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2.
J Acad Nutr Diet ; 2022 Sep 06.
Article in English | MEDLINE | ID: covidwho-2131313

ABSTRACT

Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.

3.
Alzheimers Dement (N Y) ; 8(1): e12348, 2022.
Article in English | MEDLINE | ID: covidwho-2047953

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19) has caused >3.5 million deaths worldwide and affected >160 million people. At least twice as many have been infected but remained asymptomatic or minimally symptomatic. COVID-19 includes central nervous system manifestations mediated by inflammation and cerebrovascular, anoxic, and/or viral neurotoxicity mechanisms. More than one third of patients with COVID-19 develop neurologic problems during the acute phase of the illness, including loss of sense of smell or taste, seizures, and stroke. Damage or functional changes to the brain may result in chronic sequelae. The risk of incident cognitive and neuropsychiatric complications appears independent from the severity of the original pulmonary illness. It behooves the scientific and medical community to attempt to understand the molecular and/or systemic factors linking COVID-19 to neurologic illness, both short and long term. Methods: This article describes what is known so far in terms of links among COVID-19, the brain, neurological symptoms, and Alzheimer's disease (AD) and related dementias. We focus on risk factors and possible molecular, inflammatory, and viral mechanisms underlying neurological injury. We also provide a comprehensive description of the Alzheimer's Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 infection (CNS SC2) harmonized methodology to address these questions using a worldwide network of researchers and institutions. Results: Successful harmonization of designs and methods was achieved through a consensus process initially fragmented by specific interest groups (epidemiology, clinical assessments, cognitive evaluation, biomarkers, and neuroimaging). Conclusions from subcommittees were presented to the whole group and discussed extensively. Presently data collection is ongoing at 19 sites in 12 countries representing Asia, Africa, the Americas, and Europe. Discussion: The Alzheimer's Association Global Consortium harmonized methodology is proposed as a model to study long-term neurocognitive sequelae of SARS-CoV-2 infection. Key Points: The following review describes what is known so far in terms of molecular and epidemiological links among COVID-19, the brain, neurological symptoms, and AD and related dementias (ADRD)The primary objective of this large-scale collaboration is to clarify the pathogenesis of ADRD and to advance our understanding of the impact of a neurotropic virus on the long-term risk of cognitive decline and other CNS sequelae. No available evidence supports the notion that cognitive impairment after SARS-CoV-2 infection is a form of dementia (ADRD or otherwise). The longitudinal methodologies espoused by the consortium are intended to provide data to answer this question as clearly as possible controlling for possible confounders. Our specific hypothesis is that SARS-CoV-2 triggers ADRD-like pathology following the extended olfactory cortical network (EOCN) in older individuals with specific genetic susceptibility.The proposed harmonization strategies and flexible study designs offer the possibility to include large samples of under-represented racial and ethnic groups, creating a rich set of harmonized cohorts for future studies of the pathophysiology, determinants, long-term consequences, and trends in cognitive aging, ADRD, and vascular disease.We provide a framework for current and future studies to be carried out within the Consortium. and offers a "green paper" to the research community with a very broad, global base of support, on tools suitable for low- and middle-income countries aimed to compare and combine future longitudinal data on the topic.The Consortium proposes a combination of design and statistical methods as a means of approaching causal inference of the COVID-19 neuropsychiatric sequelae. We expect that deep phenotyping of neuropsychiatric sequelae may provide a series of candidate syndromes with phenomenological and biological characterization that can be further explored. By generating high-quality harmonized data across sites we aim to capture both descriptive and, where possible, causal associations.

