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INTRODUCTION AND OBJECTIVE: Psychotropic medications have a significant impact on sexual health. Long-term usage is strongly associated with dyspareunia, decreased libido, hypogonadism and erectile dysfunction. We hypothesized that the prescription rates for psychotropic medications increased in adolescent patients during the COVID-19 pandemic because of the unprecedented stress levels on youth in isolation. Therefore, we evaluated the prescription rates of psychotropic medications as well as concurrent use of PDE5i in adolescent patients during the COVID-19 pandemic compared to the pre-pandemic era. METHOD(S): We utilized data generated from TriNetX Research Network to conduct a retrospective matched cohort study. Adolescent patients aged 10-19 presenting for outpatient evaluation were placed into two cohorts: 1) outpatient evaluation before and 2) during the COVID-19 pandemic. Patients with prior psychiatric diagnoses and those with prior use of psychotropic medications were excluded. The outcomes of interest were new prescriptions within 90 days of outpatient evaluation. Propensity score matching was performed using logistic regression to build cohorts of equal size. RESULT(S): A total of 1,612,283 adolescents pre-COVID-19 and 1,008,161 adolescents presenting during the COVID-19 pandemic for outpatient evaluations were identified. After propensity matching, a total of 1,005,408 adolescents were included in each cohort each withan average age of 14.7 +/- 2.84 and 52% female and 48% male. Prescribing of antipsychotics and benzodiazepines were more frequent during the pandemic for adolescents (RR: 1.58, 95% CI 1.01-2.2). However, they were less likely to receive antidepressants (Risk Ratio (RR): 0.6, 95% Confidence Interval (CI) 0.57-0.63), anxiolytics (RR: 0.78, 95% CI 0.75-0.81), stimulants (RR: 0.26, 95% CI 0.25-0.27), as well as mood stabilizers (RR: 0.44, 95% CI 0.39-0.49). Erectile dysfunction requiring oral PDE5i in this cohort was more frequent during the pandemic for adolescents (RR: 1.53, 95% CI 1.05-2.01). CONCLUSION(S): The rates of antipsychotic and benzodiazepine prescriptions increased during the COVID-19 global pandemic compared to preceding years. This coincided with a statistically significant increase in the prescription of PDE5i for erectile dysfunction. Adolescents may face an increased risk of sexual dysfunction as both their illness and the medications they are prescribed both have a positive association with sexual dysfunction. Clinicians must be cognizant of the fact that adolescents may face an increased risk of medication related sexual dysfunction.
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INTRODUCTION: Health care workers (HCW) have been identified as a risk group to suffer psychological burden derived from Coronavirus Disease 19 (COVID-19) pandemic. In addition, possible gender differences in the emotional reactions derived from COVID-19 pandemic have been suggested in this population. The aims of the study were to explore the impact of COVID-19 as well as possible gender differences on mental health status and suicidality in a cohort of HCW. MATERIALS AND METHODS: One thousand four hundred and thirty-two HCW responded to an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Mental health status was measured by General Health Questionnaire 28 (GHQ-28) in both time periods. RESULTS: HCW informed of a worsening in somatic symptomatology over the follow up period. Gender differences were found in all GHQ-28 dimensions as well in the total score of the questionnaire. Post-hoc analyses displayed significant interaction between the time and gender in somatic and anxiety dimensions as well as in GHQ-28 total score. Stress produced by COVID-19 spreading and the feeling of being overwhelmed at work resulted the main predictors of psychological distress although each domain is characterized by a specific set of predictors. CONCLUSIONS: Somatic reactions represent the most sensitive dimension over the follow-up period. Moreover, women are characterized by a greater psychological distress at the beginning, although these differences tend to disappear over time. Finally, a complex network of factors predicted different dimensions of psychological distress, showing the complexity of prevention in high-risk populations facing major disasters.
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New technologies are having a decisive influence on the behaviour of tourists. Nowadays, all tourists search information on the internet before enjoying any service offered by tourism companies. Consequently, online reputation is an essential component in the marketing strategy of tourism brands. On the other hand, the Covid-19 pandemic has revolutionized tourism activity since its emergence in March 2020. Its direct effects have been widely studied in the literature, but no studies have yet been conducted on the effects of this pandemic on the online reputation of tourism brands. The aim of this paper is to empirically test whether this effect exists and if so whether it has been positive or negative. For this purpose, the weekly time series between January 2017 and September 2020 of ReviewPro's Global Review Index (GRI) were analyzed for 5 of the 8 accommodation which represent "Hospederías de Extremadura" tourism brand. To achieve the objectives of this paper, a pre-Covid period and a Covid period were considered and both the median values of the GRI and the trends in both periods have been compared. The results obtained demonstrate the disruptive character that the pandemic has had on the online reputation of tourism brands. © 2022 Sánchez Rivero, M., Murillo González, L., Rodríguez Rangel, M.C..
