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Introduction: COVID-19 pandemic has been associated with increased rates of de-pression, anxiety, and suicidal ideation. Individuals with mental illnesses are disproportionately affected by additional complex health issues. This study aims to examine the knowledge and impact of COVID-19 among patients with mental disorders at the Harris County Psychiatric Center (HCPC). Method(s): A retrospective review of surveys was conducted for patients with mental illness at HCPC. Participants were surveyed on demographics, COVID-19 knowledge, and COVID-19 healthcare impact. The data were analyzed with SPSS 20 for Windows at a 0.05 significance level. Result(s): A total of 46 patients were included in the study. We found that the patient population with mental disorders has different methods of obtaining information regarding COVID-19 and practices varying safety measures. To be precise, more women (52.2%) than men (21.7%) learned about COVID-19 through family and friends (p=0.032). More Hispanic (21.4%) compared to non-Hispanic (0%) patients learned about COVID-19 through resources from the World Health Organization (WHO) (p=0.032). Fewer African American (AA) patients avoided contact with people who were sick (39% vs. 81%) Caucasian (p=0.01) and (100%) Asian/Native American/Pacific Islander [ANAPI] patients (p=0.04). We found more non-Hispanic (50.0%) vs. Hispanic (7.1%) patients reported that their personal time (time outside of work) was unchanged by COVID-19 (p=0.007). More Hispanic (57.1%) vs. non-Hispanic (17.9%) patients reported increased time with family members (p=0.009). Compared to Hispanic patients, more non-Hispanic patients reported unchanged difficulty scheduling appoint-ments (46.4% vs. 7.1%) (p=0.015), obtaining prescription (71.4% vs. 35.7%) (p=0.045), and finding housing placement (53.6% vs. 21.4%) (p=0.047). Furthermore, more Caucasian compared to AA patients reported more changes in how they feel (35.7% vs. 76.2%) (p=0.033), anxiety (52.6% vs. 0%) (p=0.002), stress (47.4% vs. 7.7%) (p=0.024), and sadness (30% vs. 0%) (p=0.031). Finally, more ANAPI (67%) compared to AA patients (0%) reported increased anxiety (p=0.025). Conclusion(s): Our findings suggest that African American patients report less knowledge of COVID-19 prevention and less impact on their mental health by the pandemic compared to other racial groups. Our findings suggest that African American patients may have limited knowledge of COVID-19 prevention compared to other races, Caucasian and Asian/Native American/Pacific Islander patients may have increased mood changes, and Hispanic patients may be experiencing more healthcare inequality amidst the pandemic. However, further inves-tigation of the impending ramifications of the pandemic is warranted.Copyright © 2023 Bentham Science Publishers.
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Background In May 2021, the US Food and Drug Administration (FDA) released a revised draft guidance for industry on ''Adjustment for Covariates in Randomized Clinical Trials for Drugs and Biological Products.'' This guidance discusses adjustment for covariates in the statistical analysis of randomized clinical trials in drug development programs. It specifically focuses on the use of prognostic baseline factors to improve precision for estimating treatment effects. The impact depends on the specifics of the trial, but typical sample size reductions range from 5-25% (at no cost). Despite regulators such as the FDA and the European Medicines Agency recommending covariate adjustment, it remains highly underutilized leading to inefficient trials in many disease areas. This is especially true for binary, ordinal, and time-to-event outcomes, which are quite common in COVID-19 trials and are, moreover, prevalent as primary outcomes in many disease areas (e.g. Alzheimer's disease and stroke). Research and guidance on this topic could therefore not be more timely. In response to the FDA draft guidance on covariate adjustment, this session invites experts who represent a variety of viewpoints, coming from academia and Pharmaceutical industry. The aim of this session is to provide insight into the state-of-the-art methods at a high level and from a practical perspective. We moreover want to discuss the main obstacles that lead to the underutilization of covariate adjustment, all of which we aim to surmount in this session. Finally, we want to discuss the connections of the different talks to the FDA draft guidance and provide options for better