4.
de Erausquin, Gabriel A.; Snyder, Heather, Brugha, Traolach S.; Seshadri, Sudha, Carrillo, Maria, Sagar, Rajesh, Huang, Yueqin, Newton, Charles, Tartaglia, Carmela, Teunissen, Charlotte, Håkanson, Krister, Akinyemi, Rufus, Prasad, Kameshwar, D'Avossa, Giovanni, Gonzalez‐Aleman, Gabriela, Hosseini, Akram, Vavougios, George D.; Sachdev, Perminder, Bankart, John, Mors, Niels Peter Ole, Lipton, Richard, Katz, Mindy, Fox, Peter T.; Katshu, Mohammad Zia, Iyengar, M. Sriram, Weinstein, Galit, Sohrabi, Hamid R.; Jenkins, Rachel, Stein, Dan J.; Hugon, Jacques, Mavreas, Venetsanos, Blangero, John, Cruchaga, Carlos, Krishna, Murali, Wadoo, Ovais, Becerra, Rodrigo, Zwir, Igor, Longstreth, William T.; Kroenenberg, Golo, Edison, Paul, Mukaetova‐Ladinska, Elizabeta, Staufenberg, Ekkehart, Figueredo‐Aguiar, Mariana, Yécora, Agustín, Vaca, Fabiana, Zamponi, Hernan P.; Re, Vincenzina Lo, Majid, Abdul, Sundarakumar, Jonas, Gonzalez, Hector M.; Geerlings, Mirjam I.; Skoog, Ingmar, Salmoiraghi, Alberto, Boneschi, Filippo Martinelli, Patel, Vibuthi N.; Santos, Juan M.; Arroyo, Guillermo Rivera, Moreno, Antonio Caballero, Felix, Pascal, Gallo, Carla, Arai, Hidenori, Yamada, Masahito, Iwatsubo, Takeshi, Sharma, Malveeka, Chakraborty, Nandini, Ferreccio, Catterina, Akena, Dickens, Brayne, Carol, Maestre, Gladys, Blangero, Sarah Williams, Brusco, Luis I.; Siddarth, Prabha, Hughes, Timothy M.; Zuñiga, Alfredo Ramírez, Kambeitz, Joseph, Laza, Agustin Ruiz, Allen, Norrina, Panos, Stella, Merrill, David, Ibáñez, Agustín, Tsuang, Debby, Valishvili, Nino, Shrestha, Srishti, Wang, Sophia, Padma, Vasantha, Anstey, Kaarin J.; Ravindrdanath, Vijayalakshmi, Blennow, Kaj, Mullins, Paul, Łojek, Emilia, Pria, Anand, Mosley, Thomas H.; Gowland, Penny, Girard, Timothy D.; Bowtell, Richard, Vahidy, Farhaan S..
Alzheimer's & dementia (New York, N. Y.) ; 8(1), 2022.
Article in English | EuropePMC | ID: covidwho-2045308

ABSTRACT

Introduction Coronavirus disease 2019 (COVID‐19) has caused >3.5 million deaths worldwide and affected >160 million people. At least twice as many have been infected but remained asymptomatic or minimally symptomatic. COVID‐19 includes central nervous system manifestations mediated by inflammation and cerebrovascular, anoxic, and/or viral neurotoxicity mechanisms. More than one third of patients with COVID‐19 develop neurologic problems during the acute phase of the illness, including loss of sense of smell or taste, seizures, and stroke. Damage or functional changes to the brain may result in chronic sequelae. The risk of incident cognitive and neuropsychiatric complications appears independent from the severity of the original pulmonary illness. It behooves the scientific and medical community to attempt to understand the molecular and/or systemic factors linking COVID‐19 to neurologic illness, both short and long term. Methods This article describes what is known so far in terms of links among COVID‐19, the brain, neurological symptoms, and Alzheimer's disease (AD) and related dementias. We focus on risk factors and possible molecular, inflammatory, and viral mechanisms underlying neurological injury. We also provide a comprehensive description of the Alzheimer's Association Consortium on Chronic Neuropsychiatric Sequelae of SARS‐CoV‐2 infection (CNS SC2) harmonized methodology to address these questions using a worldwide network of researchers and institutions. Results Successful harmonization of designs and methods was achieved through a consensus process initially fragmented by specific interest groups (epidemiology, clinical assessments, cognitive evaluation, biomarkers, and neuroimaging). Conclusions from subcommittees were presented to the whole group and discussed extensively. Presently data collection is ongoing at 19 sites in 12 countries representing Asia, Africa, the Americas, and Europe. Discussion The Alzheimer's Association Global Consortium harmonized methodology is proposed as a model to study long‐term neurocognitive sequelae of SARS‐CoV‐2 infection. Key Points The following review describes what is known so far in terms of molecular and epidemiological links among COVID‐19, the brain, neurological symptoms, and AD and related dementias (ADRD) The primary objective of this large‐scale collaboration is to clarify the pathogenesis of ADRD and to advance our understanding of the impact of a neurotropic virus on the long‐term risk of cognitive decline and other CNS sequelae. No available evidence supports the notion that cognitive impairment after SARS‐CoV‐2 infection is a form of dementia (ADRD or otherwise). The longitudinal methodologies espoused by the consortium are intended to provide data to answer this question as clearly as possible controlling for possible confounders. Our specific hypothesis is that SARS‐CoV‐2 triggers ADRD‐like pathology following the extended olfactory cortical network (EOCN) in older individuals with specific genetic susceptibility. The proposed harmonization strategies and flexible study designs offer the possibility to include large samples of under‐represented racial and ethnic groups, creating a rich set of harmonized cohorts for future studies of the pathophysiology, determinants, long‐term consequences, and trends in cognitive aging, ADRD, and vascular disease. We provide a framework for current and future studies to be carried out within the Consortium. and offers a “green paper” to the research community with a very broad, global base of support, on tools suitable for low‐ and middle‐income countries aimed to compare and combine future longitudinal data on the topic. The Consortium proposes a combination of design and statistical methods as a means of approaching causal inference of the COVID‐19 neuropsychiatric sequelae. We expect that deep phenotyping of neuropsychiatric sequelae may provide a series of candidate syndromes with phenomenological and biologic l character zation that can be further explored. By generating high‐quality harmonized data across sites we aim to capture both descriptive and, where possible, causal associations.

