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Background Studies have shown increased rates of intimate partner violence (IPV) during the Covid-19 lockdowns. Healthcare services (HCS) have an important role in detection and screening of women victims of IPV. These women tend to visit the HCS more frequently, which creates an opportunity to detect, screen, and inform them about relevant support services. Methods We conducted an online survey during Israel's 2nd and 3rd lockdowns (October 2020-February 2021). A self-administrated structured questionnaire was distributed in Arabic and Hebrew via social media. Eligibility criteria included women >18 years old. 519 women completed the questionnaire: Palestinian-Arab=73;non-immigrant Jew=319;and immigrant Jew=127. We asked women whether they were ever screened (ES) for IPV or received information (RI) on support services in the HCS. Results 37.2% of the women reported any IPV;Palestinian-Arab women reported higher rates of IPV (49.3%) compared to non-immigrant Jew (34.2%) and immigrant Jew (37.8%). Prevalence of ES and RI on support services were low among the total study sample (21.8%, 47% respectively). Only 12.1% reported on both (ES and RI). Among women who reported IPV, only 26.9% reported that they had been ES, 39.4% RI, and 13.5% both. Whilst Palestinian-Arab women victims of IPV reported higher ES and a lower RI (30.6%,25% respectively) non-immigrant and immigrant Jew reported the opposite -higher prevalence of RI and less ES (non-immigrant Jew 45%,25.7%. Immigrant Jew 37.5%,27%, respectively). In the multivariate analysis after adjusts, Palestinian-Arab women were less likely to RI regarding support services (OR = 0.33,90%CI=0.19-0.57), while immigrant Jew women had a greater chance to be ES in HCS (OR = 4.29, 90% CI=1.43-12.80). Conclusions To increase IPV detection in the HCS, there is a need for interventions on screening and providing information on support services specifically during emergencies where IPV is likely to increase. Key messages During emergency situations such as the Covid-19 when IPV is likely to increase, HCS should make more efforts for IPV screening and providing information on support services to women victims of IPV. Tailored intervention should consider barriers in the HCS for providing less information on support services to minority women, and less screening for immigrant women.
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Background Maternal Respectful Care (MRC) approach was recommended by the WHO for improving maternal birth experience and mental health. We examined the association between MRC and Post-Traumatic Stress Disorder (PTSD) among postpartum women. Methods A cross-sectional study took place between November 2020 and October 2021. 817 postpartum women (Jewish- 444 Arab-373) were interviewed via Zoom due to Covid-19 limitations. MRC was measured by 26 statements from disrespectful/ abusive care during childbirth in facilities (DACF);4 statements from the Mother on Respect questionnaire (MOR-feeling mistreatment based on ethno-national background, level of command of the Hebrew language and disagreement with the staff);and 4 statements regarding abuse of the NorVold Abuse Questionnaire (NorAQ). PTSD was measured by Solomon et al.'s tool, and dichotomized into 12 score cutoff. (Yes /No PTSD). Results PTSD prevalence was 14.3%, significantly higher among Palestinian-Arab compared to Jewish women (22.0%,7.9%, respectively), and it was higher in women who had lower MRC scores: did not receive postpartum education (19.9%,11.9 % respectively) received;received midwife support 11.7%,18.4% didn't receive;reported racism 26.1%,11.4% not;Felt humiliated at healthcare services vs. not (16.8% , 10.6%, respectively);women who reported mistreatment based on national/cultural background, compared to others (MOR) (36.6%,13.1%, respectively). In the multivariate analysis after adjusting to different independent variables, Palestinian-Arab women were 6.04 times at risk for PTSD (OR = 6.04,95% CI = 3.38-10.78),Women who reported racism are 2.14 times more likely to PTSD (OR = 2.14, 95% CI = 1.30-3.54). Women who reported feeling humiliated visiting the health care system are 2.08 times more likely to PTSD (OR = 2.08,95% CI = 1.23-3.52). Conclusions MRC is an important factor for maternal PTSD among postpartum women and it should be considered specifically among minority women. Key messages MRC can contribute to quality care, improving birthing mothers experience and reducing negative health outcomes such as PTSD, and it should be improved for women. The health care services need to run a program to overcome racism and reduce unrespectful care for postpartum women.
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Objectives The COVID-19 pandemic has generated global mental health crisis. It has resulted in new sources of anxiety and depression among breast cancer patients. This study aimed to evaluate the anxiety and depression in Tunisian breast cancer patients. Methods We conducted an observational study between January and May 2021 during the COVID-19 pandemic. Symptoms of anxiety and depression in cancer patients were screened using the Hospital Anxiety and Depression Scale (HADS). We present preliminary results of a large study. Twenty patients replied to this survey until now. Results Mean age of interviewed patients was 47 years [30-67 years]. Eleven patients (55%) had metastatic disease. We reported 14 complete/partial responses (70%), 3 stable diseases (15%) and 3 progressive diseases (15%). About marital status, 14 (70%) were married, 2 (10%) divorced, 41(5%) widowed and 3 (15%) were single. Five women (25%) wanted to see a psychiatrist. The incidence of depression was 35% (7/20). Six patients (86%) had mild depression and one patient (14%) moderate depression. The incidence of anxiety was 25% (5/ 20). of those patients, 3 (60%) were experiencing mild anxiety, one patient (20%) moderate anxiety and one (20%) severe anxiety. There were no correlations between anxiety or depression and age, educational or socioeconomic level, marital status, breast cancer stage and treatment delays during COVID. Conclusions This study showed high rates of depression and anxiety during the COVID-19 pandemic. A psychological care should be offered to breast cancer patients.