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Introduction: Calcitonin gene-related peptide (CGRP) a is well-known to be implicated in migraine pathophysiology. Its b isoform, released mainly in the enteric nervous system, has not been as extensively studied. Previous research prompt CGRP has a role in gastrointestinal motility, as well as immune and intestinal blood flow regulation. It is postulated to help peptic ulcer healing, and immune cell migration and regulation in acute gastrointestinal infections. In COVID-19 between 2% and 50% of patients develop diarrhea, and its prevalence increases with the severity of the disease. The pathophysiology of the diarrhea in this infection is not completely clear but CGRP has been proposed to play a role in different aspects of the symptomatology. Inflammatory bowel disease (IBD), known to be associated with migraine, is a chronic gastrointestinal autoimmune disease. Neuropeptides like CGRP might play a role in the complex pathophysiology of the disease, but this has not been well established yet. On the other hand, the most frequent adverse event of new monoclonal antibodies against CGRP for migraine is constipation, which points out that the blockage may affect CGRPbeta release. Objective(s): To assess the role of CGRPbeta in two gastrointestinal disorders: COVID-19 with acute diarrhea;and IBD. Method(s): CGRPbeta were measured by ELISA (CUSABIO, China) in early morning serum samples in patients with IBD at diagnosis, as well as in COVID-19 inpatients experiencing diarrhea. We compared each group with a cohort of healthy controls matched by age and sex. Image: Results: Twenty-six COVID-19 inpatients with diarrhea were included (mean age=62+/-16 years, range 31-91 years;69.2% females) who were matched with 30 healthy controls (mean age=61+/-15 years, range 29-89 years, 66.6% women). Fifty-nine patients with early IBD (mean age 48.9+/-16.4 years, range 21-79 years;62,7% females were matched with 59 healthy controls (mean age 49.0+/-14.9 years, range 23-77 years;62,7% females). While CGRPbeta levels were significantly elevated in COVID-19 patients (6,3+/-2.6 pg/mL) vs controls (4.2+/-2.4 pg/mL) (+26.2%;p<0.01), CGRPbeta levels in patients with IBD were significantly decreased (3.1+/-1.8 pg/mL) as compared to controls (4.8+/-2.6 pg/mL) (-35.4%, p<0.001). Conclusion(s): CGRPbeta seems to exert different actions depending on the underlying conditions. While its increase with diarrhea in COVID-19 patients fits very well with the known acute effects of increase gastrointestinal motility in CGRP infusion in volunteers, the decrease in CGRPbeta levels in IBD confirm a protective role of this peptide in the homeostasis of the intestinal mucosa. These findings may help to explain the role of CGRPbeta in digestive manifestations of migraine and in the constipation seen in migraine patients on CGRP antibodies as well.
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The COVID-19 pandemic has promoted the need to take care of health at home, using M-Health systems to monitor vital signs in healthy people and in those with heart conditions. Thus, the body sensor networks (BSNs) are extremely useful for sensing and alerting when some type of health risk is identified such as arrhythmia and low oxygen levels as well as for helping to make a decision. This chapter describes a home health monitoring system to identify cardiac risk events and monitor oxygenation levels in a person using a BSN simulator and exploring the energy performance of the network, considering the IoT devices installed at home. The work is oriented toward monitoring and identifying risk events in closed spaces, and it is addressed to people with two types of conditions: (1) those with heart diseases and (2) those people who need to monitor their oxygen levels after recovering from the COVID-19 disease. © 2022 Elsevier Inc. All rights reserved.
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Public Significance Statement The global pandemic of COVID-19 shifted the clinical training of professional psychology students from in-person, to virtual, or telesupervision. Studying this particular historical event provides us with insights about the challenges and benefits of conducting telesupervision (a) on a wide scale, (b) for the first time for many professional psychology trainees, and (c) within the context of a global crisis that disrupted everyday protocols. By investigating the experiences of professional psychology trainees during this rare crisis, we are provided not only a starting point for developing best telesupervision practices overall but also best practices for clinical supervision during crises. The global pandemic, COVID-19, changed the clinical supervision landscape in professional psychology. Supervisees transitioned from in-person supervision, to virtual, or telesupervision, in some cases, with limited preparation. We used a mixed methods approach to evaluate supervisee experiences during the transition to telesupervision precipitated by the global pandemic and to provide a historical record of the impact of the pandemic on clinical training. We also assessed the relationship between the supervisory working alliance and attitudes toward telesupervision. Authors used consensual qualitative research-modified to analyze qualitative data from 324 participants. Data revealed categories of technology, organization and productivity, and communication and connection, as the top three challenges experienced by clinical supervisees. Supervisees reported flexibility and convenience and saving time and money, as the top two benefits of engaging in telesupervision during the pandemic. Quantitative data from 310 participants suggested a moderate, positive, relationship between supervisee perception of the working alliance and attitudes toward telesupervision. Implications for research, practice, and theory are discussed.
