Dysfunctional breathing induces vocal cord dysfunction following COVID-19 infection

Introduction/Aim: SARS-CoV-2 (COVID-19) has affected over 60 million people world-wide. In most cases symptoms are mild, however some people have ongoing symptoms lasting longer known as 'long COVID'. Exertional breathlessness is a common complaint in these patients. Dysfunctional breathing (DB) and vocal cord dysfunction (VCD) are two underappreciated causes of breathlessness. We hypothesized that in individuals who had experienced COVID-19, dysfunctional breathing could give rise to VCD. Method(s): Nine convenience-sampled participants with confirmed COVID-19 infection were included following resolution of the acute illness. Vocal cords movements were visualised via continuous laryngoscopy. Hyperventilation was employed as a surrogate for DB, using a standard protocol of 40 breathes per minute (bpm). Participants breathed through a flow sensor with concomitant laryngoscopy, and we monitored hyperventilation, gas exchange measurements and laryngeal movements. After 12-weeks patients returned for repeat hyperventilation testing. Result(s): The nine participants consisted of five females and four males, age range 24-66 years. Three of the nine participants developed classic inspiratory VCD during hyperventilation. Patients with VCD were female, younger (<45), reported significantly reduced exercise tolerance post infection and had been physically very active prior to COVID infection. In two participants VCD associated with hyperventilation had resolved on laryngoscopy at 12-weeks. In these two participants who had VCD, breathlessness and reduced exercise tolerance resolved at 12-weeks following laryngeal retraining. In one person evidence of VCD and reduced exercise tolerance persisted post 12-weeks review. Conclusion(s): This study provides the first evidence that COVID-19 may facilitate VCD via DB, causing unexplained breathlessness. Our findings suggest that this disease process may be implicated in 'long COVID' and provide a rationale for therapies such as breathing and laryngeal retraining.

Factors associated with the quality of life of nursing home residents during the COVID-19 Pandemic: A cross-sectional study

Objectives Quality of life (QoL) of nursing home (NH) residents is critical, yet understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, lack of access to geriatric professionals, and care aide burnout were associated with NH residents' QoL. Design Cross-sectional study (Jul-Dec 2021) Setting And Participants: We purposefully selected 9 NHs in Alberta, Canada based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). We included data for 689 residents from 18 care units. Methods We used the DEMQOL-CH to assess resident QoL through video-based care aide interviews. Independent variables included COVID-19 outbreak in the NH in the last 2 weeks (health authority records), care unit-levels of care aide burnout (9-item short form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit (validated surveys), and resident covariates (Resident Assessment Instrument – Minimum Data Set 2.0). Results Recent COVID-19 outbreaks (β=0.189, 95% confidence interval [CI]: 0.058;0.320), higher proportions of emotionally exhausted care aides on a care unit (β=0.681, 95%CI: 0.246;1.115) and lack of access to geriatric professionals (β=0.216, 95%CI: 0.003;0.428) were significantly associated with poorer resident QoL. Conclusions and Implications Policies aimed at reducing infection outbreaks, better supporting staff, and increasing access to specialist providers, may help to mitigate how COVID-19 has negatively affected NH resident QoL.

Narcissism, national narcissism, COVID-19 conspiracy belief, and social media use as predictors of compliance with COVID-19 public health guidelines.

Understanding health belief models, and the variables that influence adherence to public health measures imposed by local governments and international health bodies, is crucial to slowing down the spread of the virus that causes COVID-19. Conspiracy theories about the virus have quickly spread on social media and have been linked to reluctance to comply with COVID-19 regulations. Personality traits such as narcissism and collective national narcissism have also been associated with the way we perceive severity and susceptibility to the disease. To examine this further, participants (N = 183) completed an online questionnaire measuring belief in COVID-19 conspiracies, trait narcissism, national narcissism, and social media usage. A model containing these variables was able to significantly predict adherence to COVID-19 preventative health behaviours, with higher levels of COVID-19 conspiracy belief, narcissism, and social media usage all contributing to reduced adherence to recommended COVID-19 health behaviours. The findings suggest conspiracy beliefs, narcissism, and social media play a key role in adherence to behaviours orientated towards stopping the spread of COVID-19. Governments and social media companies need to demonstrate greater awareness of the negative effects of conspiracy theories spread through social media, in addition to awareness of how these effects may be greater in more narcissistic individuals.

Changes in antidepressant use in Australia: A nationwide analysis (2015-2021).

BACKGROUND: Depression and anxiety affect 4-14% of Australians every year; symptoms may have been exacerbated during the COVID-19 pandemic. We examined recent patterns of antidepressant use in Australia in the period 2015-2021, which includes the first year of the pandemic. METHODS: We used national dispensing claims for people aged ⩾10 years to investigate annual trends in prevalent and new antidepressant use (no antidepressants dispensed in the year prior). We conducted stratified analyses by sex, age group and antidepressant class. We report outcomes from 2015 to 2019 and used time series analysis to quantify changes during the first year of the COVID-19 pandemic (March 2020-February 2021). RESULTS: In 2019, the annual prevalence of antidepressant use was 170.4 per 1000 women and 101.8 per 1000 men, an increase of 7.0% and 9.2% from 2015, respectively. New antidepressant use also increased for both sexes (3.0% for women and 4.9% for men) and across most age groups, particularly among adolescents (aged 10-17 years; 46-57%). During the first year of the COVID-19 pandemic, we observed higher than expected prevalent use (+2.2%, 95% CI = [0.3%, 4.2%]) among females, corresponding to a predicted excess of 45,217 (95% CI = [5,819, 84,614]) females dispensed antidepressants. The largest increases during the first year of the pandemic occurred among female adolescents for both prevalent (+11.7%, 95% CI = [4.1%, 20.5%]) and new antidepressant use (+15.6%, 95% CI = [8.5%, 23.7%]). CONCLUSION: Antidepressant use continues to increase in Australia overall and especially among young people. We found a differential impact of the COVID-19 pandemic in treated depression and anxiety, greater among females than males, and greater among young females than other age groups, suggesting an increased mental health burden in populations already on a trajectory of increased use of antidepressants prior to the pandemic. Reasons for these differences require further investigation.

