Effectiveness of an online short-term audio-based mindfulness program on negative emotions during the COVID-19 pandemic: Latent growth curve analyses of anxiety and moderated mediation effects of anxiety between mindfulness and negative affect.

This pilot study aims to explore the effects and mechanisms of a mindfulness-based intervention on negative emotions in community settings during the COVID-19 pandemic. Participants (N = 100) were randomized into an intervention group (n = 50) and a waitlist control group (n = 50). Participants in the mindfulness group underwent 3 weeks (21 sessions) of an online audio-based mindfulness-based intervention program and completed the online measures four times whereas those in the waitlist control group needed to complete the measures twice. Participants completed measures of the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule. The results of the measures of the two groups were compared. Moderated mediation analysis was used to analyze intervention outcomes on negative affect through anxiety. Unconditional quadratic latent growth analysis was used to test the growth trajectories of anxiety. The results showed that this intervention program was effective at improving positive affect and at reducing depression, anxiety, and negative affect. The baseline anxiety moderator was found to be significant, and indirect effects of anxiety post-intervention were found between the mindfulness-based intervention and negative affect. Anxiety levels of participants were not at the same starting point and had similar but non-quadratic growth trajectories. The mindfulness-based intervention program was effective at promoting mental wellbeing and reducing mental problems in community settings in China. Mindfulness practices were beneficial to people with different anxiety levels but had more obvious benefits on anxiety and a negative affect for participants with low anxiety levels. Clinical trial registration: ISRCTN16205138 on 26/02/2021.

Methodologies Used to Study the Feasibility, Usability, Efficacy, and Effectiveness of Social Robots For Elderly Adults: Scoping Review.

BACKGROUND: New research fields to design social robots for older people are emerging. By providing support with communication and social interaction, these robots aim to increase quality of life. Because of the decline in functioning due to cognitive impairment in older people, social robots are regarded as promising, especially for people with dementia. Although study outcomes are hopeful, the quality of studies on the effectiveness of social robots for the elderly is still low due to many methodological limitations. OBJECTIVE: We aimed to review the methodologies used thus far in studies evaluating the feasibility, usability, efficacy, and effectiveness of social robots in clinical and social settings for elderly people, including persons with dementia. METHODS: Dedicated search strings were developed. Searches in MEDLINE (PubMed), Web of Science, PsycInfo, and CINAHL were performed on August 13, 2020. RESULTS: In the 33 included papers, 23 different social robots were investigated for their feasibility, usability, efficacy, and effectiveness. A total of 8 (24.2%) studies included elderly persons in the community, 9 (27.3%) included long-term care facility residents, and 16 (48.5%) included people with dementia. Most of the studies had a single aim, of which 7 (21.2%) focused on efficacy and 7 (21.2%) focused on effectiveness. Moreover, forms of randomized controlled trials were the most applied designs. Feasibility and usability were often studied together in mixed methods or experimental designs and were most often studied in individual interventions. Feasibility was often assessed with the Unified Theory of the Acceptance and Use of Technology model. Efficacy and effectiveness studies used a range of psychosocial and cognitive outcome measures. However, the included studies failed to find significant improvements in quality of life, depression, and cognition. CONCLUSIONS: This study identified several shortcomings in methodologies used to evaluate social robots, resulting in ambivalent study findings. To improve the quality of these types of studies, efficacy/effectiveness studies will benefit from appropriate randomized controlled trial designs with large sample sizes and individual intervention sessions. Experimental designs might work best for feasibility and usability studies. For each of the 3 goals (efficacy/effectiveness, feasibility, and usability) we also recommend a mixed method of data collection. Multiple interaction sessions running for at least 1 month might aid researchers in drawing significant results and prove the real long-term impact of social robots.

Diagnostic accuracy of point-of-care tests in acute community-acquired lower respiratory tract infections. A systematic review and meta-analysis.

BACKGROUND: Point-of-care tests could be essential in differentiating bacterial and viral acute community-acquired lower respiratory tract infections and driving antibiotic stewardship in the community. OBJECTIVES: To assess diagnostic test accuracy of point-of-care tests in community settings for acute community-acquired lower respiratory tract infections. DATA SOURCES: Multiple databases (MEDLINE, EMBASE, Web of Science, Cochrane Library, Open Gray) from inception to 31 May 2021, without language restrictions. STUDY ELIGIBILITY CRITERIA: Diagnostic test accuracy studies involving patients at primary care, outpatient clinic, emergency department and long-term care facilities with a clinical suspicion of acute community-acquired lower respiratory tract infections. The comparator was any test used as a comparison to the index test. In order not to limit the study inclusion, the comparator was not defined a priori. ASSESSMENT OF RISK OF BIAS: Four investigators independently extracted data, rated risk of bias, and assessed the quality using QUADAS-2. METHODS OF DATA SYNTHESIS: The measures of diagnostic test accuracy were calculated with 95% CI. RESULTS: A total of 421 studies addressed at least one point-of-care test. The diagnostic performance of molecular tests was higher compared with that of rapid diagnostic tests for all the pathogens studied. The accuracy of stand-alone signs and symptoms or biomarkers was poor. Lung ultrasound showed high sensitivity and specificity (90% for both) for the diagnosis of bacterial pneumonia. Rapid antigen-based diagnostic tests for influenza, respiratory syncytial virus, human metapneumovirus, and Streptococcus pneumoniae had sub-optimal sensitivity (range 49%-84%) but high specificity (>80%). DISCUSSION: Physical examination and host biomarkers are not sufficiently reliable as stand-alone tests to differentiate between bacterial and viral pneumonia. Lung ultrasound shows higher accuracy than chest X-ray for bacterial pneumonia at emergency department. Rapid antigen-based diagnostic tests cannot be considered fully reliable because of high false-negative rates. Overall, molecular tests for all the pathogens considered were found to be the most accurate.

Personal protective equipment training team: a community nursing initiative.

COVID-19 provided significant challenges for community services and care homes. Residential and nursing care patients are considered highly vulnerable to the coronavirus due to their physical needs and environmental factors. Significant concern was raised with personal protective equipment (PPE) availability and appropriate training and support in local care homes. Members of the district nursing team and community services formed a team to deliver face to face training and support to care home workers to improve PPE adherence and reduce risks of transmission. Visits were offered to all 46 care homes in the locality and over 55 visits for teaching were performed in the first month. Challenges were faced with managing and prioritising frontline clinical duties. Feedback was overwhelmingly positive and care staff benefited from face-to-face delivery of education to support best practice.

Collaboration between a tertiary pain centre and community teams during the pandemic.

People with chronic pain faced potential treatment disruption during the COVID-19 pandemic in Singapore, as the focus of healthcare shifted. A model of rapid integration of a pain centre with community healthcare teams was implemented to care for vulnerable older patients with chronic pain and multiple comorbidities. Telemedicine and home visits by community nurses were used, with risk-mitigation measures, ensuring comprehensive assessment and treatment compliance. Medications from pain physicians were delivered at home through a hospital pharmacy. A secure national electronic health records system used by all teams ensured seamless access and documentation. Potential emergency department visits, admissions and delayed discharges were thus avoided. Integration of community teams with chronic pain management services can be recommended to ensure pandemic preparedness.