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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.
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Background: Coronavirus disease 2019 (COVID-19) pandemic is still spreading worldwide and it has resulted in severe economic disruptions and unrivalled challenges to health-care system. Aims and Objectives: This study was planned to evaluate the knowledge, attitude, practice, and acceptability of COVID-19 vaccination among medical professionals. Material(s) and Method(s): A questionnaire-based cross-sectional study was conducted on 276 medical professionals working in Puducherry using convenience sampling method. Data were collected using self-administered questionnaire. Descriptive statistics such as frequencies and percentages were computed. Statistical analysis was done using SPSS software 28.0 Version. Pearson's Chi-square analysis and multinomial regression analysis were performed. Result(s): Among the 276 respondents, 71 (25.7%) were affected with COVID-19 infection, 274 (99.2%) got vaccinated. Two doses were taken by 90.6% and 24 (8.7%) had received one dose of vaccination during the study period. Adequate knowledge was seen (P = 0.029) among the doctors who received two doses of vaccination (P = 0.019). Positive attitude was observed among the professionals who were vaccinated with CoviShield (P <= 0.001) and received two doses of vaccination (P = 0.003). About 79% of participants experienced common side effects due to vaccination. About 83.3% of participants were willing to take Booster dose and their choice of vaccine was CoviShield 76.4%, Covaxin 21.7%, and only 12% endorsed Sputnik V. About 69.2% of them have accepted that after mass vaccination campaigns, COVID-19 infection has been reduced. Conclusion(s): The present study findings showed adequate knowledge, favorable attitude, good practice, and acceptability of COVID-19 vaccination. Public health officials should utilize this opportunity and engage the medical professionals in educational campaigns which could reduce the misconceptions and alleviate the fear about the vaccination among the general population.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Objectives: Several populations are at greater risk of severe COVID-19 due to inadequate responses to COVID-19 vaccines. Many of these individuals, and their caregivers, continue practicing varying degrees of social isolation to avoid SARS-CoV-2 infection. Following the end of lockdowns, the behaviors and impacts of continued isolation on the quality-of-life of high-risk populations remain poorly understood. This study describes the main avoidance and protective behaviors and ongoing impacts experienced by adults and caregivers of adults at high-risk of severe COVID-19. Method(s): Four virtual focus groups (April-July 2022) were conducted with individuals at high-risk of severe COVID-19, or caregivers, recruited via a convenience sample from patient panels. A discussion guide of open-ended questions was prepared based on COVID-19 guidance documents and a literature review. For qualitative analyses, an inductive approach was used for behaviors, deductive for impacts. A pre-defined codebook was updated throughout as needed. Salient concepts were defined as those mentioned by >=30% of participants or in every focus-group session. Result(s): Fourteen participants were interviewed (12 patients, 2 caregivers). Participants highlighted continued behaviors greatly impacting their quality-of-life. Avoidance behaviors (staying home, avoiding bystanders, avoiding shopping facilities and gatherings, using delivery services, family protection [43%-64%]) and protective behaviors (masking [79%], vaccination [57%]) were reported. Negative impacts included family relationship impacts (71%), collapse of social relationships (57%), difficulties accessing healthcare (43%), anxiety, fear, loneliness and depression (36%-50%), and impacts on employment/finances (36%). Positive impacts included the advent of telehealth (57%) and recognizing family importance (36%). Lack of trust in authority (57%) and hoarding of medications (36%) were negative general impacts of the COVID-19 pandemic highlighted. Concepts reported by patients and caregivers were similar. Conclusion(s): Individuals at high-risk of severe COVID-19 and their caregivers maintained avoidance and protective behaviors similar to those reported during lockdowns. This study highlights the continued burden experienced by high-risk populations.Copyright © 2023
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Introduction: There is a dearth of information on older users (65+ years) of medical cannabis, who may face unique challenges due to altered metabolism with aging, concurrent medication use, and risk of adverse effects. This observational study aimed to describe a large cohort of older medical cannabis users in Canada. Method(s): From Oct 2014 to Oct 2020, a commercial medical cannabis provider based in Canada collected anonymized data for research purposes from patient volunteers. Data included demographic, social, and health details (at intake) and cannabis products, self-perceived changes in symptoms and change in medications (at follow-up, variable duration). Cannabis products were categorized as cannabidiol (CBD) only, tetrahydocannabinol (THC) only or mixed CBD/THC. Of the mixed, formulations could be in 1:1 ratios (CBD+/THC+), predominantly CBD (CBD+/THC-) or predominantly THC (CBD-/THC+). Result(s): In total, 9766 subjects in the older cohort (65+ years old) completed the entire questionnaire (mean age (SD) = 73.6 (6.8) y, 60% female). They represented 23.1% of the total dataset (N = 42,267, mean (SD) =51.5 (16.8) y). The proportion of adults in the older cohort tended to increase over time (pre-2018: 17.6%;2018: 26.7%;2019: 31.2%;2020: 22.7%, when the overall intake decreased from 8869 to 5644). Among the older cohort, 15.5% were previous cannabis users and 67.7% were referred for chronic pain (mainly arthritis, chronic pain, lower back pain). Concomitant analgesic use was common (over-the-counter analgesics: 44.5%;opioids: 28.3%;NSAIDs: 24.5%). 