Narcissism, national narcissism, COVID-19 conspiracy belief, and social media use as predictors of compliance with COVID-19 public health guidelines

Understanding health belief models, and the variables that influence adherence to public health measures imposed by local governments and international health bodies, is crucial to slowing down the spread of the virus that causes COVID-19. Conspiracy theories about the virus have quickly spread on social media and have been linked to reluctance to comply with COVID-19 regulations. Personality traits such as narcissism and collective national narcissism have also been associated with the way we perceive severity and susceptibility to the disease. To examine this further, participants (N = 183) completed an online questionnaire measuring belief in COVID-19 conspiracies, trait narcissism, national narcissism, and social media usage. A model containing these variables was able to significantly predict adherence to COVID-19 preventative health behaviours, with higher levels of COVID-19 conspiracy belief, narcissism, and social media usage all contributing to reduced adherence to recommended COVID-19 health behaviours. The findings suggest conspiracy beliefs, narcissism, and social media play a key role in adherence to behaviours orientated towards stopping the spread of COVID-19. Governments and social media companies need to demonstrate greater awareness of the negative effects of conspiracy theories spread through social media, in addition to awareness of how these effects may be greater in more narcissistic individuals.

Reflecting upon 30 Years of STEM Partnerships between Industry, University, and Public Schools: Past Lessons, Current Successes, and Future Dreams

The importance of partnerships is critical in educational arenas, but information on how partnerships form with the involvement of corporations, districts, and universities working in harmony is limited in the current literature. The teacher preparation program described in this paper is a “built-to-last” partnership model with over 650 teachers prepared to be teacher-leaders in science, technology, engineering, and mathematics (STEM) education. The authors provide a history of the program’s development, the sustainability of the program over time, the content of the various components of the partnership, and the evolution of the program, including its current status.

Changes in antidepressant use in Australia: A nationwide analysis prior to and during the COVID-19 pandemic (2015-2021) (preprint)

Background: Depression and anxiety affect 4% to 14% of Australians every year; symptoms may have been exacerbated during the COVID-19 pandemic. We examined recent patterns of antidepressant use in Australia in the period 2015 to 2021, which includes the first year of the pandemic. Methods: We used national dispensing claims for people aged [≥]10 years to investigate annual trends in prevalent and new antidepressant use (no antidepressants dispensed in the year prior). We conducted stratified analyses by sex, age group and antidepressant class. We report outcomes from 2015 to 2019 and used time series analysis to quantify changes during the first year of the COVID-19 pandemic (March 2020 to February 2021). Results: In 2019 the annual prevalence of antidepressant use was 170.4 per 1,000 women and 101.8 per 1,000 men, an increase of 7.0% and 9.2% from 2015, respectively. New antidepressant use also increased for both sexes (3.0% for women and 4.9% for men) and across most age groups, particularly among adolescents (aged 10-17 years; 46%-57%). During the first year of the COVID-19 pandemic, we observed higher than expected prevalent use (+2.2%, 95%CI 0.3%, 4.2%) among females, corresponding to a predicted excess of 45,217 (95%CI 5,819, 84,614) females dispensed antidepressants. The largest increases during the first year of the pandemic occurred among female adolescents for both prevalent (+11.7%, 95%CI 4.1%, 20.5%) and new antidepressant use (+15.6%, 95%CI 8.5%, 23.7%). Conclusion: Antidepressant use continues to increase in Australia overall and especially among young people. We found a differential impact of the COVID-19 pandemic in treated depression and anxiety, greater among females than males, and greater among young females than other age groups, suggesting an increased mental health burden in populations already on a trajectory of increased use of antidepressants prior to the pandemic. Reasons for these differences require further investigation.

Changes in antibiotic prescribing following COVID-19 restrictions: Lessons for post-pandemic antibiotic stewardship.

AIMS: Public health responses to reduce SARS-CoV-2 transmission have profoundly affected the epidemiology and management of other infections. We examined the impact of COVID-19 restrictions on antibiotic dispensing in Australia. METHODS: We used national claims data to investigate antibiotic dispensing trends from November 2015 to October 2020 and whether changes reflected reductions in primary care consultations. We used interrupted time series analysis to quantify changes in monthly antibiotic dispensing and face-to-face and telehealth GP consultations and examined changes by recipient age, pharmacy State and prescriber specialty. RESULTS: Over the study period, an estimated 19 921 370 people had 125 495 137 antibiotic dispensings, 71% prescribed by GPs. Following COVID-19 restrictions, we observed a sustained 36% (95% CI: 33-40%) reduction in antibiotic dispensings from April 2020. Antibiotics recommended for managing respiratory tract infections showed large reductions (range 51-69%), whereas those recommended for non-respiratory infections were unchanged. Dispensings prescribed by GPs decreased from 63.5 per 1000 population for April-October 2019 to 37.0 per 1000 for April-October 2020. Total GP consultation rates remained stable, but from April 2020, 31% of consultations were telehealth. CONCLUSION: In a setting with a low COVID-19 incidence, restrictions were associated with a substantial reduction in community dispensings of antibiotics primarily used to treat respiratory infections, coincident with reported reductions in respiratory viral infections. Our findings are informative for post-pandemic antimicrobial stewardship and highlight the potential to reduce inappropriate prescribing by GPs and specialists for respiratory viral infections.