Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Enfermedad tuberculosa entre trabajadores de salud

Introduction: Tuberculosis (TB) transmission is a well-recognized risk in healthcare facilities. This risk is variable considering to the nature of such facilities (primary, secondary, or tertiary care), the prevalence of TB in the community, occupational groups of healthcare workers (HCW), the particular area in which they work, and the effectiveness of control programs. Objectives: To describe the features of TB and results of therapy for this disease in HCW seen in the TB Control Program in Cayetano Heredia National Hospital in Lima, Peru. Material and methods: A descriptive observational study was performed, including cases (HCWs) and controls (patients) admitted in the TB Control Program in Cayetano Heredia National Hospital in Lima, Peru, between 1994 and 2007. Results: 957 TB cases were seen in the TB Control Program in Cayetano Heredia Hospital from January 1994 to December 2007. One hundred and fifty nine (16,6%) were HCW, their average age was 31,05 ±8,79 years, 84 (52,8%) were female, and 122 (76,7%) developed pulmonary disease. Of these latter cases, 36,5% were healthcare professionals and 34,6% were medicine, nursing, or health technology students. Amongst healthcare professionals that developed TB, 41 (71%) were physicians, and most of them (63%) were residents in-training. Amongst students, medicine students accounted for most TB cases (87%), and 75% of them were senior medical students (interns and 6th year). Twenty isolated of M. tuberculosis had susceptibility tests performed, 11 (55%) were resistant to at least one antituberculous drug, 5 (25%) were multidrug resistant M. tuberculosis isolates, 8 (40%) were isoniazid-resistant, 6 (30%), were rifampin-resistant, 6 (30%) were streptomycin-resistant, and 4 (20%) were ethambutol-resistant. Seventy four (60,7%) of 122 HCWs with pulmonary TB entered the Program with sputum smears negative for acid-fast bacilli (AFB), and only 41 (33%) controls had negative sputum smears (p<0.001). HCWs received the same antituberculous therapy and for the same time compared to controls (7,2 ±3,1 months and 6,8 ±3,6 months, p= 0,3), but they received a higher number of doses during the first phase of antituberculous therapy (73,2 ±65,6 vs. 59,01 ±44,5 doses, p= 0.001). Five per cent of HCWs and 13,21% controls had a contact diagnosed with TB during the control period (p<0.001). Conclusions: Most healthcare workers with TB were professionals or students, with a high frequency of MDR strains, there were no deaths in the population studied, and smear-negative forms were most frequent amongst pulmonary TB cases. Compared with controls, TB cases in HCWs had better curation rates with the same time of therapy, but using more daily doses.Introducción: la transmisión de Mycobacterium tuberculosis es un riesgo reconocido en las instituciones de salud. El riesgo varía según el tipo de instalación, la prevalencia de tuberculosis (TB) en la comunidad, el grupo ocupacional de los trabajadores, el área de la instalación en que trabajan y la efectividad del control. Objetivo: describir las características de la enfermedad tuberculosa y los resultados del tratamiento entre los trabajadores de salud atendidos en el Programa de Control de la Tuberculosis del Hospital Nacional Cayetano Heredia. Material y método: estudio descriptivo observacional de casos entre trabajadores de salud (TS) y pacientes (controles) entre que ingresaron al Programa de Control de la Tuberculosis (PCT) del Hospital Nacional Cayetano Heredia (HNCH) entre 1994 al 2007. Resultados: de enero 1994 a diciembre 2007 se atendieron 957 enfermos de tuberculosis de los cuales 159 (16,6%) fueron TS, con edad promedio de 31,05 ±8,79, siendo 84 (52,8%) mujeres y 122 (76,7%) con enfermedad pulmonar. De estos 36,5% fueron profesionales y 34,6% estudiantes de ciencias de la salud. Entre los profesionales de la salud hubo 41 médicos (71%) y de ellos los residentes fueron mayoría (63%). Entre los estudiantes de ciencias de la salud el grupo mayoritario fue el de los estudiantes de medicina (87%), y dentro de ellos la mayoría (75%) externos e internos. De 20 cepas con sensibilidad realizada 11 (55%) fueron resistentes al menos a un fármaco, 5 (25%) multidrogoresistentes, 8 (40%) resistentes a isoniacida, 6 (30%) a rifampicina, 6 (30%) a estreptomicina y 4 (20%) a etambutol. Setenta y cuatro (60,7%) de los 122 TS con TB pulmonar ingresaron con BK negativo, y sólo 41 (33,6%) controles (p<0,001). Los TS recibieron el mismo tipo y tiempo de tratamiento (7,2 ± 3,1 meses) que sus controles (6,8 ± 3,6 meses), (p=0,3) pero mayor número de dosis de la primera fase diaria del tratamiento (73,2 ± 65,6 vs 59,01 ± 44,5 dosis) p= 0,001. El 5,03% de los TS y el 13,21% de los controles tuvo algún contacto al que se le diagnosticó tuberculosis durante el control de los mismos. (p<0,001) Conclusiones: los TS con TB en su mayoría fueron profesionales o estudiantes de ciencias de la salud, con elevado porcentaje de cepas MDR, no habiendo fallecido ninguno por TB, predominando entre los pulmonares las formas negativas. Comparado con los otros pacientes con TB estos curaron más, en igual tiempo de tratamiento, pero con más número de dosis diarias

