RESUMEN
OBJECTIVE: The current study investigated the experiences, wellbeing impacts, and coping strategies of frontline workers who participated in "Hotels for Heroes", an Australian voluntary hotel quarantine program during the COVID-19 pandemic. The program was open to those who were COVID-19 positive or exposed to COVID-19 as part of their profession. METHODS: Frontline workers who had stayed in voluntary quarantine between April 2020 and March 2021 were invited to participate in a voluntary, anonymous, cross-sectional online survey including both quantitative and qualitative responses. Complete responses were collected from 106 participants, which included data on sociodemographic and occupational characteristics, experiences of the Hotels for Heroes program, and validated mental health measures. RESULTS: Mental health problems were prevalent amongst frontline workers (e.g., moderate anxiety symptoms, severe depression symptoms, and greater than usual impact of fatigue). For some, quarantine appeared to be helpful for anxiety and burnout, but quarantine also appeared to impact anxiety, depression, and PTSD negatively, and longer stays in quarantine were associated with significantly higher coronavirus anxiety and fatigue impacts. The most widely received support in quarantine was from designated program staff; however, this was reportedly accessed by less than half of the participants. CONCLUSIONS: The current study points to specific aspects of mental health care that can be applied to participants of similar voluntary quarantine programs in the future. It seems necessary to screen for psychological needs at various stages of quarantine, and to allocate appropriate care and improve its accessibility, as many participants did not utilise the routine support offered. Support should especially target disease-related anxiety, symptoms of depression and trauma, and the impacts of fatigue. Future research is needed to clarify specific phases of need throughout quarantine programs, and the barriers for participants receiving mental health supports in these contexts.
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COVID-19 , Humanos , COVID-19/epidemiología , Pandemias , SARS-CoV-2 , Cuarentena/psicología , Estudios Transversales , Depresión/epidemiología , Australia , Ansiedad/epidemiologíaRESUMEN
INTRODUCTION: 3-Hydroxyphencyclidine (3-HO-PCP) is a new psychoactive substance (NPS) and a hydroxy derivative of phencyclidine (PCP), and N-ethylhexedrone (Hexen) is a synthetic cathinone. We describe an analytically confirmed case of acute toxicity related to the use of both 3-hydroxyphencyclidine and N-ethylhexedrone. CASE REPORT: A 56-year-old male was brought to the Emergency Department by ambulance with hyperthermia (39.9 °C), sinus tachycardia (150 beats per minute), reduced consciousness, ocular clonus, and vertical nystagmus. He was treated with cooled intravenous (IV) fluids and IV benzodiazepines. Following 1 hour of treatment, his temperature fell to 37.7 °C, he developed rhabdomyolysis (creatine kinase peaked at 5999 IU (normal range < 229 IU)): he was managed with supportive measures and was discharged after 25 hours. The patient admitted regular use of Hexen and recent use of 3-HO-PCP. Analysis of urine and serum identified 3-hydroxyphencyclidine and metabolites, N-ethylhexedrone and metabolites, and clephedrone and metabolites. DISCUSSION: This is a case of analytically confirmed toxicity to 3-HO-PCP and N-ethylhexedrone. The acute toxicity reported in this patient is consistent with the use of 3-HO-PCP, but there were sympathomimetic and serotonergic features potentially consistent with the cathinone N-ethylhexedrone. The description of the acute toxicity of NPS, such as these, is vital to aid medical toxicologists and emergency medicine physicians treating patients who use them.
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Fenciclidina/análogos & derivados , Intoxicación/diagnóstico , Psicotrópicos/envenenamiento , Detección de Abuso de Sustancias , Trastornos Relacionados con Sustancias/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Fenciclidina/síntesis química , Fenciclidina/envenenamiento , Intoxicación/fisiopatología , Intoxicación/terapia , Valor Predictivo de las Pruebas , Psicotrópicos/síntesis química , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/fisiopatología , Trastornos Relacionados con Sustancias/terapia , UrinálisisRESUMEN
A short cut review was carried out to see if administering anti-emetics reduced the incidence of vomiting when sedating children for procedures. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. Three randomised, controlled trials were found and one cohort study. The studies suggested that administration of an anti-emetic was associated with a reduced risk of vomiting during the procedural sedation.
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Anestésicos Disociativos/efectos adversos , Antieméticos/uso terapéutico , Sedación Consciente , Ketamina/efectos adversos , Vómitos/prevención & control , Niño , HumanosRESUMEN
OBJECTIVE: To quantify the cost-effectiveness of, and evaluate patient satisfaction with, day care for management of hypertensive disorders of pregnancy. DESIGN: Retrospective descriptive study. SETTING: Pregnancy Day Care Centre, Royal Women's Hospital, Melbourne. SAMPLE: A total of 1200 consecutive women attending with a hypertensive disorder of pregnancy. METHODS: Sociodemographic details and perinatal outcome were entered in a purpose designed computer program. A satisfaction questionnaire was administered to 130 women. Clinical costing data were calculated by casemix analysts to compare traditional inpatient and day care models of care. RESULTS: An admission to the Pregnancy Day Care Centre cost an average of 684.85 dollars less than a traditional inpatient admission. Women had an overwhelming preference for day care. CONCLUSION: Pregnancy day care is a cost-effective method of providing care for women with hypertensive disorders of pregnancy. Women prefer day care to inpatient care.