scholarly journals “It’s Been Ugly”: A Large-Scale Qualitative Study into the Difficulties Frontline Doctors Faced across Two Waves of the COVID-19 Pandemic

2021 ◽  
Vol 18 (24) ◽  
pp. 13067
Author(s):  
Sophie Harris ◽  
Elizabeth Jenkinson ◽  
Edward Carlton ◽  
Tom Roberts ◽  
Jo Daniels
Keyword(s):  
Content Analysis ◽  
Intensive Care ◽  
Large Scale ◽  
Control Measures ◽  
Emotional Impact ◽  
Infection Control Measures ◽  
Conventional Content Analysis ◽  
The Uk ◽  
Insight Into

This study aimed to gain an uncensored insight into the most difficult aspects of working as a frontline doctor across successive COVID-19 pandemic waves. Data collected by the parent study (CERA) was analysed using conventional content analysis. Participants comprised frontline doctors who worked in emergency, anaesthetic, and intensive care medicine in the UK and Ireland during the COVID-19 pandemic (n = 1379). All seniority levels were represented, 42.8% of the sample were male, and 69.2% were white. Four themes were identified with nine respective categories (in parentheses): (1) I’m not a COVID hero, I’m COVID cannon fodder (exposed and unprotected, “a kick in the teeth”); (2) the relentlessness and pervasiveness of COVID (“no respite”, “shifting sands”); (3) the ugly truths of the frontline (“inhumane” care, complex team dynamics); (4) an overwhelmed system exacerbated by COVID (overstretched and under-resourced, constant changes and uncertainty, the added hinderance of infection control measures). Findings reflect the multifaceted challenges faced after successive pandemic waves; basic wellbeing needs continue to be neglected and the emotional impact is further pronounced. Steps are necessary to mitigate the repeated trauma exposure of frontline doctors as COVID-19 becomes endemic and health services attempt to recover with inevitable long-term sequelae.

scholarly journals Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

2021 ◽  
pp. 1-24
Author(s):  
Eliza R. Thompson ◽  
Faith S. Williams ◽  
Pat A. Giacin ◽  
Shay Drummond ◽  
Eric Brown ◽  
...  
Keyword(s):  
Large Scale ◽  
Infection Prevention ◽  
Index Patient ◽  
Field Investigation ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Va Health Care System ◽  
Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

ICU admissions: Consequences after discharge

2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell
Keyword(s):  
Intensive Care ◽  
Cognitive Decline ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Psychiatric Disturbance ◽  
Intensive Care Department ◽  
Previous Level ◽  
The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

A shift from science to politics : a content analysis of COVID-19 Videos on YouTube (Preprint)

2021 ◽  
Author(s):  
Chyun-Fung Shi ◽  
Matthew C So ◽  
Sophie Stelmach ◽  
Arielle Earn ◽  
David J D Earn ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Content Analysis ◽  
Large Scale ◽  
Control Measures ◽  
Mitigation Measures ◽  
Health Campaigns ◽  
Public Attention ◽  
Conflicting Information ◽  
Social Media Platforms

BACKGROUND The COVID-19 pandemic is the first pandemic where social media platforms relayed information on a large scale, enabling an “infodemic” of conflicting information which undermined the global response to the pandemic. Understanding how the information circulated and evolved on social media platforms is essential for planning future public health campaigns. OBJECTIVE This study investigated what types of themes about COVID-19 were most viewed on YouTube during the first 8 months of the pandemic, and how COVID-19 themes progressed over this period. METHODS We analyzed top-viewed YouTube COVID-19 related videos in English from from December 1, 2019 to August 16, 2020 with an open inductive content analysis. We coded 536 videos associated with 1.1 billion views across the study period. East Asian countries were the first to report the virus, while most of the top-viewed videos in English were from the US. Videos from straight news outlets dominated the top-viewed videos throughout the outbreak, and public health authorities contributed the fewest. Although straight news was the dominant COVID-19 video source with various types of themes, its viewership per video was similar to that for entertainment news and YouTubers after March. RESULTS We found, first, that collective public attention to the COVID-19 pandemic on YouTube peaked around March 2020, before the outbreak peaked, and flattened afterwards despite a spike in worldwide cases. Second, more videos focused on prevention early on, but videos with political themes increased through time. Third, regarding prevention and control measures, masking received much less attention than lockdown and social distancing in the study period. CONCLUSIONS Our study suggests that a transition of focus from science to politics on social media intensified the COVID-19 infodemic and may have weakened mitigation measures during the first waves of the COVID-19 pandemic. It is recommended that authorities should consider co-operating with reputable social media influencers to promote health campaigns and improve health literacy. In addition, given high levels of globalization of social platforms and polarization of users, tailoring communication towards different digital communities is likely to be essential.

