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Pinilla Rello A, Magallón Martínez A, Vicente Iturbe C, Escolano-Pueyo A, Herranz Bayo E, Aguilo Lafarga I. Assessment of the effectiveness of tocilizumab on mortality and progression to mechanical ventilation or intensive care in patients with COVID-19 admitted to a tertiary hospital. Eur J Hosp Pharm 2024; 31:212-219. [PMID: 36150845 PMCID: PMC11042469 DOI: 10.1136/ejhpharm-2022-003366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/05/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The evidence for tocilizumab in the treatment of COVID-19 is contradictory, with some clinical trials showing benefits in regard to progression to mechanical ventilation (MV) and/or mortality. The aim of this study is to evaluate in real clinical practice the effectiveness of tocilizumab in treating COVID-19 and to identify prognostic factors for patient outcomes. METHODS This was an observational, retrospective study of COVID-19 patients treated with tocilizumab between March 2020 and February 2021 in a tertiary hospital. Variables were demographics, comorbidities, vital signs, analytical parameters, COVID-19 treatment, progression to MV, intensive care unit (ICU) admission, hospital stay, and mortality. RESULTS A total of 685 patients (64.7% men, median 68 years) were included. Overall mortality was 23.4% (14.2% in the first 14 days post-tocilizumab) and 93.3% in patients with MV and/or in the ICU at 14 days post-tocilizumab. In addition, 61.5% of discharges occurred during the same period. In patients who died, statistically significant differences were observed in the baseline analytical parameters of C-reactive protein (CRP), D-dimer and higher lactate dehydrogenase (LDH) (p<0.05). CONCLUSIONS In most patients the clinical results of tocilizumab were observed at 14 days post-administration and could benefit from earlier administration of treatment. Baseline levels of CRP, D-dimer and LDH could be prognostic factors for the evolution of the COVID-19 patient.
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Rhead R, Harber-Aschan L, Onwumere J, Polling C, Dorrington S, Ehsan A, Stevelink SAM, Khunti K, Mir G, Morriss R, Wessely S, Woodhead C, Hatch S. Ethnic inequalities among NHS staff in England: workplace experiences during the COVID-19 pandemic. Occup Environ Med 2024; 81:113-121. [PMID: 38378264 PMCID: PMC10958323 DOI: 10.1136/oemed-2023-108976] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/23/2023] [Indexed: 02/22/2024]
Abstract
OBJECTIVES This study aims to determine how workplace experiences of National Health Service (NHS) staff varied by ethnicity during the COVID-19 pandemic and how these experiences are associated with mental and physical health at the time of the study. METHODS An online Inequalities Survey was conducted by the Tackling Inequalities and Discrimination Experiences in Health Services study in collaboration with NHS CHECK. This Inequalities Survey collected measures relating to workplace experiences (such as personal protective equipment (PPE), risk assessments, redeployments and discrimination) as well as mental health (Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7)), and physical health (PHQ-15) from NHS staff working in the 18 trusts participating with the NHS CHECK study between February and October 2021 (N=4622). RESULTS Regression analysis of this cross-sectional data revealed that staff from black and mixed/other ethnic groups had greater odds of experiencing workplace harassment (adjusted OR (AOR) 2.43 (95% CI 1.56 to 3.78) and 2.38 (95% CI 1.12 to 5.07), respectively) and discrimination (AOR 4.36 (95% CI 2.73 to 6.96) and 3.94 (95% CI 1.67 to 9.33), respectively) compared with white British staff. Staff from black ethnic groups also had greater odds than white British staff of reporting PPE unavailability (AOR 2.16 (95% CI 1.16 to 4.00)). Such workplace experiences were associated with negative physical and mental health outcomes, though this association varied by ethnicity. Conversely, understanding employment rights around redeployment, being informed about and having the ability to inform redeployment decisions were associated with lower odds of poor physical and mental health. CONCLUSIONS Structural changes to the way staff from ethnically minoritised groups are supported, and how their complaints are addressed by leaders within the NHS are urgently required.
