Recording of intellectual disability in general hospitals in England 2006-2019: Cohort study using linked datasets.

BACKGROUND: Accurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital and factors associated with the condition being unrecorded. METHODS AND FINDINGS: Retrospective cohort study using 2 linked datasets of routinely collected clinical data in England. We identified adults with diagnosed intellectual disability in a large secondary mental healthcare database and used general hospital records to investigate recording of intellectual disability when people were admitted to general hospitals between 2006 and 2019. Trends over time and factors associated with intellectual disability being unrecorded were investigated. We obtained data on 2,477 adults with intellectual disability who were admitted to a general hospital in England at least once during the study period (total number of admissions = 27,314; median number of admissions = 5). People with intellectual disability were accurately recorded as having the condition during 2.9% (95% CI 2.7% to 3.1%) of their admissions. Broadening the criteria to include a nonspecific code of learning difficulty increased recording to 27.7% (95% CI 27.2% to 28.3%) of all admissions. In analyses adjusted for age, sex, ethnicity, and socioeconomic deprivation, having a mild intellectual disability and being married were associated with increased odds of the intellectual disability being unrecorded in hospital records. We had no measure of quality of hospital care received and could not relate this to the presence or absence of a record of intellectual disability in the patient record. CONCLUSIONS: Recognition and recording of intellectual disability in adults admitted to English general hospitals needs to be improved. Staff awareness training, screening at the point of admission, and data sharing between health and social care services could improve care for people with intellectual disability.

The COVID-19 Pandemic: Quantification of Temporal Variations in Air Pollutants Before, During and Post the Lockdown in Jeddah City, Saudi Arabia

The government of Saudi Arabia imposed a strict lockdown between March and July 2020 to stop the spread of the coronavirus disease (COVID-19), which has led to a sharp decline in economic activities. The daily temporal variations of PM10, PM2.5, carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) were used to investigate the changes in air quality in response to COVID-19 lockdown control measures from January to December 2020 in Jeddah, Saudi Arabia. Meteorological parameters (wind speed, direction, temperature, relative humidity) were also analyzed to understand the changes during the pandemic. As a result, significant reductions in the concentrations of NO2 (– 44.5%), CO (– 41.5%), and PM2.5, PM10 (– 29.5%, each) were measured in the capital city of Jeddah during the quarantine compared to the pre-lockdown average. In contrast, the lockdown caused a significant increase in O3 by 41%. The changes in air quality during the COVID-19 outbreak by comparing the average pollutant concentration before lockdown (January 1–March 21, 2020) and the following 12 weeks during the partial lockdown (March 22–July 28, 2020), reveal a very significant decrease in pollutants, and consequently a significant improvement in air quality. Observed differences are attributable to changes in point source emissions associated with changes in localized activities, possibly related to decreased economic and industrial activity in response to the lockdown. The results of the present study show during the study period indicated a positive response to lockdown during the COVID-19 pandemic. Furthermore, the results can be used to establish future control measures and strategies to improve air quality.

The effect of remotely delivered lifestyle interventions on cognition in older adults without dementia: A systematic review and meta-analysis.

Up to 40% of dementias may be preventable via risk factor modification. This inference has motivated the development of lifestyle interventions for reducing cognitive decline. Typically delivered to older adults face-to-face, the COVID-19 pandemic has necessitated their adaptation for remote delivery. We systematically reviewed randomized controlled trials of remotely delivered lifestyle interventions (≥4 weeks duration and delivered >50% remotely), for adults aged ≥ 60 without dementia, examining effects on objective cognitive measures. Comparators were active (face-to-face or remote) or passive. Ten studies (n = 2967) comprising multidomain (k = 4), physical activity (k = 3) or psychosocial (k = 3) remote interventions were included. Data were synthesized using robust variance estimation meta-analysis. The pooled estimate comparing the effect of remote interventions versus comparators on cognition was not significant (g=-0.02; 95%CI [-0.14, 0.09]; p = .66); subgroup analyses by type of intervention or comparator also yielded non-significant effects. Most studies had low risk of bias. Current evidence to support remote lifestyle interventions is limited. Included studies were conducted pre-pandemic, and evaluated individual, rather than group interventions. Future studies may exploit the greater digital connectivity of older people since the pandemic. Group formats, more frequently efficacious than individual interventions in face-to-face dementia prevention trials, may be a rational approach for future remote trials.

Social connectedness and dementia prevention: Pilot of the APPLE-Tree video-call intervention during the Covid-19 pandemic.

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic reduced access to social activities and routine health care that are central to dementia prevention. We developed a group-based, video-call, cognitive well-being intervention; and investigated its acceptability and feasibility; exploring through participants' accounts how the intervention was experienced and used in the pandemic context. RESEARCH DESIGN AND METHOD: We recruited adults aged 60+ years with memory concerns (without dementia). Participants completed baseline assessments and qualitative interviews/focus groups before and after the 10-week intervention. Qualitative interview data and facilitator notes were integrated in a thematic analysis. RESULTS: 12/17 participants approached completed baseline assessments, attended 100/120 (83.3%) intervention sessions and met 140/170 (82.4%) of goals set. Most had not used video calling before. In the thematic analysis, our overarching theme was social connectedness. Three sub-themes were as follows: Retaining independence and social connectedness: social connectedness could not be at the expense of independence; Adapting social connectedness in the pandemic: participants strived to compensate for previous social connectedness as the pandemic reduced support networks; Managing social connections within and through the intervention: although there were tensions, for example, between sharing of achievements feeling supportive and competitive, participants engaged with various lifestyle changes; social connections supported group attendance and implementation of lifestyle changes. DISCUSSION AND IMPLICATIONS: Our intervention was acceptable and feasible to deliver by group video-call. We argue that dementia prevention is both an individual and societal concern. For more vulnerable populations, messages that lifestyle change can help memory should be communicated alongside supportive, relational approaches to enabling lifestyle changes.

Risk Perceptions, Attitude and Preventive Practices of Egyptians towards COVID-19 (preprint)

Background: COVID-19 is the latest global pandemic. To date, no antiviral treatment or vaccine has been explicitly recommended for it. Therefore, applying preventive measures to control its spread is the most critical intervention. Perceived risk and attitude determines population’s reaction.Objectives: study perceptions, attitude and practices towards COVID-19 among EgyptiansMethods: The study was cross-sectional using a snowball nonrandom sample from public population of Egyptian Community. They were asked to fulfill predesigned online questionnaire that was available from 16th to 24th March 2020.Results: The study included 1663 participants from all governorates of Egypt. More than half were at age group 21-30 years, 64.3% females and 85.1% students. Main source of information was social media (46.4%). Most of Participants had positive attitude and moderate degree of fear. Only 25.4% of students satisfied with distance learning, 41.4% of participants believe that they are susceptible to infection and 61% believe in seriousness of the disease. About half of participants reported that they follow preventive precautions. Majority of participants (81.3%) believe in effectiveness of these precautions. Participant’s practices were relatively satisfactory except for wearing protective masks, movement of families outside home, reducing touch of nose and eyes, and getting enough sleeping hours. Binary logistic regression identified that significant predictors of good practice were female sex, belief in susceptibility, seriousness, and effectiveness of precautions.On conclusion: Obligatory wearing of masks was an important governmental necessary step and to improve population reaction to control COVID-19, we need to promote realistic risk perceptions and effective attitudes.