scholarly journals Content analysis for <i>Agricultural Records</i> of the United Kingdom, AD 200 to 1977: a study of frequency in human records concerning climate phenomenon

2011 ◽  
Vol 7 (4) ◽  
pp. 2555-2577
Author(s):  
D. H. Holt
Keyword(s):  
Content Analysis ◽  
Ice Age ◽  
Climate Data ◽  
The United Kingdom ◽  
Weather Phenomenon ◽  
Continuous Record ◽  
Frequency Occurrence ◽  
The Uk ◽  
Climate Events

Abstract. A content analysis has been completed on a text from the UK that has gathered agricultural and climate data from the years AD 220 to 1977 from 100s of sources. The content analysis coded all references to climate and agriculture to ascertain which climate events were recorded and which were not. This study addressed the question: is there bias in human records of climate? This evaluated the continuous record (AD 1654–1977), discontinous record (AD 220–1653), the whole record (AD 220–1977), the Little Climate Optimum (AD 850–1250) and the Little Ice Age (AD 1450–1880). This study shows that there is no significant variation in any of these periods in frequency occurrence of "good" or "bad" climate suggesting humans are not recording long-term changes in climate, but they are recording weather phenomenon as it occurs.

scholarly journals Content Analysis of the Free COVID-19 Telephone Consultations Available during the First Wave of the Pandemic in Japan

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1593
Author(s):  
Kyoko Yoshioka-Maeda ◽  
Yuka Sumikawa ◽  
Noriha Tanaka ◽  
Chikako Honda ◽  
Riho Iwasaki-Motegi ◽  
...  
Keyword(s):  
Public Health ◽  
Content Analysis ◽  
Infection Control ◽  
Qualitative Content Analysis ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Cross Sectional ◽  
Telephone Consultation ◽  
Infection Control Measures ◽  
Consultation Services

This cross-sectional study aimed to (1) describe the unclassified contents of telephone consultation services provided by a public health center during the first wave of COVID-19 in Japan and (2) examine whether the contents required assistance from public health nurses (PHNs). We analyzed a total of 207 calls in which the purpose of the call was unclassified into pre-set categories. PHNs transcribed the exact text of the consultation conversations recorded from 25 March to 20 April 2020 in City A. Approximately half of the calls were from residents. Seven categories were extracted through a qualitative content analysis. The most common topic was infection control measures, where the presence of COVID-19 infection was assumed (n = 62); the second most common was extreme anxiety and fear of infection (n = 50). Questions about the COVID-19 response system (n = 30), discrimination and misunderstandings about COVID-19 (n = 24), and response measures for COVID-19 outbreaks within organizations (n = 18) were also included. The unclassified consultations included various topics, several of which required the expertise of a PHN. Each local government should consider sharing and task-shifting telephone consultation services among PHNs and other staff to reduce their burden and allow them to concentrate on conducting infection control more effectively.

scholarly journals Spread of Carbapenemase Producing Klebsiella pneumoniae Isolates in Our Hospital: Investigation of Molecular Typing and Clonal Relationship

2021 ◽  
Author(s):  
Reyhan Kiş ◽  
Ebru Demiray Gündüz ◽  
Ayşe Nur Sarı ◽  
Zeynep Gülay
Keyword(s):  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Hospital Staff ◽  
Control Measures ◽  
Automated System ◽  
Microbiology Laboratory ◽  
Clonal Relationship ◽  
Infection Control Measures ◽  
Carbapenem Resistant

