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1.
Journal of Patient-Reported Outcomes ; 6(1), 2022.
Article in English | ProQuest Central | ID: covidwho-1837078

ABSTRACT

BackgroundWe aimed to create a questionnaire to assess the health-related quality of life including functioning, symptoms, and general health status of adult patients with current or previous COVID-19. Here, we report on Phase I and II of the development.MethodsInternationally recognized methodology for questionnaire development was followed. In Phase I, a comprehensive literature review was performed to identify relevant COVID-19 issues. Decisions for inclusion, exclusion, and data extraction were completed independently in teams of two and then compared. The resulting issues were discussed with health care professionals (HCPs) and current and former COVID-19 patients. The input of HCPs and patients was carefully considered, and the list of issues updated. In Phase II, this updated list was operationalized into items/questions.ResultsThe literature review yielded 3342 publications, 339 of which were selected for full-text review, and 75 issues were identified. Discussions with 44 HCPs from seven countries and 52 patients from six countries showed that psychological symptoms, worries, and reduced functioning lasted the longest for patients, and there were considerable discrepancies between HCPs and patients concerning the importance of some of the symptoms. The final list included 73 issues, which were operationalized into an 80-item questionnaire.ConclusionThe resulting COVID-19 questionnaire covers health–related quality of life issues relevant to COVID-19 patients and is available in several languages. The next steps include testing of the applicability and patients’ acceptability of the questionnaire (Phase IIIA) and preliminary psychometric testing (Phase IIIB).

2.
JMIR Ment Health ; 9(4): e36217, 2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1731692

ABSTRACT

BACKGROUND: Although the COVID-19 pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of preexisting mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated; however, the uptake and usage of the app among older veterans have not been explored. OBJECTIVE: The purpose of this study was to characterize smartphone ownership rates among US veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app. METHODS: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3078 US military veterans before and 1 year into the pandemic. The NHRVS sample was drawn from KnowledgePanel, a research panel of more than 50,000 households maintained by Ipsos, Inc. The median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peripandemic follow-up assessment on a mobile device (n=814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n=34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020, and November 7, 2021. RESULTS: We found that most US veterans (81.5%) own smartphones, and that veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related posttraumatic stress disorder symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach were relatively low (3.3% of eligible participants, n=34), 50% of the participants returned to the app for more than 1 day of use. The interactive tools for managing stress were used most frequently. CONCLUSIONS: The COVID-19 pandemic has increased the need for and creation of digital mental health tools. However, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools such as apps to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-319204

ABSTRACT

Since May 2020, several COVID-19 outbreaks have occurred in the German meat industry despite various protective measures, and temperature and ventilation conditions were considered as possible high-risk factors. This cross-sectional study examined meat and poultry plants to examine possible risk factors. Companies completed a self-administered questionnaire on the work environment and protective measures taken to prevent SARS-CoV-2 infection. Multivariable logistic regression analysis adjusted for the possibility to distance at least 1.5 meters, break rules, and employment status was performed to identify risk factors associated with COVID-19 cases. Twenty-two meat and poultry plants with 19,072 employees participated. The prevalence of COVID-19 in the seven plants with more than 10 cases was 12.1% and was highest in the deboning and meat cutting area with 16.1%. A subsample analysis where information on maximal ventilation rate per employee was available revealed an effect for ventilation rate (adjusted odds ratio (AOR) 0.996, 95% CI 0.993-0.999). When including temperature as an interaction term in the working area, the effect of the ventilation rate did not change. Increasing room temperatures resulted in a lower chance of obtaining a positive COVID-19 test result (AOR 0.90 95% CI 0.82-0.99), and a 0.1% greater chance of a positive COVID-19 test for the interaction term (AOR 1.001, 95% CI 1.000-1.003). Our results further indicate that climate conditions and low outdoor air flow are factors that can promote the spread of SARS-CoV-2 aerosols. A possible requirement for pandemic mitigation strategies in industrial workplace settings is to increase the ventilation rate.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-306555

ABSTRACT

Study Objectives: To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD. Methods: Participants were 122 adolescents (ages 15-17;61% male;48% with ADHD). Parents reported on adolescents’ sleep duration and difficulties initiating and maintaining sleep (DIMS);adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019-February 2020) and during (May-June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19. Results: Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically-elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19. Conclusions: COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.