practice. Talk by Min Zhang ''Covariate adjustment for randomized clinical trials when covariates are subject to missingness.'' One practical issue that may have limited the use of covariate adjustment is that covariates are often subject to missingness. Existing statistical methodologies often ignore this issue and assume covariates are completely observed. We discuss conditions under which robust covariate adjustment can be achieved when the missingness of covariates is present. We study various methods for handling missing data and compare their performances in terms of robustness and efficiency through comprehensive simulation studies. Recommendations on strategies for handling missing covariates to achieve robust covariate adjustment are provided. Talk by Mark van der Laan on ''Targeted Learning of causal effects in randomized Trials with continuous time-to-event outcomes.'' Targeted maximum likelihood estimation (TMLE) provides a general methodology for estimation of causal parameters in the presence of high-dimensional nuisance parameters. Generally, TMLE consists of a twostep procedure that combines data-adaptive nuisance parameter estimation with semi-parametric efficiency and rigorous statistical inference obtained via a targeted update step. In this talk, we demonstrate the practical applicability of TMLE for standard survival and competing risks settings where event times are not confined to take place on a discrete and finite grid. We demonstrate TMLE updates that simultaneously target point-treatment-specific survival curves and treatmentcause- specific subdistributions in the competing risk setting, across treatment and time points. We consider the case that we only observe baseline covariates as well as the case that we also track time-dependent covariates that potentially inform censoring/drop-out. This results in estimates that are not only fully efficient, but also respect the natural monotonicity of survival functions and cause-specific subdistributions. It moreover makes sure that the sum of subdistributions and survival equals 1. We propose a super-learner for the causespecific conditional hazards that incorporate many possible Cox models as well as a variety of highly adaptive Lasso estimators. Asymptotic theoretical guarantees are given and finite-sample robust performance is demonstrated with simulations. We illustrate the usage of the considered methods for a ovo Nordisk Leader study as well as for publicly available data from a trial on adjuvant chemotherapy for colon cancer. Talk by Kelly Van Lancker on ''Combining Covariate Adjustment with Information Monitoring and Group Sequential Designs to Improve Randomized Trial Efficiency'' In this talk, we focus on the knowledge gap in statistical methodology that leads to the underutilization of covariate adjustment. A first obstacle is the uncertainty of its efficiency gain and corresponding sample size reduction at the design stage;an incorrect projection of a covariate's prognostic value risks an over- or underpowered future trial. A second open problem is the incompatibility of many covariate-adjusted estimators with the commonly used group sequential, information-based designs (GSDs). To overcome these challenges, we suggest combining covariate adjustment with information monitoring and continuing the trial until the required information level is surpassed. Since adjusted estimators typically have smaller variance than standard estimators, the information accrues faster leading to faster trials. Building on this, we propose a new statistical method that orthogonalizes estimators in order to (1) have the independent increments property needed to apply GSDs and (2) simultaneously improve (or leave unchanged) the variance at each analysis. Such a method is needed in order to fully leverage prognostic baseline variables to speed up clinical trials without sacrificing validity or power. We prove that this method has properties such as the independent increments, consistency, asymptotic normality, and correct type I error and power, and evaluate its performance in simulations and data analyses. Discussion by Frank Bretz This talk will discuss connections between the three previous presentations in the session and recommendations in the May 2021 FDA revised draft guidance for industry document on ''Adjustment for Covariates in Randomized Clinical Trials for Drugs and Biological Products.'' It will moreover touch on the broad impact of covariate adjustment for the pharmaceutical industry and provide advice on better practice.