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The COVID-19 pandemic has changed the consumption habits of tourists to benefit sustainable destinations that are not overcrowded, such as rural tourism destinations. However, the periods of compulsory lockdown have had devastating effects on tourism businesses operating in rural areas and have even jeopardised their economic viability. The aim of this article is to quantify in relative terms the effects that the period of compulsory lockdown in a markedly tourist country, such as Spain, between March and May 2020 has had on rural accommodation in one of the most rural provinces of Spain (Caceres). Based on a random sample of 225 rural accommodation establishments and the consideration of various factors, statistical techniques of comparison of means and proportions were used to detect differences in the intensity of the effects of the compulsory lockdown on the economic-financial management, bookings, facilities, and input of rural accommodation establishments in the province. The results obtained show that the economic, labour, and management effects of the COVID-19 pandemic on rural tourism businesses in the province of Caceres have been very substantial. In particular, the businesses with the highest level of tourist services on supply, i.e., those that, in addition to accommodation, also offer other tourist activities, have been the most affected. In view of this situation, urgent emergency measures have been put in place at a provincial level to alleviate the economic loss and the destruction of jobs caused by this pandemic.
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The SARS-CoV-2 infection promotes a lack of control of the immune system with a predominance of a rapidly onset inflammatory response and the triggering of a cytokine storm. The objective of this review is to understand better the immune mechanisms and their lack of control activated by SARS-CoV-2. The activation of innate immunity against infection is the key factor for viral control or its progression towards COVID-19. The adaptive immune response is also disturbed by SARS-CoV-2, which enables a higher infection rate, as well as systemic immune lack of control that can trigger shock and tissue damage in different organs, death from COVID-19 or autoimmunity post-COVID-19. © 2021 Facultad de Medicina Dr. Aurelio Melean. All Rights Reserved.
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Introduction: The exhaustive registry of COVID-19 cases in patients with IBD is a unique opportunity to learn how to deal with this infection, especially in reference to the management of immunosuppressive treatment, isolation measures or if the disease is more severe in IBD patients due to immunosuppression. Aims & Methods: Aims: The aims of this study were to know the incidence and characteristics of COVID-19 in the ENEIDA cohort during the first wave of the pandemic;the outcomes among those under immunosuppressants/ biologics for IBD;the risk factors for contracting the infection and poor outcomes;and the impact of the infection after three-month followup. Methods: Prospective observational cohort study of all IBD patients with COVID-19 included in the ENEIDA registry (with 60.512 patients in that period) between March and July 2020, with at least 3 months of follow-up. Any patient with a confirmed (by PCR or SARS-CoV-2 serology) or probable (suggestive clinical picture) infection was considered as a case. Results: A total of 482 patients with COVID-19 from 63 centres were included: 247 Crohn's disease, 221 ulcerative colitis and 14 unclassified colitis;median age 52 years (IQR: 42-61), 48% women and 44% 1 comorbidity. Diagnosis was made by PCR: 62% and serology: 35%. The most frequent symptoms: fever (69%), followed by cough (63%) and asthenia (38%). During lockdown 78% followed strict isolation. 35% required hospital admission (ICU: 2.7%) and 12% fulfilled criteria for SIRS upon admission. 18 patients died from COVID-19 (mortality:3.7%). 12% stop IBD medication during COVID-19. At 3 months, taken into account all included cases, 76% were in remission of IBD. Age 50 years (OR 2.09;95% CI:1.27-3.4;p=0.004), 1 comorbidities (OR 2.28;95% CI:1.4-3.6;p=0.001), and systemic steroids <3 months before infection (OR 1.3;95%CI:1-1.6;p= 0.003), were risk factors for hospitalisation due to COVID-19. A Charlson score 2 (OR 5.4;95%CI:1.5-20.1;p=0.01) was associated with ICU admission. Age 60 years (OR 7.1;95%CI:1.8-27.4;p=0.004) and having 2 comorbidities (OR 3.9;95% CI:1.3-11.6;p=0.01) were risk factors for COVID- 19 related death. Conclusion: IBD does not seem to worsen the prognosis of COVID-19, even when immunosuppressants and biological drugs are used. Age and comorbidity are the most important prognostic factors for more severe COVID-19 in IBD patients.
