Articles: pandemics.
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Background: Goals-of-care conversations (GoCCs) are essential for individualized end-of-life care. Shared decision-making (SDM) that elicits patients' goals and values to collaboratively make life sustaining treatment (LST) decisions is best practice. However, it is unknown how the COVID-19 pandemic onset and associated changes to care delivery, stress on providers, and clinical uncertainty affected SDM and recommendation-making during GoCCs. ⋯ In adjusted regression models, being a physician and discussing patients' goals and values were positively associated with giving an LST recommendation (B = 0.380, p = 0.031 and B = 0.400, p < 0.001, respectively) at peak-COVID-19. Conclusion: Providers who discuss patients' preferences and values are more likely to report giving a recommendation; both behaviors are markers of SDM during GoCCs. Our findings suggest potential areas for training in conducting patient-centered GoCCs.
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The objective is to determine how the COVID-19 pandemic affected care for patients undergoing thoracic surgery for cancer. ⋯ Telemedicine enabled cancer care to continue during the COVID-19 pandemic without delays in surgery, cancer progression, or worsened postoperative morbidity and was generally well received.
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Following the COVID-19 pandemic, the NHS is facing increasing pressures because of growing patient demand and hospital backlogs. With the number of GPs declining, the average number of patients per GP has increased. There are reports of hospital trusts and GP practices introducing doctors' assistants (DAs) to help with clinical and administrative tasks, which has reduced the workload of doctors. As the authors are not aware of any DAs working with GPs locally, Maylands Healthcare (14 000 patients) has introduced this new workforce model by assigning a DA to each clinician's worklist. ⋯ This study demonstrates that the introduction of DAs has helped to manage the administrative workload in primary care, improving efficiency, patient care, and safety.
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The COVID-19 pandemic has significant impacts on the US socioeconomic structure. Gun violence is a major public health issue and the effects on this area have not been well-elucidated. The objective of this study was to determine the impacts of the pandemic on mass shootings in six major United States cities with historically high rates of gun violence. ⋯ This study is the first to use ArcGIS technology to describe the patterns of mass shooting in six major US cities during the COVID-19 pandemic. The number of mass shootings in six US cities remained largely unchanged which suggests that changes in mass shootings is likely occurring in smaller cities. Future studies should focus on the changing patterns of homicides in at-risk communities and other possible social influences.
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Annals of Saudi medicine · Jul 2023
Predictors of disease severity in patients hospitalized with coronavirus disease 2019.
Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, manifests as a respiratory illness primarily and symptoms range from asymptomatic to severe respiratory syndrome and even death. During the pandemic, due to overcrowding of medical facilities, clinical assessment to triage patients for home care or in-hospital treatment was an essential element of management. ⋯ None.