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Objective: This study investigated differences in stress, anxiety, and social support between collegiate student-athletes and nonathletes during the COVID-19 pandemic. Participants: College students enrolled at a NCAA Division III private liberal arts college in the Midwest. Methods: Participants (n = 58) completed a series of surveys each month for 4 months that included the Generalized Anxiety Disorder Questionnaire, Perceived Stress Scale Questionnaire, and Multidimensional Scale of Perceived Social Support Questionnaire. Results: There were significant main effects of time for stress and social support across the 4 months (p < 0.05), but not for anxiety. There was a significant difference in anxiety levels between athletes and nonathletes (p < 0.01), but not for social support or stress (p > 0.05). Conclusions: Nonathletes maintained support networks, or found alternate outlets of support, in addition to coping with anxiety and stress levels when compared to athletes.
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Background: The cellular inflammation generated by SARS-COV-2 has been linked with different psychological impairments to long-term. The Mindfulness-based cognitive therapy can generate positive changes in these patients. Aim(s): To know the effects of a brief behavioural cognitive e-therapy on emotional symptoms, and cellular inflammation in COVID-19 survivors. Method(s): A quasi-experimental study was carried out. Participated two groups of survivors COVID-19 patients;experimental group (TG;4) and wait-list group (WLG;6). Both groups were evaluated using The General Anxiety Disorder Questionnaire, the Patient Health Questionnaire, and the brief Davidson Trauma Scale. Cellular inflammation was evaluated by an assessment of salivary IL-6 in a three-phase paradigm: baseline, stress, and recovery. The TG has received eight virtual mindfulness-based cognitive therapy sessions lasting two hours. The statistical analysis was performed using the software SPSS version 26. Result(s): The average age was about 58+/-11.57 years (TG), and 44.33+/- 17.18 years (WLG). The TG showed a only a clinical differences in the psychological symptoms (anxiety;Mepre = 15.50, Mepost = 8, depression;Mepre =13, Mepost =6 and PTSD;Mepre = 10, Mepost = 5.50), and in the il-6 levels (Base line Mepre = 7.11 pg/mL, Mepost = 16 pg/mL, stress phase Mepre = 10.07 pg/mL, Mepost = 8.77 pg/mL, and recovery phase Me = 14.08 pg/mL, Me = 16.29 pg/mL). Conclusion(s): This type of therapy can helps to reduce the levels of the emotional alterations and generate a modulation of the il-6 levels. The effects of this type of treatment need to continue in research as a therapeutic option for the population that survives COVID-19.
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Background: The post-COVID syndrome generates physical and respiratory complications that can be accompanied by psychological impairments, which can affect long-term mental and physical health. Objective(s): Know the prevalence and severity of PTSD, anxiety, and depression in surviving COVID-19 patients in a follow-up evaluation. Method(s): A cross-sectional descriptive study was conducted. 227 survivors COVID-19 patients participated, were assessed three months following discharge hospital. The following questionnaires were used: The Brief Davidson Trauma Scale, the General Anxiety Disorder Questionnaire, and the Patient Health Questionnaire. A descriptive and statically analysis was performed using the statistical software SPSS version 26. Result(s): The 64.5% of the patients were men, 60.9% required of invasive mechanical ventilation (IMV) during the hospitalization, the average age was about 48.23+/-14.33 years old. The 40% of the patients showed symptoms associated with PTSD, 38.4% anxiety symptoms, 36.6% depression symptoms. There were statistically significant differences between the type of treatment during hospitalization (IMV vs without IMV), in PTSD (t=2.482, df=223, p=.014, XIMV = 5.21, XWIMV = 6.08) and anxiety (t= -2.006, df=223, p=.046, XIMV = 4.05, XWIMV =5.44). Conclusion(s): Survivors of COVID-19 experience a high prevalence of PTSD, anxiety, and depression even three months after discharge from hospital. Patients who did not require IMV during hospitalization experienced a high prevalence and severity of PTSD and anxiety symptoms. Screening for PTSD and other emotional disturbances should be considered in follow-up evaluations in patients discharged from the hospital.