7.9% of the sample (compared to 19.9% in the whole sample) were referred for psychiatric disorders, though 21.4% indicated antidepressant use and 12.3% indicated benzodiazepine use. Another 7% were referred for neurological disorders. Follow-up data were captured in visits (11,992) from 4698 older patients, averaging 2.5 visits per patient. The type of medical cannabis used changed over time, with increasing use of cannabis oil compared to herbal cannabis. In 2020, of 2478 visits, 78.9% use was cannabis oil and 6.7% was herbal forms (pre-2018: 57.6% vs 36.2%). The composition of cannabis oil demonstrated a preference for cannabinoid oil (CBD+) over tetrahydrocannabinol (THC+) in 6043 visits: 45.2% were using CBD+ preparations, only 3.2% were using THC+ preparations, and for CBD/THC combinations, CBD predominated (CBD+/THC-: 30.5%;CBD+/THC+: 16.8%;CBD-/THC+: 4.3%). Adverse-effects (7062 visits) included dry mouth (15.8%), drowsiness (8.6%), dizziness (4%) and hallucinations (0.6%). Patients reported improved pain, sleep and mood over time, though 15-20% reported no improvement or worsening. Medication use was mostly unchanged, though 40% of opioid users reported requiring reduced dosages. Conclusion(s): These data were drawn from a large convenience sample. The data suggest an increasing proportion of older users of medical cannabis, though COVID-19 may have affected recent use. Female users comprised a higher proportion, and cannabis oil containing CBD was preferred. Systematic studies of effectiveness and safety in older users of cannabinoids are needed given its increasing use. Funding(s): No funding was received for this work.Copyright © 2021
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Background: During covid-19 period not only general public was victim of anxiety besides all medical professional also face anxiety and change their Information seeking behaviour according their personality. Curiosity is in human nature with the easy access to internet the new horizon to information has been opened. People searching trends have shown that they are interested in health risk to health treatment for their health related problems. Aim(s): In this study examined the influences of anxiety (ISA) and Personality traits (PT) on health information seeking behaviour (HISB) among the Doctor, paraprofessional and final year medical students who are frontline worker during pandemic situation. Methodology: The study adopted survey method with non-probability convenience sampling to collect statistical. Questionnaires werefiled from 313 participants by utilizing convenient sampling and analyzing the data through SPSS. Result(s): The result showed that significant relation between personality traits, information seeking anxiety and health information seeking behaviour. In medical library user PT has significant impact on HISB (p<.05), (AVG_PT=.002) and ISA has impact on HISB but it is not significant in medical professional (beta -.070) value shows ISA has negative impact on HISB. Practical implication: This study will be beneficial for information professionals, health care workers, policy makers and administrators to access of information resources in hybrid format. Conclusion(s): Medical professional's plays an important role in our society. They work hard and served the nation during pandemic situation. Anxiety is natural phenomena to every person. So medical professional also feel anxietybut the medical profession demands its professionals to stay cool, calm and free of anxiety by having analytical and cognitive skills, in order to fulfill the needs of their profession. This research helps to understand that ISA has no significant impact on HISB while PT has significant impact on HISB.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background: The outbreak of acute respiratory syndrome with novel coronavirus 2019 (COVID-19) in December 2019 in Wuhan, China, caused a worldwide outbreak of the disease. To treat the disease, some drugs were identified and introduced that did not show a significant effect on the recovery of the disease. Due to the need to manage inpatient beds, this study was conducted to evaluate the effectiveness of Remdesivir in the treatment of outpatients with moderate to severe COVID-19. Method(s): The present study was a retrospective cohort with a convenience sampling method. It was conducted by referring to the records of COVID-19 patients who were referred to the respiratory clinic of Shahid Beheshti Hospital as outpatients in the period from April to August 2021. Result(s): This study was conducted on 263 COVID-19 patients with a mean age of 51.16+/-14.39 years from 19 and 90 years old. Data were collected through a researcher-made checklist and analyzed using SPSS 20. Kolmogorov-Smirnov test, paired t-test, and Mc Nemar's test were used to evaluate the data. The significance level was considered at the level of 0.05. Conclusion(s): Findings revealed that no clear correlation was found between hospitalization and death rate compared to other patients. In our study, the risk factors for severe COVID-19 did not affect the rate of hospitalization or death of patients.Copyright © 2023 Bentham Science Publishers.
