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                  <text>Dominio científico: Coronavirus</text>
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                <text>As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives? With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel struggle with acute shortages of equipment—both to treat patients and protect themselves. With their personal and possibly their family’s lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks—including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers’ risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal.</text>
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                <text>DOI: 10.5811/westjem.2020.4.47549</text>
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                <text>Western Journal of Emergency Medicine</text>
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                <text>eScholarship Publishing, University of California</text>
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                <text>Medicine, Medical emergencies. Critical care. Intensive care. First aid</text>
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                <text>Healthcare Transformation in the Post-Coronavirus Pandemic Era</text>
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                <text>Abdul Rahman Jazieh, Zisis Kozlakidis</text>
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                <text>coronavirus, covid-19, ethics, technological innovation, healthcare transformation</text>
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                <text>10.3389/fmed.2020.00429</text>
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                <text>Epidemiology and Health</text>
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                <text>Korean Society of Epidemiology</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>Healthcare worker infected with Middle East Respiratory Syndrome during cardiopulmonary resuscitation in Korea, 2015</text>
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                <text>Hae-Sung Nam, Miyeon Yeon, Jung Wan Park, Jee-Young Hong, Ji Woong Son</text>
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                <text>OBJECTIVES During the outbreak of the Middle East Respiratory Syndrome (MERS) in Korea in 2015, the Korea Centers for Disease Control and Prevention (KCDC) confirmed a case of MERS in a healthcare worker in Daejeon, South Korea. To verify the precise route of infection for the case, we conducted an in-depth epidemiological investigation in cooperation with the KCDC. METHODS We reviewed the MERS outbreak investigation report of the KCDC, and interviewed the healthcare worker who had recovered from MERS. Using the media interview data, we reaffirmed and supplemented the nature of the exposure. RESULTS The healthcare worker, a nurse, was infected while performing cardiopulmonary resuscitation (CPR) for a MERS patient in an isolation room. During the CPR which lasted for an hour, a large amount of body fluid was splashed. The nurse was presumed to have touched the mask to adjust its position during the CPR. She suggested that she was contaminated with the MERS patient’s body fluids by wiping away the sweat from her face during the CPR. CONCLUSIONS The possible routes of infection may include the following: respiratory invasion of aerosols contaminated with MERS-coronavirus (MERS-CoV) through a gap between the face and mask; mucosal exposure to sweat contaminated with MERS-CoV; and contamination during doffing of personal protective equipment. The MERS guidelines should reflect this case to decrease the risk of infection during CPR.</text>
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                <text>2017</text>
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                <text>Middle East respiratory syndrome, Epidemiology, infectious disease transmission, Patient-to-professional, cardiopulmonary resuscitation, Korea</text>
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                <text>DOI: 10.4178/epih.e2017052</text>
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                <text>Epidemiology and Health</text>
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                <text>Korean Society of Epidemiology</text>
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                <text>Medicine</text>
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                <text>EN</text>
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                <text>Healthcare Worker Seroconversion in SARS Outbreak</text>
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                <text>Pierce K. H. Chow, Khee-Chee Soo, Melissa Teo, Eng Eong Ooi, Kong Wee Ong, Bijon Kumar Sil, Hiang-Khoon Tan, Timothy Ng</text>
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                <text>Serum samples were obtained from healthcare workers 5 weeks after exposure to an outbreak of severe acute respiratory syndrome (SARS). A sensitive dot blot enzyme-linked immunosorbent assay, complemented by a specific neutralization test, shows that only persons in whom probable SARS was diagnosed had specific antibodies and suggests that subclinical SARS is not an important feature of the disease.</text>
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                <text>2004</text>
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                <text>Outbreak, healthcare workers, dispatch, severe acute respiratory syndrome, Seroconversion, subclinical infection</text>
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                <text>DOI: 10.3201/eid1002.030397</text>
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                <text>Emerging Infectious Diseases</text>
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                <text>Centers for Disease Control and Prevention</text>
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                <text>Infectious and parasitic diseases, Medicine</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>Healthcare Worker&amp;rsquo;s Mental Health During the Epidemic Peak of COVID-19 [Letter]</text>
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                <text>Nugroho HSW, Acob JRU, Martiningsih W</text>