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Introduction: Within the post-Covid syndrome, sleep disturbances are one of the most persistent symptoms, in which women are more 50% vulnerable than men to insomnia. Objective(s): To compare the prevalence of sleep disorders in post-Covid patients according to sex. Method(s): A cross-sectional observational study was carried out. The participants were 264 post-Covid patients evaluated 3 months after hospital discharge, divided into men (n=156, G1) and women (n=108, G2). A general sleep habits survey and the Berlin SAOS questionnaire were used for sleep assessment. Statistical analyses were performed using SPSS v25. Result(s): Mean age was G1: 54.16 +/-11.751 and G2: 54.23 +/- 13.319. There were differences (p<0.05) between both sexes in the following disorders (G1 vs G2): snoring (73.1% vs 58.3%), primary snoring (45.6% vs 28.6%), unrefreshing sleep more than 3 times a week (28.2% vs 43.5%), tiredness or fatigue during the day at least 3 times a week (30.1% vs 51.9%), sudden movements in extremities: (37.2% vs 22.2%), onset insomnia: (34.0% vs 53.7%), intermediate insomnia (36.5% vs 58.3%), final insomnia: (39.7% vs 55.6%). No differences (p>0.05) were found in pauses in breathing, teeth grinding, feeling of paralysis and feeling of choking, with a prevalence greater than 20% in all cases. Conclusion(s): In our study, the affectation of most sleep disorders are more frequent in the female sex, with the predominance of different types of insomnia (onset, intermediate and final);which could be related to affective disorders. In men, the most prevalent disorders were snoring and sudden movements, mostly linked to respiratory disorders.
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Introduction: Cognitive impairment is observed in patients for Covid-19;derived from both multiple organic dysfunctions due to the disease and its management during hospital stay. Existing literature reports greater cognitive impairment (60-80%) in patients with invasive mechanical ventilation (IMV), compared to those who did not require it (50-70%). Objective(s): To compare cognitive impairment among COVID-19 survivors with and without IMV during hospital stay. Method(s): A cross-sectional observational study was conducted. A total of 211 COVID-19 survivors participated, 64.9% required IMV (G1) and 35.1% did not (G2). The Montreal Cognitive Assessment (MOCA) was used to assess cognitive functions at a 9 month follow-up after hospital discharge. Statistical analyses were performed in SPSS V25. Result(s): Patients presented the following characteristics: male sex (G1: 61.8%, G2: 54.1%), and average age G1: 54.05+/-11.89, G2: 57.21+/-11.90 years. In both groups (G1 vs. G2) no significant differences (p<0.05) were found in the prevalence of probable mild cognitive impairment (72.3% vs. 82.4%), neither in the mean of principal affections reports: attention (4. 70+/-1.23 vs. 4.80+/-1.03) and memory (2.69+/-1.53 vs. 2.86+/-1.59). Orientation (5.60+/-.71 vs. 5.82+/-.41), was the only value that reached statistically significant differences (p=.013), but without clinical significance. Conclusion(s): Both groups have high prevalence of patients with probable mild cognitive impairment yet nine months after discharge, contrasting with the prevalence reported to patients with IMV and to the recovery time (3-6 months). Cognitive sequelae have a greater impact than reported in all patients regardless of treatment.
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Introduction: COVID-19 survivor patients report a complaint subjectively related to memory and attentionconcentration problems when carry out their daily activities. Objective(s): To investigate the presence of cognitive sequelae associated with COVID-19. Method(s): An observational cross-sectional study was conducted. Participated 229 COVID-19 survivor patients, who were evaluated with Montreal Cognitive Assessment (MoCA) and classified into three groups: a) severe cognitive impairment (G1, <13points, n=11), b) mild cognitive impairment (G2, 13-21 points, n=34), and c) without cognitive alterations (G3, 22-30 points, n=184). Statistical analyses were performed in SPSS V25. Result(s): Average age and male sex: G1: 67.36+/-10.71, 63.6%;G2: 58.76+/-11.55, 61.8%;G3: 53.32+/-11.39, 58.7%. G1 presented statistically differences (p <0.001) in all cognitive functions with the other groups (G1, G2, G3): visuospatial/executive ability (0.09+/-0.30, 0.53+/-0.50, 0.83+/-0.38), identification (2.00+/-0.89, 2.82+/-0.38, 2.92+/-0.32), attention (2.45+/-0.82, 3.97+/-1.16, 5.02+/-0.97), repetition (0.18+/-0.40, 0.29+/-0.46, 1.02+/-0.79), fluency (0.18+/-0.40, 0.68+/-0.47, 0.93+/-0.24), abstraction (0.18+/-0.40, 0.68+/-0.72, 1.41+/-0.77), deferred remembering (0.73+/-1.10, 1.44+/-1.37, 3.13+/-1.36) and orientation (4.64+/-0.92, 5.35+/-0.73, 5.79+/-0.49);except in executive ability, identification, repetition, abstraction and deferred remembering with respect to G2 (p<0.05). Conclusion(s): Cognitive alterations were found in patients post- COVID, especially in attention and deferred remembering, which could be related to errors of execution in other areas. In the case of the severe cognitive impairment, age may be a related variable. Necessary integrate this variable in the rehabilitation plan for a better prognosis and quality of life of patients.