5.
Archives of Disease in Childhood ; 106(Suppl 1):A222-A223, 2021.
Article in English | ProQuest Central | ID: covidwho-1443448

ABSTRACT

BackgroundBulky hand-written notes and frequent staff changeovers (due to on-call shift patterns) mean that details of plans for complex or long stay patients can be missed. Muddled verbal handovers are tiresome and things can be forgotten at the end of busy night shift. Wading through paper notes can be unnecessarily time consuming, making onward referral harder and slower, and mistakes more likely if the clinical problem is difficult to understand. Most paediatric patients are discharged before 7 days, so patients that stay longer than this are likely to have more complex medical needs. This project was conducted at a busy London DGH during the Covid-19 pandemic.ObjectivesThe overall objectives of the project are toReduce the amount of time wasted reading through paper notes to understand the clinical history.For all staff to be able to easily understand the clinical problem and execute the next steps of the management planReduce the potential for patient harm through missed clinical plansPrompt teams to consider differentials and alternative management options in challenging clinical scenariosMethodsRetrospective data was analysed to see the numbers of patients admitted for ≥7 days to get an idea of the scope of the problem. Diagnostic data was gathered using a fishbone diagram to explore the issues surrounding the problem. The Model for Improvement method was used to plan and execute the project. Various change ideas were considered as part of this project and a questionnaire was sent to junior doctors within the department to gauge current feelings about difficulties around making referrals for complex patients.ResultsOver an 8 week period, there were between 1–4 patients each week that fulfilled the criteria of admission ≥ 7 days, with the longest staying for 3 weeks. Each of these patients were discussed with at least one referral centre during their admission and several were diagnostically challenging.Paediatric juniors were surveyed to gather objective and subjective data on current practise. 13 people responded;69% had spent >10 minutes going through patient notes prior to making a referral. 75% felt they spent ‘considerable time’ going through patient notes to make a referral, 76% felt it took longer than necessary and 69% felt that despite this they had still missed important parts of the history.A weekly proforma was developed to summarise patient notes for anyone admitted for ≥7 days;this has been developed and improved through a series of Plan-Do-Study-Act cycles and will be introduced alongside restarting the weekly complex patient MDT meeting.ConclusionsInitial data indicates that there are enough patients admitted to the Paediatric ward for ≥7 days on a regular basis to merit an intervention. Feedback from colleagues indicates that navigating complex patient notes is a source of frustration and that there is a need to summarise them more effectively. Progress has been delayed due to the Covid-19 pandemic as the Paediatric ward was closed for several months. However now the ward has re-opened there is opportunity to move this project forward, and implement a positive change.

6.
Archives of Disease in Childhood ; 106(Suppl 1):A151, 2021.
Article in English | ProQuest Central | ID: covidwho-1443422

ABSTRACT

BackgroundClinical Governance (CG) underpins the daily practice of doctors, nurses and allied health professionals (AHPs), affecting how we care for patients as well as ongoing education and aspiration to excellence.The 7 pillars of Clinical Governance, namely: Risk Management, Clinical Audit, Education and Training, Clinical Effectiveness, Information, Patient Experience and Staff Management influence every aspect of working. However, involvement in clinical governance is frequently seen as the remit of consultants and senior managers, and can feel far removed from junior doctors, nurses and others on the ground day-to-day.This project took place across the general paediatric and neonatal departments of a busy London District General Hospital. It was conducted during the Covid-19 pandemic, with its additional pressures.ObjectivesThe aim of this project was to:Gauge levels of knowledge, awareness and involvement in CG amongst the entire paediatric and neonatal teams.Raise the profile of CG.Investigate ways of disseminating information from CG activity, including meetings, rapid reviews, serious incident reports.Begin a monthly CG newsletter.Run other CG-based teaching and activities aimed at increasing awareness.MethodsQuality Improvement methodology was followed, using the Model for Improvement.An initial questionnaire of junior and senior doctors, nurses and AHPs evaluated understanding of CG, most effective ways of communication, reading habits of existing departmental bulletins, and areas of CG participants wished to learn more about. This was used to generate change ideas.MeasureWe surveyed the same group monthly on their perceived knowledge, involvement and awareness of CG. This generated a score out of 12.7 Plan-Do-Study-Act cycles were carried out (to date):Choosing name of a new monthly newsletter by competition,A monthly Clinical Governance newsletter ‘The Chaterpillar’, communicating learning points from CG activity;‘Greatix of the month’;CG Pillar of the month;and advertising upcoming learning events,Seminar on Quality Improvement,Simulation training based on a serious incident involving an adolescent in a mental health crisis,Teaching following a pharmacology rapid review,Interactive Clinical Governance teachingReflections on ‘Journey of a Datix’ResultsMultiple changes were adopted into the fabric of the department, including the monthly CG newsletter, regular mental health-based simulation training, and clinical governance in the teaching timetable.Although the measure across the three months showed the median score of knowledge, involvement and awareness of CG remained unchanged, there was greater participation of junior doctors, nurses and AHPs in subsequent surveys. The consultant’s scores were generally high, so this consistency implied greater multidisciplinary involvement was occurring within the department.ConclusionsClinical Governance remains the foundation of clinical activity, and quality improvement methodology has brought about change within our department. Further change ideas include a ‘Clinical Governance Week’ and greater involvement of nurses. The project (still in progress) has led to lasting impact and enrichment of the paediatric department.There is new involvement, ideas and energy to be harnessed beyond the traditional senior management, enabling lasting improvement in clinical practice for our department and beyond, as more individuals are empowered with the knowledge and skills required to be tomorrow’s leaders.

