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E-learning during the COVID-19 pandemic: the impact on medical students’ perceived academic progress COVID-19大流行期间的电子学习:对医学生学业进步感知的影响
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0005
Bogdan-Viorel Vîlceleanu, A. Balan, E. Jugănaru, Elena Merlușcă, A. Rascu, M. Oțelea
Abstract The Covid-19 pandemic created one of the most stressful situations all around the world and affected almost all activity sectors, including medical education. Sudden restrictions on social interactions forced an abrupt transition from amphitheatres and physical examinations to online lectures and, despite difficulties, the academic community rallied to continue teaching. The swift transition left academia with no time to design custom platforms and confined the university to choose among a set of readily available tools: Google Classroom and Google Meet, Zoom and Moodle, which offer a basic framework for substituting the students’ needs. In some countries, ours included, most of the summer term took place online. Although pandemics are, hopefully, rare events, the experience with online classes should be used to improve and expand current teaching models, since this improvement could be a means to a general improvement of the medical teaching system. On the other hand, the COVID-19 pandemic is not finished yet and many restrictions continue, affecting at least 20% of the total undergraduate training of several generations of doctors. The study aims to identify – within the medical students’ community - transferable aspects of online classes to the post-pandemic teaching in the perspective of blended learning. We deliberately chose to omit the examination part of the educational process in order to set the focus on the delivery of teaching. In this first analysis of the results, the degree of progress in reaching a high professionalism level was analyzed starting from the self-assessment of professional growth, that was previously found to be in good agreement with the actual achievements as derived from the traditional formative examination. [1]
2019冠状病毒病大流行造成了世界上最紧张的局面之一,影响了包括医学教育在内的几乎所有活动部门。突然对社交活动的限制迫使人们从露天剧场和体检突然转变为在线授课,尽管困难重重,学术界还是团结起来继续教学。这种迅速的转变使得学术界没有时间设计定制平台,并限制了大学在一套现成的工具中进行选择:谷歌课堂和谷歌见面,Zoom和Moodle,这些工具为替代学生的需求提供了一个基本框架。在一些国家,包括我们的国家,夏季学期的大部分时间都是在网上进行的。虽然大流行希望是罕见的事件,但应该利用在线课程的经验来改进和扩展当前的教学模式,因为这种改进可以成为全面改进医学教学系统的一种手段。另一方面,新冠肺炎疫情尚未结束,许多限制仍在继续,影响了至少20%的几代医生本科培训。这项研究旨在从混合学习的角度,在医学生社区内确定在线课程可转移到大流行后教学的方面。我们故意选择省略教育过程中的考试部分,以便将重点放在教学的交付上。在对结果的第一次分析中,我们从专业成长的自我评估开始,分析了达到高专业水平的进步程度,之前发现这与传统的形成性考试得出的实际成果非常吻合。[1]
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引用次数: 1
ORCHESTRA project in Romania - a prospective occupational cohort to study the impact of COVID-19 pandemic on healthcare workers 罗马尼亚ORCHESTRA项目——研究COVID-19大流行对医护人员影响的前瞻性职业队列
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0008
D. Mates, V. Calotă, C. Staicu, Lavinia Călugărenu, Mădălina Ipate, M. Margineanu, M. Oțelea, O. Persecă, F. Popescu, A. Rascu, S. Teodorescu, Georgeta Botin, A. Voinoiu, A. Neamțu
Abstract ORCHESTRA is a three-year international research project funded by the European Union’s Horizon 2020 research and innovation programme, led by the University of Verona and involving 26 partners (extending to a wider network of 37 partners) from 15 countries. Romania is partner in ORCHESTRA project and is represented by The National Institute of Public Health. The challenge for the Romanian team is to enroll a prospective cohort of more than 1 000 health care workers and to follow-up, for at least 12 months, the impact of the pandemic at three main levels: mental health, long term consequences of COVID-19 and variation of the immune response in vaccinated. Secondary objectives are: the variation of risk perception during the pandemic, the preventive measures at workplace and how these evolved during the pandemic, vaccination acceptance and reasons of refusal. This paper aims to present a brief overview of the study design in Romania and the cohort description at baseline.