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Introduction: The presence of anxious, depressive and post-traumatic stress (PTSD) symptoms are the most reported psychological sequelae in post-COVID patients. The use of invasive mechanical ventilation (IMV) may contribute to the appearance of these symptoms. Objective(s): To know the differences in anxious, depressive, PTSD and fear of COVID symptoms among surviving COVID-19 patients with or without IMV, 3 months after hospital discharge. Method(s): An observational cross-sectional study was conducted. 239 surviving COVID-19 patients participated: 146 with IMV at hospitalization (67.80% men and 32.20% women) (G1) and 93 without IMV (61.29% men 38.70% women) (G2), who were evaluated with: GAD-7 for anxious symptomatology, PHQ-9 for depressive symptomatology, EMACOVID scale to measure fear of COVID-19, and the brief Davidson scale as screening for EPT. Statistical analyzes were performed in the statistical package SPSS V25. Result(s): Average age: G1= 48.62+/-13.62, G2= 48.49+/-15.43. There was a statistically significant difference in the EPT scores (G1: Md=4 [4.00-6.00];G2: Md=5 [4.00-7.00]). No statistically significant differences were found (P<0.05, G1 vs G2) in depression (Md=3 [0.00-6.00] vs Md=3 [0.00-8.50], anxiety (Md=2 [0.00-6.00] vs Md=3 [1:00-7:50]), nor fear of COVID (Md= 9 [7:00-15:00] vs Md=11.80 [7:00-14:00]), although there were clinical differences. Conclusion(s): Patients without IMV have a conscious experience of their hospitalization, which may lead to a higher level of PTSD compared to sedated patients with IMV.
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Objective. Influenza pandemic of the human lung was caused by the Influenza A (H1N1) over 100 years ago in 1918, but it recurred in pandemic fashion in 2009. Understanding the pathobiology of this infectious agent in the human lung could lead to adjuvant therapies that are relatively non-toxic and reduce the mortality of the human host. Overall, our objective was to apply morphoproteomics to pulmo-nary lung sections from an autopsied victim so that we may better define its biology from the perspective of its interaction with the host and provide options for therapeutic targets. Methods. Morphoproteomic analysis from a case study of this Influenza A (H1N1) pulmonary infection included immunohistochemical probes to detect the expressions of fatty acid synthase (FAS), CD163+ (M2 polarized monocytes/macro-phages), and programmed death-ligand 1 (PD-L1) expression as part of the host response to interaction with the Influenza A (H1N1) virus.Results. Representative sections of the Influenza A (H1N1) victim's lung showed: cytoplasmic expression of FAS in most of the sloughed and atypical alveolar pneumocytes;abundance of intra-alveolar and alveolar interstitial CD163+ macrophages/monocytes;and PD-L1 expres-sion on occasional macrophages, and focally on collections of alveolar pneumocytes and the alveolar inter-stitium.Conclusion. Morphoproteomics and microanatomical features coincide with the etiopathogenic features of pulmonary Influenza A (H1N1) infection and the host response. This plus data mining of the medical literature suggests that adjunctive, targeted therapy such as metformin and vitamin D3 could ad-dress the biology of Influenza A (H1N1) pneumonia, enhance the host immune response, and prevent its progression to a life-threatening, ventilator-dependent clinical situation.