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Affiliation(s)
- Rebecca Rhead
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Centre for Society and Mental Health, King's College London - Strand Campus, London, UK
| | - Lisa Harber-Aschan
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Demography Unit, Stockholm University, Stockholm, Sweden
| | - Juliana Onwumere
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Catherine Polling
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sarah Dorrington
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Annahita Ehsan
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Sharon A M Stevelink
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- King's Centre for Military Health Research, King's College London, London, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, Leicester, UK
- Real World Evidence Unit, University of Leicester, Leicester, UK
| | - Ghazala Mir
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Richard Morriss
- Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR ARC East Midlands, University of Nottingham, Nottingham, UK
| | - Simon Wessely
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- King's Centre for Military Health Research, King's College London, London, UK
| | - Charlotte Woodhead
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Centre for Society and Mental Health, King's College London - Strand Campus, London, UK
| | - Stephani Hatch
- Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Centre for Society and Mental Health, King's College London - Strand Campus, London, UK
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Quistgaard M, Myklebust OLP, Aure T, Austin SF, Berring LL, Vernal DL, Storebø OJ. Psychosocial interventions promoting personal recovery in people with schizophrenia: a scoping review protocol. BMJ Open 2023; 13:e073901. [PMID: 38070925 PMCID: PMC10729100 DOI: 10.1136/bmjopen-2023-073901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Personal recovery is an important aspect for many individuals diagnosed with schizophrenia, as people can live rich, fulfilling lives despite ongoing symptoms. Prior reviews have found several factors to be associated with personal recovery, but a comprehensive overview of the psychosocial interventions aimed at improving personal recovery in schizophrenia is needed. METHODS AND ANALYSIS Key terms relating to personal recovery and psychosocial interventions to promote personal recovery will be searched for in the following databases: PubMed, EMBASE, PsycINFO, CINAHL, MEDLINE, Google Scholar, Web of Science Core Collection and Cochrane. Additionally, a simple search for grey literature will be conducted in The Networked Digital Library of Theses and Dissertations. Two reviewers will individually screen and extract the data, and the selection of sources will be documented in a Preferred Reporting Items for Systematic reviews and Meta-Analyses flow chart. A content analysis will be conducted on the data, and the findings will be presented in tables, and narratively synthesised. Lastly, research gaps will be identified, and recommendations for future research will be proposed. ETHICS AND DISSEMINATION Ethics approval was not required for the development or publishing of this protocol. Findings will be disseminated through conferences, meeting with patient organisations and consumers, and published in a peer-reviewed scientific journal.
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Affiliation(s)
- Maria Quistgaard
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
| | | | | | - Stephen Fitzgerald Austin
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Mental Health Services, East, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Institute for Regional Sundhedsforskning (IRS), University of Southern Denmark, Odense, Denmark
| | - Ditte Lammers Vernal
- Psychiatry, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, North Denmark Region, Denmark
| | - Ole Jakob Storebø
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Martin CA, Woolf K, Bryant L, Goss C, Gogoi M, Lagrata S, Papineni P, Qureshi I, Wobi F, Nellums L, Khunti K, Pareek M. Coverage, completion and outcomes of COVID-19 risk assessments in a multi-ethnic nationwide cohort of UK healthcare workers: a cross-sectional analysis from the UK-REACH Study. Occup Environ Med 2023; 80:399-406. [PMID: 37221040 PMCID: PMC10314065 DOI: 10.1136/oemed-2022-108700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/31/2023] [Indexed: 05/25/2023]
Abstract
INTRODUCTION There are limited data on the outcomes of COVID-19 risk assessment in healthcare workers (HCWs) or the association of ethnicity, other sociodemographic and occupational factors with risk assessment outcomes. METHODS We used questionnaire data from UK-REACH (UK Research study into Ethnicity And COVID-19 outcomes in Healthcare workers), an ethnically diverse, nationwide cohort of UK HCWs. We derived four binary outcomes: (1) offered a risk assessment; (2) completed a risk assessment; (3) working practices changed as a result of the risk assessment; (4) wanted changes to working practices after risk assessment but working practices did not change.We examined the association of ethnicity, other sociodemographic/occupational factors and actual/perceived COVID-19 risk variables on our outcomes using multivariable logistic regression. RESULTS 8649 HCWs were included in total. HCWs from ethnic minority groups were more likely to report being offered a risk assessment than white HCWs, and those from Asian and black ethnic groups were more likely to report having completed an assessment if offered. Ethnic minority HCWs had lower odds of reporting having their work change as a result of risk assessment. Those from Asian and black ethnic groups were more likely to report no changes to their working practices despite wanting them.Previous SARS-CoV-2 infection was associated with lower odds of being offered a risk assessment and having adjustments made to working practices. DISCUSSION We found differences in risk assessment outcomes by ethnicity, other sociodemographic/occupational factors and actual/perceived COVID-19 risk factors. These findings are concerning and warrant further research using actual (rather than reported) risk assessment outcomes in an unselected cohort.
