Risultati per: Flowchart decisionale: vaccinare l’adulto ai tempi del COVID-19

Mahesarajah S, El Asmar ML, Irwin R, et al. Impact of the COVID-19 pandemic on psychotropic prescribing: a systematic review BMJ Open 2024;14:e076791. doi: 10.1136/bmjopen-2023–0 76 791
The article is updated since it was first published. The below mentioned sections have been updated:
Results- Changes in antipsychotic prescribing rates, line 21 and 22, page no. 8.
Results – Changes in antidepressant prescribing rates, line 20, page no. 8.
Discussion – Discussion of findings and implications of selected studies, line 33, page no. 9.
Table 2- Result, last paragraph.

Introduction
During the first wave of the COVID-19 outbreak in China, the surge of COVID-19 cases was rapid and drastic. Emerging evidence suggests that beyond the acute phase, patients with COVID-19 may experience a wide range of postacute or long COVID sequelae. However, the mechanism and burden of COVID-19, especially long COVID, have not yet been comprehensively clarified. To fill this knowledge gap, this large prospective follow-up study aims to investigate the short-term and long-term effects of COVID-19, explore the underlying biological mechanism and identify predictive neuroimaging and haematological biomarkers associated with these effects.

Methods and analysis
This multicentre study will recruit patients infected during the first wave of COVID-19 in China and healthy controls (HCs) with no history of COVID-19 infection from nine participating hospitals. Confirmed patients with mild or moderate COVID-19 will complete the following programmes during the acute infection phase and at 3, 12 and 24 months after infection: (a) blood test at the local laboratory, (b) multimodal brain and spine MRI scan and (c) the neuropsychological scales and questionnaires. Similarly, the uninfected HCs will complete the same programmes as the infected group mentioned above at the time of inclusion. At the first time point, 501 participants (418 patients and 83 HCs) from nine recruiting hospitals have been observed. Ultimately, all of these results will be analysed to explore the short-term and long-term effects of COVID-19.

Ethics and dissemination
Ethics approval was granted by Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU1AF2023LSK-013). Findings will be presented at national and international conferences, as well as published in peer-reviewed scientific journals.

Trial registration number
NCT05745805.

Objective
During the COVID-19 pandemic, the need for end-of-life care has increased. This type of care is different for patients with COVID-19 compared with other patients. This study aims to explain the experiences of intensive care unit (ICU) nurses in providing end-of-life care to patients with COVID-19.

Design
Qualitative content analysis.

Setting
The study population consisted of ICU nurses working in hospitals affiliated with the Kerman University of Medical Sciences in southeastern Iran.

Participants
14 ICU nurses, including 9 women and 5 men, participated in this study. Their mean age was 33.79±5.07 years, and their mean work experience was 8.64±3.5 years.

Primary and secondary objectives
The purpose of this qualitative content analysis was to explore the experiences of Iranian intensive care nurses using purposive sampling and semistructured in-depth interviews. Sampling was based on maximum variation (age, gender, professional experience and educational level) to obtain rich information. Guba and Lincoln’s criteria were applied to increase the trustworthiness and rigour of the study, and the data were analysed using Graneheim and Lundman’s method and MAXQDA 2020.

Results
ICU nurses’ experiences of caring for patients with COVID-19 at the end of life are comprehensive, and four main themes emerged from the responses: fear of death due to COVID-19 infection; physical and psychological consequences of caring for patients dying from COVID-19; confusion in caring for patients with COVID-19 at the end of life and unbelievable deaths.

Conclusion
The present study looked at the experiences of Iranian nurses providing end-of-life care during the COVID-19 pandemic. The findings suggest that the nurses experienced anxiety, excessive fatigue and guilt during end-of-life care and that the high mortality and unbelievable deaths were traumatic experiences for them.

Objective
Investigate whether deaf or hard of hearing (D/HH) patients with COVID-19 exhibited different hospitalisation outcomes compared with hearing patients with COVID-19.

Design
Cohort study

Setting
Statewide Inpatient Databases for Florida, Maryland, New York and Washington, for the year 2020.

Participants
Records of patients aged 18–64 years with COVID-19

Primary outcomes and measures
Differences in in-hospital death, 90-day readmission, length of stay, hospitalisation cost, hospitalisation cost per day, intensive care unit (ICU) or coronary care unit (CCU) utilisation and ventilation use were evaluated. Adjustment variables included patient basic characteristics, socioeconomic factors, and clinical factors.

