COVID-19 Care Research Articles

Epicardial adipose tissue defined by initial polytrauma CT of mechanically ventilated trauma patients: retrospective single-center cohort study to predict short-term outcomes.

Epicardial adipose tissue (EAT) detected by computed tomography (CT) is associated with morbidity and mortality in patients with COVID-19 and other critical care patient cohorts, whereas their prognostic relevance in trauma patients remains unclear. The present study explored associations with four potential short-term outcomes in trauma patients. All consecutive trauma patients requiring emergency tracheal intubation and mechanical ventilation before initial whole-body CT imaging at a level-1 trauma center over a 12-year period (2008-2019) were reanalyzed for this study. EAT was measured semiquantitatively in initial CT and analyzed regarding associations with 24-hour and 30-day mortality using Cox proportional hazard models. In survivors, associations of EAT with intensive care unit length of stay (ICU LOS) and mechanical ventilation duration were analyzed using linear regression analyses. Four hundred fifty-five patients (74.7% male) with a median age of 49 years, and a median injury severity score (ISS) of 26 points were analyzed. In univariable analysis, EAT index was significantly associated with 24-hour and 30-day mortality (p = 0.007, and p = 0.013, respectively). After adjustment for significant predictors age, body mass index, and ISS, no significant associations were confirmed (p = 0.622, and p = 0.903, respectively). In a subanalysis of 353 survivors, EAT index was significantly associated with ICU LOS and mechanical ventilation duration in univariable analyses (p = 0.031, and p = 0.014, respectively), but not in multivariable analyses (p = 0.81 and p = 0.46, respectively). EAT index was associated with short-term outcomes in severely injured trauma patients, which not remained significant in multivariable analysis, suggesting that its prognostic capability is limited.

The work-lives of Canadian Registered Dietitians during the COVID-19 pandemic: a descriptive analysis of survey data

BackgroundHealthcare workers experienced significant disruptions to both their personal and professional lives throughout the COVID-19 pandemic. How healthcare workers were impacted varied, depending on area of specialization, work setting, and factors such as gender. Dietetics is a female-dominated profession and the differential impact on women of the COVID-19 pandemic has been widely reported. While researchers have explored Registered Dietitians’ (RDs) experiences during the pandemic, none have looked explicitly at their experiences of redeployment. The objectives of this study were to better understand: (i) the impact of COVID-19 (and related redeployments) on the work-lives of RDs, (ii) what types of COVID-19 related supports and training were made available to these RDs, and (iii) the impact of RD redeployment on access to RD services.MethodsAn online survey was administered in June 2022. Any RD that that was publicly-employed in Canada during the pandemic was eligible to participate. The survey included questions related to respondent demographics, professional details, redeployment and training. We conducted descriptive analyses on the quantitative data.ResultsThe survey was completed by 205 eligible RDs. There were notable differences between public health and clinical RDs’ redeployment experiences. Only 17% of clinical RDs had been redeployed, compared to 88% of public health RDs. Public health RDs were redeployed for longer and were more likely to be redeployed to roles that did not required RD-specific knowledge or skills. The most commonly reported mandatory training was for proper use of personal protective equipment. The most commonly reported reasons for a lengthy absence from work were anxiety about contracting COVID-19, school closures and limited child care availability.ConclusionsPublic health RDs are at the forefront of campaigns to reduce the burden of chronic disease, improve health equity and enhance the sustainability of food systems. Close to 90% of these RDs were redeployed, with many seeing their typical work undone for many months. More research is needed to quantify the consequences of going without a public health nutrition workforce for an extended period of time and to understand the differential impact gender may have had on work experiences during the pandemic.

Development and validation of a model to predict ceiling of care in COVID-19 hospitalized patients