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Objectives: The growing implementation of extracorporeal membrane oxygenation (ECMO) for patients with COVID19 has led to increased involvement of nurses in treating ECMO-supported patients (ECMO-SP). In June 2021, the Israeli Ministry of Health;s Nursing Administration published the first director;s circular in the world to detail the nursing scope of practice in caring for ECMO-SP. This study aimed to examine how often nurses perform various activities while caring for adult ECMO-SP. Method(s): A cross-sectional study. A convenience sample consisted of 76 registered ICU nurses (mean age 41.3+/-8.7 years;71% female). A 20-item Nursing Activities in the Care of ECMO-SP instrument was developed based on the Israeli Ministry of Health;s procedure on Nursing Practice in the Care of ECMO-SP and a literature review. The instrument examined how often nurses perform various activities on a Likert scale ranging from 1 (Never) to 5 (Always). Exploratory and confirmatory factor analyses (EFA and CFA), as well as descriptive statistics and Pierson;s correlations were performed. Result(s): When examined in EFA and CFA, the instrument yielded acceptable fit indices. The instrument contains four subscales with the following mean +/- SD scores: Factor 1. Nursing care of ECMO-SP not related to the ECMO device (7 items, a=0.90), M+/-SD=4.66+/-0.61;Factor 2. Activities on the ECMO device during emergencies (5 items, a=0.82), M+/-SD=2.1+/-0.91;Factor 3. ECMO device calibrating and monitoring (4 items, a=0.72), M+/-SD=3.26+/-1.0;and Factor 4. Medication and blood administration through the ECMO device (4 items, a=0.73), M+/-SD=1.52+/-0.60. Of the 20 nursing activities, 10 (50%) were reported as "never" or "rarely" performed. Nine out of 20 items (45%) were reported as "very often" or "always" performed. Conclusion(s): Ten out of 20 (50%) activities while caring for ECMO-SP listed in the scope of practice as permissible for nurses to perform were reported as not performed at all or performed rarely. Policymakers need to act so that the activities listed in the nursing scope of practice are carried out by nurses in practice.
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Aims: Onco-hematologic diseases (lymphomas, myeloma, leukemia) require intensive treatment regimens and represent a burden at the affective and instrumental level for their caregivers. The aim of this study was to investigate the link between caregiving burden and depressive symptoms in caregivers of onco-hematologic patients during the SARS-CoV-2 pandemic. Method(s): A convenience sample of 101 caregivers of onco-hematologic patients were recruited at the Hematology Unit of the Holy Spirit Hospital, Pescara, Italy. Most of the caregivers were female (80%) with an average age of 41 years old (SD = 14.01). Participants were administered the Caregiver Burden Inventory (CBI), the Patient Health Questionnaire-9 (PHQ-9) for depression, and the Fear of Covid-19 Scale (FCV-19S) during two months of the COVID-19-related stay-at-home period (April-May 2021). Result(s): Moderate-to-severe depression (PHQ-9 > 10) were reported by 36% of caregivers. Depressive symptoms were associated with caregivers' time-dependence (r = 0.43), developmental (r = 0.61), physical (r = 0.72), social (r = 0.60), and emotional burden (r = 0.43) (all ps < 0.001). CBI explained 53% of the PHQ-9 variance, particularly the physical (beta = 0.54, p < 0.001) and the social (beta = 0.30, p < 0.01) dimensions of burden. Unexpectedly, COVID-19 was not associated with caregiver burden and depressive symptoms. Conclusion(s): Caregivers of onco-hematologic patients may experience depression due to the burden of caregiving, which is related mostly to the patients' disease rather than extraordinary, even dramatic events such as the pandemic. Psychological interventions are needed for them.Copyright © 2023
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The aim of this study was to investigate factors influencing UK sonographers' practice of adult bowel ultrasound. A mixed-method online questionnaire was designed and shared on social media platforms in April 2021. Research restrictions due to COVID19 limited the sample size permitted. Convenience sampling recruited thirty UK sonographers performing adult abdominal ultrasound in their practice. