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  • Open Access English
    Authors: 
    Government of Canada;

    Objective: This tool will assist in considering risks associated with the use of parks and outdoor recreational spaces during the coronavirus disease (COVID-19) pandemic and provide examples of strategies that may be implemented to reduce potential risks. Audience: Those responsible for parks and outdoor recreational places and programming (e.g., federal/provincial/territorial, and local/municipal authorities, Indigenous leadership, sports and recreation organizations and coaches and leaders). Outdoor recreation spaces or recreational activities that require staff (for example to accept payment for entrance fees, to provide food and beverage services, etc.) should also refer to the tool for workplaces and businesses for guidance on risk assessment and risk mitigation related to business operations.

  • Open Access English
    Authors: 
    Dores, Artemisa Rocha; Geraldo, A.; Carvalho, I.; Barbosa, F.;
    Publisher: Cambridge Core
    Country: Portugal
  • Open Access English
    Authors: 
    Nguyen, T.N. Haussen, D.C. Qureshi, M.M. Yamagami, H. Fujinaka, T. Mansour, O.Y. Abdalkader, M. Frankel, M. Qiu, Z. Taylor, A. Lylyk, P. Eker, O.F. Mechtouff, L. Piotin, M. Lima, F.O. Mont'Alverne, F. Izzath, W. Sakai, N. Mohammaden, M. Al-Bayati, A.R. Renieri, L. Mangiafico, S. Ozretic, D. Chalumeau, V. Ahmad, S. Rashid, U. Hussain, S.I. John, S. Griffin, E. Thornton, J. Fiorot, J.A. Rivera, R. Hammami, N. Cervantes-Arslanian, A.M. Dasenbrock, H.H. Vu, H.L. Nguyen, V.Q. Hetts, S. Bourcier, R. Guile, R. Walker, M. Sharma, M. Frei, D. Jabbour, P. Herial, N. Al-Mufti, F. Ozdemir, A.O. Aykac, O. Gandhi, D. Chugh, C. Matouk, C. Lavoie, P. Edgell, R. Beer-Furlan, A. Chen, M. Killer-Oberpfalzer, M. Pereira, V.M. Nicholson, P. Huded, V. Ohara, N. Watanabe, D. Shin, D.H. Magalhaes, P.S.C. Kikano, R. Ortega-Gutierrez, S. Farooqui, M. Abou-Hamden, A. Amano, T. Yamamoto, R. Weeks, A. Cora, E.A. Sivan-Hoffmann, R. Crosa, R. Möhlenbruch, M. Nagel, S. Al-Jehani, H. Sheth, S.A. Rivera, V.S.L. Si;
    Country: Greece

    Background During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study's objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March-31 May 2020. The prior 1-year control period (1 March-31 May 2019) was obtained to account for seasonal variation. Findings There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI -24.3% to -20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170-1035 procedures, respectively, representing an 11.5% (95%CI -13.5% to -9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI -28.0% to -22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile. Interpretation There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction. ©

  • Open Access English
    Authors: 
    Mamelund, Svenn-Erik; Dimka, Jessica;
    Publisher: Routledge

    Despite common perceptions to the contrary, pandemic diseases do not affect populations indiscriminately. In this paper, we review literature produced by demographers, historians, epidemiologists, and other researchers on disparities during the 1918–20 influenza pandemic and the Covid-19 pandemic. Evidence from these studies demonstrates that lower socio-economic status and minority/stigmatized race or ethnicity are associated with higher morbidity and mortality. However, such research often lacks theoretical frameworks or appropriate data to explain the mechanisms underlying these disparities fully. We suggest using a framework that considers proximal and distal factors contributing to differential exposure, susceptibility, and consequences as one way to move this research forward. Further, current pandemic preparedness plans emphasize medically defined risk groups and epidemiological approaches. Therefore, we conclude by arguing in favour of a transdisciplinary paradigm that recognizes socially defined risk groups, includes input from the social sciences and humanities and other diverse perspectives, and contributes to the reduction of health disparities before a pandemic hits.

