Major changes and pedagogical challenges in the curriculum of physicians in the post-pandemic of COVID-19: a systematic review

Introduction: Respiratory disease (COVID-19) caused by the new coronavirus (SARSCoV-2) has spread around the world causing respiratory illnesses and deaths. The COVID-19 pandemic caused an unprecedented crisis in the field of education. It is essential to reflect on the role of educational systems in curricular training, especially for doctors. Objective: The present study prepared a systematic review to analyze the main curriculum changes in medical education institutions around the world. Methods: The present study followed a systematic review model (PRISMA). The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar database, using scientific articles from 2009 to 2021. Results: As a corollary of the literary search system, 155 studies were analyzed and submitted to eligibility analysis, and then 55 high to moderate quality studies were selected. Biases did not compromise the scientific basis of the studies. It was analyzed that it is crucial that the academic education community learn from experience and prioritize a forward-thinking academic approach as practical solutions are implemented. The pandemic has brought about a lasting transformation in medicine with the advancement of telehealth, adaptive research protocols, and clinical trials with flexible approaches to achieving solutions. The studies analyzed in general did not address criticisms about the weaknesses of remote education, limiting themselves to defending it as the only viable strategy. There was no consensus on the inclusion of students in the practical activities of curricular internships and medical internships. A part of the studies defends the inclusion in hospital spaces as a way to contribute to overcoming the health crisis imposed by the pandemic. The studies evidenced the inclusion of pandemic management disciplines with a focus on public health in the medical curricula. Conclusion: The medical activity and curriculum underwent and are undergoing significant changes and adaptations. Thus, the doctor will need to develop other skills, without losing the traditional ones. The highlight is telehealth and soft skills, as they will allow students to connect to the best in world medicine, highlighting the importance of scientific knowledge when establishing treatments in cases of pandemics with a focus on public health.

Download Full-text

COVID-19:Major Metabolic and Immunological Relationships in Obesity

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt2135 ◽

2021 ◽

pp. 26-31

Author(s):

Mariana Tolentino Chaves ◽

Ana Paula Tolentino Chaves

Keyword(s):

Systematic Review ◽

Scientific Basis ◽

The Body ◽

Important Predictor ◽

Inflammatory Factors ◽

Cochrane Library ◽

Current Prevalence ◽

Medium Quality ◽

Review Model

Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There are a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of metainflammation.

Download Full-text

COVID-19: Major Metabolic and Immunological Relationships in Obesity

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt21213 ◽

2021 ◽

pp. 87-93

Author(s):

Mariana Tolentino Chaves ◽

Ana Paula Tolentino Chaves

Keyword(s):

Systematic Review ◽

Scientific Basis ◽

The Body ◽

Important Predictor ◽

Inflammatory Factors ◽

Cochrane Library ◽

Current Prevalence ◽

Medium Quality ◽

Review Model

Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There is a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of met inflammation.

Download Full-text

Major Actions of Preventive Measures on Sars-Cov-2: An Updated Vision for Emergency Physicians

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt2139 ◽

2021 ◽

pp. 56-62

Author(s):

Mariana de Almeida Lima ◽

Manoel de Almeida Lima ◽

Vitor Bottós da Silva ◽

Dorival Scantamburlo Júnior ◽

Marcio Cesar Reino Gaggini

Keyword(s):