ORCHESTRA是一个为期三年的国际研究项目,由欧盟“地平线2020”研究和创新计划资助,由维罗纳大学领导,涉及来自15个国家的26个合作伙伴(扩展到更广泛的37个合作伙伴网络)。罗马尼亚是ORCHESTRA项目的合作伙伴,由国家公共卫生研究所代表。罗马尼亚小组面临的挑战是招募一个由1000多名卫生保健工作者组成的前瞻性队列,并在三个主要层面对大流行的影响进行至少12个月的随访:心理健康、COVID-19的长期后果和接种疫苗者免疫反应的变化。次要目标是:大流行期间风险认知的变化、工作场所的预防措施及其在大流行期间的演变情况、疫苗接种接受情况和拒绝原因。本文旨在简要概述罗马尼亚的研究设计和基线时的队列描述。
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引用次数: 1
Beneficial effect of hyperbaric oxygen therapy in solving a nosocomial COVID-19 infection. Case report and short literature review 高压氧治疗治疗院内感染的有益效果。病例报告及简短文献回顾
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0007
Cristina-Elena Micu, R. Smărăndescu, I. Arghir, Mihaela Trenchea, Bogdan-Alexandru Barbu, C. Handra
Abstract The infection with the new coronavirus SARS-CoV-2 was declared a global health emergency in early 2020 and, two months later, became recognized as a pandemic, affecting the world’s population regardless of age, ethnicity, geographical area. COVID-19 generally presents with altered general condition (fever, chills, marked fatigue, muscle aches, headache), respiratory manifestations from cough to dyspnea, acute respiratory distress, and multiorgan damage in critical forms. Manifestations can occur between 2 days and two weeks after exposure, the disease evolving from mildly symptomatic to moderate, severe, and even fatal forms. Our reported clinical case of COVID-19 is that of a 59-year-old nurse with diabetes and hypertension as risk factors. Accidental occupational exposure to SARS-CoV-2 infection occurred due to non-compliance with the existing dressing-undressing protective equipment protocols in facilities with treatment beds. We diagnosed a moderate-severe COVID-19, displaying bilateral lung damage and mild desaturation, complicated by bacterial superinfection with Klebsiella spp. The patient underwent antiviral, antibiotic, anticoagulant, cortisone treatment during hospitalization. In the first two months after discharge, we recommended seven hyperbaric therapy sessions to relieve respiratory symptoms and enhance regression of fibrotic lung lesions.
新型冠状病毒SARS-CoV-2感染于2020年初被宣布为全球突发卫生事件,两个月后成为公认的大流行,不分年龄、种族、地理区域影响全球人口。COVID-19通常表现为全身状况改变(发烧、发冷、明显疲劳、肌肉疼痛、头痛)、咳嗽、呼吸困难等呼吸系统症状、急性呼吸窘迫以及严重形式的多器官损伤。症状可在接触后2天至2周内出现,从轻度症状发展到中度、严重甚至致命形式。我们报告的COVID-19临床病例是一名59岁的护士,糖尿病和高血压是危险因素。由于在有治疗床位的设施中未遵守现有的换衣防护设备规程,意外职业暴露于SARS-CoV-2感染。我们诊断为中重度COVID-19,表现为双侧肺损伤和轻度去饱和,合并克雷伯氏杆菌的细菌重复感染,患者住院期间接受了抗病毒、抗生素、抗凝血剂、可的松治疗。在出院后的头两个月,我们推荐7次高压氧治疗,以缓解呼吸道症状,促进纤维化肺病变的消退。
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引用次数: 1
Epidemiological model of COVID-19 in healthcare workers: occupational vs. environmental disease COVID-19在医护人员中的流行病学模型:职业性与环境性疾病
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0001
Mihaela Stoia
Abstract This study aims to estimate the occupational etiology of COVID-19 in the healthcare sector and obtain a risk matrix for the burden of disease across occupations and specific activities. The study population included 4515 cases and 133077 controls. We have used an epidemiological model that included data collected over one year from employed persons with confirmed SARS-CoV-2 infection, age group 20-64, and residing in Sibiu County. We measured the incidence rate (IR), relative risk (RR), and risk of COVID-19 attributable to the occupational exposure (AR), respectively, statistical analysis based on frequency distribution and the portion of cases to compute the risk levels in social- and healthcare workers. According to this model, approximately 70.5% of COVID-19 risk could be attributable to occupational exposure. The workplace is a strong predictor of infection risk (RR 3.4), particularly in residential long-term care facilities, hospitals, and ambulance services. The highest-risk job functions are nurse, nursing assistant, ambulance worker, and dentist. In conclusion, we believe in having demonstrated that epidemiological modeling may be helpful for risk management and notification of COVID-19 as an occupational disease in frontline staff and essential healthcare personnel.