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using inductive thematic analysis. Quantitative data revealed that 53% (n= 16) of the participants expressed a lack of confidence in scanning the bowel, while 77%, (n = 23) indicated a high level of interest in training in bowel ultrasound. Although 63.3% (n = 19) of the participants reported a high level of confidence in scanning the bowel for suspected appendicitis, the majority (70%, n = 21) expressed lack of confidence in examining the bowel for other pathologies like inflammatory bowel disease (IBD). Inductive thematic analysis of qualitative data revealed that the participants had varying opinions on this topic. Emerging themes included training opportunities, preference of other imaging modalities, management challenges, sonographers, and radiologists' influence. Qualitative results suggested that factors influencing sonographer evaluation of the bowel include advanced levels of training, a high degree of support from radiologists, regular bowel ultrasound lists, audits, and feedback from clinicians. Based on the findings of this study, most sonographers are not confident in practising bowel ultrasound beyond the evaluation of suspected appendicitis. Surveyed sonographers were interested in expanding their roles into other areas of bowel ultrasound like examining for Crohn's and ulcerative colitis. Sonographer role extension into this area of practice is limited by various factors like chronic shortage of sonographers, increasing workload, limited training, and the perception of diminishing support from radiologists. We recommend a future study that is not limited by a small sample size.
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Intro: COVID-19 vaccines are safe and effective at reducing risk of severe COVID-19 among pregnant women, a group at higher risk of severe disease. However, vaccine uptake has been slow among people in Zambia. We sought to describe vaccine uptake among pregnant women in Zambia. Method(s): We conducted serial cross-sectional surveys among pregnant women attending first antenatal care visits in one rural and two urban districts of Zambia from December 2021 through June 2022. Ten health facilities per district were randomly selected and a convenience sample of 20 women per facility per month were recruited. Consenting participants were administered an electronic questionnaire asking about offers and receipt of COVID-19 vaccines. Finding(s): In total, 3,652 women were recruited from December 2021 to June 2022, and 82.4% had not received a COVID-19 vaccine. Vaccine coverage among participants rose from 10.5% in December 2021 to 28.7% in June 2022 (p<0.01). During the same period, the proportion of women who reported being offered a vaccine rose significantly from 22.4% to 52.5% (p<0.01), with a non-significant increase in the proportion of women who were unvaccinated but willing to accept a vaccine (58.0% to 65.8%, p=0.59). Among 785 women who were unvaccinated and not willing to accept a vaccine, 42.3% were concerned about the safety of vaccination during pregnancy. Conclusion(s): Vaccine coverage among pregnant women in Zambia remains low and safety concerns during pregnancy are high. Door-to-door vaccination campaigns and individual vaccination consultations at all healthcare encounters may increase the number of women being offered a vaccine. Focused safety messaging for pregnant women may help to alleviate fears and increase COVID-19 vaccine uptake.Copyright © 2023
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AIM: The objective is to explore the general perception, knowledge, and attitude of people in Saudi Arabia toward the COVID-19 vaccination. METHOD(S): An observational and cross-sectional study was conducted with 332 Saudi adult population attending primary health centers in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia, between May and July2021 using a self-administered questionnaire. All adults, equal, or older than 18 years old of both genders during the period of the study were included and the only exclusion criteria are the age and patient with psychiatric disorder. We use convenience-sampling technique, due to the difficulty to generate sampling frame. Data are going to be entered and analyzed using Statistics Package for the Social Science version 21 software in August 2021. RESULT(S): Majority of participants (93.4%) had good knowledge about COVID-19 vaccines, regarding attitude more than 50% have positive attitude toward vaccination. Despite this high level on acceptance 48.5% of the participant in this study disclosed that they are not aware of vaccine side effects. With regard to perception, 66.9% of our study subjects believed that vaccination is necessary to eradicate COVID-19 pandemic. Furthermore, 72.4% thought that everyone should be vaccinated, starting with general public 74.5%, then health worker 57.9%. CONCLUSION(S): Almost most of Saudi population aware about the COVID-19 vaccines. Most Saudi people knew about it through media. A long-term side effect of getting vaccines is the main obstacles toward vaccine acceptance.Copyright © 2023, Scientific Foundation SPIROSKI. All rights reserved.
