ABSTRACT
The COVID-19 pandemic instantly changed the day-to-day practices of the criminal justice system. The court system, traditionally reliant on face-to-face interaction, had to quickly alter operations to decrease the virus' spread while remaining functional as an integral role in the criminal justice system. The current exploratory study examines the response strategies U.S. court systems implemented, impacts on case processing, case backlogs, and additional consequences endured due to the pandemic. Using responses from self-report surveys of court staff (e.g., judges, clerks), results indicated that courts prioritized the types of cases heard and implemented multiple mitigation strategies that were deemed effective, some of which may be sustainable post-pandemic. Despite an increase in virtual jury trials and hearings, many courts saw a surge in backlogged cases and complications in assembling juries. The overall findings may inform judiciary policy and practice concerning short and long-term pandemic outcomes on court processing and future pandemic preparedness.
ABSTRACT
Background: Studies suggest perinatal infection with SARSCoV- 2 can induce adverse birth outcomes, but studies published to date have substantial limitations. Most have identified cases based upon their presentation for clinical care, and very few have examined pandemic-related stress which may also impact adverse birth outcomes. Objective(s): To evaluate the relationships between SARSCoV- 2 infection in pregnancy and pandemic-related stress with birth outcomes. Study Design: We conducted an observational study of 211 mother-newborn dyads in three urban cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program. Serology for SARS-CoV-2 was assessed in a convenience sample of prenatal maternal, cord serum or dried blood spots from births occurring between January 2020-September 2021. Specimens were assessed for IgG, IgM, and IgA antibodies to nucleocapsid, S1 spike, S2 spike, and receptor-binding domain. A Pandemic-related Traumatic Stress (PTS) scale was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Acute Stress Disorder criteria. Result(s): 36% were positive for at least one antibody type, chiefly IgG. Self-report of infection was not significantly correlated with combined serology. There were no differences in gestational age (GA), birth weight, preterm birth (PTB), or low birth weight (LBW) among seropositive mothers. However, IgM seropositive mothers had children with lower BW (434g, 95% CI: 116- 752), BW Z score-for-GA (0.73 SD, 95% CI 0.10-1.36) and were more likely to deliver preterm (OR 8.75, 95% CI 1.22-62.4). Associations with LBW sustained in sensitivity analyses limited to pre-vaccine samples, and PTS symptoms were not associated with birth outcomes. The addition of PTS did not substantially change associations with BW, although associations with PTB attenuated to near-significance. Conclusion(s): We identified decreased birth weight and increased prematurity in mothers IgM seropositive to SARS-CoV-2, independent of PTS. Though there are limits to interpretation, the data support efforts to prevent SARS-CoV-2 infections in pregnancy.
ABSTRACT
Background: The COVID-19 pandemic catalyzed major changes in how youth mental health (MH) services are delivered. Understanding youth's MH, awareness and use of services since the pandemic, and differences between youth with and without a MH diagnosis, can help us optimize MH services during the pandemic and beyond. Objective(s): We investigated youth's MH and service use one year into the pandemic and explored differences between those with and without a self-reported MH diagnosis. Method(s): In February 2021, we administered a web-based survey to youth, 12-25 years, in Ontario. Data from 1373 out of 1497 (91.72%) participants were analyzed. We assessed differences in MH and service use between those with (N=623, 45.38%) and without (N=750, 54.62%) a self-reported MH diagnosis. Logistic regressions were used to explore MH diagnosis as a predictor of service use while controlling for confounders. Result(s): 86.73% of participants reported worse MH since COVID-19, with no between-group differences. Participants with a MH diagnosis had higher rates of MH problems, service awareness and use, compared to those without a diagnosis. MH diagnosis was the strongest predictor of service use. Gender and affordability of basic needs also independently predicted use of distinct services. Conclusion(s): Various services are required to mitigate the negative effects of the pandemic on youth MH and meet their service needs. Whether youth have a MH diagnosis may be important to understanding what services they are aware of and use. Sustaining pandemic-related service changes require increasing youth's awareness of digital interventions and overcoming other barriers to care.Copyright © 2023, Canadian Academy of Child and Adolescent Psychiatry. All rights reserved.
