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Objectives: To compare pregnancy loss rates, preterm birth rates and gestational age at delivery in women vaccinated against COVID-19 during pregnancy vs. those unvaccinated. Method(s): Data were captured from Dorsata Prenatal, an electronic medical record (EMR) system that captures obstetrical data for tens of thousands of pregnancies annually. Patients who delivered between February 11, 2021-June 2, 2022, were included. The vaccinated group included women who had at least one COVID-19 vaccination documented in their EMR between 30 days prior to pregnancy and delivery. The unvaccinated group included women without a COVID-19 vaccination documented. The primary outcome measure was gestational age (GA) at delivery. We analyzed the data using chi-square tests, with significance set at p<0.01. Result(s): A total of 51,994 pregnant women were identified-7,947 (15.3%) in the vaccinated group and 44,047 (84.7%) in the unvaccinated group. Vaccination rate varied by race (Asian: 19.7%;White: 17.3%;Black: 11.2%, P<0.001), ethnicity (Latino: 8.6%;Not-Latino: 18.7%;P<0.001), marital status (Married: 19.2%;Single: 8.8%;P<0.001), mother's age (>=35 years: 20.0%;<35 years 14.2%;P<0.001), and region (Northeast: 19.2%;South: 15.2%;West: 9.1%;P<0.001). The vaccinated group had significantly lower rate of preterm delivery (Gestational Age [GA]<37 weeks;vaccinated: 7.8% vs. unvaccinated: 9.6%;P<0.001), and significantly lower rates of pregnancy loss (GA<20 weeks;vaccinated: 1.1% vs. unvaccinated: 4.1%;P<0.001). Conclusion(s): This is one of the largest real-world studies to date in women who received the COVID-19 vaccination during pregnancy. Vaccination rates varied significantly across race/ethnicity. Vaccinated patients had lower preterm delivery and pregnancy loss rates compared with unvaccinated patients.Copyright © 2023
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Objectives: To determine the relationship between the COVID-19 vaccine and the menstruation and to determine the factors associated with menstrual abnormalities after COVID-19 Vaccine. Method(s): Female students from the Unaizah College of Pharmacy and Medicine at Qassim University who were over the age of menarche, had received the vaccine, were not pregnant or nursing, were not using contraceptives, did not have a history of primary ovarian insufficiency, hypothalamic menopause, or had undergone a hysterectomy were invited to participate. A universal sampling method was used to collect the data using an online method. Consequently, a total of 299 enrolled students participated in the survey. Result(s): Out of 329 registered students, 299 agreed to participate, giving a response rate of 90.88%. The mean age of the participants was 22.1 +/- 1.70, majority were unmarried (n=255;85.3%) and were from PharmD (n=206;69.8%). A total of 70(26.1%) reported to have COVID-19 infection. About 258(86.2 %) reported menstrual symptoms post-vaccination, of which 108(41.8%) reported irregular, 94(36.4 %)length of menstruation changed, for 56(21.7%) mensuration completely stopped. Only 16(6.20%) required a hospital visit to resolve post COVID vaccination menstrual symptoms. Previous COVID 19 infection significantly influenced the incidence of mensural abnormalities (p=0.03). After the second dose of the vaccine, Pfizer-BioNTech (91.3%) followed by Johnson and Johnson (66.7%), there were significant variations in the menstrual abnormalities across different vaccination types (p = 0.014). Conclusion(s): The study showed a possible link between the COVID-19 vaccine and menstrual abnormalities which needs further investigation regarding its impact on their quality of life.Copyright © 2023
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Objective To explore the sociodemographic and psychological factors influencing the continuity of treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019 (COVID-19). Methods A total of 277 patients with chronic kidney disease who were admitted to Department of Nephrology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. 2020 to Mar. 2021 were enrolled and divided into 3 groups: non-dialysis group (n=102), hemodialysis (HD) group (n=108), and peritoneal dialysis (PD) group (n=67). All patients were investigated by online and offline questionnaires, including self-designed basic situation questionnaire, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). The general sociodemographic data, anxiety and depression of the 3 groups were compared, and the influence of sociodemographic and psychological factors on the interruption or delay of treatment was analyzed by binary logistic regression model. Results There were significant differences in age distribution, marital status, occupation, medical insurance type, caregiver type, whether there was an urgent need for hospitalization and whether treatment was delayed or interrupted among the 3 groups (all P<0.05). The average SAS score of 65 PD patients was 38.15+/-15.83, including 53 (81.5%) patients without anxiety, 7 (10.8%) patients with mild anxiety, and 5 (7.7%) patients with moderate to severe anxiety. The average SAS score of 104 patients in the HD