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Objectives: COVID 19 and increasing unmet needs of health technology had accelerated an adoption of digital health globally and the major categories are mobile-health, health information technology, telemedicine. Digital health interventions have various benefit on clinical efficacy, quality of care and reducing healthcare costs. The objective of the study is to identify new reimbursement policy trend of digital health medical devices in South Korea. Method(s): Official announcements published in national bodies and supplementary secondary research were used to capture policies, frameworks and currently approved products since 2019. Result(s): With policy development, several digital health devices and AI software have been introduced as non-reimbursement by utilizing new Health Technology Assessment (nHTA) pathway including grace period of nHTA and innovative medical devices integrated assessment pathway. AI based cardiac arrest risk management software (DeepCARS) and electroceutical device for major depressive disorders (MINDD STIM) have been approved as non-reimbursement use for about 3 years. Two digital therapeutics for insomnia and AI software for diagnosis of cerebral infarction were approved as the first innovative medical devices under new integrated assessment system, and they could be treated in the market. In addition, there is remote patient monitoring (RPM) reimbursement service fee. Continuous glucose monitoring devices have been reimbursed for type 1 diabetes patients by the National Health Insurance Service (NHIS) since January 2019. Homecare RPM service for peritoneal dialysis patients with cloud platform (Sharesource) has been reimbursed since December 2019, and long-term continuous ECG monitoring service fee for wearable ECG monitoring devices (ATpatch, MEMO) became reimbursement since January 2022. Conclusion(s): Although Korean government has been developed guidelines for digital health actively, only few products had been reimbursed. To introduce new technologies for improved patient centric treatment, novel value-based assessment and new pricing guideline of digital health medical devices are quite required.Copyright © 2023
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This study compares the serological antibody level post-COVID-19 vaccine among healthy subjects and psychiatric patients on antidepressant therapy. It also examines the difference in antidepressants' side effects experienced by psychiatric patients following the completion of two vaccine doses. A comparative posttest quasi-experimental study was conducted among healthy subjects and psychiatric patients on antidepressant medication in a teaching hospital in Malaysia. Elecsys Anti-SARS-CoV-2 assay was used to detect the antibody titre between weeks 4 and 12 post vaccination. The antidepressant side-effect checklist (ASEC) was used to monitor the occurrence of antidepressant-related side effects pre-and post-vaccination. 24 psychiatric patients and 26 healthy subjects were included. There was no significant difference in the antibody level between the patients (median = 1509 u/ml) and the healthy subjects (median = 995 u/ml). There was no significant worsening in the antidepressant-related side effects. The antibody level post-COVID-19 vaccine did not differ significantly between patients on antidepressant therapy and healthy subjects. Additionally, there was no change in the antidepressant side effects experienced by the patients following the completion of the vaccine.Copyright © 2022, Research Trends (P) LTD.. All rights reserved.