ABSTRACT
BackgroundDuring the COVID-19 pandemic, asynchronous consultations were introduced for patients with vasculitis. To assess disease activity without of face-to-face clinical reviews and blood testing, patients submitted patient reported outcome measures (PROMs) via electronic survey forms, which were subsequently triaged by clinicians.Objectives1. To investigate how patients' vasculitis disease activity was affected by the COVID-19 pandemic through retrospective comparison of clinician-assessed scores recorded pre-pandemic with intra-pandemic self-reported patient reported outcome measures (PROMs) and disease scores submitted by patients remotely.2. To assess patients' clinical outcomes, including allocation of follow-up and further management/treatment escalation during this period.3. To validate self-reported BVAS scores against an existing PROM.MethodsThis is a retrospectively study of patients with a known diagnosis of vasculitis under the care of the Nuffield Orthopaedic Centre, Oxford. For the purposes of this study, we included patients with all vasculitis diagnoses.Clinician-reported scores (Bristol Vasculitis Activity score v.3, BVAS) were recorded during in-person clinics pre-pandemic (defined as 01/01/2019-31/12/2019) [1].Patients' self-reported BVAS (SR-BVAS) and AAV-PRO (ANCA-associated vasculitis patient-reported outcomes) scores were submitted by patients via electronic forms containing the requisite questionnaires sent out during-pandemic (defined as 01/12/2020-31/03/22) [2].SR-BVAS has not been validated but was collected to allow clinical comparison to disease activity scores completed by clinicians. Response were stored and analysed in a secure database. Score comparison was performed using Wilcoxon Sign Rank testing. Clinical outcome data was collected from the local Electronic Patient Record. Data analysis was performed in Microsoft Excel and R (version 4.2.1).ResultsWe noted a significantly higher overall level of patient-reported disease activity during the pandemic than was recorded in clinics prior. In the total cohort of all vasculitis patients for whom we had data, the median BVAS increased from 2 pre-pandemic (N = 335, range 0-21) to 6 intra-pandemic (N = 143, range 0-42) (p <0.001). The overall proportion of patients with severe/active disease (defined as BVAS ≥4) increased from 27% to 36% during the pandemic period.In a smaller cohort of 64 patients for whom we had paired pre- and during-pandemic scores, increased disease activity was reported (p<0.01). Notably, the number with a BVAS consistent with severe disease increased from 7 (11%) to 19 (30%).There was a significant positive correlation between SR-BVAS and AAV-PRO (r=0.61, p< 0.001) submitted by patients during-pandemic;however, at low BVAS (≤3), the AAV-PRO ranged widely (28-87)Follow-up data was available for all 64 patients in this cohort: 8/19 (42%) with a during-pandemic SR-BVAS ≥4 were seen in clinic within 3 months (telemedicine or face-to-face).ConclusionPatients reported worsening of vasculitis disease activity during the COVID-19 pandemic. This may be attributable to impacts on well-being or access to healthcare services. We note that disease activity scores in vasculitis may be limited in their ability to capture the whole picture disease activity in the absence of clinical assessment [3]. 42% of patients with self-reported high disease activity were seen within 3 months. There was a significant positive correlation between AAV-PRO and SR-BVAS, suggesting it has some use as a PROM.References[1]Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S, et al.. Ann Rheum Dis. 2009 Dec;68(12):1827–32.[2]Malley T, Jackman J, Manderson S, Saldana Pena L, Evans E, Barrett J, et al. Ann Rheum Dis. 2021 Jun 1;80(Suppl 1):289.[3]Luqmani RA. Nephrology Dialysis Transplantation. 2015 Apr 1;30(suppl_1):i76–82.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
ABSTRACT
Background: COVID-19-Pandemic Lockdowns initiated online teaching-learning in India. We aimed to assess mental health (MH) of adolescents studying online for academic milestone of matriculation during these circumstances. Material(s) and Method(s): It was a cross sectional study carried out in Western Maharashtra, during 2021. MH of study subjects was assessed by presence and severity of symptoms of depression, anxiety, stress (DAS) and emotional intelligence (EI). They were measured by DAS Scale-42 (DASS-42) and Schutte's self-report EI test (SET) respectively with collection of socio-demographic information maintaining confidentiality. Data were analysed by SPSS-20 software. MH parameters were compared with pre-pandemic pilot and other studies to study effect of online education and overall COVID-19 Pandemic scenario on MH of study subjects. Result(s): Total 1162 adolescents participated, out of which 59 were omitted from the analysis due to incomplete data. Out of remaining 1103 participants, 43% boys & 57 % girls with the mean age of 14.69 (+0.78) years. Majority of them belonged to middle socio-economic-status. Mean DAS and EI scores denoted mild anxiety with no evidence of depression and stress. Mean EI score was in normal range. Mean DAS scores were significantly lower and mean EI score was significantly higher than reported in -pandemic pilot and other studies. Conclusion(s): MH derangement of matriculating adolescents during COVID-19- Pandemic with online education seemed to be less severe than that was in pre-pandemic times with in-class education. Recommendations: MH support at schools needs to be strengthened. During the post-COVID-19 period, online school education may be continued in LMIC like India on the basis of willingness of students and parents but with caution and understanding of socio-cultural background and support.Copyright © 2022 Pravara Institute of Medical Sciences. All rights reserved.
