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- Moura, Carolina, et al.
(författare)
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The Impact of COVID-19 on Burns: A Brazilian Study
- 2023
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Ingår i: European Burn Journal. - : MDPI. - 2673-1991. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- During the COVID-19 pandemic, some of the strategies chosen to contain the spread, such as social isolation and use of alcohol-based hand sanitizer, were suspected to increase the risk of domestic accidents, especially burns. The aim of this study was, therefore, to investigate possible differences in epidemiological trends among burned patients admitted to the main referral hospital of the State of Minas Gerais, Brazil, before and during the pandemic. Methods: All categories of new burns admitted at the Burn Unit of the Joao XXIII Hospital in Belo Horizonte, Minas Gerais. The study group consisted of burn patients admitted between 1 March and 31 December 2020, and the control group consisted of those admitted between 1 March and 31 December 2019. The population was analyzed descriptively, and differences between patients admitted before and during the pandemic were tested using t-test, Wilcoxon Mann-Whitney Rank Sum test, the Chi-Squared test or Fisher's exact test, as appropriate. Results: During the study period, 914 patients were admitted at the burns unit, 535 before the pandemic (control group) and 379 during the pandemic (study group). During the pandemic, referral from other hospitals decreased, while time between injury and admission remained unchanged. TBSA% and LOS diminished, while the depth of burns, presence of inhalation injuries, and in-hospital mortality did not. In adults, the place and mechanism of injury changed during the pandemic, while in children they did not. Conclusion: Fewer patients with burns were referred for specialized burn care during the pandemic, although patients admitted for specialized burn care had smaller TBSA% and shorter LOS.
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| 3. |
- Ferreira, Julia, et al.
(författare)
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Evolution of Gender Disparities Among Brazilian Surgical, Anesthesia, and Obstetric Providers.
- 2022
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Ingår i: Journal of Surgical Research. - : Elsevier. - 0022-4804 .- 1095-8673. ; 275, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Since 2010, most graduating physicians in Brazil have been female, nevertheless gender disparities among surgical specialties still exist. This study aims to explore whether the increase in female physicians has translated to increased female representation among surgical specialties in Brazil.METHODS: Data on gender, years of practice, and specialty was extracted from Demografia Médica do Brasil, from 2015 to 2020. The percentage of women across 18 surgical, anesthesia, and obstetric (SAO) specialties and the relative increases in female representation during the study period were calculated.RESULTS: Of the 18 SAO specialties studied, 16 (88%) were predominantly male (>50%). Only obstetrics/gynecology and breast surgery showed a female predominance, with 58% and 52%, respectively. Urology, neurosurgery, and orthopedic surgery and traumatology were the three specialties with the largest presence of men - and the lowest absolute growth in the female workforce from 2015 to 2020.CONCLUSIONS: In Brazil, where significant gender disparities persist, women are still underrepresented in surgical specialties. Female presence is predominant in surgical specialties dedicated to the care of female patients, while it remains poor in those with male patient dominance. Over the last 5 y, the proportion of women working in SAO specialties has grown, but not as much as in nonsurgical specialties. Future studies should focus on investigating the causes of gender disparities in Brazil to understand and tackle the barriers to pursuing surgical specialties.
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| 4. |
- Graner, Mariana, et al.
(författare)
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Who Gets Burned in Brazil?
- 2023
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Ingår i: Journal of Burn Care & Research. - : OXFORD UNIV PRESS. - 1559-047X .- 1559-0488.