6.
Compr Psychiatry ; 118: 152346, 2022 10.
Article in English | MEDLINE | ID: covidwho-1982871

ABSTRACT

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.


Subject(s)
Behavior, Addictive , COVID-19 , Gambling , Behavior, Addictive/diagnosis , Behavior, Addictive/epidemiology , COVID-19/epidemiology , Female , Gambling/epidemiology , Humans , Internet , Male , Pandemics
7.
Gastroenterology ; 162(7):S-1008, 2022.
Article in English | EMBASE | ID: covidwho-1967396

ABSTRACT

BACKGROUND: Immune-modulating medications for inflammatory bowel diseases (IBD) have been associated with suboptimal vaccine responses. There is conflicting data with SARS-CoV-2 vaccination. METHODS: We measured SARS-CoV-2 vaccine immunogenicity at 2 weeks post 2nd mRNA vaccine in IBD patients as compared to normal healthy donors (NHD). We measured humoral immune responses to SARS-CoV-2: anti-spike Immunoglobulin G (IgG) and anti-receptor binding domain (RBD) IgG were measured by ELISA, and neutralizing antibody titers were measured using recombinant, reporter SARS-CoV-2. Antigen specific memory B cells were measured using recombinant SARS-CoV-2 proteins. Activation induced marker T cell (AIM) assays were performed using SARS-CoV-2 spike megapools. Immunophenotyping was performed by flow cytometry. RESULTS: We enrolled 29 patients with IBD (19 with Crohn's disease, 10 with ulcerative colitis) on infliximab (IFX) monotherapy (N=9), IFX combination therapy with a thiopurine (N=9), vedolizumab monotherapy (N= 11) as compared to matched NHD (N=12). At 2 weeks post vaccination, all subjects made detectable anti-spike IgG and anti-RBD IgG. There were no differences in anti-spike IgG titers among the different groups. IBD patients on IFX monotherapy, but not IBD patients on IFX combination therapy or vedolizumab monotherapy, had lower anti-RBD and neutralization titers as compared to NHD (p-value: 0.041 and 0.023, respectively) (Fig. 1). There were no significant differences in the percentage of spike-specific or RBD-specific memory B cells in IBD patients as compared to NHD (Fig. 1). There were no differences in the percentage of spike-specific CD4+ or CD8+ T cells in all IBD patients as compared to NHDs (Fig. 2). CONCLUSIONS: We demonstrate overall comparable and perserved cell-mediated immunity to SARS-CoV-2 vaccination in a small cohort of IBD patients treated with a range of different immune-modulating medications as compared to healthy controls. Larger numbers of patients are needed to validate these findings.

