Risultati per: COVID-19: scoperto un nuovo meccanismo di resistenza immunitaria

Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contibute to understand the epidemiology of this condition from a multinational approach.

The primary endpoint of time to sustained clinical improvement for distinct asunercept arms compared to SOC failed to meet statistical significance. The compound was safe and well tolerated.

Objectives
In Colombia, 4.3% of the population 5 years or older lives with a disability. They face higher levels of poverty and social exclusion compared with persons without disabilities. This article aims to understand the factors associated with access to preventative and curative health services for people with disabilities in Colombia. Additionally, it explores whether access to health services for people with disabilities changed during the COVID-19 pandemic.

Design
This is a population-based repeated cross-sectional study.

Setting
This study took place in Colombia, from 2018 to 2021.

Data sources and participants
National Quality of Life Survey datasets in Colombia from 2018 to 2021, including people 5 years or older, were reviewed. People were classified into three groups: person with any disability, person with multiple disabilities and person without disabilities.

Primary and secondary outcome measures
A multinomial regression model was used to calculate the probability of access to preventative services during the previous year in four categories: general practitioner (GP) and dentist, GP only, dentist only and no consultation. A logistic model for curative consultations with and without hospitalisation in people who reported having a health problem.

Results
People with disabilities demanded more preventative health services, except for dental services, compared with people without disabilities. Similarly, they experienced more health problems and demanded more curative services than people without disabilities, except during the year 2020, when no significant differences were found between people with and without disabilities. For people with disabilities, poverty was not associated with a lower likelihood of consultation, except for preventative dental consultations, which were significantly lower for poor people with disabilities. In addition, the subsidised insurance regimen was identified as an important variable in the utilisation of healthcare in Colombia.

Conclusion
People with disabilities in Colombia demand more health services compared with people without disabilities. Despite being in a worse condition according to various socioeconomic indicators, few factors affect their demand for healthcare services. The COVID-19 pandemic was associated with a significant reduction in the probability of access to outpatient treatment services during 2020 for people with disabilities. Longitudinal studies and comparison with other Latin American countries are recommended.

Objectives
To determine associations between the banning of sex work during the COVID-19 pandemic, and work, financial problems, mental well-being and HIV/sexually transmittable infection (STI) testing among sex workers in the Netherlands.

Design
Two cross-sectional online surveys. The first survey covered two time-periods: pre-COVID-19 (1 January 2019 to 31 December 2019) and period 1 (15 March 2020 to 1 July 2020). The second survey covered period 2 (1 January 2021 to 31 December 2021).

Setting
The Netherlands

Participants
In total, 106 (first survey) and 196 (second survey) sex workers participated. Most of the participants in the first and second survey were cisgender women (respectively, 76.4% and 66.5%), followed by cisgender men (respectively, 12.3% and 15.7%) and the combination of transgender men, transgender women, non-binary or other (respectively, 11.3% and 17.6%). Most participants were born in the Netherlands (respectively, 61.4% and 69.7%).

Primary and secondary outcome measures
We provide descriptive statistics of self-reported work during and prior to COVID-19 measures, financial problems due to COVID-19 measures and HIV/STI testing and mental well-being during the COVID-19 pandemic. We also performed logistic and linear regression analyses to identify risk factors associated with reporting financial problems due to COVID-19 measures, not testing for HIV/STIs and lower mental well-being during the COVID-19 pandemic.

Results
In periods 1 and 2, respectively, 69.6% and 62.0% reported financial problems due to the COVID-19 measures. Among those who reported to have had sex with clients, the percentage not HIV/STI testing was: 4.5% (95% CI: 0.9; 12.5) pre-COVID-19, 28.2% (95% CI: 15.0; 44.9) in period 1, and 15.2% (95% CI: 9.7; 22.3) in period 2. In the multivariate analysis, reported financial problems due to the COVID-19 pandemic was associated with not HIV/STI testing (OR: 12.1, p

Introduction
The COVID-19 pandemic has had a major impact on nursing staff, resulting in alarming turnover rates. As part of the Quebec (Canada) government’s response to the pandemic, nurses have been offered exceptional financial incentives. Considering the cost of these measures, the current article presents the research protocol of a study aiming to explore the impact of financial incentives on full-time equivalent, and retention rates among the nursing staff in two healthcare settings in Quebec.

