Influence of socio-demographic factors on perceived stress in outpatients with depression and anxiety in remission during the COVID-19 pandemic

Objective: The study aimed at identifying the influence of socio-demographic factors on perceived stress during the first and the second "waves" of the COVID-19 pandemic among patients with depression and anxiety in remission compared to controls. Method: The study was designed as case-control, cross-sectional and non-interventional, and included 60 outpatients with depressive and anxiety disorders in remission and 60 controls with or without family history of affective disorder. A self-assessment scale (Perceived Stress Scale, PSS-10) was used to evaluate perceived stress. The remission was objectified by the Clinical Global Impression scale (CGI-S 2) and a questionnaire about the socio-demographic features and clinical characteristics of the disorders was completed. Results: By using multiple logistic regression, it was found that the diagnostic category and/or the relevant family history did not predict higher levels of perceived stress during the COVID-19 pandemic (p > 0.05). Females were associated with higher risk of moderate or high stress (OR=2.613, p=0.017), as well as those working from home during the pandemic (OR=4.00, p=0.026). Conclusions: Addressing the COVID-19 effects on mental health in a biopsychosocial manner, the study shows the impact of socio-demographic factors such as gender and work environment in times of a psychosocial crisis. The lack of differences in stress perception by the patients in remission and healthy controls implicates the importance of adequate maintenance treatment and easy access to mental health services in times of crisis.

Pathological internet use levels and psychiatric diagnoses in adolescents admitted to a child psychiatry outpatient clinic after face-to-face education restriction due to the pandemic

Introduction: During the period of social restrictions against the pandemic, the screen time of individuals increased significantly, and youths' mental health was adversely affected due to the restriction of peer interactions and physical activities. The aim of this study was to evaluate the levels of internet overuse and psychiatric disorders in adolescents who applied to the child psychiatry outpatient clinic after the distance education period. Materials and Methods: A semi-structured tool, "Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version" (K-SADS-PL) was used to assess psychiatric diagnoses and Young Internet Addiction Test (IAT) to determine excessive internet usage. A total of 141 adolescents aged 11-18 years were recruited for this study. Results: The average score for IAT was statistically significantly higher in the youths with social anxiety disorder compared to those without (p=0.001) even after controlling for socioeconomic status (SES) (p=0.007). According to the hierarchical regression analyses, the girl gender (B=-6.899, p=0.029), younger age (B=-1.526, p=0.032) and co-morbidity of OCD (B=5.292, p=0.042) have statistically significantly predicted higher IAT scores in adolescents diagnosed with anxiety disorders. Conclusion: Identifying the common psychiatric diagnoses related to pathological internet use in adolescents, who started face-to-face education after a long break would enable mental health professionals to plan appropriate interventions for problematic areas particularly in vulnerable population more quickly when similar outbreaks recur.

New data show health care spending in Rhode Island rebounded in 2021 after pandemic-driven declines

The article focuses on new data from the Office of the Health Insurance Commissioner (OHIC) in Rhode Island, which shows a rebound in overall health care spending in 2021 after declines during the COVID-19 pandemic, particularly in the commercial market and Medicare.

Analysis of epidemiological features of COVID-19 in Pavlodar region

Introduction: Coronavirus infection (COVID-19), first reported at the end of 2019, which has spilled over into a worldwide pandemic and has affected all aspects of our modern lives. The aim is to study and analyze the epidemiological features of COVID-19 in the Pavlodar region. Materials and methods: Study design is a descriptive retrospective study analysis. The data were obtained from official sources of the Republican Center for e-Health of the Ministry of Health of the Republic of Kazakhstan. The study includes patients from June 30, 2020 to October 31, 2021 who received outpatient and inpatient treatment for coronavirus infection in medical institutions of the Pavlodar region. Study materials - uploading reports from the Republican Center for e-Health of the Ministry of Health of the Republic of Kazakhstan. Results: This article presents epidemiological data on the incidence of coronavirus infection in the population of Pavlodar region. The number of detected cases of COVID-19 from June 30, 2020 to October 31, 2021 was 29,443. Distribution of patients by sex predominated women - 17,831 (60.56%), than men - 11,612 (39.44%). The majority of cases were in the age group from 61 to 70 years old, with a male to female ratio of 1:1.54. Statistical significance was found between duration of stay and type of inpatient care (p < 0.001, VS-MPR*=2.135 x 10+22). Conclusion: The study showed that the number of women who fell ill prevailed over the number of men who fell ill, although the number of deaths among men prevailed over the number of deaths among women. In the study, there was no significant difference in the duration of stay for men and women in home care, compared to patients under 24-hour observation.