Public Health ◽

Preventive Measures ◽

Diagnostic Methods ◽

World Health ◽

Cochrane Library ◽

Ministry Of Health ◽

Clinical Criteria ◽

The World ◽

Review Model ◽

Health Organization

Introduction: The new coronavirus (SARS-CoV-2), has infected more than 23 million individuals to date and has resulted in more than 800,000 deaths worldwide. The rapid spread of SARS-CoV-2 and its variants requires the urgent development of accurate diagnostic methods, effective treatments, and vaccines. The recommendations are also related to the Expert Consensus for Clinical Management of Covid-19, at the headquarters of the Pan American Health Organization / World Health Organization (PAHO / WHO) in Brasilia (Brazil). Objective: To gather the main pathophysiological considerations of COVID-19, as well as the actions of investigation, management, and adoption of preventive measures against the complications caused by SARS-CoV-2 in the emergency of hospitals. Methods: This study followed an integrative review model based on the systematic review model. The search for the articles occurred in the databases WHO, PAHO, Ministry of Health, PubMed, Embase, Ovid, Cochrane Library, and Google Scholar. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 58 clinical studies were recruited and submitted to eligibility analysis and, after that, 26 studies were selected, including official public health guidelines and regulations. To the published articles, studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies. Based on the main literary findings, as well as the main public health guidelines published in the world, patients with COVID-19 may present respiratory syndromes very similar to the common influenza virus (influenza), being a challenge for early detection during screening. in emergency departments. According to the official health agencies of Brazil (Ministry of Health) and the world (WHO/PAHO) and their regulations, it was defined that the clinical criteria for hospital discharge should take into account the improvement of the clinical picture, the absence of tachydyspnea and hypoxia, the absence of O2 supplementation for at least 24 hours, hemodynamic stability, good oral acceptance and absence of fever.

Download Full-text

Concerns around public health recommendations on face mask use among individuals who are not medically diagnosed with COVID-19 supported by a systematic review search for evidence.

10.21203/rs.3.rs-16701/v3 ◽

2020 ◽

Cited By ~ 2

Author(s):

Keshini Madara Marasinghe

Keyword(s):

Public Health ◽

Systematic Review ◽

Health Professionals ◽

Scientific Evidence ◽

Large Population ◽

Face Mask ◽

Cochrane Library ◽

Global Alignment ◽

The World ◽

Guidelines And Recommendations

Abstract BackgroundContradicting and inconsistent public health recommendations regarding face mask use have been provided to individuals who are not yet medically diagnosed with COVID-19, which is significantly a large population. Face masks are being used by individuals who are not medically diagnosed with COVID-19 as a means to limit the spread of COVID-19 in several countries around the world. While some countries recommend the use of face masks, other countries strictly do not recommend their use to limit the transmission of COVID-19 among individuals who are not medically diagnosed with COVID-19. This paper critically analyses public health recommendations provided to this population regarding face mask use by public health and health professionals of different countries supported by a systematic review that searched for evidence on face mask use among this specific population in limiting the spread of COVID-19.MethodsTo carry out the systematic review portion of this paper, databases Cochrane Library, EMBASE, Google Scholar, PubMed, and Scopus were searched for relevant studies. Two groups of keywords were combined: those relating to face masks and COVID-19.ResultsThe systematic review search did not find any studies that investigated the effectiveness of face mask use in limiting the spread of COVID-19 among those who are not medically diagnosed with COVID-19 to support current public health recommendations.ConclusionsThe finding of the systematic review search, which is a lack of scientific evidence, questions the basis of inconsistent public health recommendations that have been provided to the public at a very early yet a crucial stage of an outbreak. A closer attention need to be given to the procedures and practices behind providing public health guidelines and recommendations during an outbreak by public health and health professionals around the world. This paper calls for 1) evidence-based public health recommendations; 2) considerations when providing public health recommendations in the absence of evidence; 3) evidence and knowledge transparency on current public health recommendations; 4) global alignment on public health recommendations; and 5) further research to strengthen public health recommendations.

Download Full-text

Eating NAFTA

10.1525/california/9780520291805.001.0001 ◽

2018 ◽

Cited By ~ 21

Author(s):

Alyshia Gálvez

Keyword(s):