ABSTRACT
Aims: During the COVID-19 pandemic, care for the elderly in the community was greatly limited. Accordingly, the demand for alternative community care have increased to cope with changing situations. In this study, we tried to find out whether the companion robot improved mood state and related problem in depressive or isolated community dwelling elderly. Method(s): For 186 community dwelling elderly who have received social welfare service due to depression or social isolation, we provided companion robot that could support their daily living. The robot was equipped with special program that could recognize and respond to the participant's own emotion. It was part of behavioural activation techniques which is one of powerful treatment for depression. The self-report questionnaires were used to measure changes in cognitive function, depression, suicidality, loneliness, resilience and satisfaction of life. Outcomes were measured before using companion robot and after 3 months, and we compared them. Result(s): The elderly using companion robot for 3 months showed improved cognitive function, depression (p < .001), suicidality (p < .001), and loneliness (p = .033) in the self-report questionnaire. Resilience (p = .749) and satisfaction of life (p = .246) were also improved but not reached significance. Conclusion(s): These findings showed that the use of companion robot with emotional recognition coaching program could help improve depression, cognitive function, loneliness and suicidal ideation. In particular, this effect was also useful for those who were diagnosed with depression. Also if we can put more techniques of behavioural activation programs into robot, it could be useful in community care for depressive and isolated elderly.
ABSTRACT
The COVID-19 pandemic created a range of stressors, among them difficulties related to work conditions, financial changes, lack of childcare, and confinement or isolation due to social distancing. Among families and married individuals, these stressors were often expressed in additional daily hassles, with an influence on mental health. This study examined two moderated mediation models based on Bodenmann's systemic-transactional stress model. Specifically, the models tested the hypothesis that intra-dyadic stress mediates the association between extra-dyadic stress and mental health, while two measures of family functioning, cohesion and flexibility, moderate the relationship between extra and intra-dyadic stress. Participants were 480 Palestinian adults in Israel who completed self-report questionnaires. All were in opposite-sex marriages and identified as either cisgender women or cisgender men. The results showed partial mediation patterns supporting both models, indicating that family cohesion and flexibility weakened the mediating effect of intra-dyadic stress on the relationship between extra-dyadic stress and mental health. These findings increase our understanding of the variables that affected mental health during the pandemic, and suggest that when faced with extra-dyadic stress, married individuals with good family environments are less likely to experience high levels of intra-dyadic stress, which is in turn associated with preserved mental health. Limitations and implications for planning interventions for couples and families during the pandemic are discussed.
ABSTRACT
BackgroundRestrictions on outdoor movements due to the coronavirus disease (COVID-19) pandemic have led to a decreased physical activity;this can lead to sarcopenia and frailty in older adults. Our recent study has demonstrated a significant decrease in the trunk muscle mass immediately after the pandemic's first wave (April–May 2020) among Japanese community-dwelling older women. In the present study, we further examined whether muscle mass recovery or deterioration occurs after 1 year of the pandemic's first wave by comparing physical measurements among the following assessment periods: before the first wave, immediately after the first wave, and at 1-year follow-up thereafter.MethodsThis study included 77 women (78.0 ± 5.7 years) who underwent physical measurements for muscle mass, grip strength, one-leg stand-up ability (3 s), and oral motor skills and answered questionnaires on sociality (social network, participation, and support) in the three assessment periods.ResultsThe frequency of going out and the subjective vitality were significantly decreased immediately after the first wave;these recovered at the 1-year follow-up (P < 0.001). When comparing muscular measures, the trunk muscle mass index preferentially decreased immediately after the first wave but recovered significantly at the 1-year follow-up (P < 0.001). Conversely, the appendicular skeletal muscle mass index (ASMI) and grip strength continued to decrease until the 1-year follow-up (P < 0.001 and P = 0.03, respectively). The ability to perform a one-leg stand-up for 3 s and the oral motor skills did not change significantly across the assessment periods. The prevalence of pre-sarcopenia and sarcopenia tended to increase during these periods (P = 0.068). The reduction and subsequent recovery patterns for sociality were similar to those observed for the trunk muscle mass.ConclusionsOur findings demonstrated differences in the reversibility of skeletal muscle mass and strength at 1 year after the first wave of the COVID-19 pandemic: the trunk muscle mass declined acutely and recovered rapidly, whereas the ASMI and grip strength declined continuously. These differences in the skeletal muscle recovery and deterioration might help formulate short-term or long-term strategies for COVID-19-related sarcopenia prevention in community-dwelling older adults.