Thoughts on diagnosis and treatment plan of patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant in large shelter hospitals in Shanghai

The epidemic caused by the infection of severe acute respiratory syndrome coronavirus 2 omicron variant broke out in Shanghai in Mar. 2022. Omicron variant has characteristics such as strong concealment and rapid transmission, resulting in significant differences between the current round of epidemic and that in Wuhan. The number of infected patients (mainly asymptomatic infected patients) increased rapidly in a short term. Based on dynamic zero policy, shelter hospitals were set up in time in Shanghai to treat the patients. It is suggested that medical resources and patient characteristics should be taken into account in the independent cabin of a shelter hospital with more than 10 000 beds, and the clinical medical practice should be divided to 5 modes (universal education and management, community outpatient clinic, ward duty, emergency rescue, and temporary observation and transport) to optimize the allocation of medical resources, so as to further enhance the treatment capacity and efficiency of shelter hospitals.

Treatment of patients with Coronavirus infection COVID-19 at the post-hospital stage using hyperbaric oxygenation

Introduction. It is commonly known that patients who have been exposed to the coronavirus in the past and are in the recovery stage now, experience a decline in health-related quality of life, decreased productivity and decrease in cognitive functions, energy and breathing discomfort. aim. Efficiency analysis of hyperbaric oxygenation therapy for patients with syndrome on outpatient treatment stage of rehabilitation. This article also gives consideration to the management problems of patients who have been exposed to COVID-19 in the outpatient treatment stage. We consider disease process and theoretical determinants for the progress of pathological conditions as the result of earlier disease. material and methods. 110 outpatients who have been exposed to the coronavirus in the past and treated with hyperbaric oxygenation therapy are included in the research. Results estimation was based on a patient-reported outcomes questionnaire and simple, noninvasive methods, including remote thermography. results and discussion. The hyperbaric oxygenation method has shown us high efficiency for reducing residual symptoms of COVID-19. Conclusion. Inclusion of hyperbaric oxygenation into Post-COVID-19 rehabilitation program leads to immediate treatment effects, decreasing faintness and fatigability, increasing exercise tolerance, decreasing breathing discomfort, and, as a consequence helping to speed up recovery and getting back to social life and work- related activities. noninvasive methods, including remote thermography. results and discussion. The hyperbaric oxygenation method has shown us high efficiency for reducing residual symptoms of COVID-19. Conclusion. Inclusion of hyperbaric oxygenation into Post-COVID-19 rehabilitation program leads to immediate treatment effects, decreasing faintness and fatigability, increasing exercise tolerance, decreasing breathing discomfort, and, as a consequence helping to speed up recovery and getting back to social life and work- related activities. noninvasive methods, including remote thermography. results and discussion. The hyperbaric oxygenation method has shown us high efficiency for reducing residual symptoms of COVID-19. Conclusion. Inclusion of hyperbaric oxygenation into Post-COVID-19 rehabilitation program leads to immediate treatment effects, decreasing faintness and fatigability, increasing exercise tolerance, decreasing breathing discomfort, and, as a consequence helping to speed up recovery and getting back to social life and work- related activities.