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TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: COVID Pneumonia is associated with high morbidity and mortality accounting for 3 million deaths worldwide. This aim of this study is to identify risk factors related to mortality in patients admitted to the hospital with COVID Pneumonia and to compare baseline characteristics and outcomes of different racial groups. METHODS: This is a retrospective observational study of patients 18 years and older who were admitted to an academic medical center between March to May of 2020. Categorical variables were reported as counts and percentages, using Chi Square or Exact Fischer test. Continuous variables were reported in means and standard deviation using Student T test. Logistic regression was performed to identify factors associated with mortality. RESULTS: 190 patients were included in the study, 157 (82.63%) were African American (AA). AA patients had significantly higher weight, BMI and creatinine on admission. Prevalence of chronic kidney disease (CKD) was significantly higher in AA patients while the prevalence of atrial fibrillation was higher in non-AA patients. There was no difference in all-cause mortality between non-AA and AA groups (27.27% VS 20.38%, p=0.38). Factors that were associated with all-cause mortality included underlying CVA (OR=2.84, p<0.01, CI (1.3, 6.22)), thrombocytopenia (OR=0.99, p<0.01, CI (0.98, 0.99)), acute kidney injury (OR=2.95, p<0.01, CI (1.45, 6)), elevated alkaline phosphatase (OR=1.006, p=0.035, CI (1.0004, 1.01)), elevated D dimer (OR=1.0003, p<0.01, CI (1.00008, 1.0006)), elevated CRP (OR=1.1, p<0.01, CI (1.04, 1.16)), acute respiratory distress syndrome (ARDS) (OR=11.17, p<0.01, CI (4.9, 25.46)), intubation (OR=22.56, p<0.01, CI (9.49, 53.66)), vasopressor requirement (OR=14.77, p<0.01, CI (6.36, 34.3)) and use of hydroxychloroquine (OR=25.37, p<0.01, CI (2.96, 217.55)). Multi-variable logistic regression was used to control for confounding and race was not associated with mortality (OR=0.25, p=0.21, CI (0.03,2.19)). CONCLUSIONS: In patients with COVID pneumonia, organ dysfunction and the use of Hydroxychloroquine were factors associated with increased mortality. Despite significant differences in baseline weight, BMI, prevalence of AF and CKD among AA and non-AA patients, there was no significant difference in mortality between the 2 groups. CLINICAL IMPLICATIONS: Clinicians should consider early close monitoring of patients with COVID19 pneumonia and evidence of end organ dysfunction since there seems to be an association with increased mortality. Based on our retrospective study the use of hydroxychloroquine should be avoided in this patient population. DISCLOSURES: No relevant relationships by Adekola Adedeji, source=Web Response No relevant relationships by Prangthip Charoenpong, source=Web Response No relevant relationships by Nour Daoud, source=Web Response No relevant relationships by Deon Ford, source=Web Response No relevant relationships by Nasim Motayar, source=Web Response No relevant relationships by Diana Song, source=Web Response
ABSTRACT
Background: The COVID-19 pandemic was confirmed to have reached Tunisia on March 2nd, 2020, and has therefore disrupted oncology practice ever since. We report the main difficulties encountered by oncologists across the country during the pandemic. Methods: We conducted a national online survey on medical, surgical, and radiation oncologists to investigate their practice changes during the COVID-19 pandemic from March 2020 to January 2021. Results: 136 oncologists responded to the survey (surgical oncologists 35.8%, medical oncologists 37.8%, and radiation oncologists 26.4%);80% were working in public hospitals. Among oncologists working in the public sector, 59% were asked to join covid-19 units. Five percent stated that their cancer care units were requisitioned for the management of COVID-19 patients and therefore, their patients were referred to other hospitals to pursue their treatment. Moreover, when comparing the number of new cancer cases diagnosed during and before covid-19, 63% of the surveyed oncologists reported a decrease in the number of new cases while 27% stated that the number was stable. During the lockdown, 45% of the participants noted that only 25 to 50% of their patients attended the follow-up visits and that 83% of them missed their CT imaging appointments. On the other hand, 62% of the surveyed oncologists stated that their patients experienced delayed curative surgeries, and 41% had chemotherapy delays. Decreased consultations at the emergency oncology departments were reported by 88% of the oncologists. Besides, 40% of oncologists reported that they adopted telemedicine to monitor patients during the lockdown, and, 48 % stated that they participated in videoconferences to learn about patients’ management during the pandemic. Finally, 46% of the surveyed oncologists reported losing patients due to the COVID-19 infection, which was a trigger for anxiety symptoms in 35% of the participants. Conclusions: Oncologists reported deleterious effects of COVID-19 on oncology practice and patients’ management. Establishing standardized practice guidelines during the pandemic may help to decrease oncologists’ distress and reassure them about the appropriateness of their treatment policies. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.