7.
Qual Life Res ; 30(12): 3367-3381, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1274900

ABSTRACT

PURPOSE: This systematic review was performed to identify all relevant health-related quality of life (HRQoL) issues associated with COVID-19. METHODS: A systematic literature search was undertaken in April 2020. In four teams of three reviewers each, all abstracts were independently reviewed for inclusion by two reviewers. Using a pre-defined checklist of 93 criteria for each publication, data extraction was performed independently by two reviewers and subsequently compared and discussed. If necessary, a third reviewer resolved any discrepancies. The search was updated in February 2021 to retrieve new publications on HRQoL issues including issues related to the long-term consequences of COVID-19. RESULTS: The search in April 2020 identified 3342 potentially relevant publications, and 339 publications were selected for full-text review and data extraction. We identified 75 distinct symptoms and other HRQoL issues categorized into 12 thematic areas; from general symptoms such as fever, myalgia, and fatigue, to neurological and psychological issues. The updated search revealed three extra issues experienced during active disease and long-term problems with fatigue, psychological issues and impaired cognitive function. CONCLUSION: This first comprehensive systematic review provides a detailed overview of the wide range of HRQoL issues experienced by patients with COVID-19 throughout the course of the disease. It demonstrates the devastating impact of the disease and provides critically important information for clinicians, to enable them to better recognize the disease and to provide knowledge important for treatment and follow-up. The results provided the foundation for the international development of a COVID-19 specific patient-reported HRQoL questionnaire.


Subject(s)
COVID-19/psychology , Quality of Life/psychology , COVID-19/epidemiology , Fatigue , Humans , Pandemics , Patient Reported Outcome Measures , SARS-CoV-2 , Surveys and Questionnaires
8.
PLoS One ; 16(6): e0242456, 2021.
Article in English | MEDLINE | ID: covidwho-1264207

ABSTRACT

Since May 2020, several COVID-19 outbreaks have occurred in the German meat industry despite various protective measures, and temperature and ventilation conditions were considered as possible high-risk factors. This cross-sectional study examined meat and poultry plants to assess possible risk factors. Companies completed a self-administered questionnaire on the work environment and protective measures taken to prevent SARS-CoV-2 infection. Multivariable logistic regression analysis adjusted for the possibility to distance at least 1.5 meters, break rules, and employment status was performed to identify risk factors associated with COVID-19 cases. Twenty-two meat and poultry plants with 19,072 employees participated. The prevalence of COVID-19 in the seven plants with more than 10 cases was 12.1% and was highest in the deboning and meat cutting area with 16.1%. A subsample analysis where information on maximal ventilation rate per employee was available revealed an association with the ventilation rate (adjusted odds ratio (AOR) 0.996, 95% CI 0.993-0.999). When including temperature as an interaction term in the working area, the association with the ventilation rate did not change. When room temperatures increased, the chance of testing positive for COVID-19 (AOR 0.90 95% CI 0.82-0.99) decreased, and the chance for testing positive for COVID-19for the interaction term (AOR 1.001, 95% CI 1.000-1.003) increased. Employees who work where a minimum distance of less than 1.5 m between workers was the norm had a higher chance of testing positive (AOR 3.61; 95% CI 2.83-4.6). Our results further indicate that climate conditions and low outdoor air flow are factors that can promote the spread of SARS-CoV-2 aerosols. A possible requirement for pandemic mitigation strategies in industrial workplace settings is to increase the ventilation rate.