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[Background] Sleep is closely related to immune function and human health, and adequate sleep is an important foundation for human health. [Objective] This study investigates the sleep status of the first-line medical staff in Wuhan in a fight against the coronavirus disease 2019 (COVID-19) outbreak, provides reference for improving the sleep quality of the first-line medical staff in public health emergencies. [Methods] Through convenience sampling, 112 medical workers (first-line group) who aided the COVID-19 fight in Wuhan and 134 medical staff (non-first-line group) who did not participate in the fight were selected. The Pittsburgh Sleep Quality Index (PSQI) was employed to collect data on the incidence of sleep disorders, time to fall asleep, duration of sleep, sleep efficiency, sleep disorders, use of sleep aid, and daytime functions. In addition, a self-made questionnaire was used to investigate the common concerns and time allocation characteristics of the first-line medical workers in the context of major infectious disease outbreaks. [Results] There were no significant differences between the two groups in demographic variables such as gender, age, job title, educational background, marriage status, number of children, and working years (P > 0.05). In the first-line group, 62 medical workers (55.36%) reported sleep disorders, while in the non-first-line group, 54 medical workers (40.30%) did;the difference was statistically significant (P=0.008). Among the seven components of the PSQI, the median sleep time (component 3) score of the first-line group was 1.5, which was higher than that of the non-first-line group (median 1.0) (P < 0.001);the median sleep efficiency (component 4) score of the first-line group was 1.0, which was higher than that of the non-first-line group (median 0) (P < 0.001). The actual sleep duration of the first-line group [(5.65+/-1.15) h] was lower than that of the non-first-line group [(7.00+/-1.40) h] (P < 0.001). The distributions of common concerns were different between the two group. The top three concerns were being infected (76.79%), exhausted (37.50%), and overloaded (27.68%) in the first-line group, and family members being infected (53.73%), being infected (45.52%), and child care (33.58%) in the non-first-line group. [Conclusion] The first-line medical team members report poor sleep quality, short sleep time, low sleep efficiency, sleep disorders, and many psychological concerns. It is necessary to take appropriate measures to improve their sleep quality.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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[Background] The epidemic of coronavirus disease 2019 (COVID-19) seriously affects the psychological status of medical staff who directly face the risk of the disease. [Objective] This study investigates the prevalence and related factors of depression, anxiety, and insomnia among medical staff during the COVID-19 pandemic. [Methods] From February 13 to March 1, 2020, a network questionnaire survey was conducted among 482 medical staff selected by convenience sampling. A self-designed questionnaire was used to investigate the basic demographic information and COVID-19-related questions. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI) were used to estimate the prevalence of depression, anxiety, and insomnia among the medical staff. Stepwise multiple linear regression analysis was performed with PHQ-9 score, GAD-7 score, and ISI score as dependent variables. Multivariate logistic regression analysis (forward-conditional method) on depression, anxiety, and insomnia as dependent variables was performed with basic demographic information and COVID-19-related questions as independent variables. [Results] Among the surveyed medical staff, the prevalence rates of depression, anxiety, and insomnia were 14.3%, 11.2%, and 23.2%, respectively. There were no significant differences in the prevalence rates among different age, gender, local risk level, and occupation groups and those aiding Hubei Province or not. The medical staff who directly contacted fever or diagnosed patients had more serious depression (b=1.73, 95%CI: 0.79-2.66) and insomnia (b=2.43, 95%CI: 1.48-3.39) and a higher risk of insomnia (OR=1.89, 95%CI: 1.21-2.96). The medical staff whose current protective measures cannot prevent infection had more serious depression (b=1.72, 95% CI: 0.65-2.80), anxiety (b=1.75, 95% CI: 0.76-2.75), and insomnia (b=1.73, 95% CI: 0.63-2.82), and had a higher risk of depression (OR=1.97, 95% CI: 1.11-3.49), anxiety (OR=3.00, 95%CI: 1.64-5.46), and insomnia (OR=1.79, 95%CI: 1.08-2.96). [Conclusion] During the COVID-19 epidemic, the risks of depression, anxiety, and insomnia among selected medical staff are increased compared with the non-epidemic period. Occupational exposure to high-risk groups and protective measures would significantly affect mental health of medical staff.