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Affiliation(s)
- Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Katherine Woolf
- Research Department of Medical Education, University College London Medical School, London, UK
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Charles Goss
- Department of Occupational Health, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Susie Lagrata
- Queen Square Insitute of Neurology and National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Padmasayee Papineni
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Harrow, UK
| | - Irtiza Qureshi
- Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Fatimah Wobi
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
- School of Law, University of Leicester, Leicester, UK
| | - Laura Nellums
- Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Manish Pareek
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
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Nwaru C, Li H, Bonander C, Santosa A, Franzén S, Rosvall M, Nyberg F. Occupational role and COVID-19 among foreign-born healthcare workers in Sweden: a registry-based study. Eur J Public Health 2023; 33:202-208. [PMID: 36762873 PMCID: PMC10066486 DOI: 10.1093/eurpub/ckad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Many studies report that foreign-born healthcare workers (HCWs) in high-income countries have an elevated risk of COVID-19. However, research has not yet specifically evaluated the distribution of COVID-19 among foreign-born workers in different healthcare work groups. We examined the risk of COVID-19 infection and hospitalization among foreign-born HCWs in different occupational roles in Sweden. METHODS We linked occupational data (2019) of 783 950 employed foreign-born workers (20-65 years) to COVID-19 data registered between 1 January 2020 and 30 September 2021. We used Cox proportional hazards regression to estimate the hazard ratio (HR) with 95% confidence intervals (95% CIs) of COVID-19 infection and hospitalization in eight healthcare occupational groups vs. non-HCWs and assessed whether region of birth modified the association between healthcare occupations and COVID-19. RESULTS All HCWs had a higher risk of COVID-19 outcomes than non-HCWs, but the risk differed by occupational role. Hospital-based assistant nurses had the highest risk (infection: HR 1.78; 95% CI 1.72-1.85; hospitalization: HR 1.79; 95% CI 1.52-2.11); allied HCWs had the lowest risk (infection: HR 1.22; 95% CI 1.10-1.35; hospitalization: HR 0.98; 95% CI 0.59-1.63). The relative hazard of the outcomes varied across foreign-born workers from different regions. For example, the relative risk of COVID-19 infection associated with being a physician compared to a non-HCW was 31% higher for African-born than European-born workers. CONCLUSIONS The risk of COVID-19 among foreign-born HCWs differed by occupational role and immigrant background. Public health efforts that target occupational exposures as well as incorporate culturally responsive measures may help reduce COVID-19 risk among foreign-born HCWs.