ABSTRACT
Objective: Studies have reported significant cognitive impairment following Covid-19, although the majority of reports rely on patients' self-report or short screening instruments to quantify cognitive function. Additionally, little is known about the development of cognitive impairment post Covid-19 and how these trajectories are related to psychiatric and medical variables. Method(s): Patients presenting a spectrum of neurological symptoms following Covid-19 infection were recruited from a national multicenter study. At 6 (N = 77) and 12 (N = 58) months post-covid infection, they completed a comprehensive neuropsychological assessment. At 6 months self-reported symptoms of cognitive dysfunction and fatigue were extracted from questionnaires and depression diagnoses from the MINI neuropsychiatric interview. A control group (N = 58), antibody verified Covid-19 negative, completed neuropsychological assessment. Result(s): At 6 months, verbal and visual memory, attention/working memory, and executive function were significantly reduced in patients compared to healthy controls. These impairments were not associated to acute illness severity indexes, and only moderately correlated to subjective cognitive complaints, level of fatigue, and diagnosis of depression at 6 months. There was a significant improvement in cognitive function across affected domains from 6 to 12 months post infection. This improvement was not associated with depression or self-report at 6 months, nor was the improvement related to acute illness severity. Conclusion(s): Covid-19 patients presenting with neurological symptoms showed significant cognitive impairment at 6 months. However, at 12 months their cognitive functions were normalized and no longer different from healthy controls. These results indicate a good prognosis regarding cognitive function in most patients following Covid-19 infection.Copyright © 2023
ABSTRACT
BackgroundThe COVID-19 pandemic had a substantial influence on the mental health of healthcare workers. This study investigated general health status, the prevalence, and the severity of depressive spectrum and anxiety-related disorders. It evaluated the association between various factors and depression, anxiety, and stress among healthcare workers in the Khatam-Alanbia Hospital in Iran, after 2 years since the corona virus disease 2019 (COVID-19) pandemic.ResultsIn this online cross-sectional study, 409 participants were selected and given a questionnaire about demographic, personal, and clinical characteristics as well as stressors related to COVID-19. The participants completed the General Health Questionnaire (GHQ-28) and the 42-item Depression, Anxiety, and Stress Scale (DASS-42) to report depression, anxiety, and stress/tension levels. We found that the overall incidence of depression, anxiety and stress among health care workers during the COVID-19 pandemic was 44.25%, 50.62%, and 43.76%, respectively. Participants with severe to very severe depression, anxiety and stress accounted for 19.2%, 26.6%, and 18.2% of the sample, respectively. Being female was associated with higher odds of depression, anxiety, and stress.ConclusionsTwo years after the COVID-19 outbreak, health workers are still showing a significant level of depression, anxiety, stress, and remarkable signs of psychological distress. The situation of a health care worker is worrying. The long-term psychological implications of infectious diseases should not be ignored. Mental health services could play an essential role in rehabilitation.
ABSTRACT
By combining words and images that impact emotions and generate empathetic storytelling, advertising (ADV) has evolved into a form of communication for promoting consumer awareness, positive social change, and ADV-related decisional processes, even on topics of high-social relevance such as crisis communication. This study explored consumers' emotional and cognitive responses to crisis-related ADVs using implicit (autonomic) and explicit (self-report) measurements. Nineteen participants watched twelve high-impact social communications about Covid-19, personal health, safety, and prosociality, while autonomic and self-report data were collected. Personal health, safety, and prosociality had higher skin conductance than Covid-19 stimuli, indicating higher arousal and engagement. Personal health reported lower heart rate variability values than Covid-19, suggesting greater emotional reactions for personal health topics, but also lesser mental load for Covid-19 stimuli. Self-report results confirmed autonomic findings. In conclusion, communications about personal health, safety, and prosociality generate higher emotional impact and allow for effective storytelling that facilitates viewer identification, developing a high level of empathy.
ABSTRACT
Graduate students experience an environment of intense demands. The COVID-19 pandemic caused the suspension of face-to-face academic activities, affecting the daily lives of these people. This study aimed to analyze the impact of COVID-19 on the mental health of stricto sensu graduate students in the health area of a public university in Ceara regardind the use of antidepressant and anxiolytic drugs. This cross-sectional, descriptive study uses a remote questionnaire from August 2021 to February 2022. Socio-demographic, clinical, medication use, and data from the "Self-Report Questionnaire" test were collected. 217 master's and doctoral students participated in the study, most of them female (71%), between 21 and 30 years old (55.3%) and without children (76.5%). The results showed an increase in the number of graduate students with symptoms of anxiety and/or depression after the pandemic (23.4%). Among the main symptoms, there is a strong indication of mental suffering (60.4%), nervousness, tension or concern (77.9%), sadness (55.3%), difficulties in carrying out daily activities with satisfaction (55.4%), and tiredness (65%). These symptoms were most prevalent among women. Regarding medication use (anxiolytics/antidepressants), 38.2% responded positively. Of these, 40.9% increased the dosage, and 79.5% experienced adverse reactions. In this way, the COVID-19 pandemic negatively affected graduate students' mental health, reinforcing the need for universities to develop strategies to mitigate these students' emotional suffering.Copyright © 2023, Conselho Federal de Farmacia. All rights reserved.