Objective: Carbapenem resistance has been reported with increasing frequency among members of Enterobacterales, especially in the last 10 years. Screening and detection of carbapenemase-producing isolates is important in terms of both directing the treatment and preventing its spread. In our study, it was aimed to determine the carbapenemase types and molecular epidemiological relationships of carbapenem resistant Klebsiella pneumoniae isolates, which were isolated sequentially from the samples sent to microbiology laboratory of our hospital. Method: A total of 32 carbapenem-resistant K. pneumoniae isolates of the samples sent to microbiology laboratory between July and September 2014, were included in the study. In addition to classical methods, identification of isolates at species level was made with BD Phoenix ID/AST automated system. Carbapenemase types (blaOXA-48, blaNDM, blaIMP, blaKPC, blaVIM and blaGES) of the isolates were investigated by PCR. The clonal relationship between the isolates was assessed with PFGE. Results: It was noted that 18 isolates were obtained from intensive care units, 9 from inpatient and 5 from outpatient departments. The blaOXA48 gene was found in all isolates while the other carbapenemase genes were not found. It was determined that strains were isolated from 32 patients in our hospital had 12 different PFGE pulsotypes, named as A-L. Among these, the most common ones were B (n=18) and closely related B1 pattern (n=2). The remaining isolates were represented by 11 different types. It was observed that the first isolate with B pulsotype was responsible for the spread of the outbreak from General Intensive Care Unit. Conclusion: It has been thought that the spread of carbapenem- resistant K. pneumoniae isolates in the hospital was probably occurred through the transfer of isolates from patients with gastrointestinal colonization to other patients through hospital staff. Therefore, the spread of the isolates in hospitals can be limited by detecting colonization with active surveillance programs and by applying contact isolation and effective infection control measures.

Pediatric Chronic Critical Illness, Prolonged ICU Admissions, and Clinician Distress

2021 ◽  
Author(s):  
Alison H. Miles ◽  
Cynda H. Rushton ◽  
Brian M. Wise ◽  
Aka Moore ◽  
Renee D. Boss
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Critical Illness ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Goals Of Care ◽  
Chronic Critical Illness ◽  
Conventional Content Analysis ◽  
Clinical Interactions

AbstractTo gain an in-depth understanding of the experience of pediatric intensive care unit (PICU) clinicians caring for children with chronic critical illness (CCI), we conducted, audiotaped, and transcribed in-person interviews with PICU clinicians. We used purposive sampling to identify five PICU patients who died following long admissions, whose care generated substantial staff distress. We recruited four to six interdisciplinary clinicians per patient who had frequent clinical interactions with the patient/family for interviews. Conventional content analysis was applied to the transcripts resulting in the emergence of five themes: nonbeneficial treatment; who is driving care? Elusive goals of care, compromised personhood, and suffering. Interventions directed at increasing consensus, clarifying goals of care, developing systems allowing children with CCI to be cared for outside of the ICU, and improving communication may help to ameliorate this distress.

The epidemiology, risk factors and outcomes of Carbapenem-resistant Klebsiella pneumoniae infections in the intensive care unit from 2012 to 2018

2020 ◽  
Author(s):  
Ping Wang ◽  
Xiaocui Zou ◽  
Boting Zhou ◽  
Tao Yin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Control Measures ◽  
Icu Patients ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Incidence And Mortality ◽  
Changing Trend ◽  
Different Sources

Abstract Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an increasing globally threat for human health, but the trends and clinical characteristics of CRKP infections in the intensive care unit(ICU) remain uninvestigated.Methods: A retrospective study was conducted among ICU patients infected with KP isolates from January 2012 to December 2018. Carbapenem resistant to Klebsiella pneumoniae was defined according to Clinical and Laboratory Standards Institute (CLSI) criteria. The incidence and changing trend of CRKP were determined. CRKP patient sources, specimen types, infection sources and outcomes were investigated. Results: There were 256(40.13%) patients with CRKP and 382(59.87%) patients with CSKP. The incidence of CRKP increased from 2012(11.11%) to 2017(63.48%) and decreased in 2018(51.52%). The proportion of isolates not susceptible to three carbapenems increased from 0 to 98.04%. The rates of CRKP isolated from blood, wound, urine and pleural fluid were higher than that of CSKP. CRKP infections were mainly ICU acquired, rather than input acquired. Conclusion: The incidence of CRKP was high in ICU, but showed a downward trend. Implementation of different infection control measures to different sources of patients, specimen types, and KP infections are necessary. Surveillance data will be needed for ICU patients to decrease the incidence and mortality of CRKP.

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