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Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Material(s) and Method(s): Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Result(s): A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion(s): The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Introduction: Combination of daratumumab (Dara) and lenalidomide (Len) may enhance the function of teclistamab (Tec), potentially resulting in improved antimyeloma activity in a broader population. We present initial safety and efficacy data of Tec-Dara- Len combination in patients with multiple myeloma (MM) in a phase 1b study (MajesTEC-2;NCT04722146). Method(s): Eligible patients who received 1-3 prior lines of therapy (LOT), including a proteasome inhibitor and immune-modulatory drug, were given weekly doses of Tec (0.72-or- 1.5 mg/kg with step-up dosing) + Dara 1800 mg + Len 25 mg. Responses per International Myeloma Working Group criteria, adverse events (Aes) per CTCAE v5.0, and for cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) per ASTCT guidelines, were assessed. Result(s): 32 patients received Tec-Dara- Len (0.72 mg/kg, n = 13;1.5 mg/kg, n = 19). At data cut-off (11 July 2022), median follow-up (range) was 5.78 months (1.0-10.4) and median treatment duration was 4.98 months (0.10-10.35). Median age was 62 years (38-75);87.5% were male. Median prior LOT was 2 (1-3), 18.8% were refractory to Dara and 28.1% refractory to Len. CRS was most frequent AE (81.3% [n = 26], all grade 1/2), 95% occurred during cycle1. Median time to onset was 2 days (1-8), median duration was 2 days (1-22). No ICANS were reported. Frequent Aes (>=25.0% across both dose levels) were neutropenia (75.0% [n = 24];grade 3/4: 68.8% [n = 22]), fatigue (43.8% [n = 14];grade 3/4: 6.3% [n = 2]), diarrhoea (37.5% [n = 12];all grade 1/2), insomnia (31.3% [n = 10];grade 3/4: 3.1% [n = 1]), cough (28.1% [n = 9];all grade 1/2), hypophosphatemia (25.0% [n = 8];all grade 1/2), and pyrexia (25% [n = 8];grade 3/4: 6.3% [n = 2]). Febrile neutropenia frequency was 12.5% (n = 4). Infections occurred in 24 patients (75.0%;grade 3/4: 28.1% [n = 9]). Most common were upper respiratory infection (21.9% [n = 7]), COVID-19 (21.9% [n = 7]), and pneumonia (21.9% [n = 7]). Three (9.4%) had COVID-19 pneumonia. One (3.1%) discontinued due to COVID-19 infection and this patient subsequently died of this infection. Overall response rate (ORR, median follow-up) was 13/13 (8.61 months) at 0.72 mg/kg and 13/16 evaluable patients (less mature at 4.17 months) at 1.5 mg/kg. 12 patients attained very good/better partial response at 0.72 mg/kg dose, and response was not mature for 1.5 mg/kg group. Median time to first response was 1.0 month (0.7-2.0). Preliminary pharmacokinetic concentrations of Tec-Dara- Len were similar as seen with Tec monotherapy. Tec-Dara- Len- treatment led to proinflammatory cytokine production and T-cell activation. Conclusion(s): The combination of Tec-Dara- Len has no new safety signals beyond those seen with Tec or Dara-Len individually. Promising ORR supports the potential for this combination to have enhanced early disease control through the addition of Tec. These data warrant further investigation.
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Objectives: Glycogen Storage Disease Type Ia (GSDIa) is a rare inherited disorder resulting in acute hypoglycemia due to impaired release of glucose from glycogen. Despite dietary management practices to prevent hypoglycemia in patients with GSDIa, complications still occur in children and throughout adulthood. This retrospective cohort study compared the prevalence of complications in adults and children with GSDIa. Method(s): Using ICD-10 diagnosis codes, the IQVIA Pharmetrics Plus database was searched for patients with >=2 GSDI claims (E74.01) from January 2016 through February 2020, with >=12 months continuous enrollment beginning prior to March 2019 (for one year of follow-up before COVID-19), and no inflammatory bowel disease diagnoses (indicative of GSDIb). Complication prevalence in adults and children with GSDIa was summarized descriptively. Result(s): In total, 557 patients with GSDIa were identified (adults, 67%;male, 63%), including 372 adults (median age, 41 years) and 185 children (median age, 7 years). Complications occurring only in adults were atherosclerotic heart disease (8.6%), pulmonary hypertension (3.0%), primary liver cancer (1.9%), dialysis (0.8%), and focal segmental glomerulosclerosis (0.3%). Other complications with the greatest prevalence in adults/children included gout (11.8%/0.5%), insomnia (10.0%/1.1%), osteoarthritis (22.0%/2.7%), severe chronic kidney disease (4.3%/0.5%), malignant neoplasm (10.8%/1.6%), hypertension (49.7%/8.7%), acute kidney failure (15.3%/2.7%), pancreatitis (3.0%/0.5%), gallstones (7.8%/1.6%), benign neoplasm (37.4%/8.1%), hepatocellular adenoma (7.0%/1.6%), neoplasm (41.1%/9.7%), and hyperlipidemia (45.2%/10.8%). Complications with the greatest prevalence in children/adults included poor growth (22.2%/1.9%), gastrostomy (29.7%/3.2%), kidney hypertrophy (2.7%/0.8%), seizure (1.6%/0.5%), hypoglycemia (27.0%/11.3%), hepatomegaly (28.7%/15.9%), kidney transplant (1.6%/1.1%), diarrhea (26.5%/18.6%), nausea and/or vomiting (43.8%/35.8%), acidosis (20.0%/17.2%), and anemia due to enzyme disorders (43.8%/40.6%). Conclusion(s): GSDIa is associated with numerous, potentially serious complications. Compared with children, adults with GSDIa had a greater prevalence of chronic complications, potentially indicating the progressive nature of disease. Children with GSDIa had more acute complications related to suboptimal metabolic control.Copyright © 2023
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Objective To investigate the physical and mental condition and medicine consumption of medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 144 frontline medical staff who fighting against the COVID-19 epidemic from a tertiary first-class hospital from Apr. 4 to May 12, 2022 were surveyed by questionnaires online. Their physical condition including body weight change before the medical work and one month later, sleep quality and the medicine consumption during the medical work were collected and analyzed. Results The mean body weight of frontline doctors before the medical work and one month later were (69.80+/-8.35) kg and (68.60+/-7.37) kg, while those of nurses were (55.36+/-8.27) kg and (53.80+/-7.38) kg, both showing a decreasing trend but without significant difference (all P0.05). A total of 63.89% (92/144) frontline medical staff suffered from insomnia, of which 27.08% (39/144) needed drug intervention. The top 5 common diseases among frontline medical staff were sleep disorder (63.89%, 92/144), skin injury (25.69%, 37/144), body pain (23.61%, 34/144), oral ulcer (13.19%, 19/144), and acute upper respiratory tract infection (9.72%, 14/144). A total of 155 medical staff used drugs, and the top 5 common drugs were skin application (16.77%, 26/155), Ganmao'an granule (12.26%, 19/155), zolpidem tartrate tablets (11.61%, 18/155), Kangfuxin liquid (11.61%, 18/155), and celecoxib capsules (8.39%, 13/155). Conclusion Frontline medical staff in shelter hospitals are prone to have body weight change, sleep disorder, skin injury, body pain, oral ulcer, acute upper respiratory tract infection and so on, which suggests that in future similar large-scale medical support, it is necessary to pay sufficient attention to the physical condition of frontline medical staff and provide them sufficient medicine.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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The pandemic caused by COVID-19 has led to radical lifestyle changes worldwide, particularly in the Republic of Bulgaria, and was a factor for global changes in economics, politics, healthcare and daily life. Aim(s): The aim of the study was to analyze the public attitudes, awareness and fears related to the COVID-19 disease in the Republic of Bulgaria. Material(s) and Method(s): The survey was conducted between August 1st, 2022 and September 1st, 2022 via an anonymous questionnaire consisting of 24 closed questions. A total of 1861 people, aged 18-69 years and older, took part in the survey after being selected randomly. The data were statistically processed via MS Excel. Result(s): The main source of information to the respondents on issues related to COVID-19 was the Internet (29,8%), followed by TV (26%) and the specialized website (Single information portal) - 15,9%. More than one-third (35,1%) of the respondents was afraid of getting infected and an equal share of participants reported that they have been infected with COVID-19. More than half of the respondents (52,5%) adhered to all the provisions of the governmental bodies related to limiting the COVID-19 pandemic. The most frequent symptom of post- COVID-19 syndrome was being easily fatigued (26,7%), followed by shortness of breath (13,4%) and persistent cough (11,6%). Conclusion(s): The survey could be useful in understanding what were the public attitudes, awareness and fears related to the COVID-19 disease in the Republic of Bulgaria during the pandemic.Copyright © 2023 D. Penchev et al., published by Sciendo.