BackgroundTherapeutic ceiling of care is the maximum level of care deemed appropiate to offer to a patient based on their clinical profile and therefore their potential to derive benefit, within the context of the availability of resources. To our knowledge, there are no models to predict ceiling of care decisions in COVID-19 patients or other acute illnesses. We aimed to develop and validate a clinical prediction model to predict ceiling of care decisions using information readily available at the point of hospital admission.MethodsWe studied a cohort of adult COVID-19 patients who were hospitalized in 5 centres of Catalonia between 2020 and 2021. All patients had microbiologically proven SARS-CoV-2 infection at the time of hospitalization. Their therapeutic ceiling of care was assessed at hospital admission. Comorbidities collected at hospital admission, age and sex were considered as potential factors for predicting ceiling of care. A logistic regression model was used to predict the ceiling of care. The final model was validated internally and externally using a cohort obtained from the Leeds Teaching Hospitals NHS Trust. The TRIPOD Checklist for Prediction Model Development and Validation from the EQUATOR Network has been followed to report the model.ResultsA total of 5813 patients were included in the development cohort, of whom 31.5% were assigned a ceiling of care at the point of hospital admission. A model including age, COVID-19 wave, chronic kidney disease, dementia, dyslipidaemia, heart failure, metastasis, peripheral vascular disease, chronic obstructive pulmonary disease, and stroke or transient ischaemic attack had excellent discrimination and calibration. Subgroup analysis by sex, age group, and relevant comorbidities showed excellent figures for calibration and discrimination. External validation on the Leeds Teaching Hospitals cohort also showed good performance.ConclusionsCeiling of care can be predicted with great accuracy from a patient’s clinical information available at the point of hospital admission. Cohorts without information on ceiling of care could use our model to estimate the probability of ceiling of care. In future pandemics, during emergency situations or when dealing with frail patients, where time-sensitive decisions about the use of life-prolonging treatments are required, this model, combined with clinical expertise, could be valuable. However, future work is needed to evaluate the use of this prediction tool outside COVID-19.

Effectiveness of Treatment Approaches in COVID-19 Pneumonia: A Comparative Evaluation between a Specialized Center and Conventional Hospitals.

The early stages of the COVID-19 pandemic overwhelmed general hospitals in Spain. In response, a dedicated hospital for COVID-19 care, the Hospital de Emergencias Enfermera Isabel Zendal (HEEIZ), was established. This study aimed to compare clinical outcomes of COVID-19 patients treated at the specialized HEEIZ with those at conventional general hospitals (CGHs) in Madrid, Spain. The study was a prospective, observational cohort study including COVID-19 patients admitted to the HEEIZ and 14 CGHs (December 2020 to August 2021). Patients were assigned based on hospital preference. Clinical data were collected and analyzed using multivariate regression to assess primary and secondary outcomes, including hospital mortality, need of invasive mechanical ventilation (IMV), and pharmacological treatments. The HEEIZ cohort (n = 2997) was younger and had lower Charlson comorbidity scores than the CGH cohort (n = 1526). Adjusted HEEIZ hospital mortality was not significantly higher compared with CGHs (OR: 1.274; 95% CI: 0.781-2.079; p = 0.332). During the study period, patients admitted to the HEEIZ showed no significant differences in clinical outcomes, compared with patients admitted at CGHs. These results might support the use of specialized centers in managing pandemic surges, allowing CGHs to handle other needs.

Diabetes mellitus in sub-saharan Africa during the COVID-19 pandemic: A scoping review.

The COVID-19 pandemic impacted the healthcare and outcomes of individuals with various chronic diseases. However, there is a paucity of data on the impact of the COVID-19 pandemic on diabetes mellitus (DM) in low-resource settings. To address this, we conducted a scoping review to explore the literature published on diabetes-related COVID-19 outcomes and care during the COVID-19 pandemic in countries of sub-Saharan Africa. We applied our search strategy to PubMed, Web of Science, CINAHL, African Index Medicus, Google Scholar, Cochrane Library, Scopus, Science Direct, ERIC and Embase to obtain relevant articles published from January 2020 to March 2023. Two independent reviewers were involved in screening the retrieved articles. Data from eligible articles were extracted from quantitative, qualitative and mixed-methods studies. Quantitative evidence was summarised using descriptive statistics, while a thematic framework was used to identify and categorise themes from qualitative evidence. We found 42 of the retrieved 360 articles eligible, mainly from South Africa, Ethiopia and Ghana (73.4%). The incidence of DM among COVID-19 cases was 13.7/1,000 person-days observation. COVID-19 was associated with increased odds of death (OR 1.30-9.0, 95% CI), hospitalisation (OR 3.30-3.73: 95% CI), and severity (OR: 1.30-4.05, 95% CI) in persons with DM. Challenges in caring for DM during the pandemic were inadequate patient self-management, difficulties in healthcare access, and inadequate healthcare resources. The COVID-19 pandemic was characterised by a high incidence of DM in persons infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and high COVID-19-associated mortality, severity, and hospitalisation among people persons with DM. The pandemic also created difficulties in DM self-management and worsened the quality of DM care services. Policymakers should devise preventive and management strategies for DM during emerging and re-emerging infectious disease epidemics and outbreaks, given that such occurrences are increasingly frequent in the region.

