Risultati per: Il significato della carica virale e l’effetto del vaccino anti-COVID-19

Objective
This study aimed to determine the prevalence and associated factors of perceived stress among pregnant women during the COVID-19 pandemic period in Northwest Ethiopia.

Method
A cross-sectional study.

Setting
University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.

Participants
A total of 415 pregnant women were recruited by using a systematic random sampling technique from 28 April 2020 to 12 June 2020.

Measurement
The required data were collected through face-to-face interviews. The Perceived Stress Scale was used to assess perceived stress. The Edinburgh Postnatal Depression Scale and Oslo Social Support Scale 3 were used for associated factors. The data were analysed by using SPSS V.20. We also included sociodemographic, obstetrical and gynaecology, substance use and intimate partner-related factors. Logistic regression analysis was used to identify associated factors with perceived stress. Bivariate and multivariable logistic regression analyses were used to identify the effect of each independent variable with the outcome variable. A p value of less than 0.05 was considered to be statistically significant.

Results
A total of 415 pregnant women participated in the study with response rate of 98.57%. The prevalence of perceived stress is found to be 13.7% (95% CI=10.4% to 17.1%). According to the multivariable logistic regression result, being a student (adjusted OR (AOR)=9.67, 95% CI=2.739 to 34.183), being at the first and third trimesters of gestational age (AOR=3.56, 95% CI=1.065 to 11.885; AOR=4.80, 95% CI=1.851 to 14.479, respectively), and having antenatal depression (AOR=3.51, 95% CI=1.628 to 7.563) were factors positively associated with perceived stress.

Conclusion
The prevalence of perceived stress among pregnant people was relatively high. This study recommends that all pregnant people should be screened and treated for perceived stress particularly during the first and third trimesters. Emphasis should be given to early detection and treatment of antenatal depression. Pregnant students must be strongly evaluated and intervened for perceived stress.

Quando i due virus circoleranno insieme ci sarà un tiro alla fune o un meccanismo virus scaccia virus? Ed entro fine anno sono in arrivo anche nuovi vaccini

Se nelle prossime settimane non ci sarà un aumento sensibile dei ricoveri questo significherebbe che l’epidemia è finalmente più gestibile e ci si può convivere

Objective
To assess implementation and ease of implementation of control measures in schools as reported by staff and parents.

Design
A descriptive cross-sectional survey.

Setting
Staff and parents/guardians of the 132 primary schools and 19 secondary schools participating in COVID-19 surveillance in school kids (sKIDs and sKIDsPLUS Studies).

Main outcome measure
Prevalence of control measures implemented in schools in autumn 2020, parental and staff perception of ease of implementation.

Results
In total, 56 of 151 (37%) schools participated in this study, with 1953 parents and 986 staff members completing the questionnaire. Most common measures implemented by schools included regular hand cleaning for students (52 of 56, 93%) and staff (70 of 73, 96%), as reported by parents and staff, respectively, and was among the easiest to implement at all times for students (57%) and even more so, for staff (78%). Maintaining 2-metre distancing was less commonly reported for students (24%–51%) as it was for staff (81%–84%), but was one of the most difficult to follow at all times for students (25%) and staff (16%) alike. Some measures were more commonly reported by primary school compared to secondary school parents, including keeping students within the same small groups (28 of 41, 68% vs 8 of 15, 53%), ensuring the same teacher for classes (29 of 41, 71% vs 6 of 15, 40%). On the other hand, wearing a face covering while at school was reported by three-quarters of secondary school parents compared with only parents of 4 of 41 (10%) primary schools. Other measures such as student temperature checks (5%–13%) and advising staff work from home if otherwise healthy (7%–15%) were rarely reported.

Conclusions
Variable implementation of infection control measures was reported, with some easier to implement (hand hygiene) than others (physical distancing).

Objective
To investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic.

Design
Critical interpretive synthesis (CIS) of qualitative research.

Participants
Studies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic.

Results
134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments.

Conclusions
The findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.

New England Journal of Medicine, Volume 387, Issue 13, September 2022.

A U.K. study suggests that it does, particularly in unvaccinated patients.

Annals of Internal Medicine, Volume 175, Issue 10, Page 1374-1382, October 2022.