Public Health ◽

Chronic Disease ◽

Low Income ◽

Food System ◽

Dietary Habits ◽

Trade Agreement ◽

Well Being ◽

Health Crisis ◽

The North ◽

The World

In the two decades since the North American Free Trade Agreement (NAFTA) went into effect, Mexico has seen an epidemic of diet-related illness. While globalization has been associated with an increase in chronic disease around the world, in Mexico, the speed and scope of the rise has been called a public health emergency. The shift in Mexican foodways is happening at a moment when the country’s ancestral cuisine is now more popular and appreciated around the world than ever. What does it mean for their health and well-being when many Mexicans eat fewer tortillas and more instant noodles, while global elites demand tacos made with handmade corn tortillas? This book examines the transformation of the Mexican food system since NAFTA and how it has made it harder for people to eat as they once did. The book contextualizes NAFTA within Mexico’s approach to economic development since the Revolution, noticing the role envisioned for rural and low-income people in the path to modernization. Examination of anti-poverty and public health policies in Mexico reveal how it has become easier for people to consume processed foods and beverages, even when to do so can be harmful to health. The book critiques Mexico’s strategy for addressing the public health crisis generated by rising rates of chronic disease for blaming the dietary habits of those whose lives have been upended by the economic and political shifts of NAFTA.

Download Full-text

Four pandemics: lessons learned, lessons lost

10.22514/sv.2020.16.0096 ◽

2020 ◽

Keyword(s):

Public Health ◽

Lessons Learned ◽

World Health ◽

Swine Flu ◽

Global Public Health ◽

Health Crisis ◽

The World ◽

Spanish Flu ◽

Future Events ◽

Health Organization

In the past 100 years, the world has faced four distinctly different pandemics: the Spanish flu of 1918-1919, the SARS pandemic of 2003, the H1N1 or “swine flu” pandemic of 2012, and the ongoing COVID-19 pandemic. Each public health crisis exposed specific systemic shortfalls and provided public health lessons for future events. The Spanish flu revealed a nursing shortage and led to a great appreciation of nursing as a profession. SARS showed the importance of having frontline clinicians be able to work with regulators and those producing guidelines. H1N1 raised questions about the nature of a global organization such as the World Health Organization in terms of the benefits and potential disadvantages of leading the fight against a long-term global public health threat. In the era of COVID-19, it seems apparent that we are learning about both the blessing and curse of social media.

Download Full-text

Routes of Transmission of Newly Emerging SARS-CoV-2: A Systematic Review

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v7i0.46797 ◽

2020 ◽

pp. S18-S31 ◽

Cited By ~ 1

Author(s):

Mahmuda Yeasmin ◽

Jannatut Tasnim ◽

Arifa Akram ◽

Md Abdullah Yusuf ◽

AKM Shamsuzzaman ◽

...

Keyword(s):

Systematic Review ◽

Citation Index ◽

Virus Disease ◽

Scientific Basis ◽

Atypical Pneumonia ◽

Highly Pathogenic ◽

Current Review ◽

Corona Virus ◽

Route Of Transmission ◽

The World

Background: In December 2019, a novel corona virus (SARS-CoV-2) causes atypical pneumonia now known as “corona virus disease 2019” (COVID-19) emerged in Wuhan, China and spread rapidly throughout the world. Objective: The purpose of the present study was to identify the different plausible routes of transmission of SARS-CoV-2 into the human body. Methodology: We searched electronic databases (MEDLINE, EMBASE, Science Citation Index and Chinese database) checked documents and references. We included all the studies regarding potential routes of transmission of SARS-CoV-2. All reviewers independently screened titles and abstracts, assessed studies for inclusion, appraised quality, and extracted data. Result: SARS-CoV-2 has been found to have higher level of transmissibility than other two pathogenic CoVs. Sustained human to human transmission of SARS-CoV-2 has already been established though the exact route of transmission is yet to be determined. Similar to other CoVs, respiratory droplet and contact with contaminated surfaces are considered as principle route of transmission of SARS-CoV-2 whereas aerosol, feco-oral, perinatal, ocular surface and transfusion transmissions are the plausible route of spreading of this highly pathogenic CoVs. Conclusion: In the current review, we summarize the potential route of transmission of SARS-CoV-2 in the light of previous SARS-CoV and MERS-CoV outbreaks to solidify the scientific basis on which important decisions can be made. Bangladesh Journal of Infectious Diseases, April 2020;7(suppl_1):S18-S31

Download Full-text

Lessons earned and lessons learned: What should be done next to counter the COVID-19 infodemic?