Navigating uncertainty: occupational therapists’ experiences of Long COVID management in Germany, Austria and Switzerland

Purpose Long COVID presents global challenges for healthcare professionals. Occupational therapists responded by seeking effective treatment strategies. The approaches of occupational therapists supporting long-haulers in German-speaking countries remain under-explored. The purpose of this study is to explore how occupational therapists in Germany, Austria and Switzerland navigate and apply profession-specific strategies in the new clinical landscape of Long COVID care. Materials and Methods This study used qualitative-descriptive design and content analysis to extract insights from seven semi-structured interviews with occupational therapists in inpatient and outpatient settings from three countries. Results Four overarching themes emerged: how Long COVID was encountered within the scope of occupational therapy, the multifaceted repertoire experts used to support long haulers, triumphs and challenges that emerged in Long COVID treatment, and recommendations and opportunities for occupational therapy practice. The results underscore the complex support needed for long-haulers, achieved through a multifaceted occupational therapy repertoire, incorporating client-centred, occupation-focused, and context-referencing strategies with shared decision-making and collaborative therapy planning. Conclusions Occupational therapy concepts, with their focus on human occupation, may offer new treatment options and strategies for managing emerging conditions such as Long COVID.

“You may now become who you thought was disposable”: COVID-19 Politics and Ableism

Abstract This essay critically examines the intersection of COVID-19, Long COVID, ableism, and health care disparities in the United States, emphasizing the transformative impact of COVID-19 as a mass disabling event with a disproportionate impact on marginalized communities. I also bring an autoethnographic lens to my experience of COVID-19 and Long COVID, underscoring the importance of recognizing the diverse and often untellable experiences of individuals with disabilities and challenging the prevailing ableist perspectives embedded in society. I raise ethical considerations of storytelling in the context of Long COVID and urge researchers to embrace empathy and a more inclusive approach that challenges traditional notions of objectivity and distancing within academic research. I call for a collaborative approach between disability studies and folklore studies, encouraging scholars to interrogate and explore the traditions shaped by experiences of disability.

Evaluation of the effectiveness of the training on "Home care of COVID-19 positive/suspicious patients" given to nursing students: A quasi-experimental study.

This study aims to evaluate the effects of education on home care of infected or suspected COVID-19 patients on the levels of knowledge, anxiety, and awareness of nursing students in Turkey. The study is in quasi-experimental design. A sample of 158 volunteer students studying nursing at a private university in Turkey was formed. Data were collected using, descriptive information form, "Coronavirus Anxiety Scale," "COVID-19 Awareness Scale," and the "Knowledge of COVID-19 Home Care Test." Pre-test was performed before the participants received education. Post-test was performed seven days after the intervention. SPSS version 25.0 was used for data analysis. "TREND checklist" was used for quasi-experimental/non-randomized evaluations to report the findings of the study. Anxiety levels decreased and the levels of awareness and knowledge on COVID-19 increased after receiving education on home care of infected or suspected COVID-19 patients (p < 0.001), indicating the effectiveness of the education. Education on home care of infected or suspected COVID-19 patients was an effective method to reduce anxiety and increase knowledge and awareness in nursing students. To contribute to community health, home care training can be given to nursing students, other people receiving home care, or providing home care to COVID-19 patients, infected or suspected COVID-19 patients.

A Complex Interplay: Navigating the Crossroads of Tobacco Use, Cardiovascular Disease, and the COVID-19 Pandemic: A WHF Policy Brief.