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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Background: Fitness is a marker of physiological and mental health. The purpose of this pilot study was to assess the feasibility of processes to recruit women with polycystic ovary syndrome (PCOS) during the Covid pandemic and collect their health and fitness data. Additionally, the data was used to explore possible associations between anthropometrics, PCOS biomarkers, health-related quality-of-life (HRQoL), and depressive symptoms with that of fitness and self-reported physical activity levels among women with PCOS. Method(s): A convenience sample of women with PCOS (n = 15) were recruited via flyers and the snowball method. Participants completed surveys, anthropometrics, a dual energy x-ray absorptiometry scan, blood work, and a fitness assessment. Data were statistically analyzed using Spearman correlations. Result(s): Feasibility measures of recruitment and retention rates were 83% and 100%, respectively. Fidelity measurement for process averaged 97%. Participants (age 25.9 (+/- 6.2), mostly White (80%), single (60%), and employed full-time (67%)) were categorized as obese (body mass index (BMI) 32.2 kg/m2 +/- 8.3, percent bodyfat 41.1% +/- 8.1) with <=1 comorbidity. Most participants were not regularly physically active and had high free testosterone levels (7.6 pg/mL+/-4.3), elevated high-density lipoprotein (63.2 mg/dL+/-12.9), fair cardiovascular capacity, and below average muscular strength/endurance. The following statistically significant and strong associations were found: (1) VO2 max with percent bodyfat (-0.59;p = 0.02), sex hormone binding globulin (0.73;p = 0.00), HRQoL (0.72;p = 0.00), and depressive symptoms (-0.67;p = 0.00), (2) abdominal strength with BMI (-0.66;p = 0.01) and high density lipoprotein (HDL) (0.59;p = 0.02), (3) physical activity level with percent bodyfat (-0.72;p = 0.00), and (4) resistance training with low density lipoprotein (LDL) (-0.52;p = 0.05). Conclusion(s): Collecting health and fitness data from women with PCOS is a feasible research approach. Randomized controlled trials in which health and fitness data are collected from women with PCOS are needed to confirm possible associations between fitness and PCOS clinical features and is in the planning process. Copyright: Copyright © 2023 The Author(s).
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Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a respiratory condition characterised by a progressive and irreversible decline in lung function. COPD prevalence increased by 44.2% between 1990 and 2015, resulting in 3.2 million deaths globally in 2015.(1) Inhalers are an essential treatment for people living with COPD. However, poor adherence to inhaled medicines is associated with worsening symptom severity, increased hospitalisation, comorbidity, and mortality.(2) Patient Reported Outcome Measures (PROMs) have been designed to examine the factors that contribute to poor medication adherence (MA). To date, none provide a holistic assessment that could be used to design tailored MA interventions. This study sought to address this by evaluating a novel PROM that holistically assesses four key factors of MA referred to as Social, Psychological, Usage, and Rationale, in short, SPUR. Aim(s): To explore the validity of the SPUR model as a holistic PROM of MA in patients living with COPD Methods: This cross-sectional study surveyed adults living with COPD from a large London NHS Trust between January and December 2021. Participants were eligible if they had >=1 inhaler prescribed for a minimum of 6 months prior to the study and were able to read and write in English. Participants who were too clinically unwell to independently complete the survey were excluded, which often included those with a Covid-19 diagnoses. Convenience sampling was used to recruit participants from in-patient wards and the acute admissions unit prior to administration of face-to-face surveys. Survey questions related to socio-clinical data, the SPUR tool, and a previously validated PROM known as the Inhaler Adherence Scale (IAS) that was included as a comparator. The Medication Possession Ratio (MPR), a measure of a patient's pill count in a given time period, was used as an objective comparator of MA. MPR, IAS, and SPUR scores were compared using Spearman's rank correlation coefficient (p). Symptom severity was examined using the COPD Assessment Test (CAT), with a Chi-square analysis (chi2) conducted to explore the relationship between the CAT and SPUR. Result(s): From 123 patients approached for this study, 100 participated providing a response rate of 81.3%. The modal age range was 70-79 years. Participants were predominantly white (90%), educated to GCSE level (51%), and identified as female (52%). Over two thirds (67%) were ex-smokers. SPUR was significantly (p<0.01) and positively correlated with IAS (p=0.65) and MPR (p=0.30), demonstrating that SPUR is a valid measure of MA. Chi-Square analysis identified a significant (p<0.01) relationship between CAT and SPUR scores (chi2=8.570);hence SPUR could reliably identify patients with poorer adherence, which was associated with worsening symptom severity. Conclusion(s): A study strength includes the implementation of an objective measure (MPR) and PROM (IAS) as part of validating SPUR. However, the results should be treated cautiously given the small sample size, which was limited due to Covid-19. This study provides early evidence of SPUR as a reliable holistic measure of MA with significant associations to COPD symptom severity, which could be applied in clinical practice to prospectively address patient outcomes linked to poor MA.
