Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK

The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept spreading health and social care frontline workers (HSCFW) were faced with difficulties when discharging their duties. This paper was set out to explore the challenges faced by different frontline workers in health and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care workers were drawn from domiciliary care and care homes (with and without nursing services). All the interviews were done online. The data were thematically analyzed, and the emergent themes were supported by quotes from the interviews held with participants. Following data analysis the research study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing, evolving PPE guidance and shortage of staff were challenges faced by frontline health and social care workers during COVID-19 pandemic. The results of the current study point to a need for adequate pandemic preparedness within the health and social care sector to protect both frontline workers and the individuals they look after

Perinatale Betreuung an der Grenze der Lebensfähigkeit zwischen 22 und 26 vollendeten Schwangerschaftswochen

Die ersten Empfehlungen zur Betreuung von Frühgeborenen an der Grenze der Lebensfähigkeit in der Schweiz wurden im Jahre 2002 veröffentlicht1). Als Grundlage dienten damals unter anderem Empfehlungen europäischer2), 3) und kanadischer Fachgruppen4), sowie die relevanten edizinischethischen Richtlinien der Schweizerischen Akademie der Medizinischen Wissenschaften (SAMW)5), 6). Revidierte Empfehlungen aus Nordamerika und Europa7)–11), neue Empfehlungen aus weiteren Ländern12)–17) und neue Daten zu Mortalität und Morbidität18)– 22), insbesondere auch aus der Schweiz23), 24), haben Anlass dazu gegeben, die Empfehlungen für die Schweiz zu überarbeiten

What is the optimal means of preparing the endometrium in frozenthawed embryo transfer cycles? A systematic review and meta-analysis

<p>Frozenthawed embryo transfer (FET) enables surplus embryos derived from IVF or IVF-ICSI treatment to be stored and transferred at a later date. In recent years the number of FET cycles performed has increased due to transferring fewer embryos per transfer and improved laboratory techniques. Currently, there is little consensus on the most effective method of endometrium preparation prior to FET.</p><p>Using both MEDLINE and EMBASE database a systematic review and meta-analysis of literature was performed. Case-series, casecontrol studies and articles in languages other than English, Dutch or Spanish were excluded. Those studies comparing clinical and ongoing pregnancy rates as well as live birth rates in (i) true natural cycle FET (NC-FET) versus modified NC-FET, (ii) NC-FET versus artificial cycle FET (AC-FET), (iii) AC-FET versus artificial with GnRH agonist cycle FET and (iv) NC-FET versus artificial with GnRH agonist cycle FET were included. Forest plots were constructed and relative risks or odds ratios were calculated.</p><p>A total of 43 publications were selected for critical appraisal and 20 articles were included in the final review. For all comparisons, no differences in the clinical pregnancy rate, ongoing pregnancy rate or live birth rate could be found. Based on information provided in the articles no conclusions could be drawn with regard to cancellation rates.</p><p>Based on the current literature it is not possible to identify one method of endometrium preparation in FET as being more effective than another. Therefore, all of the current methods of endometrial preparation appear to be equally successful in terms of ongoing pregnancy rate. However, in some comparisons predominantly retrospective studies were included leaving these comparisons subject to selection and publication bias. Also patients preferences as well as cost-efficiency were not addressed in any of the included studies. Therefore, prospective randomized studies addressing these issues are needed.</p>