The Coronavirus Disease 2019, commonly referred to as COVID-19, is responsible for one of the deadliest pandemics in human history. The direct, indirect and lasting repercussions of the COVID-19 pandemic on individuals and public health, as well as health systems can still be observed, even today. In the midst of the initial chaos, the role of tobacco as a prognostic factor for unfavourable COVID-19 outcomes was largely neglected. As of 2023, numerous studies have confirmed that use of tobacco, a leading risk factor for cardiovascular and other diseases, is strongly associated with increased risks of severe COVID-19 complications (e.g., hospitalisation, ICU admission, need for mechanical ventilation, long COVID, etc.) and deaths from COVID-19. In addition, evidence suggests that COVID-19 directly affects multiple organs beyond the respiratory system, disproportionately impacting individuals with comorbidities. Notably, people living with cardiovascular disease are more prone to experiencing worse outcomes, as COVID-19 often inherently manifests as thrombotic cardiovascular complications. As such, the triad of tobacco, COVID-19 and cardiovascular disease constitutes a dangerous cocktail. The lockdowns and social distancing measures imposed by governments have also had adverse effects on our lifestyles (e.g., shifts in diets, physical activity, tobacco consumption patterns, etc.) and mental well-being, all of which affect cardiovascular health. In particular, vulnerable populations are especially susceptible to tobacco use, cardiovascular disease and the psychological fallout from the pandemic. Therefore, national pandemic responses need to consider health equity as well as the social determinants of health. The pandemic has also had catastrophic impacts on many health systems, bringing some to the brink of collapse. As a result, many health services, such as services for cardiovascular disease or tobacco cessation, were severely disrupted due to fears of transmission and redirection of resources for COVID-19 care. Unfortunately, the return to pre-pandemic levels of cardiovascular disease care activity has stagnated. Nevertheless, digital solutions, such as telemedicine and apps, have flourished, and may help reduce the gaps. Advancing tobacco control was especially challenging due to interference from the tobacco industry. The industry exploited lingering uncertainties to propagate misleading information on tobacco and COVID-19 in order to promote its products. Regrettably, the links between tobacco use and risk of SARS-CoV-2 infection remain inconclusive. However, a robust body of evidence has, since then, demonstrated that tobacco use is associated with more severe COVID-19 illness and complications. Additionally, the tobacco industry also repeatedly attempted to forge partnerships with governments under the guise of corporate social responsibility. The implementation of the WHO Framework Convention on Tobacco Control could address many of the aforementioned challenges and alleviate the burden of tobacco, COVID-19, and cardiovascular disease. In particular, the implementation of Article 5.3 could protect public health policies from the vested interests of the industry. The world can learn from the COVID-19 pandemic to better prepare for future health emergencies of international concern. In light of the impact of tobacco on the COVID-19 pandemic, it is imperative that tobacco control remains a central component in pandemic preparedness and response plans.

Comparison of COVID-19 Sentinel Surveillance and COVID-19 School Absentee Surveillance in Japan

Background: In Japan, notifiable infectious disease surveillance ended and was replaced by sentinel surveillance following the COVID-19 reclassification in May 2023. Since COVID-19 sentinel surveillance is integrated into seasonal influenza surveillance, the number of reported cases varies depending on the extent to which sentinel facilities provide COVID-19 care. Therefore, we compared COVID-19 sentinel surveillance with school absentee surveillance, which is limited to high school equivalent age or younger, but provides reliable information on absences in the target population. Method: The 17-week period from week 23 (June 5 to June 11) to week 39 (September 25 to October 1) of 2023 was used as the target period. The number of weekly COVID-19 reports from 72 sentinel sites in Mie Prefecture (Population 1.7 million) as for sentinel surveillance and the number of COVID-19 absentees at a total of 998 facilities (401 kindergartens and nursery schools, and 597 elementary, junior high, and senior high schools) registered for school absentee surveillance in Mie Prefecture as for school absentee surveillance were compared across Mie Prefecture and eight health centers (Fig 1). Result: Except for the summer vacation period from week 29 to 35, sentinel surveillance and school absentee surveillance showed a significant positive correlation. During the summer vacation period, a decrease in the number of COVID-19 absentees was observed, especially in the elementary, junior high, and senior high school groups of the school absentee surveillance, compared to the sentinel surveillance (Fig 2 and 3). When compared by health center, no regional differences were observed in school absentee surveillance, but in sentinel surveillance, some health centers reported significantly more cases than others. Conclusion: The results of this study suggest that although COVID-19-based school absentee surveillance has some drawbacks, such as the limited number of subjects and the difficulty of evaluation during the summer vacation when schools are closed, it has the advantage of being able to evaluate the entire community without being affected by medical institution practice bias, and can be used to monitor trends in infectious diseases. It was considered important to combine and evaluate multiple surveillance indicators in order to accurately monitor epidemiologic trends of infectious disease over time.