European View ◽

10.1177/1781685820975878 ◽

2020 ◽

Vol 19 (2) ◽

pp. 154-163

Author(s):

Nad’a Kovalčíková ◽

Ariane Tabatabai

Keyword(s):

Public Health ◽

Lessons Learned ◽

The Novel ◽

Health Crisis ◽

The Public ◽

Public Health Crisis ◽

Societal Challenges ◽

The World ◽

Information Manipulation ◽

Novel Coronavirus

As governments and citizens around the world have struggled with the novel coronavirus, the information space has turned into a battleground. Authoritarian countries, including Russia, China and Iran, have spread disinformation on the causes of and responses to the pandemic. The over-abundance of information, also referred to as an ‘infodemic’, including manipulated information, has been both a cause and a result of the exacerbation of the public health crisis. It is further undermining trust in democratic institutions, the independent press, and facts and data, and exacerbating the rising tensions driven by economic, political and societal challenges. This article discusses the challenges democracies have faced and the measures they have adopted to counter information manipulation that impedes public health efforts. It draws seven lessons learned from the information war and offers a set of recommendations on tackling future infodemics related to public health.

Download Full-text

Effective Factors in Improving the Emergency Department Preparedness of Hospitals in Radiation and Nuclear Incidents and Nuclear Terrorism: A Systematic Review

Iranian Journal of Public Health ◽

10.18502/ijph.v49i3.3124 ◽

2020 ◽

Author(s):

Milad AHMADI MARZALEH ◽

Rita REZAEE ◽

Abbas REZAIANZADEH ◽

Mahnaz RAKHSHAN ◽

Gholamhassan HADDADI ◽

...

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Nuclear Power ◽

Final Analysis ◽

Systematic Search ◽

Cochrane Library ◽

Effective Factors ◽

Nuclear Terrorism ◽

The World ◽

Collection Form

Background: Due to existence of nuclear power plant sites in various parts of the world, as well as political threats in disaster-prone areas throughout the world, there is a probability of nuclear and radiation incidents. The present study aimed to extract effective criteria in emergency department preparedness of hospitals in radiation, nuclear incidents and nuclear terrorism in different countries around the world. Methods: A systematic search was carried out in Cochrane Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest and Embase databases between Jan 1970 and Jul 2018. The systematic search was carried out according to the PRISMA standard. The required information was extracted from the papers based on the abstract and collection form. Results: Overall, 1091 papers were finally extracted. The initial search included research papers. After reviewing the papers’ titles, abstracts and full texts, 15 papers were selected for final analysis. Next, 32 criteria were extracted. The criteria were divided into 3 categories. The categories included staff, stuff and systems (structure). The most frequent criteria included training criteria, personal protective equipment, decontamination and practice. Conclusion: The results of the systematic review provided an overview of the effective factors in improving the emergency department preparedness during radiation and nuclear incidents. In addition to the mentioned criteria in different studies, other hidden factors affect the emergency department preparedness in radiation and nuclear incidents. Thus, the highest level of preparedness should be considered.

Download Full-text

Coronavirus Pandemic: a major public health crisis for the developed and developing world

The Journal of Infection in Developing Countries ◽

10.3855/jidc.12995 ◽

2021 ◽

Vol 15 (03) ◽

pp. 366-369

Author(s):

Rooh Ullah ◽

Muhammad Suleman Rana ◽

Mehmood Qadir ◽

Muhammad Usman ◽

Niaz Ahmed

Keyword(s):

Public Health ◽

Severe Acute Respiratory Syndrome ◽

Viral Infection ◽

The Novel ◽

Global Public Health ◽

Health Crisis ◽

Public Health Crisis ◽

The World ◽

Novel Coronavirus ◽

Day By Day

Pandemic of novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in China is now become global public health crisis. At present 87.64% of the world is infected by this deadly illness. The risk from this epidemic depends on the nature of the virus, including how well it transmits from person to person, and the complications resulting from this current illness. The novel coronavirus has killed thousands of people in China and other countries as well; its rate of mortality is increasing day by day. There is an urgent need to control the virus by developing vaccine or any other antiviral drugs to save the world from this deadly viral infection.

Download Full-text