Introduction
The use of fibrinolytic therapy has been proposed in severe acute respiratory distress syndrome (ARDS). During the COVID-19 pandemic, anticoagulation has received special attention due to the frequent findings of microthrombi and fibrin deposits in the lungs and other organs. Therefore, the use of fibrinolysis has been regarded as a potential rescue therapy in these patients. In this prospective meta-analysis, we plan to synthesise evidence from ongoing clinical trials and thus assess whether fibrinolytic therapy can improve the ventilation/perfusion ratio in patients with severe COVID-19-caused ARDS as compared with standard of care.

Methods and analysis
This protocol was registered in PROSPERO. All randomised controlled trials and prospective observational trials that compare fibrinolytic therapy with standard of care in adult patients with COVID-19 and define their primary or secondary outcome as improvement in oxygenation and/or gas exchange, or mortality will be considered eligible. Safety outcomes will include bleeding event rate and requirement for transfusion. Our search on 25 January 2022 identified five eligible ongoing clinical trials. A formal search of MEDLINE (via PubMed), Embase, CENTRAL will be performed every month to identify published results and to search for further trials that meet our eligibility criteria.

Dissemination
This could be the first qualitative and quantitative synthesis summarising evidence of the efficacy and safety of fibrinolytic therapy in critically ill patients with COVID-19. We plan to publish our results in peer-reviewed journals.

PROSPERO registration number
CRD42021285281.

L’applicazione di questo studio darà la possibilità di identificare chi ha un rischio più alto di sviluppare la Mis-C, tramite l’analisi di alcuni geni

Objectives
There have been substantial amounts of misinformation surrounding the importance, safety and effectiveness of the COVID-19 vaccine. The impacts of this misinformation may be augmented as they circulate among ethnic communities, who may concurrently face other barriers related to vaccine uptake and access. To combat some of the key sources of COVID-19 vaccine misinformation among the South Asian communities of the Greater Toronto and Hamilton Area (GTHA), an interdisciplinary team of researchers and marketing experts established the South Asian Youth as Vaccine Agents of Change (SAY-VAC) programme to support and empower South Asian youth to disseminate COVID-19 vaccine information.

Design
Cross-sectional and one-group pretest–post-test design.

Setting
GTHA.

Participants
South Asian youth (18–29 years).

Intervention
The team partnered with grass-roots South Asian organisations to collaborate on shared objectives, curate key concerns, create video products regarding the COVID-19 vaccine that would resonate with the community, disseminate the products using established social media channels and evaluate the effectiveness of this effort.

Outcomes
We assessed the change in self-reported knowledge about the COVID-19 vaccine and participant confidence to facilitate a conversation around the COVID-19 vaccine using pre-post surveys, after the implementation of the SAY-VAC programme.

Results
In total, 30 South Asian youth (median age=23.2 years) from the GTHA participated in the programme. After completing the SAY-VAC programme, participants reported an increase in their self-reported knowledge regarding the COVID-19 vaccine from 73.3% to 100.0% (p=0.005), and their self-reported confidence to have a conversation about the vaccine with their unvaccinated community members increased from 63.6% to 100.0% (p=0.002). Overall, 51.9% of the participants reported being able to positively affect an unvaccinated/community member’s decision to get vaccinated.

Conclusions
The SAY-VAC programme highlights the importance of community partnerships in developing and disseminating culturally responsive health communication strategies. A constant assessment of the evidence and utilisation of non-traditional avenues to engage the public are essential.

Introduction
Little is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health effects as well as the associated risk factors is scant. This study aims to determine the short, intermediate and long-term health effects of COVID-19 on the survivors and the associated risk factors.

Methods and analysis
We propose conducting a 24-month prospective quantitative study in 10 health facilities (2 specialist, 3 regional, 2 mission and 3 subdistrict hospitals) from Lusaka and Southern Province of Zambia. Health facilities will be those which served as COVID-19 treatment centres during the third wave (June–August 2021). Study participants will comprise a randomly selected cohort of 450 COVID-19 survivors who had mild or no symptoms (80%) and severe cases (20%). Using a questionnaire, respondent demographic, clinical and laboratory data will be collected at baseline and at a 3-month interval for 18 months using a questionnaire. Respondents’ medical records will be reviewed and data collected using a checklist. Descriptive statistics will be computed to summarise respondents’ characteristics and clinical outcomes. Bivariate analysis (X2 and t-test) will be conducted to test the association between respondent characteristics and clinical outcomes. Multivariate logistic regression analysis will be run to determine the risk factors for short, intermediate and long-term health effects; adjusted ORs will be computed to test the strength of the association (p

Introduction
COVID-19 disease was declared as a pandemic by WHO since March 2020 and can have a myriad of clinical presentations affecting various organ systems. Patients with COVID-19 are known to have an increased risk of thromboembolism, including cardiovascular, pulmonary and cerebral ischaemic events. However, an increasing number of case studies have reported that COVID-19 infection is also associated with gastrointestinal ischaemia. This scoping review aims to collate the current evidence of COVID-19-related gastrointestinal ischaemia and raise awareness among healthcare professionals of this lesser known, but serious, non-pulmonary complication of COVID-19 infection.