ABSTRACT
Background: Cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulator triple combination therapy (TCT) is available to approximately 85% of the U.S. CF population. Clinical trials of TCT demonstrate numerous improvements in physical health and healthrelated quality of life (HRQoL), but fewstudies have examined the effects of TCTon mental health and psychosocial outcomes, and little is known about whether gains in HRQoL are sustained over time.We aimed to describe the HRQoL and psychosocial outcomes of people with CF (PwCF) initiating TCT and explored changes in these outcomes up to 1 year after starting TCT. Method(s): This longitudinal study enrolled PwCF aged 14 and older who were followed at a large, combined pediatric and adult CF center. Questionnaires were administered within 6 months of initiating TCT (baseline) and 3, 6, and 12 months later. Study self-report measures evaluated were HRQoL (Cystic Fibrosis Questionnaire-Revised;CFQ-R), optimism, self-efficacy, medication-related beliefs (Medication Beliefs Questionnaire;MBQ), perceived social stigma of illness, and body image. Data were also collected from medical charts on measures of health and mental health screening. Four open-ended questionswere included at each timepoint to elicit qualitative data on experiences starting TCT. Longitudinal data were analyzed using linear mixed-effects models for repeated measures. Result(s): Sixty-three adults and adolescents with CF completed the full set of surveys at baseline. Mean participant age was 30.0 +/- 14.2. Fifty-four percent identified as female, 43% as male, and 2% as nonbinary. Seventyfour percent had private insurance. Mean percentage predicted forced expiratory volume in 1 second (FEV1pp) at baseline was 76.0 +/- 24.1%, and mean body mass index (BMI) was 22.9 +/- 3.1 kg/m2. At 12 months, mean FEV1pp was 80.8 +/- 21.9%, and mean BMI was 24.5 +/- 4.1 kg/m2. On standard measures used in CF mental health screening, mean baseline Patient Health Questionnaire (PHQ-9) score was 3.4 +/- 3.5, and mean General Anxiety Disorder score was 3.4 +/- 3.7. Mean PHQ-9 (3.5 +/- 4.0) and GAD-7 (3.4 +/- 3.7) scores at 12 months were similar to baseline. We found no statistically significant differences between the survey time points in participants' physical, respiratory, or emotional functioning on the CFQ-R, but there was a significant change in social functioning ( p < 0.001). There was no statistically significant change over time in optimism or selfefficacy, but there was a significant difference in CF medication beliefs between the four survey time points ( p = 0.008 for MBQ Importance subscale), with a decrease in perceived importance from baseline to 12 months. Conclusion(s): Whereas lung function and BMI increased in our sample by 12 months, similar improvementswere not seen in standard mental health outcomes. There was no change over time in physical, respiratory, or emotional functioning, optimism, or self-efficacy. Only CFQ-R social functioning had changed by 12 months, perhaps reflecting decreased COVID-related social isolation. There was also a change in medicationrelated beliefs, with a decrease in perceived importance of taking CF medications at 12 months. Future directions include conducting qualitative analyses of open-ended questions and further examining data on social stigma, motivation to take medications, and body image, as well as examining relationships between outcome variables and baseline FEV1 and BMICopyright © 2022, European Cystic Fibrosis Society. All rights reserved
ABSTRACT
Background: Achieving UNAIDS global 95 targets among people living with HIV (PLHIV) is key to HIV epidemic control. Eswatini, a country with one of the severest HIV epidemics, has implemented an aggressive national HIV response with comprehensive HIV prevention and treatment services. We assessed progress towards these targets in the high HIV disease burden setting of Eswatini. Method(s): We compared 95-95-95 indicators and HIV incidence from two sequential Population-based HIV Impact Assessment (PHIA) surveys conducted in Eswatini in 2016 and 2021. These PHIAs were similarly designed as nationally representative household surveys among individuals 15 years and older. Respondents completed interviews and provided blood samples for HIV rapid testing (Determine and Unigold), antiretrovirals (ARV) testing, and viral load (VL) measurement. The first 95 (diagnosed PLHIV) was assessed by self-report or detectable ARVs;second 95 (on treatment) by self-report or detectable ARVs among diagnosed PLHIV, and third 95 (VL suppression, VLS) as VL < 1,000 copies/mL among PLHIV on treatment. Annual HIV incidence was estimated from recent infections (classified by HIV-1 LAg avidity assay, VL and ARV detection) using the formula recommended by the World Health Organization Incidence Working Group. Survey weights accounting for sample selection probabilities and adjusted for nonresponse and noncoverage were applied. Result(s): The 11,199 adults in the 2021 PHIA were at 94-97-96, while the 10,934 adults in the 2016 PHIA were at 87-89-91, a statistically significant increase of 5-10% in all 95 indicators (see Table). Target achievement varied by sex, but all 95 indicators improved among men (92-96-97 in 2021 vs 80-90-91 in 2016) and women (95-98-96 in 2021 vs 91-88-91 in 2016). Overall annual HIV incidence declined by 45% from 1.13% in 2016 to 0.62% in 2021 (p = 0.055). Annual HIV incidence in 2021 was nearly seven times higher among women (1.11%) than among men (0.17%). Conclusion(s): These findings reflect substantial progress toward HIV epidemic control, a remarkable achievement in the context of health, social and economic disruptions and challenges associated with the COVID-19 era. The 2021 data highlight remaining gaps in knowledge of HIV status, particularly among men, and HIV incidence reduction, particularly among women.