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Purpose This work aimed to study postpartum mental outcomes and determinants of the intake of caffeinated beverages during the pandemic in women from Argentina. Methods This cross-sectional study recruited 619 women who responded to online self-report questionnaires during the first and second waves of COVID-19, including validated instruments (Insomnia Severity Index, Perceived Stress Scale, Postpartum Depression Screening Scale, Memory Complaint Scale, and Breastfeeding Self-Efficacy Scale), and general data. Intake frequency and amount of caffeinated beverages were estimated. Multivariate regression and structural equation models identified associations and effects (p < 0.05). Results Women were under social restrictions for 60.39 days, with home and essential activities increasing caffeinated intake. They ingested (mL/d): yerba mate (1457.71), coffee (66.85), tea (67.61), and soft drinks (50.95), which provided 646.20 mg/d of caffeine. Intakes of coffee and yerba mate were higher than pre-pandemic ones. Coffee was positively associated with stress and insomnia, and indirectly linked to higher levels of depression and memory complaints, and lower breastfeeding self-efficacy. Tea showed a similar but weaker association. Yerba mate correlated inversely with depression (through direct pathways), insomnia, and memory complaints (through indirect pathways), promoting breastfeeding self-efficacy. Soft drinks and caffeine did not present significant associations. Conclusion Although findings do not imply causation, results suggest that beverages would exhibit caffeine-independent affective and cognitive roles, which might be anxiogenic in the case of coffee and tea (to a lesser extent). Yerba mate showed antidepressant potential. Given that breastfeeding might be compromised during the pandemic, yerba mate intake is promissory to protect postpartum mental health.
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Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Background: The outbreak of the COVID-19 pandemic, the constant transformation of the SARS-COV-2 virus form, exposure to substantial psychosocial stress, environmental change, and isolation have led to the inference that the overall population's mental health could be affected, resulting in an increase in cases of psychosis. Objective(s): We initiated a systematic review to determine the impact of the SARS-COV-2 virus and its long-term effects-in both symptomatic and asymptomatic cases-on people with or without psychosis. We envisioned that this would give us an insight into effective clinical intervention methods for patients with psychosis during and after the pandemic. Method(s): We selected fifteen papers that met our inclusion criteria, i.e., those that considered participants with or without psychiatric illness and exposed to SARS-COV-2 infection, for this review and were retrieved via Google, Google Scholar, MEDLINE, PubMed, and PsychINFO Database. Key Gap: There is a dearth of research in understanding how COVID-19 affects people with or without a prior personal history of psychosis. Result(s): The systematic review summary provides insight into the state of knowledge. Insights from the systematic review have also been reviewed from the salutogenesis model's perspec-tive. There is moderate evidence of new-onset psychosis during the COVID-19 pandemic in which some antipsychotics treated the psychotic symptoms of patients while treating for COVID-19. Suggestions and recommendations are made for preventive and promotive public health strategies. Conclusion(s): The Salutogenesis model and Positive Psychology Interventions (PPI) provide another preventive and promotive public health management approach.Copyright © 2023 Bentham Science Publishers.