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Tidskriftsartikel (refereegranskat)abstract
- Burns are preventable injuries that still represent a relevant public health issue. The identification of risk factors might contribute to the development of specific preventive strategies. Data of patients admitted at the Hospital due to acute burn injuries from May 2017 to December 2019, was extracted manually from medical records. The population was analyzed descriptively, and differences between groups were tested using the appropriate statistical test. The study population consisted of 370 patients with burns admitted to the Hospital burn unit during the study period. The majority of the patients were males (257/370, 70%), median age was 33 (IQR:18-43), median TBSA% was 13 (IQR 6.35-21.5 and range 0-87.5%), and 54% of patients had full-thickness burns (n = 179). Children younger than 13 years old represented 17% of the study population (n = 63), 60% of them were boys (n = 38), and scalds was the predominant mechanism of burn injury (n = 45). No children died, however 10% of adults did (n = 31). Self-inflicted burns were observed in 16 adults (5%), of whom 6 (38%) died during admission, however self-inflicted burns were not observed in children. Psychiatric disorders and substance misuse were frequent in this subgroup. White adults male from urban areas who had not completed primary school degree were the major risk group for burns. Smoking and alcohol misuse were the most frequent comorbidities. Accidental domestic flame burns were the predominant injuries in the adult population and scalds in the pediatric.
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| 5. |
- Marchi, Mattia, et al.
(författare)
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Experience of discrimination during COVID-19 pandemic : the impact of public health measures and psychological distress among refugees and other migrants in Europe
- 2022
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.
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| 6. |
- Spiritus-Beerden, Eva, et al.
(författare)
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Mental Health of Refugees and Migrants during the COVID-19 Pandemic : The Role of Experienced Discrimination and Daily Stressors
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:12
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic is a defining global health crisis of our time. While the impact of COVID-19, including its mental health impact, is increasingly being documented, there remain important gaps regarding the specific consequences of the pandemic on particular population groups, including refugees and migrants. This study aims to uncover the impact of the COVID-19 pandemic on the mental health of refugees and migrants worldwide, disentangling the possible role of social and daily stressors, i.e., experiences of discrimination and daily living conditions. Descriptive analysis and structural equation modeling were used to analyze the responses of N = 20,742 refugees and migrants on the self-reporting global ApartTogether survey. Survey findings indicated that the mental health of refugees and migrants during the COVID-19 pandemic was significantly impacted, particularly for certain subgroups, (i.e., insecure housing situation and residence status, older respondents, and females) who reported experiencing higher levels of increased discrimination and increases in daily life stressors. There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular refugee and migrant groups and to develop interventions that target their unique needs.
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| 7. |
- Truche, Paul, et al.
(författare)
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Association between government policy and delays in emergent and elective surgical care during the COVID-19 pandemic in Brazil : a modeling study
- 2021
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Ingår i: The Lancet Regional Health - Americas. - : Elsevier. - 2667-193X. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background:The impact of public health policy to reduce the spread of COVID-19 on access to surgical care is poorly defined. We aim to quantify the surgical backlog during the COVID-19 pandemic in the Brazilian public health system and determine the relationship between state-level policy response and the degree of state-level delays in public surgical care.Methods:Monthly estimates of surgical procedures performed per state from January 2016 to December 2020 were obtained from Brazil's Unified Health System Informatics Department. Forecasting models using historical surgical volume data before March 2020 (first reported COVID-19 case) were constructed to predict expected monthly operations from March through December 2020. Total, emergency, and elective surgical monthly backlogs were calculated by comparing reported volume to forecasted volume. Linear mixed effects models were used to model the relationship between public surgical delivery and two measures of health policy response: the COVID-19 Stringency Index (SI) and the Containment & Health Index (CHI) by state.Findings:Between March and December 2020, the total surgical backlog included 1,119,433 (95% Confidence Interval 762,663–1,523,995) total operations, 161,321 (95%CI 37,468–395,478) emergent operations, and 928,758 (95%CI 675,202–1,208,769) elective operations. Increased SI and CHI scores were associated with reductions in emergent surgical delays but increases in elective surgical backlogs. The maximum government stringency (score = 100) reduced emergency delays to nearly zero but tripled the elective surgical backlog.Interpretation:Strong health policy efforts to contain COVID-19 ensure minimal reductions in delivery of emergent surgery, but dramatically increase elective backlogs. Additional coordinated government efforts will be necessary to specifically address the increased elective backlogs that accompany stringent responses.
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