A pilot study on controlling Coronavirus disease 2019 (COVID-19) inflammation using melatonin supplement

No effective antiviral drugs and vaccines are available for the treatment of patients with severe coronavirus 2019 (COVID-19). Therefore, available, safe, and inexpensive drugs and supplements such as melatonin are among the proposed options for controlling inflammation. We did a randomized, single-blind study in Imam Khomeini Hospital between June 30, 2020, and August 5, 2020. Mild to moderate COVID-19 patients aged 25-65 years were eligible to enter the study based on chest CT scan, clinical symptoms, and physician diagnosis. The intervention group was prescribed 6 mg of oral melatonin for 2 weeks, which consumed half an hour before bedtime every night in low light conditions. Clinical symptoms and C-reactive protein (CRP) were measured before and after treatment in the melatonin received and control(regular medications)groups. Among screened patients with COVID-19, 14 patients were assigned to receive melatonin, and 17 patients were considered as controls. A significant difference (p=0.005) between CRP 1 and CRP 2 levels (before and after using melatonin) was found in the melatonin group while this difference (p=0.069) was not significant in the control group. Also, the percentage of recovery (based on symptoms) in patients who took melatonin was higher than that of patients in the control group (85.7%VS 47.1%). The result of this study confirmed the effectiveness of melatonin in mild to moderate outpatients with COVID-19. More clinical trials on elderly, diabetic, obese patients and severe cases are suggested in future studies.

The impact of the COVID-19 pandemic on the orthopaedics outpatient clinic

OBJECTIVE: The COVID-19 pandemic has significantly impacted orthopaedic practice since it started. In our study, we aimed to examine these effects on outpatient services. PATIENTS AND METHODS: The patients who applied to the orthopedic outpatient clinic (n=1,518) in six months period under the effect of the COVID-19 pandemic (September 2020-March 2021) and patients (n=1,207) who applied during the same period before the pandemic (September 2019-March 2020) were analyzed according to the demographic characteristics (age, gender), reasons for admission, duration of complaints, treatments applied, surgical acceptance rate, and compliance with treatment. RESULTS: The m ean age in the pre-pandemic outpatient clinic admissions was 39.1 years (1-91 years), the gender ratio was 635/572 (Female/Male), the mean age of the patients was 38.1 years (1-95), and the sex ratio was 793/ 725 (F/M) during the pandemic. Admissions of patients with acute complaints decreased after the pandemic, and applications for subacute or chronic complaints increased. Applications for sports medicine, pediatrics, and hand surgery increased, applications for trauma, foot and ankle surgery decreased, and applications for oncology and spine did not change. Conservative treatment recommendations decreased, the surgical treatment recommendation did not change, and the rate of patients who were given only follow-up decisions increased. There was no significant difference in the treatment rejection and surgical acceptance rate. CONCLUSIONS: We observed that the number of traumas decreased, and the hospital admission duration extended. The increase in the consultation rate and follow-up preference indicates that the treatment is more conservative in this period. In this process, patients should be adequately informed about the precautions taken, and their treatment should not be interrupted.

The impact of COVID-19 pandemic on the diagnostic distribution in dermatology outpatient clinic

Objective: The admission frequency of diseases, including dermatological diseases, has changed after the COVID-19 outbreak. The aim of this study was to evaluate the change in the diagnosis distribution of dermatology outpatient clinics during the COVID-19 outbreak by comparing it with the same period of the last year. Materials and Methods: The International Codes of Diseases (ICD-10) categories and patient's diagnoses were evaluated before and after the pandemic. All patients, who applied to the dermatology outpatient clinic between June 1, 2020, and September 1, 2020, were included in our study. This information was compared with the same period of the previous year.

Performance Analysis of Registration Officers during Covid-19 Pandemic Time at Puskesmas X

The outpatient registration officer is the first health service to meet so that they become the frontline in handling the spread of the COVID - 19 Pandemic. Where the medical record service fills in information to identify patient data. The purpose of this study was to determine the ser­vice in the medical record unit, to see the performance of the registration officer at PUSKESMAS X during the COVID - 19 pandemic. This study uses a descriptive qualitative method with a subject of 4 elderly patients. The results show that PUSKESMAS X during the pandemic has complied with health protocols, has Standard Determinations made by the Head of the PUSK­ESMAS and SOPs during the COVID - 19 pandemic. Conclusion PUSKESMAS X already has performance standards for health workers to achieve the best quality health services for its community. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.