Käytännön kosteikkosuunnittelu

Maatalouden vesiensuojelua edistetään monin tavoin. Ravinteita ja eroosioainesta sisältäviä valumavesiä pyritään puhdistamaan erilaisissa kosteikoissa. Tämä opas on kirjoitettu avuksi pienimuotoisten kosteikkojen perustamiseen. Oppaassa esitetään käytännönläheisesti kosteikon toteuttamisen eri vaiheet paikan valinnasta suunnitteluun ja rakentamiseen. Vuonna 2010 julkaistun painoksen tiedot on saatettu ajantasalle. Julkaisu on toteutettu osana Tehoa maatalouden vesiensuojeluun (TEHO) -hanketta ja päivitetty TEHO Plus -hankkeen toimesta. Oppaan toivotaan lisäävän kiinnostusta kosteikkojen suunnitteluun ja edelleen niiden rakentamiseen

Ciencia y persuasión social en la medicalización de la infancia en España, siglos XIX-XX Science and social persuasion in the medicalization of childhood in 19th- and 20th-century Spain

Este trabajo indaga la conversión en rutinaria de la visita del médico de niños en España. Estudia la sustitución de modelos de atención al embarazo, parto y crianza, tradicionalmente opacos para varones y objeto de cuidados mediante agentes populares, por otros accesibles a la medicina académica. A partir de la situación existente a nivel popular en el último tercio del siglo XIX, exploramos la repercusión de campañas de divulgación científica - entendidas como crítica sin cuartel a lo que se construyó como cultura popular - y la proliferación de dispositivos asistenciales gratuitos. La oferta de vigilancia sobre la alimentación de lactantes permitió familiarizar a las madres con la asistencia facultativa en la enfermedad, hasta que, en la segunda mitad del siglo XX, la Pediatría se centró preferentemente en las patologías y la Puericultura dejó de ser especialidad médica para convertirse en identidad profesional subalterna.<br>The article explores how childhood visits to doctors first became routine in Spain. The introduction of new models of prenatal care, childbirth, and childrearing required the extension of academic medicine into a terrain traditionally occupied by practitioners of popular medicine. Focusing on the status quo for most of the population in the final third of the nineteenth century, the study examines the repercussion of the era's scientific outreach campaigns (expressions of harsh criticism of what popular culture had constructed) and the spread of free health assistance. In particular, it highlights how attention to the nutritional needs of nursing mothers helped these women gain familiarity with the medical assistance available in the case of illness - so much so that by the second half of the twentieth century, the issues of health education and promotion had been relegated to a secondary plane within the medical profession