8.
Alpha Psychiatry ; 23(4): 144-154, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1954564

ABSTRACT

Some research suggests that distress, secondary to isolation and fear following COVID-19 infection, can negatively affect the long-term more than the COVID-19 infection itself. This narrative review aims to provide a global view on the neuropsychiatric consequences of COVID-19 that can be ascribed to several factors, ranging from the direct effect of infection, to the body's responses against the infection, or to the psychological sequelae of social isolation, unemployment, and fear for one's health and livelihood. Current findings show that the more severe the respiratory infection, the more likely are central nervous system (CNS) complications regarding the infection itself. The immune reactions to the infection may result in symptoms similar to chronic fatigue as well as neurocognitive deficits, which last long after the infection is gone. An increase in symptoms of depression, anxiety, and trauma-related stress may also follow upon economic fears and isolation from friends and family. The consequences of the pandemic are not limited to adults; children learning remotely and away from classmates and routine activities may develop adjustment disorders, acute stress disorder, and a variety of manifestations of grief. A summary of case reports suggests that COVID-19-related stress, economic recession, and political unrest increase the risk of suicidal behaviors and acts of violence. However, it is unknown whether manifestations of mental disorders result from social causes or whether CNS complications may be responsible.

9.
Journal of Investigative Dermatology ; 142(8, Supplement):S44, 2022.
Article in English | ScienceDirect | ID: covidwho-1936805
10.
J Psychiatr Res ; 153: 229-235, 2022 09.
Article in English | MEDLINE | ID: covidwho-1907360

ABSTRACT

BACKGROUND: The coronavirus disease 19 (COVID-19) has led to increased reliance on the internet. How problematic usage of the internet (PUI) and COVID-19 related stress and other clinical variables relate, is unknown. We hypothesised that higher PUI level would be significantly associated with higher levels of: (i) pandemic-related stress; and (ii) impulsive and compulsive symptoms and traits. METHODS: An online community-based cross-sectional survey was used for data collection. Relationships between PUI level and other variables were characterised using correlational analyses. Regression analyses determined the cumulative explanatory power of variables, with partial least squares structural equation modelling (PLS-SEM) to explore path loadings. ANOVA was used to investigate PUI level at varying lockdown levels. RESULTS: Data from 2110 participants (64.5% female), aged 18-64 years (mean: 24.3, SD: 8.1) suggested that approximately a quarter (n = 489, 23.2%) had medium to high level internet use problems. Impulsive and compulsive symptoms and traits, pandemic-stress, and age were all significantly related to PUI (p < 0.01). These associations (medium effect sizes) cumulatively explained 29% of PUI variance. PLS-SEM indicated significant contributory effects, with the association between age and PUI level mediated by impulsivity, pandemic-stress and compulsivity. DISCUSSION: Pandemic-stress, impulsive-compulsive symptoms and traits and age were related to PUI level. Enhancing resilience to stress, particularly in vulnerable populations, through lifestyle changes and implementation of adaptive coping strategies, is key to reduce risk for PUI during the COVID-19 pandemic and beyond.


Subject(s)
COVID-19 , Pandemics , Adult , COVID-19/epidemiology , Communicable Disease Control , Compulsive Behavior , Cross-Sectional Studies , Female , Humans , Internet , Male , South Africa/epidemiology
12.
J Surg Oncol ; 126(3): 407-416, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1820895

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic and associated restrictions have altered the delivery of surgical care. The purpose of this study was to explore the impact of COVID-19 on care delivery and quality of life (QOL) from the perspectives of lung cancer surgery patients, family caregivers (FCGs), and thoracic surgery teams. METHODS: Patients/FCGs enrolled in a randomized trial of a self-management intervention for lung cancer surgery preparation/recovery were invited to participate in this qualitative study. Patients/FCGs data were collected separately 1-month postdischarge. Interviews were also conducted with thoracic surgery team members. Content analysis approaches were used to develop themes. RESULTS: Forty-one respondents including 19 patients, 18 FCGs, three thoracic surgeons, and one nurse practitioner participated in the study. Patient themes included isolation, psychological distress, delayed/impacted care, and financial impact. FCGs themes included caregiving challenges, worry about COVID-19, financial hardship, isolation, and physical activity limitations. Surgical team themes included witnessing patient/FCG's distress, challenges with telehealth, communication/educational challenges, and delays in treatment. CONCLUSIONS: COVID-19 had a varied impact on care delivery and QOL for lung cancer surgery dyads. Some dyads reported minimal impact, while others experienced added psychological distress, isolation, and caregiving challenges. Surgical teams also experienced challenges in the approach used to provide care.