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Aim: SARS CoV-2 transmission in healthcare personnel was first reported on January 20, 2020. The aim of this study was to evaluate the anxiety levels experienced by healthcare personnel in Turkey during the COVID-19 pandemic and the factors affecting these levels. Material(s) and Method(s): A survey investigating sociodemographic features and examining anxiety levels was conducted among approximately 1000 healthcare personnel who were expected to take active roles in the pandemic across Turkey. The survey was conducted in three stages: before the pandemic spread to Turkey, at the beginning of the pandemic and when the pandemic became prominent. A logistic regression analysis was performed to determine the factors affecting anxiety and predictors of anxiety levels. Result(s): In the first survey, always (odds ratio, 15.781;p<0.01) and often (odds ratio, 5.365;p<0.05) media use, in the second survey media use (p<0.05) and profession (odds ratio, 0.021;p<0.05) and in the third survey, marital status (odds ratio, 17.716;p<0.01) and gender (odds ratio, 4.431;p<0.05) were determined as the predictors of anxiety related to COVID-19. Discussion(s): As a result of this study, healthcare personnel groups were defined (women, nurses, married people) who need special intervention and support to provide spiritual comfort when working on the front line in the fight against COVID-19. Further comprehensive studies are needed of the extent of psychological support required by healthcare personnel and to whom and how this support should be provided.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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A documentary review was carried out on the production and publication of research papers on the study of the variables post-COVID sequelae and their influence on the lifestyles of older adults. The purpose of the bibliometric analysis proposed in this document is to know the main characteristics of the volume of publications registered in the Scopus database during the period 2020-2021, achieving the identification of 763 publications. The information provided by this platform was organized using tables and figures, categorizing the information by Year of Publication, Country of Origin, Area of Knowledge and Type of Publication. Once these characteristics were described, a qualitative analysis was used to refer to the position of different authors on the proposed topic. Among the main findings of this research, it is found that the United States, with 209 publications, was the country with the highest scientific production registered in the name of authors affiliated with institutions of that country. The area of knowledge that made the greatest contribution to the construction of bibliographic material referring to the study of post-COVID sequelae and their influence on the lifestyles of older adults was Medicine with 636 published documents, and the type of publication that was most used during the period indicated above was the journal article, which represents 89% of the total scientific production.Copyright © 2023, Anka Publishers. All rights reserved.
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Objective: The COVID-19 pandemic that has occurred over the past 2 years has had a very significant impact on various sectors, especially public health. Indonesia, which is a tropical country, especially has to deal with cases of dengue disease which are still quite high. The government's social distancing policy that was in effect during the COVID-19 pandemic caused the control and prevention of dengue fever to be neglected by the public. Purpose(s): This study aims to increase public understanding of dengue prevention through Focus Group Discussion (FGD) and Training of Trainer (TOT) approaches. Method(s): This research was conducted using 2 approaches, namely FGD and TOT, which were followed by 15 and 30 public workers participants. The FGD and TOT were carried out by discussing and giving lectures to participants, then participants were given a pre-test and post-test question sheets. Result(s): As many as 93.3% of participants already know the causes, methods of prevention, and types of dengue mosquitoes. However, there were still 60% of participants understood the handling of mosquito larvae correctly. After the FGD and TOT were carried out, it was seen that there was an increase in participants' understanding. Conclusion(s): The FGD and TOT approaches can increase public understanding of the causes, prevention, and proper inspection of DHF mosquito larvae.Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.
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Objective: To determine experiences of mental health trainees with their online classes. Methodology: It was an online cross-sectional study carried out during month of June, 2020. The sample comprised of 231 mental health trainees of BS (n = 114) and MS (n = 117) programs of a private university of Lahore. A google doc. consisting of 15 statements was prepared to for online delivery of their classes. Result(s): 45% students responded on "to some extent to no difficulty" experience of smooth running of online lectures. On the item of overall satisfaction with delivery of online lectures, 50% students (out of 114) from BS program and 51% students (out of 117) from MS program rated on "not at all" Although satisfaction was high on the online availability of teacher for the counselling of students however, on understand lectures Only 14% students showed highest level of satisfaction. Conclusion(s): Online classes remained a big challenge for trainees and it was associated with lack of satisfaction in terms of their own learning, evaluation comprehension and health issues.Copyright © 2023, Pakistan Medical Association. All rights reserved.