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Affiliation(s)
- Chioma Nwaru
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Bonander
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Franzén
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Rosvall
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Social Medicine, Regionhälsan, Region Västra Götaland, Gothenburg, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ghassemi AE. Risk assessment and strategic action are required to protect at risk minority groups of healthcare workers in future COVID-19 pandemics. Evid Based Nurs 2023; 26:34. [PMID: 36192129 DOI: 10.1136/ebnurs-2022-103582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
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Gönenli MG, Kayı İ, Alpay-Kanıtez N, Baydaş T, Köse M, Nalbantoğlu EA, Keskinler MV, Akpınar TS, Ergönül Ö. Analysis of the Prophylactic use of Hydroxychloroquine at the Beginning of the COVID-19 Pandemic Among Physicians. INFECTIOUS DISEASES & CLINICAL MICROBIOLOGY 2022; 4:236-243. [PMID: 38633712 PMCID: PMC10986685 DOI: 10.36519/idcm.2022.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 11/22/2022] [Indexed: 04/19/2024]
Abstract
Objective Throughout the pandemic, physicians working at the frontlines have embarked on various quests to protect themselves, and many physicians preferred using hydroxychloroquine (HQN) as a prophylactic agent. This study aimed to investigate the reasons leading physicians to use HQN and its effects on them. Materials and Methods This study is cross-sectional with a target population of physicians working in pandemic hospitals in İstanbul, Turkey. We invited participants from seven hospitals via email between May 14 and June 13, 2020. An online questionnaire, including 57 questions, was sent to physicians. Results A total of 148 (26%) physicians out of 564 participants had used hydroxychloroquine for prevention. Older physicians and those with a history of exposure to COVID-19 patients without protection used prophylactic HQN more frequently. The use of HQN did not differ statistically in terms of being infected among the exposed physicians (p=0.52). Nineteen (13%) physicians using HQN developed side effects related to the drug. Diarrhea and nausea were the most common. Conclusion Prophylactic HQN use was more common among physicians older than 40 years and with higher exposure rates to a COVID-19 patient without protection. The physicians working on the front line had the highest rate of infection. HQN was not effective in the prophylaxis of COVID-19 among the exposed physicians.
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Affiliation(s)
| | - İlker Kayı
- Department of Public Health, Koç University Hospital, İstanbul, Turkey
| | | | - Tuba Baydaş
- Department of Internal Medicine, Bezmialem University Hospital, İstanbul, Turkey
| | - Murat Köse
- Department of Internal Medicine, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | | | - Miraç Vural Keskinler
- Department of Internal Medicine, Istanbul Medeniyet University, Göztepe Education and Research Hospital, İstanbul, Turkey
| | - Timur Selçuk Akpınar
- Department of Internal Medicine, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Önder Ergönül
- Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Turkey
- Koç University İşbank Center for Infectious Diseases, Istanbul, Turkey
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Jacobs W, Downey LE. Impact of conditional cash transfer programmes on antenatal care service uptake in low and middle-income countries: a systematic review. BMJ Open 2022; 12:e064673. [PMID: 36428017 PMCID: PMC9703316 DOI: 10.1136/bmjopen-2022-064673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/30/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Antenatal care (ANC) is crucial to protecting the health of pregnant women and their unborn children; however, the uptake of ANC among pregnant women in low and middle-income countries (LMICs) is suboptimal. One popular strategy to increase the uptake of health services, including ANC visits, are conditional cash transfer (CCT) programmes. CCT programmes require beneficiaries to comply with certain conditionalities in order to receive a financial sum. A systematic review was carried out to determine whether CCT programmes have a positive impact on ANC uptake in LMIC populations. METHODS Electronic databases CENTRAL, MEDLINE, Embase, Maternity and Infant Care and Global Health were searched from database inception to 21 January 2022. Reference checking and grey literature searches were also applied. Eligible study designs were randomised controlled trials, controlled before-after studies and interrupted time series analysis. Risk of bias assessments were undertaken for each study by applying the Risk of Bias 2 tool and the Risk of Bias in Non-randomised Studies of Interventions tool. RESULTS Out of 1534 screened articles, 18 publications were included for analysis. Eight studies reported statistically non-significant results on all reported outcomes. Seven studies demonstrated statistically significant positive effects ranging from 5.5% to 45% increase in ANC service uptake. A further three studies reported small but statistically significant impact of CCT on the use of ANC services in both positive (2.5% increase) and negative (3.7% decrease) directions. Subanalysis of results disaggregated by socioeconomic status (SES) indicated that ANC attendance may be more markedly improved by CCT programmes in low SES populations; however, results were inconclusive. CONCLUSION Our evidence synthesis presented here demonstrated a highly heterogeneous evidence base pertaining to the impact of CCTs on ANC attendance. More high-powered studies are required to elucidate the true impact of CCT programmes on ANC uptake, with particular focus on the barriers and enablers of such programmes in achieving intended outcomes.