ABSTRACT
Background: The safety profiles of the Ad26.COV2.S and AZD1222 COVID-19 vaccines have not been described in a general population in Malawi. We present self-reported adverse reactions (AE) following receipt of these vaccines in Malawi as part of a phone-based syndromic surveillance survey. Method(s): We conducted phone-based syndromic surveillance surveys among adults (>=18 years) with verbal consent from July 2020 to April 2022. We used secure tablets through random digit dialing to randomly select mobile phone numbers and electronic data collection forms. Survey questions included whether the respondent had received at least one dose of the COVID-19 vaccines, whether they had experienced any AE following vaccination, and the severity of the AE. We used multivariable analysis to identify factors associated with self-reported adverse reactions post-COVID-19 vaccination. Result(s): A total of 11,924 (36.0%) out of 33,150 participants reported receiving at least one dose of either Ad26.COV2.S or AZD1222 between July-December 2021;65.1% were female. An estimated 49.2% of the vaccine recipients reported at least one AE, 90.6% of which were mild, and 2.6% were severe. About 16.9% (n=656) of respondents who received the first dose of AZD1222 had AE, while 50.2% (n=2,823) of those who received the second dose of AZD1222 and nearly all individuals (n=2,385) who received Ad26.COV2.S reported AE. Joint pain (45.5%), fever (26.7%), headache (26.1%), pain at the injection site (24.4%), and fatigue (16.6%) were among the commonly reported AE. Males were less likely to report an AE compared to females [Adjusted Odds Ratio (AOR) 0.81 95% confidence interval (CI) 0.75-0.88]. Older age was associated with reduced odds of an AE compared to those aged 18-24 years: 65 years+ (AOR 0.62, 95% CI 0.50- 0.77). The likelihood of reporting AE increased with education level: tertiary education AOR 2.63 95% CI 1.96-3.53. Respondents who thought COVID-19 vaccines were not safe were more likely to report post-vaccination adverse reactions than those who thought it was very safe (AOR 1.44, 95% CI 1.30-1.61). Conclusion(s): Ad26.COV2.S and AZD1222 vaccines are well-tolerated, with primarily mild and few severe AE among adults living in Malawi. Self-report of AE following COVID-19 vaccine receipt is associated with gender, age, education, and concern about the safety of the vaccines. Recognizing these associations is key when designing and implementing COVID-19 vaccination communication messages to increase vaccination coverage.
ABSTRACT
Background: As part of an international multi-country study on COVID-19 vaccine immunogenicity (InVITE, NCT05096091), we sought to characterize baseline anti-Nucleocapsid (N) and anti-Spike (S) seropositivity by country and by self-report of prior positive SARS-CoV-2 test result. Method(s): 3063 vaccine-naive individuals from the InVITE study cohort, who received a COVID-19 vaccine as part of their country's national immunization programs at participating sites in Democratic Republic of Congo (DRC), Guinea, Liberia and Mali, were enrolled between August 2021 and February 2022. Demographic and baseline characteristics were collected at study enrollment. Blood was collected at baseline prior to initiation of the vaccine regimen. SARS-CoV-2 anti-S antibody and anti-N antibody levels were measured using Quanterix anti-S IgG semi-quantitative antibody and BioRad Platelia SARSCoV- 2 anti-N Total Ab assays, respectively. Demographic characteristics were assessed for association with positive anti-S and anti-N serology. Result(s): Baseline demographics and serology results by country and overall are shown in the table. Conclusion(s): Despite low numbers of prior self-reported positive SARS-CoV-2 test, the serology results in this cohort indicate prior infection in a significant proportion of the InVITE study participants prior to receipt of a first dose of COVID-19 vaccination. These results suggest widespread previous SARS-CoV-2 infections that were unrecognized possibly due to mild-no symptoms, poor access to/availability of testing and/or limited monitoring through surveillance. Baseline Demographics and Serology Results.