Knowledge Management in the Literature From 2021 to 2024

The COVID-19 pandemic has significantly impacted knowledge management in Higher Education Institutions (HEIs). Studies have found that material, financial, and human resources are the key factors in the knowledge network, and mistrust often exists between decision-makers and those who carry out the work. This study aimed to investigate the relationship between knowledge management and trust by conducting a cross-sectional, exploratory, and correlational study with a sample of 10 professional practitioners and social workers involved in COVID-19 care. The study findings show that innovation, competitiveness, and efficiency are the central, unifying, and structural axes of information translation and knowledge transfer. These results are not extensive to the university community, and they are innovative because they highlight the importance of trust as the guiding principle of knowledge management.

Persistent Residual Lung Abnormalities (PRLAs) as Post COVID Lung Sequel in Recovered Severe Pneumonia Case with Lung Function Abnormality at Two Year Follow Up

Coronavirus related (SARS-CoV-2) global pandemic has caused significant mortality and morbidity globally in the last three years. Although, pandemic has waned since last year, we are not in great peace of relief due to lingering effects of COVID-19 persisted even after two years of illness. Radiological phenotypes are radiological patterns or observable characteristics of COVID-19 pneumonia. Radiological outcomes are initially interpreted as post covid lung fibrosis in short term follow-up of recovered COVID-19 cases in post covid care settings and during long term evaluation these abnormalities are defined as post covid sequalae’s. In present case report, 38-year male, presented in outdoor unit for shortness of breath on exertion with history of severe COVID-19 Pneumonia resulted into acute respiratory distress syndrome with hospitalization in intensive care unit one year back and required high flow nasal cannula (HFNC) with Non-invasive ventilatory support (NIV) for two weeks. He was offered oxygen supplementation at home with antibiotics for three months and no requirement of oxygen and some respiratory symptoms even after one year. His HRCT thorax documented at one year of discharge from hospital revealed typical interstitial opacities labelled as Persistent Residual lung abnormalities (RLAs) which are predominantly reticular and linear opacities in peripheral parts of lungs without honeycombing within typical pleural based areas with parenchymal bands and minimally altered lung architecture and preserved lung volume.

Geographical coverage of SARS-CoV-2 screening and care centers in Haiti: what do national surveillance data tell us?

SummaryBackgroundIn Haiti, reported incidence and mortality rates for COVID-19 were lower than expected. We aimed to analyze factors at communal and individual level that might lead to an underestimation of the true burden of the COVID-19 epidemic in Haiti during its first two years.MethodsWe analyzed national COVID-19 surveillance data from March 2020 to December 2021, to describe the epidemic using cluster detection, time series, and cartographic approach. We performed multivariate Quasi-Poisson regression models to determine socioeconomic factors associated with incidence and mortality. We performed a mixed-effect logistic regression model to determine individual factors associated with the infection.ResultsAmong the 140 communes of Haiti, 57 (40.7%) had a COVID-19 screening center, and the incidence was six times higher in these than in those without. Only 22 (15.7%) communes had a COVID-19 care center, and the mortality was five times higher in these than in those without. All the richest communes had a COVID-19 screening center while only 30.8% of the poorest had one. And 75% of the richest communes had a COVID-19 care center while only 15.4% of the poorest had one. Having more than three healthcare workers per 1000 population in the commune was positively associated with the incidence (SIR: 3.31; IC95%: 2.50, 3.93) and the mortality (SMR: 2.73; IC95%: 2.03, 3.66). At the individual level, male gender (adjusted OR: 1.11; IC95%: 1.01, 1.22), age with a progressive increase of the risk compared to youngers, and having Haitian nationality only (adjusted OR:2.07; IC95%: 1.53, 2.82) were associated with the infection.ConclusionsThis study highlights the weakness of SARS-CoV-2 screening and care system in Haiti, particularly in the poorest communes, suggesting that the number of COVID-19 cases and deaths were probably greatly underestimated.

Adaptations to a patient navigation program for follow-up colonoscopy in rural primary care practices.