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Affiliation(s)
- Ward Jacobs
- School of Public Health, Imperial College London, London, UK
| | - Laura Emily Downey
- School of Public Health, Imperial College London, London, UK
- The George Institute for Global Health, Sydney, New South Wales, Australia
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Lamb C, Kennedy M, Clark A, Pituskin E, Kirkwood K, Babenko-Mould Y. Effectiveness of interventions on healthcare professionals' understanding and use of conscience: a systematic review protocol. BMJ Open 2022; 12:e053880. [PMID: 35896293 PMCID: PMC9335031 DOI: 10.1136/bmjopen-2021-053880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Conscience is central to moral decision making. In the context of morally pluralistic workplaces today, healthcare professionals' conscience may prompt them to make moral decisions to refrain from providing services they morally disagree with. However, such decisions are largely viewed as contentious, giving rise to polarising arguments for and against healthcare professionals' freedom of conscience. Yet, little work has been done to understand and support healthcare professionals' conscience. Instead, the rising polarity related to healthcare professionals' freedom of conscience stems from a central lack of understanding of what conscience is and the relevance it holds for healthcare professionals' clinical practice. Therefore, the degree and extent to which healthcare professionals are supported to understand and use their conscience is unknown. The objective of this review is to critically analyse the scholarly evidence available to ascertain the effectiveness of interventions that support healthcare professionals to understand and use their conscience in care practice. METHODS AND ANALYSES At least two reviewers will systematically review 10 interdisciplinary, scholarly databases to examine qualitative, quantitative and mixed-methods studies including clinical trials pertaining to interventions related to conscience for healthcare professionals. Databases to be searched include: the Cochrane Controlled Register of Trials, Medline, EMBASE, PsycINFO, Cumulative Index for Nursing and Allied Health Literature (CINAHL), Academic Search Complete, ATLA Religion Database, Religion and Philosophy Collection, PhilPapers and Scopus. Databases were searched in May 2021. Study screening, selection, extraction and risk of bias assessments on each study using the Mixed Methods Appraisal Tool will be independently conducted by independent reviewers. Descriptive data synthesis will be carried out. Statistical analysis and meta-analysis will be conducted as relevant, based on homogeneity of findings. The quality of the aggregate evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations criteria. ETHICS AND DISSEMINATION Ethical approval is not required for this review. This protocol will not involve individual patient information endangering participant rights. The results will be reported in a peer-reviewed journal and disseminated at conferences. PROSPERO REGISTRATION NUMBER CRD42021256943.
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Affiliation(s)
- Christina Lamb
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
- CCBI, St. Michael's College in the University of Toronto, Toronto, Ontario, Canada
| | - Megan Kennedy
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | - Alex Clark
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Ken Kirkwood
- School of Health Studies, Western University, London, Ontario, Canada
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10
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Martin CA, Pan D, Nazareth J, Aujayeb A, Bryant L, Carr S, Gray LJ, Gregary B, Gupta A, Guyatt AL, Gopal A, Hine T, John C, McManus IC, Melbourne C, Nellums LB, Reza R, Simpson S, Tobin MD, Woolf K, Zingwe S, Khunti K, Pareek M. Access to personal protective equipment in healthcare workers during the COVID-19 pandemic in the United Kingdom: results from a nationwide cohort study (UK-REACH). BMC Health Serv Res 2022; 22:867. [PMID: 35790970 PMCID: PMC9255515 DOI: 10.1186/s12913-022-08202-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/15/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are at high risk of SARS-CoV-2 infection. Effective use of personal protective equipment (PPE) reduces this risk. We sought to determine the prevalence and predictors of self-reported access to appropriate PPE (aPPE) for HCWs in the UK during the COVID-19 pandemic. METHODS We conducted cross sectional analyses using data from a nationwide questionnaire-based cohort study administered between December 2020-February 2021. The outcome was a binary measure of self-reported aPPE (access all of the time vs access most of the time or less frequently) at two timepoints: the first national lockdown in the UK in March 2020 (primary analysis) and at the time of questionnaire response (secondary analysis). RESULTS Ten thousand five hundred eight HCWs were included in the primary analysis, and 12,252 in the secondary analysis. 35.2% of HCWs reported aPPE at all times in the primary analysis; 83.9% reported aPPE at all times in the secondary analysis. In the primary analysis, after adjustment (for age, sex, ethnicity, migration status, occupation, aerosol generating procedure exposure, work sector and region, working hours, night shift frequency and trust in employing organisation), older HCWs and those working in Intensive Care Units were more likely to report aPPE at all times. Asian HCWs (aOR:0.77, 95%CI 0.67-0.89 [vs White]), those in allied health professional and dental roles (vs those in medical roles), and those who saw a higher number of COVID-19 patients compared to those who saw none (≥ 21 patients/week 0.74, 0.61-0.90) were less likely to report aPPE at all times. Those who trusted their employing organisation to deal with concerns about unsafe clinical practice, compared to those who did not, were twice as likely to report aPPE at all times. Significant predictors were largely unchanged in the secondary analysis. CONCLUSIONS Only a third of HCWs in the UK reported aPPE at all times during the first lockdown and that aPPE had improved later in the pandemic. We also identified key determinants of aPPE during the first UK lockdown, which have mostly persisted since lockdown was eased. These findings have important implications for the safe delivery of healthcare during the pandemic.