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Introduction: The information regarding IBD patients with COVID-19 suggests that the factors related to bad outcome are older age and comorbidity whereas immunosuppressants do not have a significant impact worsening the disease evolution. Aims & Methods: Aims: To assess if there are differences in epidemiological, demographical, and clinical characteristics between infected and non-infected IBD patients. Methods: Case-control study in IBD patients with COVID-19 (cases) compared to IBD without COVID-19 (controls) in the period March-July/2020 within the ENEIDA registry (promoted by GETECCU and with more than 60.000 IBD patients included). Cases were matched 1:2 by age (±5y), type of disease (CD/UC), gender, and centre. All controls were selected from only one investigator blind to other clinical characteristics of the patients to avoid selection bias. Results: 482 cases and 964 controls from 63 Spanish centres were included. No differences were found within the basal characteristics including CD location, CD behaviour, extraintestinal manifestations, family history of IBD or smoking habits. Cases had ≥ 1 comorbidities (cases:43%vs. controls: 35%, p=0.01) and occupational risk (cases:27% vs. controls:10.6%, p<0.0001) in a higher proportion. Strict lock-down was the only measure demonstrating protection against COVID-19 (cases:49% vs. controls:70%, p<0.0001). There were no differences in the use of systemic steroids (p=0.19), immunosuppressants (p=0.39) or biologics (p=0.28) between cases and controls. Cases were more often treated with aminosalycilates (42% vs.34%, p=0.003). Having ≥ 1 comorbidities (OR:1.6, 95%CI: 1.2-2.1), occupational risk (OR:1.95, 95%CI:1.39-2.7) and the use of aminosalycilates (OR:1.4, 95%CI: 1-1.8) were risk factors for COVID-19. On the other hand, strict lockdown was a protective factor (OR:0.38, CI:0.29-0.49). Conclusion: Comorbidities and epidemiological risk factors are the most relevant aspects for the risk of COVID-19 in IBD patients. This risk of COVID- 19 seems to be increased by aminosalycilates but not by immunosuppressants or biologics. The attitude regarding treating IBD patients with aminosalicylates during COVID-19 pandemic deserves a deeper analysis. (Table Presented).
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On March 13, 2020, the first cases of SARS-COVID19 were detected in Uruguay. During the first weeks of the pandemic, mobility was significantly reduced under the motto: "Stay home, if you can”;it was not a mandatory but encouraged confinement. After a couple of months, there was a big drop in the number of people affected by the disease. Thus, the Municipality of Montevideo defined that a small stretch of the main avenue of the city should be converted into a pedestrian walkway on Saturday afternoons, betting on a more human and 'walkable city'. It resulted in a greater enjoyment of the city by its inhabitants, as they had more space to walk while maintaining safe distancing between pedestrians. It was also possible to promote shopping, since Ave. 18 de Julio is normally a commercial walkway. Additionally, the sound pressure levels recorded by the Municipality's stationary sound level meters located at three points along the avenue, showed a reduction of environmental sound levels in pedestrian areas, improving the acoustic quality of the walkway. Sound pressure levels on Saturday afternoons at different times of the year 2020, are compared and discussed in this paper. They have been registered during and after the initial lockdown due to the COVID-19 pandemic. © INTER-NOISE 2021 .All right reserved.
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Clinical laboratories must thrive using supportive analytical tools to maintain the cost control and profitability during economic uncertainty, the shortages of laboratorians, and public healthcare emergencies like the COVID-19 pandemic. R Programming is a comprehensive open-source and platform-independent tool that can manage large datasets and display key performance indicators through real-time dashboards. This study seeks to innovate the performance excellence framework of small-sized clinical laboratories located in the United States, using R Programming's Shiny App dashboard. It will also encourage small-sized clinical laboratories to transition into a next-generation enterprise by digitizing their decision-making tools and improve performance using data analytics. © 2020 IEEE.
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The COVID-19 pandemic has caused substantial disruptions in the tourism sector. This situation has forced sectoral actors to adopt important measures, but on the other hand, it has also generated new business opportunities. Using qualitative analysis tools, this paper analyzed the perception of businesspeople in the sector regarding the COVID-19 pandemic and outlined the measures to be adopted to help the recovery of the sector in Extremadura, an emerging inland tourist destination in the southwest of Spain. The results show that their main concern is the economic impact that the crisis is having on their businesses, along with the main measures that the tourism businesspeople are requesting to overcome this situation.