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Background: Little is known about the impact of the COVID-19 pandemic on physiotherapists' mental health. The aim of this study was to investigate the impact of the COVID-19 pandemic on physiotherapists' mental health in Belgium. Method(s): A total of 115 physiotherapists from 12 general hospitals in Brussels, working in COVID-19 care units (CCU) or non-COVID-19 care units (NCCU), participated in an electronic survey including validated measurement tools for PTSD, anxiety, insomnia and burnout. Descriptive analyses were performed to assess differences in mental health outcomes between physiotherapists who worked in a CCU and those who worked in an NCCU. Multivariable logistic regression analyses were also performed to assess risk factors for burnout. Result(s): Results showed significant levels of PTSD (9.6%), anxiety (33.9%), insomnia (40%) and burnout (33.9%) among participants. However, no significant differences were found between the 2 groups. It was also found that being isolated during the COVID-19 pandemic was a risk factor for burnout. Conclusion(s): Although no significant differences were found between the two groups, this study highlights a concerning rate of psychopathological symptoms among participants. Hospitals should therefore invest more time and resources into actions aiming at preserving the mental health of physiotherapists.Copyright © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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Aim: Adolescents have experienced disruption in their daily routines, including changes in health behaviors such as an increased sedentary behavior and increased smartphone usage. The aim of this study was to assess the association of health behaviors with mental health problems. Method(s): Five cross-sectional surveys (February 2021 to May 2022) were performed during the pandemic assessing physical activity, smartphone usage, depressive symptoms (Patient Health Questionaire-9 (PHQ-9)), anxiety symptoms (Generalized Anxiety Disorder Scale 7 (GAD-7)), sleep quality (Insomnia Severity Index 7 (ISI-7)), and stress (Perceived Stress Scale 10 (PSS-10)). In total, N = 7201 adolescents (age: 14-20 years ((MW +/- SD): 16.63 +/- 1.49 years);70.2% female, 18.8% migration background) participated. Result(s): A strong increase in mobile phone usage as well as a decrease in physical activity as compared to pre-pandemic data were observed (p < 0.001). Compared to the lowest smartphone user group (<1 h/d), the adjusted odds ratios (aOR) for depressive symptoms increased with increasing smartphone usage to 1.98 (3-4 h/d), 3.30 (5-6 h/d), 4.96 (7-8 h/d), and 6.79 (>8 h/d). High utilizers (>8 h/d) were also more likely to experience clinically relevant anxiety, insomnia, or stress symptoms (aORs 3.23-5.75) compared to those using the smartphone less than 1 h/d. Conclusion(s): Results highlight the need for measures to promote responsible smartphone usage as well as to increase physical activity, so as to promote mental health in adolescence.Copyright © 2023
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The COVID-19 outbreak revealed the fragility not only of our species but also of society, which has demonstrated its ability to adapt to challenging conditions and to learn from disasters. One of the most pressing issues during the pandemic was the delivery of education during lockdowns. Education in emergency was established using various communication media, hastening the digitalization of education. However, this also highlighted the impact on the mental health of students, who were already experiencing overuse of the internet and electronic devices prior to the pandemic. In response, Tecnologico de Monterrey, a private Mexican university that also offers high school programs, launched the "Unplugged Day” initiative, which encouraged students to disconnect from electronic devices and participate in physical, cultural, creative, or reflective activities. This study applied a voluntary survey to 1850 students from March to May 2021 on a weekly basis, with the aim of analyzing symptoms of insomnia, emotions, perceptions of online education, sources of stress, and the need for professional support to manage their emotions in relation to their participation in Unplugged Day activities. Our results, obtained through a quantitative methodology, confirmed the impact of the emergency, lockdown, and forced remote education on the mental health of students. Furthermore, the results revealed that the Unplugged Day initiative is a strategy that promoted students' well-being during online education. The respondents also suggested strategies for promoting mental health and well-being of learners, whether in an emergency or not. These findings provide valuable information for governments and educational institutions to implement policies and strategies for planning education in emergency situations and for addressing the ongoing global problems of stress and mental health, which are related to the increasing use of electronic devices and the volatility, uncertainty, complexity, and ambiguity of global society. It is our responsibility to improve education so that it can play its role in preserving cultural heritage, overcoming adversity, rebuilding after catastrophes, and shaping a better future for generations to come. © 2023 by the authors.
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Based on an online cross-sectional survey, this study aimed to evaluate the role of the coronavirus disease 2019 (COVID-19) pandemic and economy-related factors in post-traumatic stress symptoms (PTSSs) and sleep in a sample of the general Lebanese population using the post-traumatic stress disorder checklist. The online survey was conducted between May 10, and May 20, 2020, and 502 Lebanese adults who have access to the internet were enrolled. Results highlighted that positive correlates of PTSS were fear of COVID-19, female gender, and waterpipe smoking;negative correlates were higher family satisfaction, higher financial wellness, older age, having access to healthcare, and never having to work. When including insomnia as an independent variable to explain PTSS, the model did not substantially change. Positive correlates of insomnia included fear of poverty, fear of COVID-19, violence at home, the number of dependent children, having a job, and having a chronic disease. Conversely, higher family satisfaction and financial wellness were associated with lower likelihood of insomnia. When entering PTSS, insomnia remained positively associated with fear of poverty, PTSS, and violence at home. However, fear of COVID-19 was no longer associated with insomnia. We concluded that both the fear of COVID-19 and the economic crisis are correlated with PTSS and insomnia. © 2023 Author(s).