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Affiliation(s)
- Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Specialist Emergency Care Hospital, Cramlington, UK
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sue Carr
- University Hospitals Leicester NHS Trust, Leicester Royal Infirmary, Leicester, UK
- General Medical Council, London, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Bindu Gregary
- Lancashire Clinical Research Facility, Royal Preston Hospital, Fulwood, UK
| | - Amit Gupta
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anna L Guyatt
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Alan Gopal
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Thomas Hine
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Catherine John
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Carl Melbourne
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Laura B Nellums
- Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rubina Reza
- Centre for Research & Development, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Sandra Simpson
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Martin D Tobin
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Stephen Zingwe
- Research and Development Department, Berkshire Healthcare NHS Foundation Trust, Bracknell, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK.
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
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11
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Synthesizing Stakeholders Perspectives on Online Psychological Interventions to Improve the Mental Health of the Italian Population during the COVID-19 Pandemic: An Online Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127008. [PMID: 35742257 PMCID: PMC9222987 DOI: 10.3390/ijerph19127008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic is expected to significantly increase the prevalence of mental health problems, thus raising the need for psychological support interventions around the world. Online psychological interventions have already been shown to be an effective solution to promote psychological treatments. Nevertheless, planning and developing an online intervention, involving possible stakeholders, might facilitate the dissemination of, willingness to use, and success of the future intervention. This study aims to explore and compare the experiences that Italians living in Italy and abroad had with available support services during the COVID-19 pandemic, their needs, and attitudes, as well as possible barriers to online psychological interventions. A sample of 1024 Italians (F = 69.8%; mean age = 41.3; SD = 15.3) was recruited through social media platforms and personal contacts and they were asked to complete an online survey. Results showed that perceived psychological distress during the COVID-19 pandemic improved. In Europe, psychological support was delivered mainly in person (69.0%), while online interventions were primarily used in extra-European countries (57%). Then, only 44% of the total sample was interested in trying an online psychological intervention. Various advantages and disadvantages were defined by stakeholders: The main advantages were the reduction in geographical distances, economic reasons, and the reduction in the waiting list; The main disadvantages were problems with technology, low motivation of users, and privacy/safety reasons. These data made it possible to improve the knowledge regarding the views and attitudes that Italians have about online psychological interventions, and shed light on how to increase the uptake of digital health.
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12
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Luna C, Estanga I, Patricia Castillo R. Abbreviated Ultrasonography Examination Protocols for COVID-19 Patients: A Streamlined Process to Reduce Staff Exposure. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2022. [DOI: 10.1177/87564793221079805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The primary goal of this article is to show that an abbreviated ultrasonography (US) examination protocols can decrease imaging time and staff exposure. Materials and Methods: This is a single-center institutional review board (IRB)-approved retrospective cohort study in which 39 patients, positive for 2019 coronavirus disease (COVID-19), underwent an abbreviated US examination protocol from April to May 2020. Radiologists, specializing in body imaging, created these protocols. Descriptive statistics were performed, including the mean duration of the abbreviated US protocols and the mean duration of the standard US protocols, as a control group. Results: The abbreviated US protocols resulted in a significant time reduction ( P < .05) compared with the regular protocol duration. Conclusion: As radiology services face this unprecedented pandemic, implementing reduced US protocols can result in safer practices decreasing staff exposure.