本研究旨在估计医疗保健部门COVID-19的职业病因,并获得跨职业和特定活动的疾病负担风险矩阵。研究人群包括4515例病例和133077例对照。我们使用了一个流行病学模型,其中包括从居住在锡比乌县的年龄在20-64岁的确诊SARS-CoV-2感染的就业人员中收集的一年内的数据。我们分别测量了COVID-19的发病率(IR)、相对危险度(RR)和职业暴露风险(AR),并根据频率分布和病例比例进行统计分析,计算了社会和卫生保健工作者的风险水平。根据该模型,约70.5%的COVID-19风险可归因于职业暴露。工作场所是感染风险的一个强有力的预测因子(RR 3.4),特别是在住宿长期护理设施、医院和救护车服务中。风险最高的工作职能是护士、护理员、救护人员和牙医。总之,我们认为,流行病学建模可能有助于一线工作人员和基本卫生保健人员对COVID-19作为职业病的风险管理和通报。
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引用次数: 0
Contact dermato-allergology - review of the literature 接触皮肤过敏症-文献综述
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0002
F. Delcroix, S. Bădulici, J. Nicolas
Abstract European Baseline Series (EBS) of haptens (contact allergens) is used throughout Europe, containing patch tests essential for the diagnosis of contact allergy (Tables I and II) [1]. Exposure to environmental allergens is constantly evolving and the EBS must be adapted accordingly in order to guarantee its relevance of the molecules tested, in particular by the addition of emerging allergens [1].
欧洲基线系列(European Baseline Series, EBS)的半抗原(接触性过敏原)在整个欧洲使用,包含了诊断接触性过敏所必需的斑贴试验(表1和表2)[1]。暴露于环境过敏原是不断变化的,EBS必须相应地进行调整,以保证其与被测分子的相关性,特别是通过添加新出现的过敏原[1]。
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引用次数: 0
COVID-19: the first pandemic of the 21th century. A review of the literature COVID-19: 21世纪的第一次大流行。文献综述
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0004
S. Bădulici
Abstract The new coronavirus SARS-CoV-2 (COVID-19) was recognized in December 2019 as a cause of severe pneumonia and has now led to a global pandemic [1, 2]. Respiratory illnesses caused by COVID-19 cover a whole range of severities. Identifying the risk factors and protective factors for the severity of COVID-19 disease is essential to direct the development of new treatments and infection prevention strategies. The first large series of cases identified several risk factors for severe forms of the disease, including advanced age, hypertension, diabetes, cardiovascular disease, exposure to tobacco, and obstructive pulmonary chronic disease [1, 3]. The Chinese Center for Disease Control and Prevention published a significant case series study of coronavirus disease 2019 (COVID-19) (72 314 cases, updated through February 11, 2020) [4, 5]. The authors of this paper summarized key findings from this report and discussed emerging understanding of and conclusions from the COVID-19 epidemic.