  • Open Access English
    Authors: 
    Banco de España;
    Publisher: Banco de España
    Country: Spain
  • Open Access English
    Authors: 
    Kinsella, Cormac M.; Santos, Pauline Dianne; Postigo-Hidalgo, Ignacio; Folgueiras-González, Alba; Passchier, Tim Casper; Szillat, Kevin P.; Akello, Joyce Odeke; Álvarez-Rodríguez, Beatriz; Martí-Carreras, Joan;

    The first cluster of patients suffering from coronavirus disease 2019 (COVID-19) was identified on December 21, 2019, and as of July 29, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been linked with 664,333 deaths and number at least 16,932,996 worldwide. Unprecedented in global societal impact, the COVID-19 pandemic has tested local, national, and international preparedness for viral outbreaks to the limits. Just as it will be vital to identify missed opportunities and improve contingency planning for future outbreaks, we must also highlight key successes and build on them. Concomitant to the emergence of a novel viral disease, there is a 'research and development gap' that poses a threat to the overall pace and quality of outbreak response during its most crucial early phase. Here, we outline key components of an adequate research response to novel viral outbreaks using the example of SARS-CoV-2. We highlight the exceptional recent progress made in fundamental science, resulting in the fastest scientific response to a major infectious disease outbreak or pandemic. We underline the vital role of the international research community, from the implementation of diagnostics and contact tracing procedures to the collective search for vaccines and antiviral therapies, sustained by unique information sharing efforts.

  • Other research product . Other ORP type . 2021
    Open Access English
    Authors: 
    Kooman, Jeroen P.; van der Sande, Frank M.;

    The COVID-19 pandemic has greatly affected nephrology. Firstly, dialysis patients appear to be at increased risk for infection due to viral transmission next to an enhanced risk for mortality as compared to the general population, even in the face of an often apparently mild clinical presentation. Derangements in the innate and adaptive immune systems may be responsible for a reduced antiviral response, whereas chronic activation of the innate immune system and endothelial dysfunction provide a background for a more severe course. The presence of severe comorbidity, older age, and a reduction of organ reserve may lead to a rapid deterioration of the clinical situation of the patients in case of severe infection. Secondly, patients with COVID-19 are at increased risk of acute kidney injury (AKI), which is related to the severity of the clinical disease. The presence of AKI, and especially the need for renal replacement therapy (RRT), is associated with an increased risk of mortality. AKI in COVID-19 has a multifactorial origin, in which direct viral invasion of kidney cells, activation of the renin-angiotensin aldosterone system, a hyperinflammatory response, hypercoagulability, and nonspecific factors such as hypotension and hypoxemia may be involved. Apart from logistic challenges and the need for strict hygiene within units, treatment of patients with ESRD and COVID-19 is not different from that of the general population. Extracorporeal treatment of patients with AKI with RRT can be complicated by frequent filter clotting due to the hypercoagulable state, for which regional citrate coagulation provides a reasonable solution. Also, acute peritoneal dialysis may be a reasonable option in these patients. Whether adjuncts to extracorporeal therapies, such as hemoadsorption, provide additional benefits in the case of severely ill COVID-19 patients needs to be addressed in controlled studies.