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Affiliation(s)
- Cibele Luna
- Department of Radiology, Jackson Memorial Hospital, University of Miami, Miami, FL, USA
| | - Indira Estanga
- Department of Radiology, Jackson Memorial Hospital, University of Miami, Miami, FL, USA
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13
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Agius RM, Kloss D, Kendrick D, Stewart M, Robertson JF. Protection from covid-19 at work: health and safety law is fit for purpose. BMJ 2021; 375:n3087. [PMID: 34907022 DOI: 10.1136/bmj.n3087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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14
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Northwood K, Siskind D, Suetani S, McArdle PA. An assessment of psychological distress and professional burnout in mental health professionals in Australia during the COVID-19 pandemic. Australas Psychiatry 2021; 29:628-634. [PMID: 34428987 PMCID: PMC8387977 DOI: 10.1177/10398562211038906] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine psychological distress and professional burnout in a cohort of Australian mental healthcare workers during the COVID-19 pandemic. METHODS This study examined a multi-disciplinary cohort of mental healthcare workers in a large metropolitan service in Australia. Demographic information as well as information on employment and individual's personal experience of the COVID-19 pandemic was collected and correlated with cross-sectional assessments of anxiety, depression and professional burnout using validated clinical questionnaires. RESULTS Mental healthcare workers reported high levels of anxiety, depression, and professional burnout. Participants reported some reduction in anxiety since the early phases of the pandemic, but the reduction was more modest in mental healthcare workers identifying as being "vulnerable" employees. CONCLUSION Despite the low numbers of COVID-19 cases, mental healthcare workers in Australia report significant levels of psychological distress and professional burnout during the pandemic.
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Affiliation(s)
- K Northwood
- Metro South Addiction and Mental Health Services, Queensland Health, Brisbane, QLD, Australia.,School of Clinical Medicine, The University of Queensland, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - D Siskind
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia.,School of Clinical Medicine, The University of Queensland, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Physical and Mental Health Stream, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - S Suetani
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia.,Physical and Mental Health Stream, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - P A McArdle
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia.,School of Clinical Medicine, The University of Queensland, Princess Alexandra Hospital, Brisbane, QLD, Australia
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15
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Bertuzzi V, Semonella M, Bruno D, Manna C, Edbrook-Childs J, Giusti EM, Castelnuovo G, Pietrabissa G. Psychological Support Interventions for Healthcare Providers and Informal Caregivers during the COVID-19 Pandemic: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136939. [PMID: 34203529 PMCID: PMC8297206 DOI: 10.3390/ijerph18136939] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
Background: During the COVID-19 pandemic, healthcare providers and informal caregivers were at an increased risk of adverse mental health effects. This systematic review provides a summary of the available evidence on the content and efficacy of the psychological support interventions in increasing mental health among healthcare providers and informal caregivers during the COVID-19 pandemic. Methods: PubMed, Google Scholar, PsychINFO, and Scopus databases were systematically searched for relevant articles, and the methodological quality of selected articles was assessed using the Quality Assessment Tool for Quantitative Studies. Results: A search of electronic databases identified five reports based on inclusion and exclusion criteria. All psychological support interventions for caregivers were delivered digitally. Despite the large heterogeneity of the selected studies, the findings support the efficacy of mental health interventions in reducing distress and burnout, while promoting self-efficacy and well-being in both healthcare providers and informal caregivers. Conclusion: Since mental health problems are expected to increase during, and as a result of, the COVID-19 pandemic, and digital tools might offer a range of mental health treatments to meet the unique and immediate needs of people, further research is needed to test the cost-effectiveness of digital psychological interventions.
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Affiliation(s)
- Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
| | | | - Denise Bruno
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
| | - Chiara Manna
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
| | - Julian Edbrook-Childs
- Evidence-Based Practices Unit, University College London and Anna Freud National Centre for Children and Families, London N1 6EB, UK;
| | - Emanuele M. Giusti
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy
- Correspondence: (E.M.G.); (G.P.)
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (V.B.); (D.B.); (C.M.); (G.C.)
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy
- Correspondence: (E.M.G.); (G.P.)