Patient navigation is a recommended practice to improve cancer screenings among underserved populations including those residing in rural areas with care access barriers. We report on patient navigation programme adaptations to increase follow-up colonoscopy rates after abnormal fecal testing in rural primary care practices. Participating clinics delivered a patient navigation programme to eligible patients from 28 affiliated clinics serving rural communities in Oregon clustered within 3 Medicaid health plans. Patient navigation adaptations were tracked using data sources including patient navigation training programme reflections, qualitative interviews, clinic meetings, and periodic reflections with practice facilitators. Initial, planned (proactive) adaptations were made to address the rural context; later, unplanned (reactive) adaptations were implemented to address the impact of the COVID-19 global pandemic. Initial planned adaptations to the patient navigation programme were made before the main trial to address the needs of the rural context, including provider shortages and geographic dispersion limiting both patient access to care and training opportunities for providers. Later unplanned adaptations were made primarily in response to COVID-19 care suspension and staff redeployments and shortages that occurred during implementation. While unplanned adaptations were implemented to address the contextual impact of the COVID-19 pandemic on care access patterns and staffing, the changes to training content and context were beneficial to the rural setting overall and should be sustained. Our findings can guide future efforts to optimise the success of such programmes in other rural settings and highlight the important role of adaptations in implementation projects.

“The dream is that there’s one place you go”: a qualitative study of women’s experiences seeking care from Long COVID clinics in the USA

BackgroundSeeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic.MethodsWe conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics.ResultsOf the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent.ConclusionsWhile the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices.

Prevalence of premenstrual syndrome and related factors among nurses.

Premenstrual syndrome (PMS) is a common condition among women during their menstrual cycle. PMS can negatively affect a woman's daily life and function. Nurses, as an important and substantial segment of healthcare staff, are affected by the demanding environment of work place. Since PMS, as a prevalent counterproductive condition, has not been studied in this population in Iran, we assessed the prevalence of PMS and its associated factors among nurses aged 23 to 49 in teaching hospitals of the Tehran province of Iran. In this cross-sectional study from April 2021 to January 2022, 280 participants from teaching hospitals were enrolled. Simple random sampling was used to determine the sample size of the study. Two validated questionnaires and a data gathering sheet were used to collect information. The premenstrual symptoms screening tool was used to determine PMS severity and the Copenhagen Psychosocial Questionnaire to evaluate the associated job demands. Demographic data and work-related data included: night shift, shift type, monthly COVID-19 care and gynecologic and past medical history were gathered. Then data were analyzed using logistic regression analysis, chi-square and t-test. The severity of PMS was: mild (42.5%); moderate (30%); and severe (27.5%). Regular menstruation and dysmenorrhea were reported by 84.6% and 72.3%, respectively. Moderate to severe PMS was associated with: monthly COVID shift (p=0.02); emotional (p<0.01) and quantitative (p<0.01) demands; regular caffeine intake (p=0.01); education level (p=0.005); regular exercise (p=0.003); regular fiber intake (p=0.08); and irregular menstrual cycles (p=0.007). In logistic regression only quantitative (p=0.003) and emotional (p=0.018) job demands were significant. Results showed that the prevalence of PMS was high among Iranian nurses and was associated with quantitative and emotional job demands. We suggest further studies focusing on preventative and effective interventions to diminish the consequences of PMS in this population. We also suggest investigating the practical application of the findings of this study for healthcare professionals and policymakers.

The two-year epidemiological investigation of the COVID-19 pandemic in the nomadic population of Fars province, Southern Iran: An ecological study (February 20, 2020, to February 19, 2022)

BackgroundThe COVID-19 pandemic has highlighted the vulnerability of traveling populations, yet little is known about the health status of nomadic communities. This ecological study aimed to investigate the health status of the nomadic population in Fars Province, Iran, during the first two years of the COVID-19 pandemic. MethodsNomadic Information Registration System (NIRS) data were used to compare COVID-19 diagnostic tests, confirmed cases, referrals, hospital admissions, deaths, and vaccination coverage between the nomadic and general populations. Non-parametric chi-square test was used for data analysis. ResultsIn Fars Province, COVID-19 diagnostic tests were performed on 2.73 % of the nomadic population and 40 % of the general population. The test positivity rate was 23.91 % for the nomadic population and 29.3 % for the general population. The case fatality ratio (CFR) for COVID-19 was 9.24 % for the nomadic population and 1.29 % for the general population. Additionally, only 41.83 % and 24.35 % of the nomadic population had received the first and second doses of a COVID-19 vaccine, respectively, which were lower than the general population's rates of 65.65 % and 59.71 %. ConclusionThe nomadic population in Fars Province received suboptimal COVID-19 care compared to the general population.