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The prevalence of psychiatric disorders namely depression, anxiety, and sleep disturbances has been increased worldwide, particularly during the COVID-19 pandemic. In this regard, the interest of recent investigations is moved toward phytomedicines and bioactive substances derived from natural sources. Although Tilia platyphyllos Scop. contains high amounts of phenolic compounds such as quercetin, kaempferol, and catechin, there is no study on the possible effects of its extract on psychological disorders. The present study was carried out to determine the antidepressant-like, anxiolytic, and sedative-hypnotic effects of the hydroethanolic extract of T. platyphyllos leaves using forced swimming test (FST), tail suspension test (TST), elevated plus maze test (EPMT), pentobarbital-induced loss of righting reflex test and open field test (OFT). Following the ethanolic extraction of T. platyphyllos leaves, the extraction yield was 14% and the total phenolic and total flavonoid contents were found to be 135.23 +/- 0.14 mg gallic acid equivalent/g dry extract and 19.02 +/- 0.03 mg rutin equivalent/g dry extract, respectively. Both FTS and TST revealed a significant antidepressant-like activity for the tested extract at 400 mg/kg compared to the control group. In addition, the anxiolytic activity of the extract was proven through OFT and EPMT in the same dose. Finally, T. platyphyllos extract at 200 mg/kg and 400 mg/kg significantly increased the sleeping time when compared to the control group reflecting its potential hypnotic activity. Co-administration of T. platyphyllos extract at 400 mg/kg and flumazenil as the GABA-A receptor antagonist decreased the sleeping time but the observed effect was not statistically significant. Therefore, we cannot completely rule out the GABA-A receptor's involvement in the hypnotic activity of the extract. The biological results presented here led us to conclude that T. platyphyllos extract can be a prominent source of antidepressant, anxiolytic and hypnotic agents. Probably, the main phenolic compounds of T. platyphyllos such as quercetin, kaempferol, and catechin are involved in the observed effects. However, there is still a great need for additional investigations on the exact mechanisms.Copyright © 2022, Iranian Association of Pharmaceutical Scientists. All rights reserved.
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This paper adds to extant research by examining the relationship between employees' fear of coronavirus disease 2019 and their suffering from insomnia. It specifically proposes mediating roles of employees' economic concerns and psychological distress and a moderating role of mindfulness in this process. The research hypotheses are tested with survey data collected through two studies among Pakistani-based professionals: 316 in study 1 and 421 in study 2. The results pinpoint a salient risk for employees who experience fear during a pandemic crisis, in that the associated economic and psychological hardships make the situation worse by undermining their sleep quality, which eventually could diminish the quality of their lives even further. It also reveals how organizations can mitigate this risk if employees can leverage pertinent personal resources, such as mindfulness.