ABSTRACT
Introduction: As of 29 July 2022, SARS-CoV-2 has infected 4.7 million Malaysians. Reinfection, defined as a new infection 90 days from initial infection is now rising due to the emergence of new variants. Studies have shown that healthcare workers (HCW) are 3.4 times more likely to test positive for COVID-19. This study aims to describe the reinfection rate of COVID-19 and protection effectiveness (PE) from past infection among HCWs in public hospitals in Malaysia. Method(s): A prospective cohort study was conducted from March 2021. HCWs were followed up to determine the post BNT162b2 vaccination humoral response to SARS-CoV-2. Additionally, participants were prompted to self-report a positive COVID-19 result. Reinfection rates were calculated using the total number of patients who had a prior infection as denominator. Infection rates were analysed at a predetermined period throughout our follow-up. Protection offered by prior infection was calculated as one minus the ratio of infection rate for COVID-19 positive patients and COVID-19 naive patients (1 - RR x 100%). Result(s): In this cohort, the cumulative incidence rate for SARS-CoV-2 is 44.6% (246/551). Reinfection rate is 6.5% (16/246). The PE at 3 and 6 months were 100% respectively while the PE at 9 and 12 months were 72.1% and 56.2%. Conclusion(s): Past infection offers 100% protection against reinfection up to 6 months but this protection steadily declines with the emergence of Omicron variant, even among vaccinated and boosted individuals. As variant-specific vaccines are still in development, reducing exposure and compliance to COVID-19 prevention guidelines are imperative to avoid infection.
ABSTRACT
Purpose: Rehabilitation to address modifiable factors associated with chronic hip-related groin pain (CHRGP) may lead to reduced pain and improved function, yet little is known about its effectiveness. We assessed the preliminary effects of two interventions that target two distinct mechanisms, sensory disturbances and abnormal movement patterns. Sensory disturbances such as peripheral and central sensitization may contribute to pain persistence long after initial injury. Joint mobilization (JtMob) may impart a neurophysiological response within the nervous system that results in pain reduction and improved mobility. Abnormal movement patterns may create altered mechanical stresses on hip joint structures, resulting in pain and activity limitations. Movement pattern training (MoveTrain) may improve movement patterns and thus patient function. Method(s): Patients with CHRGP, 18-40, were enrolled. Assessments included self-report questionnaires, clinical exam, and quantitative sensory testing. Outcomes included the Hip disability and Osteoarthritis Outcome Score (HOOS), a patient-reported outcome;frontal plane kinematics of hip, pelvis, and trunk during single leg squat;and pain pressure threshold (PPT) assessed at the anterior groin of the most bothersome hip and dominant thenar eminence (local and generalized pressure hypersensitivity, respectively). Patients were randomized to JtMob or MoveTrain in a 1:1 ratio stratified by sex and HOOS Symptoms. Treatment for both groups included 10 individualized visits over 12 weeks with a trained physical therapist (PT);assessment of patient goals and education which focused on patient-specific tasks reported by the patient to be symptom-producing;instruction in a home exercise program (HEP);and handouts that provided education, description and benefits of assigned treatment and instructions for HEP. The key element of JtMob was PT-provided manual techniques using specific criteria to determine the joint mobilization techniques and parameters used for each patient. The patient's symptom report to each technique was monitored and if indicated, the technique modified according to our outlined procedures. The HEP included flexibility exercises. The key element of MoveTrain was task-specific instruction to correct abnormal movement patterns displayed during daily and patient-specific tasks. For example, hip adduction was minimized during a step descent. The HEP included repeated practice of modified tasks. Task difficulty was progressed based on each patient's performance. Immediately after treatment completion, patients returned for follow up assessment. To assess treatment sustainability after the active treatment phase, we collected HOOS at 6 and 12 months (extended follow-up), and kinematics and PPT at 12 months. Data from patients who provided any data after baseline were analyzed with a repeated measures analysis of variance (RM-ANOVA) with baseline value as a covariate, patient as a random effect, and an autoregressive covariance structure. After adjusting for baseline, the between-group difference in change from post-treatment to each extended follow-up results from pre-planned statistical contrasts in a RM-ANOVA that includes main effects for treatment group, visit and the group by visit interaction. The within-group treatment effect at each extended follow-up was calculated by subtracting the earlier time point from the later follow-up within each treatment group. Dependent samples t-tests were used to assess the degree of within-group