ABSTRACT
Background: Physical activity is a key factor for maintaining health in old age. Due to the coronavirus disease 2019 (COVID-19) pandemic, studies have shown that there has been a decrease in physical activity;thus, considerations are now needed on how to (re)activate older individuals. One approach is to ask which factors had a positive influence on physical activity before the pandemic and to address these through interventions. Objectives: The aim of the study is to identify important factors of physical activity in a multivariate analysis in order to show possibilities for (re)activation. Materials and methods: For this purpose, multiple logistic regression was conducted based on data from a standardized, representative telephone survey (n = 2042) of the 60-year-old and older individuals in the Austrian state of Lower Austria, collected in early summer 2019. Results: Positive health status and motivational factors increase the chance of physical activity. The social component and the perception of physical activity as good for one’s health also increases the likelihood of exercising. Sociodemographic factors, apart from income, could not be identified as significant predictors in the model. Conclusions: In order to increase the chances of (re-)activation, measures need to be taken that understand physical activity as a means to different ends for older people. © 2022, The Author(s).
ABSTRACT
Background. National response mechanisms, including lockdown regulations and financial and food aid, have exacerbated adversity and provided support. They have also exposed existing inequalities, with individuals and families able to cope and recover to varying degrees. Families with young children, specifically those under the age of 5, are rarely the focus of outreach, although they care for the most vulnerable group in our society. Objective. To rapidly gather as much nationally representative information as possible on the challenges experienced by families with children under 5 years of age and the support they most urgently require. Methods. A short online survey was launched in late 2020 on a zero-cost mobile application reaching over 2 million users. A total of 15 912 individuals were eligible for participation and 13 224 parents (caring for 18 858 children under 5 years) were included in the analytic sample. Outcomes were grouped by (a) negative impacts of the pandemic, including disruptions in childcare, missed clinic visits, feeding challenges, difficulties in showing affection, behavioural challenges, and violence in the home;and (b) support received and required by the family. Chi-squared tests examined outcomes across the socio-demographic variables and standardised adjusted residuals were calculated to measure strength of differences. Results. Fathers made up 30% of the sample. Just over half of parents cared for one child under 5 and 41% for 2-3 children under 5. More than three-quarters (82%) of parents reported experiencing at least one challenge, with the most common being disruptions in childcare (69%), difficulties feeding their child (50%) and showing affection (41%). The main underlying factors were fear of infection, lack of money and negative affect in the household including stress, tension and a sense of hopelessness and depression. Fathers and families living in rural areas reported the most challenges. They were more likely to report difficulties showing affection, struggles in providing meals for young children, and higher levels of violence towards children in the home. Although needs considerably outweighed support received, government compared with civil society organisations and communities had the highest penetration of support to families, reaching between a quarter and a third of families. Conclusion. Families with young children face many challenges with little outside support for their material and psychosocial needs. It is essential that those mandated with ensuring the wellbeing of young children understand the needs of families and have the capacity to reach them in general, and particularly during times of crisis. © 2022, Health and Medical Publishing Group. All rights reserved.
ABSTRACT
BACKGROUND: Video consultations have proven to be an efficient source of support for patient-doctor interactions and have become increasingly used in orthopedics, especially during the COVID-19 pandemic. This study analyzed both patients' and doctors' acceptance of an orthopedic telemedical consultation (OTC) and compared the results of OTC examinations to the results of live consultation (LC) to identify discrepancies. METHODS: The study was carried out in an orthopedic department of a German hospital between 2019 and 2020. After written informed consent was obtained, patients voluntarily presented for follow-up by OTC and LC. The experience with and attitudes toward OTC among both patients and doctors was evaluated (using Likert scale-scored and open questions, 26 to 28 items). The results of the OTC and LC examinations were compared using a 12-item checklist. The data were analyzed by quantitative and qualitative statistics. RESULTS: A total of 53 patients were included, each of whom completed an OTC and an LC. The OTC was rated as pleasant, and the experience was rated as very satisfying (average rating on a 5-point Likert scale, with 1 indicating strong agreement: doctors: 1.2; patients: 1.3). Various technical and organizational challenges were identified. Compared to LC, OTC showed no significant differences in patient history or in inspection, palpation, or active range of motion results. Only for the functional or passive joint assessment did LC show significantly higher suitability (p < 0.05) than OTC. Recommendations for further procedures did not differ significantly between OTC and LC. CONCLUSIONS: Because of the high acceptance and the objective benefits of OTC and the similarity of clinical results with LC, OTC is recommendable for orthopedic follow-up examinations. To better assess joint functionality, meaningful digital alternatives for established examination methods should be further investigated.
Subject(s)
COVID-19 , Orthopedics , Telemedicine , Aftercare , Case-Control Studies , Humans , Pandemics , Referral and Consultation , SARS-CoV-2ABSTRACT
With the presence of the COVID-19 pandemic in Brazil, the demand for quick decisions by educational institutions did not advocate the realization of fundamental steps for planned distance education initiatives. In this context, we present the experience of an undergraduate degree at a Brazilian Federal University. The approach is qualitative based on a questionnaire to the interns, divided into data treated by Discursive Textual Analysis. The results are organized into: Built Activities: processes and products, in which is an audiovisual material produced and Perceptions of Interns on the Network Internship that cover three categories: (1) Difficulties benefit for the realization of the Internship in the Network Mode, (2) Evaluation of the Activities Developed in the Internship Discipline and (3) Expectations for the Internship Discipline. Our actions provided students and us with differentiated and reflective training experiences, as well as an increase in the perception of learning environments.
ABSTRACT
As the national reference laboratory for febrile illness in Madagascar, we processed samples from the first epidemic wave of COVID-19, between March and September 2020. We fit generalized additive models to cycle threshold (Ct) value data from our RT-qPCR platform, demonstrating a peak in high viral load, low-Ct value infections temporally coincident with peak epidemic growth rates estimated in real time from publicly-reported incidence data and retrospectively from our own laboratory testing data across three administrative regions. We additionally demonstrate a statistically significant effect of duration of time since infection onset on Ct value, suggesting that Ct value can be used as a biomarker of the stage at which an individual is sampled in the course of an infection trajectory. As an extension, the population level Ct distribution at a given timepoint can be used to estimate population-level epidemiological dynamics. We illustrate this concept by adopting a recently-developed, nested modeling approach, embedding a within-host viral kinetics model within a population-level Susceptible-Exposed-Infectious-Recovered (SEIR) framework, to mechanistically estimate epidemic growth rates from cross-sectional Ct distributions across three regions in Madagascar. We find that Ct-derived epidemic growth estimates slightly precede those derived from incidence data across the first epidemic wave, suggesting delays in surveillance and case reporting. Our findings indicate that public reporting of Ct values could offer an important resource for epidemiological inference in low surveillance settings, enabling forecasts of impending incidence peaks in regions with limited case reporting.