Subject(s)
COVID-19/transmission , Food Industry , Workplace , COVID-19/epidemiology , Cross-Sectional Studies , Disease Outbreaks , Employment , Food Industry/organization & administration , Germany/epidemiology , Humans , Meat Products/supply & distribution , Risk Factors , SARS-CoV-2/isolation & purification , Temperature , Ventilation , Workplace/organization & administration
9.
J Med Internet Res ; 23(3): e26559, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1133838

ABSTRACT

BACKGROUND: The COVID-19 pandemic has significantly impacted mental health and well-being. Mobile mental health apps can be scalable and useful tools in large-scale disaster responses and are particularly promising for reaching vulnerable populations. COVID Coach is a free, evidence-informed mobile app designed specifically to provide tools and resources for addressing COVID-19-related stress. OBJECTIVE: The purpose of this study was to characterize the overall usage of COVID Coach, explore retention and return usage, and assess whether the app was reaching individuals who may benefit from mental health resources. METHODS: Anonymous usage data collected from COVID Coach between May 1, 2020, through October 31, 2020, were extracted and analyzed for this study. The sample included 49,287 unique user codes and 3,368,931 in-app events. RESULTS: Usage of interactive tools for coping and stress management comprised the majority of key app events (n=325,691, 70.4%), and the majority of app users tried a tool for managing stress (n=28,009, 58.8%). COVID Coach was utilized for ≤3 days by 80.9% (n=34,611) of the sample whose first day of app use occurred within the 6-month observation window. Usage of the key content in COVID Coach predicted returning to the app for a second day. Among those who tried at least one coping tool on their first day of app use, 57.2% (n=11,444) returned for a second visit; whereas only 46.3% (n=10,546) of those who did not try a tool returned (P<.001). Symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) were prevalent among app users. For example, among app users who completed an anxiety assessment on their first day of app use (n=4870, 11.4% of users), 55.1% (n=2680) reported levels of anxiety that were moderate to severe, and 29.9% (n=1455) of scores fell into the severe symptom range. On average, those with moderate levels of depression on their first day of app use returned to the app for a greater number of days (mean 3.72 days) than those with minimal symptoms (mean 3.08 days; t1=3.01, P=.003). Individuals with significant PTSD symptoms on their first day of app use utilized the app for a significantly greater number of days (mean 3.79 days) than those with fewer symptoms (mean 3.13 days; t1=2.29, P=.02). CONCLUSIONS: As the mental health impacts of the pandemic continue to be widespread and increasing, digital health resources, such as apps like COVID Coach, are a scalable way to provide evidence-informed tools and resources. Future research is needed to better understand for whom and under what conditions the app is most helpful and how to increase and sustain engagement.


Subject(s)
COVID-19/psychology , Mobile Applications/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , Data Science , Female , Humans , Male , Mental Health , Pandemics , SARS-CoV-2/isolation & purification
10.
Sleep ; 44(8)2021 08 13.
Article in English | MEDLINE | ID: covidwho-1101871

ABSTRACT

STUDY OBJECTIVES: To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD. METHODS: Participants were 122 adolescents (ages 15-17; 61% male; 48% with ADHD). Parents reported on adolescents' sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019 to February 2020) and during (May-June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19. RESULTS: Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19. CONCLUSIONS: COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.


Subject(s)
Attention Deficit Disorder with Hyperactivity , COVID-19 , Sleep Wake Disorders , Adolescent , Attention Deficit Disorder with Hyperactivity/epidemiology , Female , Humans , Male , Pandemics , Prospective Studies , SARS-CoV-2 , Sleep , Sleep Wake Disorders/epidemiology
11.
Eur J Epidemiol ; 36(2): 213-218, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1047292

ABSTRACT

Since the beginning of the COVID-19 pandemic, data have been accumulated to examine excess mortality in the first half of 2020. Mortality in the preceding year or years is used to calculate the expected number of deaths, which is then compared with the actual number of deaths in 2020. We calculated weekly age- and sex-specific mortality rates for 93.1% of the Italian municipalities for the years 2015-2019 and for the first 26 weeks in 2020. We assumed the mortality experience during 2015-2019 as the reference period to calculate standardised mortality ratios. Furthermore, in order to compare the mortality experience of males and females, we calculated sex- and age- specific weekly direct standardised mortality rates and differences between the observed and expected number of deaths. We observed considerable changes in the demographics in the Italian population between the years 2015 and 2020, particularly among people 60 years and older and among males. The population is aging and the proportion of elderly males has increased, which was not reflected adequately in previous estimates of excess mortality. Standardized excess mortality results show that in Italy between the 8th and 26th weeks in 2020, there were 33,035 excess deaths, which is only 643 fewer deaths than the official COVID-19 death toll for this time period. A comparative increase in the mortality rates was observed in March among both sexes, but particularly for males. Comparisons with recently published data show considerably higher excess deaths, but these data were either not covering the complete country or did not account for age and sex. Neglecting the demographic changes in a region, even over a short time span, can result in biased estimates.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Italy/epidemiology , Male , Middle Aged , Pandemics , SARS-CoV-2 , Sex Distribution , Young Adult
12.
Anesth Analg ; 131(2): 403-409, 2020 08.
Article in English | MEDLINE | ID: covidwho-663546
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