Methods and analysis
A sequential mixed design (QUANT- >QUAL) will be used. The quantitative phase will involve a quantitative descriptive analysis and the qualitative phase will consist of a qualitative descriptive study. Administrative data (working hours, employment status and retention rate) will be analysed over a 4.5-year follow-up (from 1 January 2019 to 30 June 2023) to explore the impact of the financial incentives. Focus groups will explore nurses’ views on financial incentives. The results will inform the development of future interventions to mitigate attrition problems among nurses and ultimately improve access to and the continuity of public health services.

Ethics and dissemination
The study has been approved by ethics committees of the participating healthcare settings (Comité d’éthique de la recherche sectorial en santé des populations et première ligne du CIUSSS de la Capitale-Nationale; Comité d’éthique de la recherche du CISSS de Chaudière-Appalaches). The results will be disseminated mainly in scientific publications and at academic conferences in addition to presentations tailored to various non-academic audiences.

Background
The National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID-19 pandemic. An in-depth understanding of healthcare workers’ (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs’ concerns during the COVID-19 pandemic—expressed in real time during an active mental health crisis.

Design
This study involved analysis of data from ‘Shout’, a text message-based, UK-wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudorandom sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 to March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose-built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with subthemes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication.

Results
Three themes emerged from the data: (1) poor mental health, subthemes—(a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. (2) Negative work experiences, subthemes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and (d) abuse at work. (3) The impact of the COVID-19 pandemic, subthemes: (a) additional work pressure and (b) isolation and risk.

Conclusion
This study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision.

Objective
To determine whether a chemokine receptor type 2 antagonist, DMX-200 (repagermanium), in combination with an angiotensin receptor blocker, candesartan, improves clinical outcomes in people with COVID-19.

Design
Prospective, multicentre, double-blind, placebo-controlled trial.

Setting
Ten acute care hospitals in India.

Participants
Adults

Approximately 22% of deaths in 2021 from COVID-19 in US hospitals could be attributed to the imbalance between the number of patients being treated by the hospital and the resources to care for them, according to a cohort study published in the Annals of Internal Medicine.

This cohort study examines cardiovascular complications of postvaccine and other types of myocarditis (ie, post–COVID-19 and conventional myocarditis) during 18-month follow-up.

Objectives
The purpose of this study is to describe and evaluate, in a real-life context, the support and communicate with families (SCF) team’s contribution to maintaining communication and supporting relatives when patients are at the end of their lives by mobilising the points of view of SCF team members, healthcare professionals, managers and the relatives themselves.

Design
An in-depth mixed-method case study (quantitative and qualitative). Individual interviews were conducted with members of the SCF team to assess the activities and areas for improvement and with co-managers of active COVID-19 units. Healthcare professionals and managers completed a questionnaire to assess the contribution made by the SCF team. Hospitalised patients’ relatives completed a questionnaire on their experience with the SCF team.

Setting
The study was conducted in a university teaching hospital in the province of Québec, Canada.

Participants
Members of the SCF team, healthcare professionals, managers and relatives of hospitalised patients.

Results
Between April and July 2020, 131 telephone communications with families and healthcare professionals, 43 support sessions for relatives of end-of-life patients and 35 therapeutic humanitarian visits were carried out by members of the SCF team. Team members felt that they had played an active role in humanising care. Fully 83.1% of the healthcare professionals and managers reported that the SCF team’s work had met the relatives’ needs, while 15.1% believed that the SCF team should be maintained after the pandemic. Fully 95% of the relatives appreciated receiving the telephone calls and visits, while 82% felt that the visits had positive effects on hospitalised patients.