新型冠状病毒SARS-CoV-2 (COVID-19)于2019年12月被确认为严重肺炎的病因,目前已导致全球大流行[1,2]。由COVID-19引起的呼吸系统疾病涵盖了一系列严重程度。确定COVID-19疾病严重程度的风险因素和保护因素对于指导制定新的治疗方法和感染预防战略至关重要。第一批大型系列病例确定了严重形式疾病的几个危险因素,包括高龄、高血压、糖尿病、心血管疾病、接触烟草和阻塞性肺慢性疾病[1,3]。中国疾病预防控制中心发布了2019冠状病毒病(COVID-19)的重要病例系列研究(72 314例,截至2020年2月11日更新)[4,5]。本文作者总结了本报告的主要发现,并讨论了对COVID-19疫情的新认识和结论。
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引用次数: 0
Different perspectives of doctors and nurses about the continuation of usage of some of the protection measures after the end of the COVID-19 pandemic 医生和护士对COVID-19大流行结束后继续使用某些保护措施的不同看法
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0006
M. Oțelea, D. Mates, A. Rascu
Abstract The current pandemic pointed toward a revision of the protection measures against infectious diseases. For any given new pathogen against which human species showed no immunity, isolation and personal protection equipment proved to reduce disease transmission. In medical settings, when there is inevitable contact with infected patients, these preventive measures have undoubtedly change the process of care delivery. The study aims to investigate the opinion of the healthcare workers about the utilization of the personal protective equipment after the pandemic stops. For this purpose, we conducted an online survey about changes related to the COVID-19 pandemic. For the healthcare workers, the survey also included several questions related to personal protective equipment. A total of 512 responders, doctors, and nurses answered to the survey. We performed comparisons between these two categories of personnel using the χ test. Overall, the results show that doctors are keener to follow the recommendations for the personal protective equipment in the future; there was a statistically significant difference (p<0.001) for the usage of gloves and masks while examining febrile patients, and for the handwashing after the examination of each patient. The type of service (outpatient or inpatient procedures) and direct contact with a COVID-19 patient were other factors to modulate the responses regarding using personal protective equipment in the future. The fact that 14.06% of the responders did not consider it necessary to wash hands after examining each patient underlines the urgent need for safety education in all healthcare workers and nurses.
当前的大流行要求对传染病防护措施进行修订。对于任何人类没有免疫力的新病原体,隔离和个人防护设备被证明可以减少疾病传播。在医疗环境中,当不可避免地与受感染患者接触时,这些预防措施无疑改变了提供护理的过程。本研究旨在调查疫情结束后医护人员对个人防护装备使用情况的看法。为此,我们对新冠肺炎疫情相关变化进行了在线调查。对于医护人员,调查还包括几个与个人防护装备有关的问题。共有512名应答者、医生和护士回答了调查。我们使用χ检验对这两类人员进行比较。总体而言,结果表明,医生在未来更愿意遵循个人防护装备的建议;发热患者检查时手套和口罩的使用情况和每个患者检查后的洗手情况差异有统计学意义(p<0.001)。服务类型(门诊或住院程序)和与COVID-19患者的直接接触是影响未来使用个人防护装备反应的其他因素。14.06%的应答者认为在检查每个病人后没有必要洗手,这一事实强调了对所有医护人员和护士进行安全教育的迫切需要。
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引用次数: 0
Successful management of a professional viola player with a complex playing related musculoskeletal disorder 成功治疗一名职业中提琴手的复杂的与演奏相关的肌肉骨骼疾病
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0009
F. Popescu, M. Vaida, Grant Mackay, C. Borza, E. Pauncu, D. Roman, C. Maliţa, I. Dragoi
Abstract Objective: This paper presents the case of a 53-year-old female professional violist with chronic disabling neck and shoulder pain who had failed standard conservative management. A multimodal approach including Mulligan Concept manual therapy techniques resulted in a successful return to the workplace. Methods: Mobilization with Movements and Sustained Natural Apophyseal Glides as part of Mulligan Concept manual therapy approach, were the main treatment techniques utilized. Neuro-dynamic exercises, strengthening exercises, ergonomic interventions, alterations in playing load, and posture training were also implemented. Pain, range of motion and disability levels were monitored throughout treatment. Results: Significant improvements were seen in both neck and shoulder range of motion alongside considerable pain reduction in both regions. Clinically meaningful improvements were also noted in Neck Disability Index and Shoulder Pain and Disability Index scores. Discussion: Ergonomic intervention with postural correction and replacement with a lighter viola also contributed to patient recovery and return to the workplace. The Mulligan approach has proved to be effective in a wide variety of conditions. Still, it has not previously been considered in managing complex neck and upper limb disfunctions in string players. Conclusion: This paper highlights how an intensive manual therapy program had better results compared with standard conservative management. Multimodal intervention with occupational, ergonomic, and physiotherapy approaches was effective, leading to progressive re-integration into the workplace. Mulligan Concept manual therapy techniques should be considered in the management of playing related musculoskeletal disorders.