group was 36.86+/-14.03, including 81 (77.9%) patients without anxiety, 18 (17.3%) patients with mild anxiety, and 5 (4.8%) patients with moderate to severe anxiety. There were no significant differences in the mean score of SAS or anxiety severity grading between the 2 groups (both P>0.05). The mean SDS scores of 65 PD patients were 53.42+/-13.30, including 22 (33.8%) patients without depression, 21 (32.3%) patients with mild depression, and 22 (33.8%) patients with moderate to severe depression. The mean SDS scores of 104 patients in the HD group were 50.79+/-10.76, including 36 (34.6%) patients without depression, 56 (53.8%) patients with mild depression, and 12 (11.6%) patients with moderate to severe depression. There were no significant differences in mean SDS scores or depression severity grading between the 2 groups (both P>0.05). The results of intra-group comparison showed that the incidence and severity of depression were higher than those of anxiety in both groups. Multivariate binary logistic regression analysis showed that high school education level (odds ratio [OR]=5.618, 95% confidence interval [CI]) 2.136-14.776, P<0.01), and unmarried (OR=6.916, 95% CI 1.441-33.185, P=0.016), divorced (OR= 5.588, 95% CI 1.442-21.664, P=0.013), urgent need for hospitalization (OR=8.655, 95% CI 3.847-19.476, P<0.01) could positively promote the continuity of treatment in maintenance dialysis patients under the regular epidemic prevention and control of COVID-19. In the non-dialysis group, no sociodemographic and psychological factors were found to be associated with the interruption or delay of treatment (P>0.05). Conclusion Education, marital status, and urgent need for hospitalization are correlated with the continuity of treatment in patients with chronic kidney disease on maintenance dialysis.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Intro: The burden of infectious diseases is influenced by the structure of the population at risk. Population ageing may have implications for the disease burden of future epidemics. Moreover, changing household structures induced by population ageing may influence the dynamics of disease transmission and burden of infections transmitted via close contact interactions. We aim to investigate the impact of demographic change on the disease transmission dynamics and future disease burden and illustrate this for COVID-19 and influenza-like illness (ILI). Method(s): We simulate the Belgian population between 2020 and 2050 using an individual-based model with census data. The simulated population structures were used as input for an infectious disease model that distinguishes between exposure to infection in the household versus exposure in the community at large. We mimicked outbreaks of COVID-19 and ILI of varying total final size. Finding(s): The simulated population ages between 2020 and 2050, which also affects household size and composition. As the proportion of elderly people in the population increases, the overall attack rate slightly decreases because older age groups have fewer contacts and are therefore less likely to incur and transmit infections. Despite the lower per-person attack rate, the estimated disease burden increases as morbidity and mortality increases with the age at infection. Conclusion(s): The demographic changes induced by population ageing have an impact on the burden of future outbreaks of COVID-19 and ILI in Belgium. The shifting age distribution implies that the elderly, a population group with increased morbidity and mortality in case of infection, make up an increasing proportion of the total population. Population ageing also leads to an increasing proportion of single-person households and collective households (e.g. nursing homes) in the population. Since the household attack rate varies by household size and composition, the living arrangements of the elderly population influences the disease burden of future epidemics to some extent.Copyright © 2023
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Background: Despite favorable vaccine responses of people with HIV (PWH), susceptibility to SARS-CoV-2 (SCv2) infection and increased risk of COVID-19 in immunocompromised PWH continue to be of concern. Here, we searched the Swiss HIV Cohort Study (SHCS) with>9500 actively enrolled, optimally treated PWH to identify factors associated with SCv2 infection in the pre-and postvaccination area. Method(s): We utilized information on SCv2 events reported to the SHCS in 2020 -2021. To detect asymptomatic infection, we screened pre-pandemic (2019) and pandemic (2020-2021) bio-banked plasma for SCv2 antibodies (Ab). SCv2+ and matched SCv2- PWH were additionally screened for Abs to circulating human coronaviruses (HCoV). Data were compared to HIV negative (HIV-) controls. SCv2 data and >26 behavioral, immunologic and disease-parameters available in the SHCS data base were analyzed by logistic regression, conditional logistic regression, and Bayesian multivariate regression. Result(s): Considering information on the SCv2 status of 6270 SHCS participants, neither HIV-1 viral load nor CD4+ T cell levels were linked with increased SCv2 infection risk. COVID-19-linked