Conclusion
The COVID-19 pandemic forced the introduction of a social innovation involving support for and communication with families. The intention of this innovation was to support the complexity of highly emotional situations experienced by families during the COVID-19 pandemic.

Objectives
To investigate worry about COVID-19 during the pandemic, and whether worry was associated with phase of the pandemic, COVID-19 death and incidence rates, Government interventions (including lockdown and advertising), age, being clinically at-risk, ethnicity, thinking that the Government had put the right measures in place, perceived risk of COVID-19 to self and the UK, and perceived severity of COVID-19.

Design
Secondary analysis of a series of cross-sectional surveys.

Setting
73 online surveys conducted for the English Department of Health and Social Care between 28 January 2020 and 13 April 2022.

Participants
Participants were people aged 16 years and over living in the UK (approximately 2000 per wave).

Primary outcome measures
Our primary outcome was self-reported worry about COVID-19.

Results
Rates of being ‘extremely’ or ‘very’ worried changed over time. Worry increased as infection rates increased and fell during lockdowns, but the association became less obvious over time. Respondents aged 60 years and over were less likely to be worried after the launch of the vaccination campaign, while those who were clinically at-risk or from a minoritised ethnic community were more likely to be worried. Higher worry was associated with higher perceived risk, and higher perceived severity of COVID-19. There was no evidence for an association with agreeing that the Government was putting the right measures in place to prevent the spread of COVID-19. The launch of graphic Government advertising campaigns about COVID-19 had no noticeable effect on levels of public worry.

Conclusions
In future infectious disease outbreaks, spikes in worry may attenuate over time, although some sections of society may experience higher anxiety than others.

Takenobu K, Yoshida S, Katanoda K, et al. Impact of workplace smoke-free policy on secondhand smoke exposure from cigarettes and exposure to secondhand heated tobacco product aerosol during COVID-19 pandemic in Japan: the JACSIS 2020 study. BMJ Open 2022;12:e056891. doi: 10.1136/bmjopen-2021-056891
This article was previously published with an error.
The authors have informed the journal that two of the authors have received payment from the tobacco industry on projects unrelated to the one described in the article. This was not in breach of the journal’s policy at the time of publication, which stated that we will not ‘consider for publication any study that is partly or wholly funded by the tobacco industry’.1 However, to make these personal funds transparent, we have corrected the competing interests statement of the article.

E’ efficace in adulti con aumentato rischio della patologia

Objectives
During the COVID-19 epidemic, due to the high risk associated with travel and group gatherings, the Ministry of Public Health in Qatar introduced home delivery of pharmaceutical services. This study aims to investigate the satisfaction and preferences of patients who used the new home delivery services provided by health centres (HCs).

Study design
A cross-sectional study was conducted using an exploratory questionnaire to assess patients’ preferences for pharmaceutical delivery services.

Settings
Primary care.

Participants
A convenient sample of 604 adults who used the pharmaceutical delivery services was recruited. The study tool measured satisfaction with a set of 11 service evaluation criteria on a Likert scale of 5 grades. The score ranged between 1 for highly dissatisfied and 5 for highly satisfied. A quantitative summary satisfaction score was calculated by summing the satisfaction rating for home delivery on the 11 service evaluation criteria. The final score was adjusted to a maximum of 100 for ease of understanding.

Results
Results showed that 45.5% of participants were highly satisfied with the overall quality of the home delivery service. Furthermore, 58.9% were willing to recommend the service to others, while only 30.9% considered the delivery cost to be reasonable. Among the factors associated with satisfaction was nationality, where Qatari nationals had a significantly higher mean satisfaction score (89%) compared with expatriates (79.5%).

Outcome
The satisfaction score exhibited a significant positive trend with age and educational level. Factors such as gender, the time required to access the HCs, frequency of requesting pharmacy service and income categories did not show a significant difference in the satisfaction score.

Conclusion
The home delivery service is a promising addition to primary care. It may play a crucial role in enhancing accessibility for the beneficiaries reducing unnecessary visits to HCs in the future.