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Background: B-cell lymphoma-2 (Bcl-2) proteins play an important role in multiple myeloma (MM) cell survival and represent an attractive therapeutic target. In prior trials, a subgroup analysis of patients with t(11;14)-positive relapsed/refractory (R/R) MM showed the combination of a Bcl-2 inhibitor, a proteasome inhibitor, and dexamethasone improved progression-free survival with no increased mortality. BGB-11417, a Bcl-2 inhibitor, is more potent and selective than venetoclax. BGB-11417- 105 (NCT04973605) is a phase 1b/2 study assessing the safety and efficacy of BGB-11417 monotherapy, in combination with dexamethasone, or with dexamethasone+carfilzomib in patients with t(11;14)-positive R/R MM. Preliminary safety results for the combination of BGB-11417 + dexamethasone are presented. Method(s): Eligible patients had t(11;14)-positive R/R MM and had been exposed to a proteasome inhibitor, immunomodulatory agent, and anti-CD38 therapy. Patients received 80-, 160-, 320-, or 640-mg BGB-11417 daily with 40-mg dexamethasone weekly until death, intolerability, or disease progression. Dose escalation was guided by a mTPI-2 design and overall review by a safety monitoring committee. Pharmacokinetics (PK) were also assessed. Result(s): As of 1 July 2022, 10 patients were enrolled in the 80-, 160-, and 320-mg (3 patients each) and 640-mg (1 patient) dose-escalation cohorts of BGB-11417 + dexamethasone. The median age was 69 years (range, 52-81) and median prior lines of therapy was 3 (range, 1-5). The median treatment duration was 3.2 months (range, 0.5-6.5). No patients experienced dose-limiting toxicity at any dose level. Three patients died whilst on study: 1 due to COVID-19 complications 157 days after treatment discontinuation (day 208), 1 due to progressive disease 50 days after treatment discontinuation (day 89), and 1 due to COVID-19 whilst on study treatment (day 78). No deaths were associated with study treatment. Two patients experienced Grade >= 3 treatment-emergent adverse events (TEAEs). One patient in the 160-mg cohort experienced Grade 3 increase in liver enzymes and lymphopenia. One patient in the 320-mg cohort experienced Grade 3 lymphopenia. The most common TEAEs were insomnia (50%), fatigue (30%), arthralgia (20%), back pain (20%), lymphopenia (20%), and nausea (20%). BGB-11417 exposure increased dose-dependently from 80 mg to 320 mg with high interpatient PK variability. BGB-11417 exposures after single and multiple doses appeared similar, indicating limited accumulation. Conclusion(s): BGB-11417 plus dexamethasone was generally well-tolerated in patients with R/R MM harbouring t(11;14) at doses <=640 mg. Efficacy data are forthcoming. Recruitment is ongoing in the US, Australia, and New Zealand;the BGB-11417, dexamethasone, and carfilzomib combination arm will open in the future.
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Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05);age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05);and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Objectives: To identify associations between demographics, social determinants of health, health conditions, and reported history of insomnia. A cross-sectional study including 11,960 adult community members recruited through HealthStreet, a community outreach program at University of Florida. Methods: Health assessments were conducted via interviews. Participants reported their demographic background, level of social support, history of health conditions, and insomnia. Logistic regression was used to understand associations between risk factors and history of insomnia. Results: The prevalence of self-reported insomnia was 27.3%. Adults aged ≥ 65 years (OR = 1.16) and women (OR = 1.18) reported higher rates of insomnia than their counterparts. Black/African American individuals reported lower rates of insomnia (OR = 0.72) than White individuals. Individuals with food insecurity (OR = 1.53), a military history (OR = 1.30), lower social support (OR = 1.24), living alone (OR = 1.14), anxiety (OR = 2.33), cardiometabolic disease (OR = 1.58), and attention-deficit hyperactivity disorder (ADHD) (OR = 1.44) were significantly more likely to endorse insomnia compared with their counterparts. Depression (OR = 2.57) had the strongest association with insomnia. Conclusions: This study provides evidence regarding who is at greater risk for insomnia among a large community-based sample. Our findings highlight the importance of screening for insomnia, particularly among patients who experience food insecurity, are military veterans, have anxiety, depression, ADHD, or cardiometabolic disease, as well as those who live alone or have lower levels of social support. Future public health campaigns should provide education on insomnia symptoms, treatments, and evidenced-based sleep-promotion strategies.
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The reorganization of treatment facilities during the COVID-19 pandemic has altered the working conditions of large numbers of the health workers (HW) worldwide. The implementation of professional activities in such realities has led to an increased risk of developing a number of psychological disorders, including insomnia. The percentage of insomnia in HW has increased significantly. The nurses were the most vulnerable, because they are women and they work in an understaffed environment. The influence of shift work and stress conditions on the risk of insomnia, methods of prevention and treatment of this disorder are thoroughly examined in the article.