摘要目的:本文报道一名53岁女性职业中提琴手慢性致残性颈肩疼痛,标准保守治疗失败。包括Mulligan概念手工治疗技术在内的多模式方法成功地回到了工作场所。方法:采用Mulligan概念手法治疗方法的主要治疗手法为运动动员和持续自然椎体滑动。神经动力学练习、强化练习、人体工程学干预、游戏负荷的改变和姿势训练也被实施。在整个治疗过程中监测疼痛、活动范围和残疾水平。结果:颈部和肩部的活动范围均有显著改善,这两个区域的疼痛也明显减轻。颈部残疾指数和肩部疼痛和残疾指数评分也有临床意义的改善。讨论:人体工程学干预与姿势矫正和更换较轻的中提琴也有助于患者恢复和重返工作场所。Mulligan方法已被证明在各种情况下都是有效的。尽管如此,它在弦乐演奏者复杂的颈部和上肢功能障碍的治疗中还没有被考虑过。结论:本文强调了与标准保守治疗相比,强化手工治疗方案有更好的效果。采用职业、人体工程学和物理治疗方法的多模式干预是有效的,导致逐步重新融入工作场所。在游戏相关的肌肉骨骼疾病的治疗中,应考虑Mulligan概念手法治疗技术。
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引用次数: 0
The questionnaire as a tool for collecting information in support of medical researchers 调查表作为收集信息以支持医学研究人员的工具
Pub Date : 2021-10-26 DOI: 10.2478/rjom-2021-0003
Mădălina Ipate, B. Draghici, M. Margineanu
Abstract In medical and epidemiological research, multi-item questionnaires are often used to assess changes in the health of a particular group of subjects over a certain period. They can target a selected population sample based on specific exposure characteristics or target the whole population. Also, they can constitute an objective tool to help health professionals improve the quality of life and guide patients to the most appropriate care suitable [1,2]. Trying to complete an entirely new questionnaire or translating an existing questionnaire from another language can be difficult. The biggest challenge is making a questionnaire that is effective for use in research and clinical conditions. This article tries to guide for adapting validated and translated questionnaires to apply them to various population categories. We want to support readers less familiar with the process of developing and adapting validated questionnaires. Although using an existing questionnaire will save time and resources, a questionnaire that includes all items of interest to the researcher may not be available, or the current questionnaire may not be translated into the language required for respondents. If no already validated questionnaires are available or suitable, it is necessary to design a new questionnaire. For this, there are several steps to follow that one must take into account.
在医学和流行病学研究中,通常采用多项目问卷来评估特定人群在一定时期内的健康变化。它们可以根据特定的暴露特征针对选定的人群样本,也可以针对整个人群。同时,它们也可以作为一种客观的工具,帮助卫生专业人员提高生活质量,并指导患者进行最合适的护理[1,2]。尝试完成一份全新的调查问卷或从另一种语言翻译一份现有的调查问卷可能会很困难。最大的挑战是制作一份在研究和临床条件下有效使用的问卷。本文试图指导如何调整经过验证和翻译的调查问卷,使其适用于不同的人口类别。我们希望为不熟悉开发和调整有效问卷的过程的读者提供支持。虽然使用现有的调查问卷将节省时间和资源,但可能无法获得包括研究人员感兴趣的所有项目的调查问卷,或者当前的调查问卷可能无法翻译成受访者所需的语言。如果没有可用或合适的已验证问卷,则有必要设计新的问卷。为此,有几个必须考虑到的步骤。
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引用次数: 0
The diagnosis of occupational asthma confirmed by serial peak expiratory flow rate monitoring 职业性哮喘的诊断经连续呼气峰流速监测证实
Pub Date : 2020-08-27 DOI: 10.2478/rjom-2020-0003
A. Rascu, E. Naghi, C. Handra, I. Arghir, D. Mates, L. Moise, M. Oțelea
Abstract Occupational asthma, the most common occupational respiratory disease in industrialized societies, accounts for 5-10% of all cases of asthma diagnosed in the world. The number of cases is increasing given the development of the “consumer society”. We aim to discuss a case of occupational asthma that we have confirmed using internationally validated methods.
职业性哮喘是工业化社会中最常见的职业性呼吸系统疾病,占全球哮喘确诊病例的5-10%。鉴于“消费社会”的发展,案件的数量正在增加。我们的目的是讨论职业性哮喘的情况下,我们已经确认使用国际验证的方法。
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引用次数: 0
期刊
Romanian Journal of Occupational Medicine
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