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Introduction: There was an increase in antipsychotic prescribing for people with dementia during the COVID-19 pandemic (1). To explain this increase, the current study was conducted to explore the views of staff working in care homes for the elderly during the pandemic on the use of antipsychotics for residents with Behavioural and Psychological Symptoms of Dementia (BPSD). Aim(s): The aim was to explore the use of antipsychotics for people with BPSD during the COVID-19 pandemic by interviewing staff in care homes about their experiences during that time. Method(s): Semi-structured interviews were conducted online with staff working in ten UK elderly care settings using convenience sampling. Participants mainly onsite care home staff were recruited through online networks, for example, Twitter, and support groups such as CHAIN and NIHR clinical research network. Interviews were conducted between May 2021-March 2022, were audio recorded, transcribed verbatim, and analysed inductively using thematic analysis in NVivo version 12. Result(s): Ten interviews were completed with managers (n=2), care staff (n=6) and nurses (n=2) in nursing homes (n=7) and residential homes (n=3) (all were female). The first theme 'Challenges experienced in care provision' entails challenges experienced in the care environment;residents were confined to their rooms, activities were suspended, staff were absent and stressed, and family visits were barred. The reduced human contact affected residents' sense of self, mental and physical wellbeing, and in turn, their behaviours. The second theme 'Prescribing process' refers to doctors prescribing medicines in response to staff raising concerns. The third theme 'Attitude toward antipsychotics' denotes participants' positive and negative beliefs about antipsychotics. The positive beliefs included antipsychotics being the right choice and beneficial, an increased need and continued use of antipsychotics, use of a combination of medications and weighing the risks and benefits of antipsychotics. The negative beliefs included reports of adverse effects and short-term benefits of antipsychotics, antipsychotics not always beneficial, benefits in deprescribing, dislike for antipsychotics and belief antipsychotics are the last resort. Some expressed the need for antipsychotics had not increased but been driven by health professionals involved. The fourth theme 'Other psychotropic medication' alluded to other commonly used psychotropic medications and associated risks and benefits. The fifth theme 'Measures implemented within care settings' represented strategies implemented to avert the initiation or bolster antipsychotic deprescribing such as non-pharmacological approaches, nurses' assessment of residents before requesting antipsychotics, multidisciplinary consultation, and medication review. Conclusion(s): This is the first study that reports care home staff views on antipsychotic use for residents with dementia during the pandemic. The limitations include that only views of female respondents were obtained and the limited sample size. Care homes faced enormous challenges in the provision of care services to residents with dementia during the pandemic. The multitude of difficulties experienced in care homes due to lack of preparedness may have influenced staff to have positive views of antipsychotics and their use as an option during the pandemic. It's important to acknowledge and address these difficulties for example through education and training interventions to help with future preparedness.
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Introduction: Vaccination against COVID-19 can help prevent serious complications and death. The World Health Organization (WHO) Strategic Advisory Groups of Experts (SAGE) collated few evidences that vaccine hesitancy was due to socio-psychological factors like decreased trust on the safety or the effectiveness of the vaccines. In Malaysia, the main challenge was to ensure the broadest possible acceptance of COVID-19 vaccinations. This study aimed to assess the association between complete vaccination status with health factors and perception towards COVID-19 vaccine uptake amongst people living in Seberang Perai, Penang. Method(s): A cross-sectional study among 410 adults aged >=18 years old was carried out using convenience sampling technique in September 2021. Validated items related to vaccine perceptions were adapted from previous literature. Baseline vaccination data were obtained from the vaccination centre at Hospital Seberang Jaya. Descriptive and inferential statistics were conducted using SPSS version 22.0. Result(s): The mean age of the respondents was 31 (standard deviation (SD) +/- 10) years. A total of 317 respondents were women. More than half of them, 219 (53.7%) were tertiary educated. Total of 147 respondents completed vaccination and there was a significant difference between gender and age, p<0.001 and p=0.013, respectively. There was also a significant difference between vaccination status and perceptions on COVID-19 vaccines to be safe and effective (OR: 4.8, 95% CI: 1.2, 18.2, p=0.013). Conclusion(s): There were no associations between vaccination and health status, while those perceived COVID-19 vaccine to be safe and effective were more likely to be vaccinated as compared to those who did not.