Outpatient care for COVID-19 patients: brief position statement by the Czech Pneumological And Phthisiological Society (January 2021)

This position paper follows the documents of the Czech Pulmonological and Phthisiological Society Czech Medical Association of J. E. Purkyne concerning COVID-19. This is a consensus document of a panel of experts on outpatient treatment COVID-19. This position paper is based on the available literature and experience with COVID-19 treatment. The position paper will be continuously updated.

Evaluation of the psychiatric diagnosis of children and adolescents before and during the COVID-19 pandemic: A sample from a university hospital

Objective: The aim of this study is to determine the sociodemographic characteristics and psychiatric diagnoses of children and adolescents who refered to the psychiatry outpatient clinic during the COVID-19 pandemic. Method: This study enrolled the patients who were presented to the Child and Adolescent Psychiatry outpatient clinic between September 2019 and March 2020 and between September 2020 and March 2021. The patients were scanned retrospectively with the Nucleus outpatient clinic system. The data were analyzed with SSPS 21.0. Age, gender and psychiatric diagnosis of patients Results: were examined. This study enrolled 1157 patients with 10.8 mean age and 61.5% male participants. 53% (n = 622) of patients was diagnosed before pandemia and 46.2% (n = 535) of patients was diagnosed during pandemia. Before pandemia: patients were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) 40%, Anxiety Disorder (AD) 16.1%, Autism Spectrum Disorder (ASD) 5.1%. During pandemia: patients were diagnosed with ADHD 27.3%, AD 19.3%, ASD 5.6%. During the pandemia the number of female patients increased (p = 0.017), mean age of patients decreased (p = 0.035), the diagnosed ADHD rates decreased (p < 0.001) and the diagnosed AD (p = 0.024), Major Depressive Disorder (MDD) (p=0.001) rates increased. Conclusion: In our study the diagnosis of AD and MDD during pandemia increased and the diagnosis of ADHD decreased. Because of the online education during pandemia, number of ADHD patients decreased and increasing in diagnosis of AD and MDD might caused by phsycial and social limitations. In this period it is important to follow and treat the patients that already have psychiatric disorder like ADHD. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Turkish) Amac: Cin'de baslayan ve tum dunyayi etkileyen COVID-19 salgini global bir saglik krizine donusmustur. Bu calismanin amaci, COVID-19 pandemisi sirasinda psikiyatri poliklinigine basvuran cocuk ve ergenlerin sosyodemografik ozelliklerini ve psikiyatrik tanilarini belirlemektir. Yontem: AFSU cocuk psikiyatri poliklinigine Eylul 2019-Mart 2020 ve Eylul 2020-Mart 2021 tarihleri arasinda basvuran hastalar calismaya dahil edilmistir. Hastalar retrospektif olarak Nucleus poliklinik sistemi ile taranmistir. Veriler SSPS 21.0 ile analiz edilmistir. Vakalarin yas, cinsiyet ve psikiyatrik tanilari incelenmistir. Bulgular: Calismaya 1157 hasta dahil edilmistir. Hastalarin yas ortalamasi 10,8 yil ve %61,5'i erkek cinsiyetteydi. Hastalarin %53,8'i (n = 622) pandemi oncesinde, %46,2'si (n = 535) pandemi sonrasinda basvuru yapmistir. Pandemi sonrasi donemde, pandemi oncesi doneme gore basvurular kiz cinsiyet yonunde artmistir (p = 0,017) ve basvuranlarin yas ortalamasi azalmistir (p = 0,035). Pandemi oncesinde basvuranlarin %40,0'i Dikkat Eksikligi ve Hiperaktivite Bozuklugu (DEHB), %16,1'i Anksiyete Bozuklugu (AB), %5,1'i Otizm Spektrum Bozuklugu (OSB) ana tanisi alirken, pandemi sonrasi basvuranlarin %27,3'u DEHB, %19,3'u AB, %5,6'si OSB ana tanisi almistir. Pandemi sonrasinda pandemi oncesine gore DEHB tanisi alma sikligi azalmistir (p < 0,001), AB (p = 0,024) ve Major Depresif Bozukluk (MDB) (p = 0,001) tanilarinda artis gorulmustur. Sonuc: Calismamizda pandemi sonrasi AB ve MDB tanilarinin artis gosterdigi, DEHB tanisinin ise azaldigi gorulmustur. Pandemi sirasinda uzaktan egitim surecine gecilmesi, DEHB belirtileri nedeniyle yapilan basvurulari azaltirken ortaya cikan fiziksel ve sosyal kisitliliklar AB ve MDB tanilarini arttirmis olabilir. Bu donemde DEHB gibi mevcut psikiyatrik bozuklugu olan hastalarin takiplerinin ve tedavilerinin aksatilmamasi uzun donemde gidisat icin onem arz etmektedir. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Special Section: COVID-19. (Special Section: COVID-19.)