Subject(s)
COVID-19 , Lung Neoplasms , Aftercare , COVID-19/epidemiology , Humans , Lung Neoplasms/surgery , Pandemics , Patient Discharge , Quality of Life/psychology
13.
Journal of Mixed Methods Research ; : 15586898221084504, 2022.
Article in English | Sage | ID: covidwho-1794085

ABSTRACT

The rare circumstances of COVID-19 have transformed research toward increased dependence on online spaces. This article examines related challenges and opportunities, focusing on how philosophical and ethical implications are differentially manifest amid crisis. Anchored by a transformative perspective, our framework recognizes heightened vulnerabilities amid COVID-19;it seeks dexterous strategies for implementing qualitative strands that adapt well to a virtual context while remaining philosophically grounded and ethical. Our findings highlight issues of unequal access, disembodiment, safety and vulnerability, researcher positionality, anonymity, and the delineation between private and public spaces;we also showcase an array of virtual qualitative methods. We conclude that ethical practice in the use of online methods is likely to be broadly applicable and adaptable to the mixed methods research community.

14.
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation ; 41(4):S399-S399, 2022.
Article in English | EuropePMC | ID: covidwho-1781950

ABSTRACT

Introduction Solid organ transplant recipients (SOTR) have lower SARS-CoV-2 spike seroconversion than healthy subjects (HS) following vaccination. A breakthrough (BT) infection is defined as the detection of SARS-CoV-2 in a respiratory specimen after a person is ≥14 days after completing the recommended doses for a vaccine. We report a case of SARS-CoV-2 BT infection in a SOTR who was immunologically followed longitudinally following vaccination. Case Report A 44-year-old man with a history of non-ischemic cardiomyopathy (NICM) and end stage renal disease had undergone heart and kidney transplantation in December 2017 with thymoglobulin induction. His NICM was secondary to radiation for non-Hodgkin's lymphoma treated with autologous bone marrow transplant in 2001. Maintenance immunosuppression consisted of sirolimus 2mg daily, tacrolimus 2mg twice daily (BID), and prednisone 5mg daily at his 1st Moderna vaccine in April 2021. In anticipation of surgery, sirolimus was stopped and mycophenolate mofetil (MMF) 500mg BID was started. He was on this regimen at the time of his 2nd Moderna vaccine. Sirolimus was restarted in July and increased to 1mg daily while continuing MMF 500mg BID, tacrolimus, and prednisone. At the end of July, the patient was exposed to several family members with COVID-19. He tested positive 89 days after his 2nd Moderna vaccine (cycle threshold of 33.5). He was asymptomatic at the time, but later developed fever, myalgias, headache, and loss of taste and smell and was treated with casirivimab and imdevimab monoclonal antibody (mAb) infusion. We assessed the patient's immunologic response 14 days post 2nd Moderna vaccination and at BT infection prior to mAb infusion and compared this to HS. The patient developed SARS-CoV-2 spike-specific CD4+ T cells at 14 days post 2nd mRNA vaccine at a frequency below the average frequency for HS. At BT infection, the patient did not have SARS-CoV-2 spike-specific CD4+ T cells, partly due to virus induced lymphopenia. The patient did not develop spike-specific CD8+ T cells, spike IgG or neutralizing antibodies at 14 days post 2nd Moderna vaccination or at BT infection. Summary The patient developed SARS-CoV-2-specific CD4+ T cells following vaccination. His uneventful recovery may be secondary to these SARS-CoV-2 specific CD4+ T cells post vaccination as well as receiving mAb therapy 8 days post infection.