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BACKGROUND: Underuse of interpretation services for Limited English Proficiency (LEP) patients has been both widely reported in popularmedia and is increasingly documented in the literature. The COVID-19 pandemic has affected every aspect of healthcare and has directly impacted the use of interpreters with barriers such as strict visitation policies, limited patient interactions with healthcare workers, and withdrawal of in-person interpreters from the hospital setting. In this study we assess the use of interpreter services by healthcare professionals (HCPs) for LEP patients at an academic teaching hospital during the pandemic. METHODS: A combination of quantitative and qualitative data was obtained, and a total of 107 HCPs responded to the survey between August and October 2021. The majority of respondents were physicians (50.4%) and the largest specialties represented were Internal Medicine, Hospital Medicine, and medical subspecialties (36.4%). RESULTS: Study participants reported a preference for digital interpreters. Despite affirming the importance of interpretation services for LEP patients and endorsing the use of telephone and tablet digital methods, many HCPs cite hassle and time constraints as limiting factors for the use of interpreter services. HCPs reported wide variation in use of interpretation services based on type of encounter. Of HCPs who assessed themselves as non-fluent in Spanish, 71% reported patient encounters without interpretation services, with some reporting they “know enough Spanish to get through”. When asked to rank their likely use of interpretation services in different clinical settings, 88% stated they use interpretation in “Goals of Care Meetings”, 87%use them when “Consenting Patients”, and 80% use them for the initial encounters. However, only 47% and 51% stated that they used interpreters for follow-up encounters and consult visits, respectively. Only 25% reported using interpreters for other visits. CONCLUSIONS: The COVID-19 Pandemic has hastened a shift to digital platforms in many arenas, and healthcare interpretation services have been equally affected. However, despite hopes that digital or telephonic means of interpretation would improve interpretation use by HCPs, our study shows that HCPs continue to use these services at inadequate rates. Time constraints, hassle, and encounter type were common explanations for underuse before the pandemic and continue to be widely cited during COVID-19. The legal imperative to use adequate interpretation services at every encounter should be better communicated to HCPs, and health systems should work to decrease barriers to interpreter services use. If third party interpretation presents the same barriers to use, healthcare systems should consider a strategic change to increase the bilingual work force and certify language skills so that patients can receive language-concordant care more consistently.
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Context: This is a case of a 71-year-old male who presented with sudden onset tetraplegia after a mechanical ground level fall. He was diagnosed with a traumatic C3 AIS B spinal cord injury (SCI) and neurogenic shock requiring vasopressors and intubation. He underwent C3-C5 surgical decompression and stabilization. His course was complicated by cardiac arrest, aspiration pneumonia, alcoholic pancreatitis, and failure to wean off vasopressors. Findings: The patient was alert and intermittently cognitively intact, but his communication was limited by intubation. The healthcare team discussed his likely prognosis including long-term artificial ventilation, tube feeding, and severe tetraplegia. Under COVID-19 restrictions, the patient's wife, his durable power of attorney, and son had limited encounters with the patient. Initially, she wanted to pursue tracheostomy so the patient may participate in goals of care discussions. However, the family recalled his preference to not be on life support. The decision was made to withdraw care and he passed away on hospital day 11. Conclusion/Clinical Relevance: This case highlights the ethical dilemma of withdrawing care in the acute phase of a severe traumatic SCI. While undergoing intensive care, many factors interfere with decision making including the patient's acute medical status, altered cognition, communication limitation, and the family's physical distance and emotional state. Lastly, the patient and his family may not have had sufficient time to process the given information and understand that a meaningful life is possible with a severe disability. Informed decision making includes not only clear and thorough information but also time to adjust.
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With the arrival of the pandemic, people of all ages have found an alternative in video games to distract themselves. Additionally, streaming (live streaming of game sessions) became a way to earn income from home for creators. This type of content became part of the digital media diet of video game fans, who established a close relationship with streamers and generated different dynamics ranging from the publication of positive comments to strong rejection. Despite the implementation of rules regulating the behavior of streamers on platforms such as Twitch and Facebook, they are not able to control some irregularities, like monitoring negative comments or sexual innuendo during live streams. This has initiated various debates about the correct use of these media that gather people of all ages, from children to adults. In order to know consumers’ points of view, two focus groups were carried out (one with 8 women and another with 14 men) in order to find out the factors that influence the media competence of female streamers’ audience. The study addresses two dimensions: languages and ideology and values. In the languages dimension, although women are aware of harassment, they consider that a person has freedom of behavior during a stream. Men, meanwhile, consider that the way women show themselves in front of the camera allows them to generate money. In the ideology and values dimension, women believe that a female streamer’s behavior should not be questioned or criticized as long as it respects the rules of the community. On the other hand, men consider that the rules are interpreted subjectively, but they are aware that without these practices, the Facebook Gaming platform would not have economic income. To sum up, women take more into account the human side of people who stream while men view these behaviors as a business. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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This article analyses through a conceptual cartography, school safety, and its association with the management of the COVID-19 pandemic in Mexico. The qualitative methodology allowed the identification of a model of safe learning space in Higher Education, which emerges as a proposal to establish safe learning spaces and manage the pandemic. Once this model implemented, it was possible to inform, mobilize, attend to school content and be in confinement, which meant raising awareness of learning in Higher Education in an increasingly changing knowledge society.