This special issue includes more than 20 articles on various COVID-19 topics of interest to the busy pediatric practitioner. Clinical features include brief reports of rare and unusual presentations or sequelae of COVID-19 infection or COVID-19 vaccination. Several studies report on multisystem inflammatory syndrome of children clinical manifestations. The reader will also find various epidemiologic reports from well-known pediatric centers, both domestic and international, on COVID-19's impact on hospitalization, neonatal care, emergency room visits, outpatient care, children with special needs, and children in special populations. The mental health crisis that COVID-19 has caused among children and adolescents as well as COVID-19 vaccination attitudes and hesitancy are also addressed.

The Indirect Victims of COVID-19: Perception of Non-COVID-19 Patients about the Effect of Closure of the Medical Outpatient Services on their Health.

BACKGROUND: In order to reduce COVID-19 transmission and protect healthcare workers, the outpatient departments (OPDs) in many hospitals worldwide were closed down in the early days of the pandemic. Patients being managed for chronic medical illnesses who subsequently suffered reduced access to healthcare have been described as "the patients left behind". AIM: The study aimed at assessing the impact of the closure of the Medical OPD in University of Ilorin Teaching Hospital (UITH) on the health and perceived well-being of patients with chronic medical illnesses. METHODS: A cross-sectional study of 180 patients with chronic medical illnesses attending the MOPD in UITH. RESULTS: Mean age of participants was 50.2±18.2years, 92 (51.1%) were male, median duration of attending MOPD was 21 months (IQR 12-36). 92 patients (51.1%) perceived a negative affectation of their well-being by the closure of MOPD. Being >50 years was associated with a perception of negative affectation of well-being (P=0.042). 140 patients (77.8%) had clinic appointments that fell within the period under review. 67(69.3%) of the 97 patients who had medical complaints during the period could not reach a doctor and this was associated with a perception of negative affectation of their wellbeing. The commonest action they took was to do nothing (28.3%), three (4.5%) resorted to herbal concoctions. 19 (29.9%) felt their complaints were urgent. CONCLUSION: Our study identifies that patients with chronic medical illness are potential victims of COVID-19 related disruption of healthcare services. Healthcare managers in Nigeria must develop alternatives such as telemedicine that sustain face-to-face medical interaction during eventualities.

CONTEXTE: Afin de réduire la transmission de la COVID-19 et protéger les travailleurs de la santé, les services ambulatoires (OPD) dans de nombreux hôpitaux dans le monde ont été fermés dans les premiers jours de l'Pandémie. Patients pris en charge pour des maladies chroniques quipar la suite souffert d'un accès réduit aux soins de santé ont été décrit comme "les patients laissés pour compte". OBJECTIF: L'étude visait à évaluer l'impact de la fermeture de l'OPD médical à l'hôpital universitaire d'Ilorin (UITH) la santé et le bien-être perçu des patients atteints de chroniquesMaladies. MÉTHODES: Une étude transversale de 180 patients atteints de chroniques maladies médicales fréquentant le MOPD à l'UITH. RÉSULTATS: L'âge moyen des participants était de 50.2 ±18.2 ans, 92 ans(51.1 %) étaient des hommes, la durée médiane de la participation au MOPD était de 21mois (IQR 12-36). 92 patients (51.1 %) ont perçu un résultat negative l'affectation de leur bien-être par la fermeture du MOPD. Être >50ans était associée à une perception d'affectation négative de bien-être (P= 0.042). 140 patients (77.8 %) avaient des rendez-vous à la clinique qui s'inscrivait dans la période considérée. 67 (69.3 %) des 97 patients qui ont eu des problèmes médicaux au cours de la période n'ont pas pu atteindre un et cela était associé à une perception d'affectation negative de leur bien-être. L'action la plus courante qu'ils ont prise était de ne rien faire (28.3%), deux (4.5%) ont eu recours à des concoctions à base de plantes. 19 (29.9 %) ont ressenti leurs plaintes étaient urgentes. CONCLUSION: Notre étude identifie que les patients atteints demaladie chronique les maladies médicales sont des victimes potentielles des perturbations liées à la COVID-19des services de santé. Les gestionnaires de soins de santé au Nigeria doivent se developper des solutions de rechange comme la télémédecine qui soutiennent la médecine en personne interaction lors d'éventualités. Mots-clés: Maladie COVID-19, Maladies chroniques, COVID-19 fermeture connexe des services médicaux ambulatoires, perception.