Methods
The proposed scoping review will be conducted as per the Arksey and O’Malley methodological framework (2005) the Joanna Briggs Institute methodology for scoping reviews. A systematic search will be undertaken on different databases including EMBASE, PubMed and MEDLINE. Two independent reviewers will screen titles, abstracts and full-text articles according to the inclusion criteria and extract relevant data from the included articles. Results will be presented in a tabular form with a narrative discussion.

Ethics and dissemination
Ethical approval will not be required for this scoping review. This scoping review will provide an extensive overview of the association between COVID-19 infection and bowel ischaemia. Further ethical and methodological challenges will also be discussed in our findings to define a new research agenda. Findings will be disseminated through peer-reviewed publications and presentations at both national and international conferences.

Objectives
To explore community pharmacists and key stakeholders’ perspectives and reflections on the community pharmacy workforce’s preparedness for, and response to, COVID-19, including lessons for future public health crises.

Design, setting and participants
Qualitative study using semistructured interviews (via telephone or online videoconferencing platform), with community pharmacists and a range of key stakeholders (representing other health professions, professional/governing organisations concerned with community pharmacy and patient advocacy groups) from across Northern Ireland. Data were analysed using thematic analysis and constant comparison.

Results
Thirty interviews were conducted with community pharmacists (n=15) and key stakeholders (n=15). Four themes were identified: (1) adaptation and adjustment (reflecting how community responded quickly to the need to maintain services and adjusted and adapted services accordingly); (2) the primary point of contact (the continuing accessibility of community pharmacy when other services were not available and role as a communication hub, particularly in relation to information for patients and maintaining contact with other healthcare professionals); (3) lessons learnt (the flexibility of community pharmacy, the lack of infrastructure, especially in relation to information technology, and the need to build on the pandemic experience to develop practice); and (4) planning for the future (better infrastructure which reinforced concerns about poor technology, coordination of primary care services and preparing for the next public health crisis). There was a general view that community pharmacy needed to build on what had been learnt to advance the role of the profession.

Conclusions
The strengths of community pharmacy and its contribution to healthcare services in the COVID-19 pandemic were noted by community pharmacists and acknowledged by key stakeholders. The findings from this study should inform the policy debate on community pharmacy and its contribution to the public health agenda.

Objectives
To examine the views and experiences of community pharmacists in Northern Ireland (NI) regarding changes in community pharmacy practice/processes in preparation for, and response to, the COVID-19 pandemic.

Design
Cross-sectional telephone-administered questionnaire.

Setting and participants
Geographically stratified representative sample of 130 community pharmacists in NI between March and May 2021.

Outcome measures
Community pharmacists’ responses to questions focusing on their preparation, experience and response to the COVID-19 pandemic. Descriptive analysis was conducted including frequencies and percentages. Free-text comments were summarised using thematic analysis.

Results
One hundred and thirty pharmacists completed the questionnaire. Pharmacists responded comprehensively to implementing infection control measures, for example, management of social distancing in the shop (96.2%), making adjustments to premises, for example, barriers/screens (95.4%), while maintaining medicines supply (100.0%) and advice to patients (93.1%). Newly commissioned services were provided, for example, emergency supply service (93.1%), influenza vaccination for healthcare workers (77.7%) and volunteer deliveries to vulnerable people (54.6%). Pharmacists were least prepared for the increased workload and patients’ challenging behaviour, but the majority (96.9%) reported that they felt better prepared during the second wave. Pharmacists agreed/strongly agreed that they would be able to re-establish normal services (87.7%), were willing to administer COVID-19 vaccines (80.7%) and provide COVID-19 testing (60.8%) in the future.

Conclusions
Community pharmacists remained accessible and maintained supply of essential medicines and advice to patients throughout the pandemic. Provision of modified and additional services such as vaccination reinforced the clinical and public health role of pharmacy