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                <text>Heru Santoso Wahito Nugroho,1 Joel Rey Ugsang Acob,2 Wiwin Martiningsih3 1Poltekkes Kemenkes Surabaya, Surabaya, Indonesia; 2Faculty of Nursing, Visayas State University, Baybay, Philippines; 3Nursing Department, Poltekkes Kemenkes Malang, Malang, IndonesiaCorrespondence: Wiwin MartiningsihNursing Department, Poltekkes Kemenkes Malang, Jl. Ijen 77 C, Malang, IndonesiaEmail martini2271@gmail.com We have read the article &amp;ldquo;Healthcare Worker&amp;rsquo;s Mental Health and Their&amp;nbsp;Associated Predictors During the Epidemic Peak of COVID-19&amp;rdquo;. Based on the&amp;nbsp;results, the researchers concluded that healthcare worker&amp;rsquo;s stress, anxiety and&amp;nbsp;depression are influenced by social-support, working time, discrimination and&amp;nbsp;workplace violence; and not influenced by age, gender, working at designated&amp;nbsp;hospital, medical equipment, patient&amp;ndash;physician relations and household transmission-&amp;nbsp;related fears.1 &amp;nbsp; View the original paper by Yang and colleagues</text>
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                <text>Have you ever felt stuck? Or rather unmotivated and unsatisfied at your work? Maybe you do not feel like being a doctor anymore, but the fear of what will you do after; scares you more. Or maybe, you do wish to continue your medical practices but feel rather tired and let down at most times. In either scenario, you are not alone. Several healthcare workers feel underappreciated and suffer from lack of enthusiasm for work, feelings of cynicism towards life and low sense of personal accomplishment, in short, they feel “Burnt out”.  Burnout is on the rise in medical fraternity. Established professionals, residents in training, to young medical school trainees beginning their careers in medicine, none can escape from the brunt of burnout. Long working hours and increasing burden of bureaucratic tasks make the medical profession a tedious one. Continued exposure to human suffering and death introduces cynicism towards life and its purpose. Constant need to be compassionate to patients and their family members require immense mental and emotional fortitude. However, with an increase in violence against the medical fraternity,[5] a typical doctor begins to question the sanctity of the profession and feels unappreciated.</text>
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                <text>India and many other countries are facing the challenge and threat posed by the growing pandemic of COVID-19. Patients with chronic conditions such as heart failure (HF) are at greater risk of getting the infection. Since the HF patients are at greater risk and hospital outpatient department facilities have also stopped temporarily, patients need to be prepared for self-care for HF. The objective of this article is to integrate practices and recommendations for self-care, in order to maintain well-being and prevent patients from getting infected. HF patients are encouraged to practice preventive and protective measures to limit the risk of COVID-19. HF nurses should focus on self-care education teaching also about medications, personal and environmental hygiene, mask management, social and personal distancing, psychosocial aspect, and diet in HF. All the patients are advised and encouraged to use teleconferencing, virtual, and other means of electronic communications to avoid direct contacts with others. All HF patients should be advised to stay at home and follow the government advisories.</text>
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                <text>Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.</text>
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                <text>Thieme Medical Publishers</text>
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                <text>Contamination by heavy metals in water resources, soil and air poses one of the most severe problems that compromise food safety and public health at global and local level. In this review, the specific problem of contamination by mercury (Hg), arsenic (As), cadmium (Cd) and lead (Pb) in the environment and food is presented. A description of the sources of contamination, exposure in living beings, accumulation and retention in food and consumer products is carried out. Study cases and results in some countries included Colombia are discussed.</text>
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          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="165367">
                <text>2016</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="165368">
                <text>Arsénico, Mercúrio, Metales pesados, bio-acumulación, cadmio, metaloides, plomo, seguridad alimentaria</text>
              </elementText>
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          </element>
          <element elementId="43">
            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
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              <elementText elementTextId="165369">
                <text>10.19053/1900771X.v16.n2.2016.5447</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="165370">
                <text>Ingeniería Investigación y Desarrollo</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
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              <elementText elementTextId="165371">
                <text>Universidad Pedagógica y Tecnológica de Colombia</text>
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          </element>
          <element elementId="38">
            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
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              <elementText elementTextId="165372">
                <text>Engineering (General). Civil engineering (General), Technology (General)</text>
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          <element elementId="46">
            <name>Relation</name>
            <description>A related resource</description>
            <elementTextContainer>
              <elementText elementTextId="165373">
                <text>&lt;a href="http://revistas.uptc.edu.co/revistas/index.php/ingenieria_sogamoso/article/view/5447" target="_blank" rel="noreferrer noopener"&gt;http://revistas.uptc.edu.co/revistas/index.php/ingenieria_sogamoso/article/view/5447&lt;/a&gt;</text>
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