Impact of COVID-19 on maternal newborn child health services in Federal Medical Centre Gusau, Zamfara State

Background: Infectious diseases have been a constant threat to people's health and survival, at least thirty re-emerging and emerging diseases (Parks, 2009) are known to be of public health importance posing a burden to the health system;in addition, emergence of COVID-19 further tested the resilience of the health system to respond to public health emergencies (NCDC, 2020). This study assessed the effect of COVID-19 on use of maternal and child health (MNCH) services with objectives being the impact on family planning use, antenatal care visits, facility-based delivery and child related services such as immunization, child nutrition and outpatient clinic in FMC Gusau. Data from units offering MNCH services for six months, three months pre-covid-19 index case (January to March) and three months post covid-19 index case (April to June), corresponding to the period of lockdown, in addition same periods in the previous year (2019) was retrieved and entered into Statically package for social sciences (SPSS) now IBM statistic, comparison was made using comparable period of the year as well as a pre and post Covid index case. Over the six-months period, aggregate data shows that hospital visit for all categories of maternal newborn and child health reduced three months (April, May and June) post covid index case in the facility and subsequent proclamation of lockdown in the State, as compared to three-months pre-covid (January, February and first three weeks of March) Despite the additional burden imposed by the emergence of COVID-19 in FMC Gusau and the Attendant stretched on health system, the resilience of the health system was brought to fore, however with support from Federal ministry of health, National Centre for disease control and other agencies, FMC Gusau was able to use the COVID-19 emergency to strengthen service provision.

The trend of referrals and identification of COVID-19 patients in selected comprehensive health service centers of Tehran University of Medical Sciences

Background and Aim: The process of identifying Covid 19 cases over time (the trend) can provide valuable information about the coverage of diagnostic and screening programs over time. This study aimed to investigate the outpatient trend of Covid-19 in selected comprehensive health service centers of Tehran University of Meical Sciences, Tehran, Iran. Materials and Methods: This was a descriptive cross-sectional study. The data collected inculded the number of referalls and Polymerase Chain Reaction (PCR)-positive individuals between April 13 and December 25, 2020. Central and dispersion indices (mean, median, standard deviation and interquartile range) were used to describe quantitative variables. In addition, linear and bar charts were used to describe the trend of the variables over time. All analyses were performed using the Excel 2016 and SPSS 22 software.

The willingness to receive COVID-19 vaccine and its associated factors among teachers and students in outpatient clinic in a medical college in Beijing

Objective: To understand the willingness to receive COVID-19 vaccine among teachers and students in outpatient clinic in a medical college in Beijing, and to discuss its related factors, in order to provide reference for the implementation of COVID-19 vaccination.

Impact of coronavirus in a dermatology outpatient clinic: a single-center retrospective study

Objective: Increased anxiety among individuals following the declaration of the coronavirus disease (COVID-19) pandemic, changes in social life, and dermatological eruptions caused or triggered by the COVID-19 infection have altered the incidence of dermatological diseases. To determine the impact of the pandemic, this study evaluated changes in the frequency, profile, and diagnostic spectrum of dermatology patients during the pandemic compared to the previous year. Materials and Methods: This study compared a 6-month period from March 2020, when the first COVID-19 case was reported in Turkey, to September 2020, with the same period in 2019. Age, sex, diagnosis groups, and diagnoses were recorded and compared with the previous year.