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Introduction: The pandemic has changed regular pattern of work in clinics. We aimed to evaluate the COVID-19 related workload and psychosocial burden, as well as the possible associated factors among the pulmonology residents in Turkey. Method(s): An online survey was sent to pulmonology residents through e-mails and messages. Result(s): Out of 200 participants, majority was female (67%), between 24-29 years (72%) of age, from university hospitals (59%), and under training in 1st wave of Covid-19 (69%). Most of the residents trained during 1st wave (86%) expressed their stress and anxiety levels as more than moderate and nearly 1/3 considered resigning. Most of the residents were unsatisfied with their jobs and job conditions, and feeling stressed, anxious, worried about contamination (Table 1). Stress and anxiety was associated with gender, residency level, previous experience in Covid-19 wards, stress level during 1st wave, resigning desire, workload, and insufficient knowledge (p<0.05). On the other hand;age, hospital type, living with kids, workload, tiredness, stress level, resigning desire were associated with depressive mood. Conclusion(s): Residents were mostly affected psychosocially by the Covid-19 crisis. Considering the modifiable factors, pulmonology residency programs should be aware of and closely monitor these effects.
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Objectives: On March 11, 2020, the World Health Organization declared the new coronavirus disease 2019 (COVID-19) as a global epidemic. This study aims to assess anesthesiology and reanimation physicians' knowledge of the anesthesiology practices published by the Turkish Republic Ministry of Health during pandemic period, their awareness in Turkey. Method(s): This descriptive cross-sectional study included 2834 anesthesiologist physicians who are members of Turkish Society of Anesthesiology and Reanimation. Data were collected online over 8 weeks using a questionnaire form by SurveyMonkey (San Mateo, CA) website after national and local ethics committee approval. Result(s): The study included 332 physicians (research associates and specialist physicians). Eighteen participants were excluded from the study since they merely gave their consent and did not respond to the questions. It was determined that participants' level of awareness about the possibilities of protection during the pandemic period was high, a low level of awareness about preparation for the operating room and case management, and a high level of understanding about the normalization period. Conclusion(s): Anesthesiology and reanimation physicians had a moderate understanding and awareness of COVID-19 perioperative management. Physicians were observed to have inadequate knowledge of algorithms for personal protective equipment, equipment disinfection protocol, and general anesthesia. In this era of easier access to the current information, it is critical to maintaining the highest level of knowledge and awareness among anesthesiology and reanimation physicians who manage the COVID-19 pandemic, to ensure the continuity of training to transfer them to team members, and to carry out procedures following the recommendations.Copyright © 2022 Turkish Anaesthesiology and Intensive Care Society. All rights reserved.
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Dynamic transformation of the knowledge economy, enhanced by Industry 4.0/5.0 development and rise of the networked society in the Digital Age, emergency digitization of all social communicative spheres due to pandemic measures have imposed dramatic changes onto transdisciplinary overlap in different areas of human knowledge and experience, induced by the cross-sectorial job market demands of university level education, curriculum design and learning outcomes. The Covid-19 pandemic induced amplified digitalization measures in the higher education sphere. This end-to end digital shift in the educational processes (communication, content, outcomes and outputs, skills) heralded the introduction of metadisciplinary dimensions of learning – digital, hybrid and, blended. These meta-disciplinary dimensions can be considered conduits of vertical (endocentric) and horizontal (exocentric) transdisciplinary of digital education as a communicative system. Applied trans-disciplinary lens contributes to the solution of holistic modeling of processes and results of updating models and mechanisms of the highly dynamic communication system of education in the digital environment as a whole and its individual formats in the emergency digitization measures of different types. Copyright 2022. © by the International Institute of Informatics and Systemics. All rights reserved.
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In this contemporary world, the development of telecommunication technology is far beyond the human knowledge that allows people to stay connected who are detached thousands of miles away by the internet. An integrated mobile app is created in such a way that it enhances the life of farmers both in their financial and mental status. Telehealth care systems emerged as one of the best alternate remedies for treating people during this covid-19 crises, By video conferencing technology, doctors are likely to treat farmers who are emotionally and mentally downhearted. Tata Communications-Confidential It is as effective as traditional way of counselling in person and it's a proven fact. Not only for farmers but also crops need some attention as it is prone to some diseases, to tackle that issue experts will be providing consultations to the farmers by pre-booking them. Economic growth is highly distressed due to global pandemic, so retailing farmers goods to consumers in online platforms would greatly increase the economic growth and reduce price despite the secondary agents. Loan facilities which are available around the location of the farmers are made aware to them, Thus it will greatly influence their basic survival in agriculture. © 2021 IEEE.