hospitalization (87/982) and case fatality rates (8/982) were low, but slightly higher than in the general Swiss population when stratified by age. Compared to HIV-, PWH had lower SCv2 IgG responses (median effect size= -0.48, 95%-Credibility-Interval=[-0.7, -0.28]). Consistent with earlier findings, high HCoV Abs pre-pandemic (2019) were associated with a lower risk of a subsequent SCv2-infection and, in case or infection, with higher Ab responses. Examining behavioral factors unrelated to the HIV-status, people living in single-person households were less at risk of SCv2 infection (aOR= 0.77 [0.66,0.9]). We found a striking, highly significant protective effect of smoking on SCv2 infection risk (aOR= 0.46 [0.38,0.56], p=2.6*10-14) which was strongest in 2020 prior to vaccination and was even comparable to the effect of early vaccination in 2021. This impact of smoking was highly robust, occurred even in previous smokers and was highest for heavy smokers. Conclusion(s): Our unbiased cohort screen identified two controversially discussed factors, smoking and cross-protection by HCoV responses to be linked with reduced susceptibility to SCv2, validating their effect for the general population. Overall weaker SCv2 Ab responses in PWH are of concern and need to be monitored to ensure infection- and vaccine-mediated protection from severe disease.
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Objective: The aim of the present study was to investigate the psychiatric distress, including stress, anxiety, and depression levels, among COVID-19 positive patients who were admitted between 01 July 2020 to 31 August 2020 to the COVID-19 isolation ward of the Uttar Pradesh University of Medical Sciences, Saifai, Etawah India. Participants included 100 patients, with 55 males and 45 females. The majority of admitted patients (81%) were illiterate. Out of 100 patients, 83 were married, 16 were unmarried, and only 1 was a widow. Method(s): Levels of anxiety, depression, and stress level were noted in admitted patients using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) depression assessment, and Perceived Stress Scale 4 (PSS-4) assessment techniques, respectively. Result(s): Patient Health Questionnaire (PHQ-9) depression assessment results showed minimal, mild, and moderate depression in 9, 25, and 66 patients, respectively, with a 10.6 median score of PHQ-9. Mild, moderate, and severe anxiety (GAD-7 score) was present in 22, 28, and 50 of the patients surveyed. The mean Perceived Stress Scale 4 (PSS-4) was also analyzed, and it reported 6.1 values. The results of the study demonstrated that the patients had a high label of psychiatric distress, but still, admitted patients believe that they will come out from this pandemic condition. Conclusion(s): Although patients claimed psychiatric distress and mental health illness, they still denied the requirement of any mental health professionals to minimize stress levels and were satisfied with the medical facilities available in a hospital located in a rural area.Copyright © 2022 Bentham Science Publishers.
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Introduction: The COVID-19 pandemic is still having a strong impact on psychological and mental health worldwide. The pandemic generated a change in people's life and fear, loss of structure of daily routine, physical illness, depression, and stress, are only some of the potentially long-term consequences. The coping strategies used to deal with these difficulties may have influenced the perception of well-being, so the present study aimed to evaluate mental health in relation to individual characteristics and to explore the more effective coping strategies used by the Italian population and their impact on psychological well-being. Method(s): The web-based survey was delivered by Qualtrics between 30 November and 10 December 2020. A total of 537 individuals (>18) were recruited and all participants completed measures of sociodemographic data, general psychological well-being (PGWBI), and coping strategies (COPE-NVI). Result(s): Females, students, and unmarried people reported the lowest levels of mental health. Specifically, the coping strategy called "positive attitude" was positively correlated with psychological well-being, while "avoidance" and "social support strategies" negatively influenced it. The coping strategies named "problem-focused" and "transcendentoriented" resulted not statistically significant. Conclusion(s): The use of maladaptive strategies (e.g., avoidance-oriented) set up negative symptoms such as anxiety or depression whereas the beneficial ones can be central to optimally managing the psychological effects of long-lasting current COVID-19. From a preventive point of view, it is hence important to take care both of those who are already suffering from psychological disorders and of the non-clinical population, starting to question how psychopathology will change after the pandemic. New treatment directions should be found. The results suggest that to prevent mental disorders, therapists must consider the use of coping strategies in clinical practice. Implications for clinical preventive interventions are reported.