Quantifying the indirect impact of COVID-19 pandemic on utilisation of outpatient and immunisation services in Kenya: a longitudinal study using interrupted time series analysis.

OBJECTIVE: In this study, we assess the indirect impact of COVID-19 on utilisation of immunisation and outpatient services in Kenya. DESIGN: Longitudinal study. SETTING: Data were analysed from all healthcare facilities reporting to Kenya's health information system from January 2018 to March 2021. Multiple imputation was used to address missing data, interrupted time series analysis was used to quantify the changes in utilisation of services and sensitivity analysis was carried out to assess robustness of estimates. EXPOSURE OF INTEREST: COVID-19 outbreak and associated interventions. OUTCOME MEASURES: Monthly attendance to health facilities. We assessed changes in immunisation and various outpatient services nationally. RESULTS: Before the first case of COVID-19 and pursuant intervention measures in March 2020, uptake of health services was consistent with historical levels. There was significant drops in attendance (level changes) in April 2020 for overall outpatient visits for under-fives (rate ratio, RR 0.50, 95% CI 0.44 to 0.57), under-fives with pneumonia (RR 0.43, 95% CI 0.38 to 0.47), overall over-five visits (RR 0.65, 95% CI 0.57 to 0.75), over-fives with pneumonia (RR 0.62, 95% CI 0.55 to 0.70), fourth antenatal care visit (RR 0.86, 95% CI 0.80 to 0.93), total hypertension (RR 0.89, 95% CI 0.82 to 0.96), diabetes cases (RR 0.95 95% CI, 0.93 to 0.97) and HIV testing (RR 0.97, 95% CI 0.94 to 0.99). Immunisation services, first antenatal care visits, new cases of hypertension and diabetes were not affected. The post-COVID-19 trend was increasing, with more recent data suggesting reversal of effects and health services reverting to expected levels as of March 2021. CONCLUSION: COVID-19 pandemic has had varied indirect effects on utilisation of health services in Kenya. There is need for proactive and targeted interventions to reverse these effects as part of the pandemic's response to avert non-COVID-19 indirect mortality.

Telemental health uptake in an outpatient clinic for veterans during the COVID-19 pandemic and assessment of patient and provider attitudes

This study aimed to (a) describe the process of rapid uptake of telemental health in an outpatient mental health clinic for veterans and their family members during the coronavirus disease 2019 (COVID-19) pandemic and (b) present patient and provider attitudes about telemental health. Virtual visit (video and phone) trends for this clinic are described over the 8 weeks pre- and post-COVID-19 closure. As part of a quality improvement initiative over a subsequent 2-week period, 147 patient visits (127 unique individuals), and 24 mental health providers who were part of a multidisciplinary team were eligible to complete an anonymous self-report satisfaction survey immediately after a telehealth session. Prior to the COVID-19 closure, the clinic averaged 112.75 completed visits per week, with virtual visits accounting for less than 5% of all appointments. In the second month after closure, the clinic averaged 153.75 completed visits per week (36.36% increase in volume), with virtual visits accounting for 100% of visits (42% phone, 58% video). The proportion of video compared to telephone visits increased pre to postclosure. The no-show rate significantly decreased pre to postclosure (10.87% vs. 15.01%, resp., chi2 = 17.81, p < .001). Patient and provider satisfaction with telemental health were high. Prospectively, most patients (83.56%) expressed preference for televisits-only or televisits combined with in-person visits. Patients and providers were satisfied with telemental health. Convenience was an oft-cited advantage by both patients and providers. Telemental health may represent a cost-effective solution to mental health care access during and beyond COVID-19. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Rapid and wide-spread uptake of telemental health in an outpatient clinic serving veterans and military service members was feasible and deemed satisfactory to patients and providers. Telemental health was associated with lower no-show rates. (PsycInfo Database Record (c) 2022 APA, all rights reserved)