Results
The analyses included 347 D/HH patients and 72 882 non-D/HH patients. Multivariable log-transformed linear regression models found an association of patients’ hearing loss status with longer length of stay (adjusted mean ratio (aMR) 1.15, 95% CI 1.04 to 1.27, p

Objective
To understand how area deprivation inequalities in COVID-19 mortality changed during the national vaccination programme in England and to identify the extent to which these inequalities might be explained by unequal vaccination uptake.

Design
Ecological study.

Setting
307 Lower Tier Local Authorities in England, March 2020 – December 2022.

Main outcome measure
Inequality in age-standardised mortality rates 28 days after a positive COVID-19 test by area-level deprivation from March 2020 to December 2022. We employ three different measures of this inequality: the disparity index, the concentration and generalised concentration index, and absolute and relative measures of inequality. We use the 2019 edition of the Index of Multiple Deprivation, transformed into quintiles.

Results
Relative inequalities in age-standardised mortality rates 28 days after a positive COVID-19 test reduced substantially (from around 6.9 times higher in most deprived to least deprived to 1.2 times higher) in the 25 months after the national vaccination rollout began. Vaccination uptake between the most and least deprived quintiles widened with each dose. Inequalities in cumulative mortality rates developed quickly, and while they stabilised and reduced, they did not disappear. We estimate that if vaccination rates in the most deprived areas had been the same as those in the least deprived, absolute disparity inequality would have been reduced from 118.9 per 100 000 (95% CI 117.0 to 120.7) to 40.2 (95% CI 3.7 to 76.7) at the end of 2022.

Conclusions
National COVID-19 vaccination strategies offer the potential to significantly reduce inequalities in COVID-19 mortality rates. However, more could be achieved if barriers to vaccination uptake in the most deprived areas are overcome.

Objectives
To explore care home managers’ views and experiences of optimising medicines use for residents with dementia during the COVID-19 pandemic.

Design, setting and participants
A descriptive exploratory qualitative study using semistructured interviews (conducted via telephone or online videoconferencing platform), with care home managers across Northern Ireland, purposively sampled from care homes that provided care for residents with dementia. Care home managers were asked to describe their experiences of accessing primary healthcare services (such as those provided by general practitioners and community pharmacists), how medicines use by residents with dementia was affected by the pandemic, and what they had learnt from their experiences. Data were analysed using inductive thematic analysis.

Results
Fourteen interviews were conducted between January and July 2022. Four themes, ‘isolation’, ‘burden’, ‘disruption’ and ‘connection and communication’, were identified; isolation was a cross-cutting theme that permeated the other themes. Care home managers described feeling isolated from healthcare professionals, healthcare services and residents’ family members. This isolation placed additional burden on care home staff and residents with dementia by increasing staff workload and negatively affecting residents’ well-being. Participants reported that disruption to primary healthcare service provision, particularly services provided by general practices, had significant impact on residents with dementia. Participants described a lack of face-to-face contact with healthcare professionals, and medication reviews often ceased to take place. The connection and communication between key stakeholders were perceived to be important when optimising medicines for residents with dementia.

Conclusions
This study has highlighted the challenges and initial impact of the COVID-19 pandemic on medicines optimisation for care home residents with dementia, which was characterised by isolation. Further research is needed to determine the extent of the long-term impact of the COVID-19 pandemic on this resident population. In future public health crises, better communication is needed between healthcare professionals and care homes.

Introduction
Long-acting injectable (LAI) cabotegravir is a promising new method for preventing HIV. Safe and effective long-acting agents for pre-exposure prophylaxis (PrEP) for HIV infection are needed to increase preventive options among sexual and gender minority adolescents.

Methods and analysis
This is a multisite, prospective implementation study of three PrEP modalities (LAI-PrEP, event-driven (ED) and daily oral), using a mixed-method design with quantitative and qualitative approaches. The study will include a sample of 550 HIV-negative adolescent men who have sex with men, non-binary individuals assigned male at birth, transgender men and women, aged 15–19 years, in three Brazilian capital cities. Participants will be allocated into two arms, according to their choice of PrEP modalities, and followed up to 36 months. Switching between oral and LAI-PrEP will be allowed, according to the participants’ needs and preferences. The qualitative studies will focus on investigating the processes involved in linkage and retention in care, switching between PrEP modalities and strategies of the implementation process of LAI-PrEP in the current PrEP programming and acceptability from health providers, policymakers and stakeholders’ perspectives.

