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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Domestic abuse (DA) is underdiagnosed by the medical community. The National Institute for Health and Care Excellence (NICE) does not recommend DA screening in primary care. The enduring use of remote consultations since COVID-19, coupled with the sensitive nature and increasing prevalence of DA, necessitates review of the NICE guideline, which was developed pre-pandemic primarily for face-to-face consultations. ⋯ The routine use of the already established WAST-short in primary care could help identify and potentially tackle DA. Training health and social care professionals in administering the brief, non-threatening DA screening questionnaire would help raise awareness, and identify and support victims.
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General practice experienced significant challenges throughout the COVID-19 pandemic. There has been little exploration of the experiences of nurses working in general practice and the impact on care delivery, job satisfaction, workload, stress and professional support. Understanding these experiences can inform future practice. ⋯ The pandemic has laid bare challenges faced by nurses in general practice. Nurses require specific support to maintain professional wellbeing and to aid retention.
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Dtsch. Med. Wochenschr. · Jul 2023
[Occupational medical aspects of COVID-19 pandemic containment: experiences from a large chemical company].
With the present paper we aim to describe the experience of a large chemical company in tackling the COVID-19 pandemic. Specifically, we describe the timing and content of implemented measures and outline the course of the pandemic from the company's perspective. ⋯ The continuous monitoring and analysis of new SARS-CoV-2 cases among employees provides valuable information for the effective management of protective measures in the company. It enables a targeted response to changes in the number of new cases on the plant site by tightening or relaxing protective measures.
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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.