of dietitians offering in-person consultations (p = 0.001). Approximately 58.9% of the dietitians provided nutrition care to COVID-19 patients, with 48.4% having access to personal protective equipment. Moreover, 17.0% of dietitians supported COVID-19 patients with enteral and parenteral nutrition. In addition, 45.0% of dietitians reported that managing COVID-19 was challenging given that it was a newly discovered condition.
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