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Aims: Medical students belong to frontline health care providers of future. Risk of COVID 19 exposure is more among medical students, and COVID 19 vaccination plays very crucial role for controlling COVID 19 pandemic. Hence, this study was planned with the objective to evaluate attitude of medical students towards COVID 19 pandemic and their vaccination status. Material(s) and Method(s): We conducted an online web-based survey among medical students of Madhya Pradesh, India. Online Google form-based Questionnaire was sent through WhatsApp groups, and responses were collected and analysed. Voluntary consent was obtained through from all the participants. Finding(s): A total of 516 medical students from different medical colleges of Madhya Pradesh voluntary participated in this study. Out of that majority of the participants were in 18-20 years' age groups, unmarried and belonged to rural areas. Most of them were worried about their MBBS studies due to COVID 19 pandemic. 71% of the medical students received two doses of the COVID 19 vaccination till 15the August, 2021. Conclusion(s): Medical students of Madhya Pradesh are worried about their MBBS course completion, examination and education shift towards online due to COVID 19 pandemic. There is a need of psychological counselling and awareness program regarding vaccination among medical students. Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Background: Patient portals support patient access, engagement, and care coordination, yet could also widen the digital divide and exacerbate disparities among vulnerable populations. There is emerging evidence that racial/ethnic minority patients are less likely to use portals, yet prior research has not examined potential rural differences. We identified sociodemographic factors associated with portal enrollment and use among a racially and geographically diverse population of cancer patients. Methods: We retrospectively examined portal enrollment and use at an NCI-designated comprehensive cancer center from January 2015 until February 2022 among patients 18+ years old with a neoplastic disease diagnosis (ICD-10-CM C00-D49). Potential predictors included gender, race/ethnicity, marital status, age, rural (Rural-Urban Continuum Codes [RUCC] 4-9) vs nonrural (RUCC 1-3) residence, residential distance from the cancer center, and time since diagnosis. We used multivariable logistic regression to generate odds ratios (ORs) for portal enrollment and having ever sent a portal message, and Poisson regression to determine incidence rate ratios (IRRs) for number of logins and number of healthcare team interactions (portal messages or appointment requests), controlling for ICD-10 diagnosis (SAS 9.4). Results: We identified 11,333 patients (average age 67 years, 59% female, 24% rural, 10% Non-Hispanic Black, 1% Hispanic, 20% non-melanoma skin cancer, 14% breast cancer, 9% lung cancer). 36% of patients had enrolled in the portal, and of these, 80% had sent at least one message. Patients logged in a median of 203.5 times and had a median of 19 portal interactions. Rural residents were less likely to enroll in the portal than urban patients (28% vs 38%, p < 0.0001). Non-Hispanic Black patients and Hispanic/Latinx patients were less likely to enroll in the portal compared with non-Hispanic White patients (22% and 27%, respectively, vs 38.5%, p < 0.0001). Women, younger patients, more recently diagnosed cancer patients, and patients who were married/ partnered were significantly more likely to enroll. In multivariable analysis controlling for cancer type, rural patients were half as likely to enroll in the portal (OR: 0.48 [0.43-0.54]). Among those enrolled, rural residents were 25% less likely to have ever sent a portal message (OR: 0.75 [(0.62-0.92]), and had nearly half the login and interaction rates (IRR: 0.66 [0.66-0.67];IRR: 0.58 [0.58-0.59], respectively). Patients who were Non-Hispanic Black, Hispanic, or unmarried were also significantly less likely to enroll or engage in the portal. Conclusions: Patient portals remain underutilized among cancer patients, despite an increased reliance on virtual communications in the COVID era. Interventions to support portal engagement among rural residents and racial/ethnic minority patients are needed to avoid potentially exacerbating health disparities.