16.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology ; 2022.
Article in English | EuropePMC | ID: covidwho-1679152
17.
J Public Health Policy ; 43(2): 234-250, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1684196

ABSTRACT

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, created the need for an effective vaccine. Questions arose about allocating the initial limited supplies in the United States. We present four allocation models and compare their characteristics for ethically meeting the health needs of the population. The literature shares broad agreement on guiding ethical principles with those of the four proposed models for vaccine allocation, featuring the concepts of utilitarianism, prioritarianism, equity, and reciprocity. We conclude that the "Interim Framework for COVID-19 Vaccine Allocation and Distribution in the United States" from the Johns Hopkins Bloomberg School of Public Health is the most comprehensive and ethically sound. We recommend government officials and policymakers at all levels consider the principles and objectives in this model as US COVID-19 vaccination distribution efforts continue. This model may serve as an effective framework for initial vaccine distribution efforts during future epidemic and pandemic events.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics/prevention & control , Public Health , SARS-CoV-2 , United States/epidemiology
18.
J Psychiatr Res ; 148: 188-196, 2022 04.
Article in English | MEDLINE | ID: covidwho-1654823

ABSTRACT

BACKGROUND: COVID-19 has profoundly affected the work of mental health professionals with many transitioning to telehealth to comply with public health measures. This large international study examined the impact of the pandemic on mental health clinicians' telehealth use. METHODS: This survey study was conducted with mental health professionals, primarily psychiatrists and psychologists, registered with WHO's Global Clinical Practice Network (GCPN). 1206 clinicians from 100 countries completed the telehealth section of the online survey in one of six languages between June 4 and July 7, 2020. Participants were asked about their use, training (i.e., aspects of telehealth addressed), perceptions, and concerns. OUTCOMES: Since the pandemic onset, 1092 (90.5%) clinicians reported to have started or increased their telehealth services. Telephone and videoconferencing were the most common modalities. 592 (49.1%) participants indicated that they had not received any training. Clinicians with no training or training that only addressed a single aspect of telehealth practice were more likely to perceive their services as somewhat ineffective than those with training that addressed two or more aspects. Most clinicians indicated positive perceptions of effectiveness and patient satisfaction. Quality of care compared to in-person services and technical issues were the most common concerns. Findings varied by WHO region, country income level, and profession. INTERPRETATION: Findings suggest a global practice change with providers perceiving telehealth as a viable option for mental health care. Increasing local training opportunities and efforts to address clinical and technological concerns is important for meeting ongoing demands.


Subject(s)
COVID-19 , Telemedicine , Health Personnel , Humans , Mental Health , Pandemics
19.
Psychiatry ; 84(4): 362-366, 2021.
Article in English | MEDLINE | ID: covidwho-1642092
20.
J Epidemiol Community Health ; 2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1629386

ABSTRACT

BACKGROUND: Over the last 30 years, South Africa has experienced four 'colliding epidemics' of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), we evaluated national and provincial health trends and progress towards important Sustainable Development Goal targets from 1990 to 2019. METHODS: We analysed GBD 2019 estimates of mortality, non-fatal health loss, summary health measures and risk factor burden, comparing trends over 1990-2007 and 2007-2019. Additionally, we decomposed changes in life expectancy by cause of death and assessed healthcare system performance. RESULTS: Across the nine provinces, inequalities in mortality and life expectancy increased over 1990-2007, largely due to differences in HIV/AIDS, then decreased over 2007-2019. Demographic change and increases in non-communicable diseases nearly doubled the number of years lived with disability between 1990 and 2019. From 1990 to 2019, risk factor burdens generally shifted from communicable and nutritional disease risks to non-communicable disease and injury risks; unsafe sex remained the top risk factor. Despite widespread improvements in healthcare system performance, the greatest gains were generally in economically advantaged provinces. CONCLUSIONS: Reductions in HIV/AIDS and related conditions have led to improved health since 2007, though most provinces still lag in key areas. To achieve health targets, provincial governments should enhance health investments and exchange of knowledge, resources and best practices alongside populations that have been left behind, especially following the COVID-19 pandemic.

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