Ethics and dissemination
The adolescent’s autonomy for consenting to their participation and understanding of PrEP will be assessed by the project team before any care is given and will be recorded in their medical record. Adolescents aged 15–17 years will sign an informed assent form, waiving the need for the approval of a legal guardian, except in cases where the adolescent is found not to have the necessary autonomy. The study was approved by the WHO Ethics Review Committee and by the local IRBs from the universities coordinating the study, the University of São Paulo, the Federal University of Bahia and the Federal University of Minas Gerais. This project is part of an effort to expedite the inclusion of new modalities in the Brazilian PrEP Programme, based on the development of studies to evaluate the implementation of LAI-PrEP and ED-PrEP as a choice. The results will be published in peer-reviewed journals and presented to the study participants and communities.

Trial registration number
https://ensaiosclinicos.gov.br/rg/RBR-104736f4. The trial registration number: RBR-104736f4

Women are more likely than men to experience post–COVID-19 condition, also known as long COVID, and a new study from Science Translational Medicine identified a possible explanation.

This Medial News article discusses recent research showing that current COVID-19 vaccines fail to elicit enough of a mucosal immune response to prevent infection.

Objective
This study aimed to assess the impact of the COVID-19 pandemic on the characteristics and outcomes of patients with burns in a burn centre situated in Northwest China.

Design
A retrospective descriptive study.

Setting
This study was conducted in Tangdu Hospital, a major regional burn centre in Xi’an, Shaanxi Province of China.

Participants
A total of 1413 patients with burns were included in the study, with the admission period spanning from 2017 to 2019 (before the pandemic) and 2020 to 2022 (during the pandemic).

Results
Burn hospitalisations decreased during the pandemic for both children (9.80%) and adults (24.68%). The pandemic was associated with a decrease in work-related burns and a corresponding increase in the risk of domestic burns (both p

Background
COVID-19 disease results in disparate responses between individuals and has led to the emergence of long coronavirus disease (Long-COVID), characterised by persistent and cyclical symptomology. To understand the complexity of Long-COVID, the importance of symptom surveillance and prospective longitudinal studies is evident.

Methods
A 9-month longitudinal prospective cohort study was conducted within Scotland (n=287), using a mobile app to determine the proportion of recovered individuals and those with persistent symptoms and common symptoms, and associations with gender and age.

Results
3.1% of participants experienced symptoms at month 9, meeting the criteria for Long-COVID, as defined by the National Institute for Health and Care Excellence terminology. The random effects model revealed a significant time (month) effect for infection recovery (p

New research suggests SARS-CoV-2 infection may increase the long-term risk of autoimmune or autoinflammatory connective tissue disorders.

Receiving COVID-19 and influenza vaccines at the same time should generate a similar reaction as receiving them separately.

Iss,adesione 43% indagini su seno, 41% su cervice e 27% su colon

Objectives
This study aimed to explore the perceptions of donation coordinators in Canada and understand how the COVID-19 pandemic impacted their work activities.

Design
A sequential mixed-method design incorporating a cross-sectional survey investigating demographic data, substance use and abuse and perceived stress related to the pandemic and semistructured qualitative interviews to further investigate those.

Setting
Organ donation organisations across Canada.

Participants
Canadian organ and tissue donation coordinators working within deceased donation programmes. Participants were recruited using a purposive sampling technique for the survey and qualitative interviews. Recruitment and data collection took place between January 2022 and March 2023.

Analysis
The data were analysed using descriptive statistics for the quantitative findings and content analysis for the qualitative data.

Results
Of the 175 available coordinators, 120 participated in the survey, and 39 participated in the qualitative interviews. The great majority were female (n=98; 81.7%), registered nurses (n=117; 97.5%) and on average 42 years old (SD=9.64). The survey result for perceived stress showed that, on average, coordinators did not experience high stress levels during the pandemic. We also identified an increase in the consumption of substances to manage workplace stress near the pandemic’s beginning. The qualitative interviews yielded two main themes (Personal Life Changes and Workplace Adjustments) in which coordinators reported their views on challenges with uncertainties, effects on their personal lives, redeployment, stressors and among others.

Conclusion
Our study’s results provide a comprehensive understanding of the perceptions and experiences of coordinators in Canada during the COVID-19 pandemic. Using a combination of methods, we identified various ways coordinators were affected by the pandemic in their personal and professional lives. These findings highlight the need to support the development of adaptive strategies and promote resilience during crises.

A meta-analysis reaffirms generally better outcomes with therapeutic than with prophylactic anticoagulation — with some exceptions.