Browsing by Author "Staton, Catherine"

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    Brazil Health Care System preparation against COVID-19
    (2020-05-13) Silva, Lincoln Luís; de Carvalho Dutra, Amanda; Iora, Pedro Henrique; Ramajo, Guilherme Luiz Rodrigues; Messias, Gabriel Antônio Fernandes; Gualda, Iago Amado Peres; Scheidt, Joao Felipe Hermann Costa; Amaral, Pedro Vasconcelos Maia do; Staton, Catherine; Rocha, Thiago Augusto Hernandes; Andrade, Luciano de; Vissoci, João Ricardo Nickenig
    Background: The coronavirus disease outbreak from 2019 (COVID-19) is associated with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a highly contagious virus that claimed thousands of lives around the world and disrupted the health system in many countries. The assessment of emergency capacity in every country is a necessary part of the COVID-19 response efforts. Thus, it is extremely recommended to evaluate the health care system to prepare the country to tackle COVID-19 challenges. Methods and Findings: A retrospective and ecological study was performed with data retrieved from the public national healthcare database (DATASUS). Numbers of intensive care unit and infirmary beds, general or intensivists physicians, nurses, nursing technicians, and ventilators from each Regional Health Unity were extracted, and the beds per health professionals and ventilators per population rates were assessed. The accessibility to health services was also performed using a spatial overlay approach to verify regions that lack assistance. It was found that Brazil lacks equity, integrity, and may struggle to assist with high complexity for the COVID-19 patients in many regions of the country. Conclusions: Brazilian health system is insufficient to tackle the COVID-19 in some regions of the country where the coronavirus may be responsible for high rates of morbidity and mortality.
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    Experiences of COVID-19 infection in North Carolina: A qualitative analysis.
    (PloS one, 2022-01) Seidenfeld, Justine; Tupetz, Anna; Fiorino, Cassandra; Limkakeng, Alexander; Silva, Lincoln; Staton, Catherine; Vissoci, Joao RN; Purakal, John

    Background and aim

    It has been demonstrated that marginalized populations across the U.S. have suffered a disproportionate burden of the coronavirus disease 2019 (COVID-19) pandemic, illustrating the role that social determinants of health play in health outcomes. To better understand how these vulnerable and high-risk populations have experienced the pandemic, we conducted a qualitative study to better understand their experiences from diagnosis through recovery.

    Methods

    We conducted a qualitative study of patients in a North Carolina healthcare system's registry who tested positive for COVID-19 from March 2020 through February 2021, identified from population-dense outbreaks of COVID-19 (hotspots). We conducted semi-structured phone interviews in English or Spanish, based on patient preference, with trained bilingual study personnel. Each interview was evaluated using a combination of deductive and inductive content analysis to determine prevalent themes related to COVID-19 knowledge, diagnosis, disease experience, and long-term impacts.

    Findings

    The 10 patients interviewed from our COVID-19 hotspot clusters were of equal distribution by sex, predominantly Black (70%), aged 22-70 years (IQR 45-62 years), and more frequently publicly insured (50% Medicaid/Medicare, vs 30% uninsured, vs 20% private insurance). Major themes identified included prior knowledge of COVID-19 and patient perceptions of their personal risk, the testing process in numerous settings, the process of quarantining at home after a positive diagnosis, the experience of receiving medical care during their illness, and difficulties with long-term recovery.

    Discussion

    Our findings suggest areas for targeted interventions to reduce COVID-19 transmission in these high-risk communities, as well as improve the patient experience throughout the COVID-19 illness course.
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    Exploring the Mediating Effects of Depression on the Effectiveness of a Brief Negotiational Intervention in Reducing Harmful Alcohol Use in Moshi, Tanzania: A Mixed Method Study
    (2024) Buono , Mia Kaitlin

    Alcohol Use Disorder (AUD) and Major Depressive Disorder (MDD) account for millions of deaths and disabilities each year with many theories on the interaction between the two disorders. Tanzania has a high rate of harmful alcohol use, depression, and alcohol-related injuries. To address the growing burden, a nurse-led Brief Negotiational Intervention (BNI) was implemented in the Kilimanjaro Christian Medical Centre Emergency Department in 2020. Three-month outcomes from this study have shown that AUDIT scores are not significantly reduced by the intervention. Thus, this study aims to explore the relationship and potential mediating effects of depression within the context of the BNI at KCMC ED. For quantitative aims, we used secondary data from the PRACT 6-month outcomes. We compared demographic characteristics between AUDIT/PHQ-9 categories using median, IQR, Kruskal-Wallis, and Fisher’s Exact Test. We then specified two cross-sectional structural equation models at 3 and 6 months to explore depression as a mediator between BNI and AUDIT scores. For our qualitative aim, we conducted 15 semi-structured interviews and analyzed data using a thematic coding approach. Out of our 282 participants, demographic characteristics differed between AUDIT/PHQ-9 groups on gender and education. Additionally, depression does not mediate the relationship between BNI and AUDIT scores at 3 or 6 months. However, BNI is reducing AUDIT and PHQ-9 scores at 6 months. Our qualitative data highlights the association between AUD and MDD and explores the importance of social communities for both disorders. More research is needed to determine the temporality between AUD and MDD in this context. Yet, this study has provided evidence that an alcohol-based BNI has provided benefits for AUD and MDD. Thus, it’s imperative to capitalize on this unintended intervention effect and modify the intervention to include a mental health component.