  • Open Access English
    Authors: 
    Kernohan, Ashleigh; Calderon, Maria;

    BACKGROUND: An emerging issue in the management of the novel COVID-19 coronavirus is morbidity and mortality associated with venous thrombolytic events. Apart from respiratory failure, coagulopathy is a common abnormality in patients with COVID‐19, with elevated levels of both fibrinogen and D‐dimer. For example, Oudkerk at al noted a number of case studies describing thrombolytic events in COVID-19 patients in their report, raising concerns about this issue. When considering management advice for patients with COVID-19 it is important to consider two factors. Firstly, what are the risk factors associated with thrombolytic events in COVID-19 patients? Secondly, what are the optimal strategies for prophylaxis and treatments for thrombolytic events in this patient groups? Understanding the current evidence for both risk factors and management strategies for venous thrombolytic events (VTE) in the these groups will aid clinical decision making. To contribute to this knowledge base, we conducted a rapid literature review using a systematic search method to identify relevant studies in relation to risk factors or managements of VTEs. METHODS: Studies included in this review were primary studies which assess risks and management of thrombolytic events in COVID-19 patients. The following search strategy was applied to Medline and EMBASE on 07/05/2020 with no limits. (“COVID-19” or COVID19 or COVID-19 or “coronavirus disease 2019” or “coronavirus disease-19” or “2019-nCoV disease” or “severe acute respiratory syndrome coronavirus 2” or “Wuhan coronavirus” or “COVID-19 virus” or “SARS-CoV-2” or “SARS2” or “2019-nCoV” or “2019 novel coronavirus” or “2019 novel coronavirus infection” AND (“D-dimer” or “coagulation parameter” or “venous thromboembolism” or “novel coronavirus pneumonia” or “blood coagulation” or “fibrin fibrinogen degradation products” or “vein thrombosis” or “thrombosis” or “lung embolism” or “PE” or “thromboembolism” or “venous thromboembolism” or “pulmonary embolism “).af. RESULTS: Included studies. The search returned 364 studied after duplicates were removed, of which 9 were included. Most of the studies which were included from France (4 studies) the other studies came from Italy (2 studies), China (1 study), the USA (1 study) and the Netherlands (1 study). Most studies were Retrospective case series, this includes Bozzani et al, Cui et al, Griffin et al, Klok et al, Leonard-Lorant et al, Llitjos et al, Poissy et al. There was one retrospective cohort study, Lodigiani et al, and one prospective cohort study, Helms et al [...]

  • Open Access English

    Introduction: Conflict-induced displacement makes affected populations more vulnerable to HIV transmission. However, this vulnerability does not always necessarily translate into more HIV infections. The extent to which conflict and displacement affect HIV transmission depends upon numerouscompeting and interacting factors such as loss of livelihoods; availability of education; the type and the length of conflict; the living arrangements and conditions of internally displaced persons (IDPs), whether formal or informal settlement; the context of their new location; and access to health services, including HIV and sexual and reproductive health programs. These factors also have direct implications for HIV vulnerability. Vulnerability results from individual and societal factors that affect adversely one’s ability to exert control over one’s own health. The factors pertaining to the quality of coverage of services and programs also influence HIV vulnerability. The characteristics of the HIV epidemic, the prevalence in the local populations, the interactions with armed forces, the occurrence of sexual violence and the risk behaviours associated with the new situations conditions of IDPs directly affect the risk of HIV transmission. HIV risk is defined as the probability that a person may acquire HIV infection by, for example, unprotected sex with partners or injecting drug use with shared needles and syringes...

  • Open Access English
    Country: Switzerland

    What are the perceptions of community groups toward preserving their health and wellbeing during a COVID-19 outbreak? Both rural, urban, camp, open and conflict settings will be included. Recognising that different locations may have been exposed to COVID-19 in its early phase, it will continue to explore within each setting throughout the outbreak period. So far, the following sites are to be included: Nigeria: Anka and Benue IDP camps (Pilot) Jordan: Syrian refugee Zaatari camp Iraq: Syrian and Iraqi refugee camp(s) Sierra Leone: Tonkolili project (Pilot) Malaysia: Penang Rohingya refugees : Myanmar Pauktaw camp, Rakhine state Bangladesh:Cox Bazaar camps and Kamrangirchar peri-urban slum Ethiopia Gambella camp Democratic Republic of Congo: South Kivu (Fizi and Kimbi-Lulenge health zones) Further sites may be submitted to ERB during the outbreak.

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