ABSTRACT
Background: Coronavirus pandemic in 2019 led India to implement a complete lockdown except for essential services. Cancer patients faced hindrances in seeking medical help. This caused stress and worry, leading to reduced quality of life (QoL). This study evaluated QoL and pain management in palliative care cancer patients during the lockdown. Patients and Methods: This was a cross-sectional observational study at a tertiary cancer hospital, over one month period with convenience sampling. Participants included all who were unable to visit the palliative outpatient department during the lockdown during the COVID-19 pandemic. They were contacted telephonically and a valid QoL questionnaire was filled out. Disease, demographic details and pain were assessed. Result(s): A total of 51 were interviewed, 45% (n = 23) patients reported difficult access to medication during the lockdown;18 (35.3%) required morphine to alleviate pain and 6 (33.33%) faced difficulty in acquiring morphine tablets. QoL scores did not differ based on access to morphine (p = 0.648). Mean QoL scores were 12.7 +/- 3.76 and 15.0 +/- 3.60 amongst patients who did not have access to other medications and those who did have access, respectively (p = 0.03). Overall QoL FACT G7 mean score was 14 +/- 3.8. The variables NRS (pain intensity) and QoL scores were found to be negatively correlated (Pearson's Correlation Coefficient: r (49) = -0.69, p < 0.00001). Conclusion(s): Evaluation of QoL of palliative care cancer patients during global crises plays an important role in the assessment of patients' overall condition as well as to maintain a continuum of care.Copyright © Via Medica.
ABSTRACT
Introduction: Technologies such as electronic prescribing, clinical decision support systems, and electronic medication dispensers, are increasingly being introduced into healthcare. Existing toolkits focus on the implementation of such technologies, rather than identifying and mitigating any unintended consequences technologies may have on patient safety. They also focus on high-level organisational issues instead of those faced by end-users: frontline staff, patients and carers. Aim(s): To identify and classify types of unintended consequences that may be encountered by technologies' end-users, in order to inform development of a tool for identifying and preventing technology-related risks on patient safety. Method(s): Five focus group discussions with healthcare professionals, patients and carers were conducted through video-conferencing. Healthcare professionals with experience of using/implementing healthcare technologies and known to the research team via professional networks were invited to participate. Patient/carer participants were recruited using convenience sampling via an external research-participant organisation. Participants were asked to identify patient safety risks associated with the use of healthcare technologies, drawn from their own experiences and through consideration of hypothetical risks. Discussions were audio-recorded and transcribed verbatim. Transcripts were analysed by two researchers (NVivo R1.6) and two public partners (manually), using iterative inductive thematic analysis. Result(s): Eleven healthcare professionals and 29 patients and carers participated in focus groups. Three focus groups comprised patients, carers, and healthcare professionals. Two involved solely patients and carers. Analysis revealed five areas of unintended consequences (Table 1). Most unintended consequences identified by patients and carers were similar to those described by healthcare professionals. Healthcare professionals also described additional unintended consequences associated with technologies designed specifically for their use. Conclusion(s): A limitation of the study is that many of the unintended consequences identified related to virtual health technologies used during the COVID-19 pandemic, which may affect generalisability. A strength is that unintended consequences that have been overlooked in existing literature, such as the build-up of patients' psychological dependence on technologies, were identified. Developing a tool based on these will allow implementers and users of healthcare technologies to consider such issues and address the potential risks they may have on patient safety before healthcare technologies are fully implemented in practice.
ABSTRACT
The aim of this research was to investigate the mediating role of time attitudes in the relationship between self-esteem and resilience in high school students. High school students' self-esteem, time attitude, and resilience have been researched comparatively. The research was carried out with a quantitative research design and survey method. Participants, who were selected using a convenience sampling method, were high school students. The 1,932 participants consisted of students in the following grade distribution: 793 ninth grade (248 male, 545 female);365 tenth grade (78 male, 257 female);350 eleventh grade (90 male, 260 female);and 434 twelfth grade (130 male, 324 female). Participants were selected from secondary education institutions in Sakarya and Kocaeli during COVID-19 from January to May 2021. Data were collected using tools such as the Two Factored Self-Esteem Scale, Adolescent Time Attitude Scale, and Ego Resilience Scale. The data was analyzed with correlation analysis and regression-based mediation analysis to investigate the relationship between self-esteem, time attitude and resilience. The SPSS 22 package program was used to analyze the data. After analyzing the data, it has been concluded that the time attitude in adolescents indeed has a mediating role in the relationship between self-esteem and resilience. The results of the research will make important contributions to the related literature.Copyright © 2023, Pharmaceutical Association of Serbia. All rights reserved.