The impact of the COVID-19 pandemic on the incidence of myocardial infarctions: an overview of current research

Introduction and Purpose: The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide, particularly impacting the management of critical non-COVID conditions such as myocardial infarction (MI). This review aims to explore the alterations in the management of MI during the pandemic and assess how these changes have influenced patient outcomes. State of Knowledge: Numerous studies have reported delays in MI treatment during the pandemic due to healthcare resource reallocation towards COVID-19 care and patient hesitance in seeking timely medical help. Innovations such as telemedicine have been integrated into patient care to overcome barriers. However, these changes have varied impacts on clinical outcomes, including increased mortality and complication rates among MI patients during the pandemic. This review consolidates findings from recent studies focusing on altered treatment protocols, patient care strategies, and overall health system response during this period. Summary: The management of myocardial infarction during the COVID-19 pandemic has witnessed substantial shifts, leading to both challenges and innovations in cardiac care. While some adjustments have provided temporary solutions, the overall impact on MI outcomes has highlighted the need for more resilient healthcare strategies that ensure the continuity of care for acute cardiac events during global health emergencies.

Long COVID Definitions and Models of Care : A Scoping Review.

Definitions of long COVID are evolving, and optimal models of care are uncertain. To perform a scoping review on definitions of long COVID and provide an overview of care models, including a proposed framework to describe and distinguish models. English-language articles from Ovid MEDLINE, PsycINFO, the Cochrane Library, SocINDEX, Scopus, Embase, and CINAHL published between January 2021 and November 2023; gray literature; and discussions with 18 key informants. Publications describing long COVID definitions or models of care, supplemented by models described by key informants. Data were extracted by one reviewer and verified for accuracy by another reviewer. Of 1960 screened citations, 38 were included. Five clinical definitions of long COVID varied with regard to timing since symptom onset and the minimum duration required for diagnosis; 1 additional definition was symptom score-based. Forty-nine long COVID care models were informed by 5 key principles: a core "lead" team, multidisciplinary expertise, comprehensive access to diagnostic and therapeutic services, a patient-centered approach, and providing capacity to meet demand. Seven characteristics provided a framework for distinguishing models: home department or clinical setting, clinical lead, collocation of other specialties, primary care role, population managed, use of teleservices, and whether the model was practice- or systems-based. Using this framework, 10 representative practice-based and 3 systems-based models of care were identified. Published literature often lacked key model details, data were insufficient to assess model outcomes, and there was overlap between and variability within models. Definitions of long COVID and care models are evolving. Research is needed to optimize models and evaluate outcomes of different models. Agency for Healthcare Research and Quality. (Protocol posted at https://effectivehealthcare.ahrq.gov/products/long-covid-models-care/protocol.).

Prolonged organizational citizenship behavior and its impact on nurses' mental health: a time to rethink

PurposeThe primary objective of this study is to understand the motivational process of the nurses who were engaged in COVID care and performed organizational citizenship behavior (OCB) without caring about their own lives. This study also aims to investigate the consequences of such OCB on life satisfaction when the situation continues for a longer period.Design/methodology/approachFor the study’s first objective, an online cross-sectional survey was conducted on 236 critical care nurses from 18 states of India extending over the period from March 2021 to November 2021, when the country passed through the second wave of COVID-19 infection. For the second objective, a longitudinal study compared the life satisfaction level during and post-COVID by giving a one-year gap (November 2022).FindingsThe findings of this study reveal that during this COVID period, nurses were strongly performing OCB through their organizational and professional commitment, but one year later, they were identified with a low level of life satisfaction.Originality/valueResearch on nurses has already categorized the profession under high emotional labor. Research also reveals that an individual’s emotional labor strategy (deep acting or surface acting) determines job satisfaction. However, under the COVID situation, nurses have displayed an extraordinary level of OCB by placing their own life at risk. Analysis of this study indicates that the OCB within the nurses during the COVID period originated from their commitment, not from the emotional labor strategy, which they used to select as a coping mechanism. However, one year later, it has affected their mental health and lowered their life satisfaction.