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16
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Alsaegh A, Belova E, Vasil’ev Y, Zabroda N, Severova L, Timofeeva M, Dobrokhotov D, Leonova A, Mitrokhin O. COVID-19 in Dental Settings: Novel Risk Assessment Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6093. [PMID: 34198770 PMCID: PMC8200944 DOI: 10.3390/ijerph18116093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/23/2022]
Abstract
The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and this emergency led to postponing elective dental care procedures. The postponing aimed to protect the public from an unknown risk caused by COVID-19. At the beginning of the outbreak, for public health authorities, the aerosol-generating procedures and the close proximity between dental care workers and patients in dentistry represented sufficient justification for the delay of dental visits. Dental care is a priority, and for many years, studies have proven that the lack and delay of dental care can cause severe consequences for the oral health of the general population, which can cause a high global burden of oral diseases. Safety is necessary while resuming dental activities, and risk assessment is an efficient method for understanding and preventing the COVID-19 infectious threats facing the dental industry and affecting dental care workers and patients. In this study, for safe dental care delivery, we adapted risk assessment criteria and an approach and an occupational classification system. Based on those tools, we also recommend measures that can help to minimize infectious risk in dental settings.
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Affiliation(s)
- Ali Alsaegh
- Institute of Dentistry Named after E.V. Borovsky, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia; (E.B.); (N.Z.); (A.L.); (O.M.)
| | - Elena Belova
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia; (E.B.); (N.Z.); (A.L.); (O.M.)
| | - Yuriy Vasil’ev
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia;
| | - Nadezhda Zabroda
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia; (E.B.); (N.Z.); (A.L.); (O.M.)
| | - Lyudmila Severova
- Department of Phthisiopulmonology and Thoracic Surgery named after M.I. Perelman, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia;
| | - Margarita Timofeeva
- Department of Medical Law, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia;
| | - Denis Dobrokhotov
- Department of Chemistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia;
| | - Alevtina Leonova
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia; (E.B.); (N.Z.); (A.L.); (O.M.)
| | - Oleg Mitrokhin
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. bldg. 8\2, 119435 Moscow, Russia; (E.B.); (N.Z.); (A.L.); (O.M.)
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17
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Gupta A. COVID-19 and extracorporeal membrane oxygenation: experiences as a patient, general practitioner, wife and mother. Anaesth Rep 2021; 9:101-105. [PMID: 34027411 PMCID: PMC8131113 DOI: 10.1002/anr3.12120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 12/24/2022] Open
Abstract
I contracted SARS‐CoV‐2 early in the first wave of the COVID‐19 pandemic in the UK and, following nine days of mechanical ventilation, was one of the first few patients to be accepted for venovenous extracorporeal membrane oxygenation. I remained in hospital for 150 days, 34 of which I spent with full extracorporeal respiratory support. I have no recollection of my time on extracorporeal membrane oxygenation, but liberation from it was not the end of my story; I had to overcome numerous physical and mental challenges during recovery and rehabilitation. I hope my story is read by others who are recovering from COVID‐19 or critical illness more generally, and that it provides hope that the challenges of rehabilitation can be overcome. This reflection is a personal view of my illness as a patient. In it, I focus upon the aspects of my care that I can remember, predominantly around the time I became unwell but also during the recovery and rehabilitation period, which remains ongoing despite my discharge from hospital and subsequent return to work as a general practitioner.
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18
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Agius RM, Hughes LT, Kendrick D, Robertson JFR, Stewart M. Assessing risk for healthcare workers during the pandemic: don't forget workplace safety committees or aerosol generating procedures. BMJ 2021; 373:n950. [PMID: 33849911 DOI: 10.1136/bmj.n950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Raymond M Agius
- Centre for Occupational and Environmental Health, Ellen Wilkinson Building, University of Manchester, Manchester M13 9PL, UK
| | - Lewis T Hughes
- Beatson West of Scotland Cancer Centre, Gartnavel Hospital, Glasgow, UK
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19
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Abbasi K. Covid-19 dissenters—or the virtue in being less cheerful. BRITISH MEDICAL JOURNAL 2021. [DOI: 10.1136/bmj.n731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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