change. Result(s): Demographics and outcome data are provided in Tables 1 and 2, respectively. Thirty-three patients with CHRGP were randomized and 29 (88%) provided post-treatment data. Four patients did not complete treatment or post-treatment testing (3 due to COVID pandemic, 1 lost to follow up);6 patients did not complete 12 month laboratory testing (due to pandemic), but did complete 12 month questionnaires. Previously, we reported that both groups reported clinically important improvements in HOOS subscales and MoveTrain group improved hip and pelvis kinematics immediately after treatment compared to baseline. After adjusting for baseline, there were no between-group differences in change in outcomes between post-treatment and extended follow-up when comparing JtMob and MoveTrain, indicating that treatment effects immediately post-treatment were maintained at 12 months after treatment completion. Conclusion(s): Our preliminary findings suggest that 12 weeks of JtMob or MoveTrain, may result in improvements in patient-reported pain and function and these effects may persist 12 months after treatment completion. A future, larger trial to definitively assess the efficacy of JtMob and MoveTrain and identify factors associated with long-term outcomes will improve our ability to develop treatment strategies for people with CHRGP. [Formula presented] [Formula presented]Copyright © 2023
ABSTRACT
The COVID-19 pandemic has caused changes in people's lifestyles, mainly in healthy eating habits and behaviors. Therefore, our objective was to evaluate the association of eating habits, family eating behaviors, lifestyles, and perception of nutritional status with the risk of overnutrition in children and adolescents during the COVID-19 pandemic. A cross-sectional study was conducted on a sample of 661 Chilean children and adolescents. The study tool was an online self-report questionnaire taken during the COVID-19 lockdown. We observed overnutrition in 37.5%. Habits such as sleeping the recommended number of hours by age group and having healthy family behaviors decreased the risk of overnutrition by 49.0% (OR= 0.510, p= <0.001) and 10.8% (OR= 0.892, p= 0.01), respectively. Parents' perception of weight gain during the pande-mic, the distortion of nutritional status and the health risk of their children's nutritional status increased 4.8 (OR= 4.846, p= <0.001), 8.5 (OR= 8.580, p= <0.001) and 3.8 (OR= 3.826, p= <0.001) times, respectively, the risk of overnutrition in children and adolescents. In conclusion, the COVID-19 lockdown and school closures may have affected lifestyles. In addition, the role of parents in the perception of nutritional status and family eating behaviors is fundamental since they could be a predictor of the risk of overnutrition. These findings propose further research to design plans and programs to avoid the consequences related to overweight and obesity.Copyright © 2023, Sociedad Chilena de Nutricion Bromatologia y Toxilogica. All rights reserved.
ABSTRACT
Purpose of Study: Fatigue is a confusing blend of feelings and actions that makes us feel strangely out of place. It has a significant negative impact on physical and emotional well-being, affecting the quality of life of patients. Fatigue has been poorly understood, due to its complex differential diagnosis, ranging from endocrine and respiratory to psychiatric disorders. In Wyoming, there has been an increase in anxiety and depression symptoms during the pandemic. Additionally, State budget cuts have caused a reduction in mental health services. Therefore, Primary care doctors must discuss, inform, and screen for mental health problems related to fatigue in the community due to the combination of rising mental health symptoms and declining mental health resources. Increasing screening for fatigue, using a Fatigue Assessment Scale (FAS), as an early intervention to address physical and/or mental Fatigue in primary care clinics, in Rock Springs, Wyoming. Methods Used: In primary care, there has been an increasing number of patients presenting with signs of fatigue, especially after the pandemic, which needs to be better understood. Currently, there is not a widespread gold-standard screening tool for Fatigue in primary care practice. Upon literature review, a simple three min, 10-item self-report questionnaire called the Fatigue Assessment Scale (FAS) addresses both physical and mental fatigue, ranging from lack of motivation to lack of energy. Summary of Results: FAS should be integrated into primary care clinics in Rock Springs, Wyoming with other screening questionnaires such as the anxiety/depression screening, to screen for and measure the severity of fatigue. Patients with physical fatigue along with shortness of breath and recent COVID exposure can benefit from pulmonary rehabilitation, whereas Patients with mental fatigue along with nausea, vomiting, and a recent chemotherapy session, can benefit from a counseling session and blood tests. Conclusion(s): FAS along with the history of present illness and physical exam will help guide the diagnosis with different clinical tests, blood tests, imagining studies, physical therapy, rehabilitation, and/or medications.