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Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic and its socio-economic consequences have had a significant impact on mental health. A quantifiable data regarding increase of mental health problems as a result of the pandemic is required to take necessary steps in tackling the issue. Aim: To estimate the prevalence of depression, perceived stress and its socio-demographic correlates among general population of South India during COVID-19. Materials and Methods: This cross-sectional survey conducted from 25th August 2021 to 25th October 2021 among the general population of South India during COVID-19. A total of 600 subjects were enrolled into the study. Study subjects included people of either sex between 20-50 years of age who were able to read and understand English and with access to internet. Subjects responded to a questionnaire packet of Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale 10 (PSS-10) and a proforma for socio-demographic data. Data was analyzed using GNU PSPP version 1. One-way Analysis of Variance (ANOVA) and independent t test were used to assess associations. A value of p-value<0.05 was considered to be statistically significant. Pearson’s correlation coefficient was used to determine correlation. Results: Of the 600 subjects who were enrolled into the study, 26.7%, 15.7%, 9.3% and 7.2% had mild, moderate, moderately severe and severe depression respectively. About 62.7% had moderate and 17.5% had high perceived stress. Whereas, 28.7% had death wishes or thoughts to hurt themselves. Females (PHQ-9: p-value=0.006;PSS-10:p-value<0.001), 20-29 age group (PHQ-9: p-value <0.001;PSS-10: p-value <0.001), students (PHQ-9: p-value <0.001;PSS-10: p-value <0.001), those who were unmarried (PHQ-9: p-value <0.001;PSS-10: p-value< 0.001), living with parents (PHQ-9: p-value <0.001;PSS-10: p-value <0.001), those who had a loss of income (PHQ-9: p-value <0.001;PSS-10: p-value=0.018) or job (PHQ-9: p-value<0.001;PSS-10: p-value<0.001) in the past 1 year, those with a history of psychiatry disorder (PHQ-9: p-value<0.001;PSS-10: p-value<0.001) had a significantly higher score in both depression and perceived stress. Correlation analysis showed a significant correlation between depression and perceived stress scores (r=0.691). Conclusion: This study showed a high prevalence of depression and perceived stress and shows the need for strengthening mental health services to address the challenge.
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BACKGROUND: Mental health problems were heterogeÂneously increased among the population groups during the COVID 19 pandemic.1 The pandemic promoted existAîng suicide risk factors such as illicit drugs and alcohol use, access to lethal means, and social disconnectedness.2 According to the CDC, 40% of US adults reported sympÂtoms of depression, anxiety, or increased substance use during COVID-19, and 10.7% of the participants reported suicidal ideation.3 OBJECTIVE: This study aimed to compare suicide rates among adult population (18-64 years old) in Marion County, Indiana in 2019 and 2020. METHODS: Data for 2019 and 2020 was ed from coroners' records in Marion County, Indiana. In 2019 and 2020, a cumulative total of 130 and 157 suicide cases were reported, respectively. We identified 104 adult suicide cases in 2019 and 116 adult suicide cases in 2020 with age range of 18 to 64 years. We analyzed the data for age, race, genÂder, job, marital status and the method of suicide. RESULTS: From 2019 to 2020, adult suicides increased by 11.5%, from 104 to 116 cases. In 2019, cases were highest during the month of January (14.4%). Most cases were white (79.8%). The average age was 39.6 years old and male to female ratio was 3.9:1.1. Almost half of the cases (49%) were unemÂployed and 36.5% were employed. Regarding marital status, 47.1% of those died by suicide were never marÂried, 27.8% were married and 19.2% were divorced. Regarding the method of suicide, gunshot wound was the most common method (58.6%), followed by hangAîng (32.6%), drug toxicity, asphyxiation, and sharp force trauma with 1.9% each. In 2020, cases were highest in January (12%) and December (11.2%). In 2019, most cases were white (76.72%). The average age was 35.7 years old and male to female was 8.6:3. About one third of cases (33.6%) were unemployed and 43.1% were employed. Regarding mariÂtal status, the majority (58.6%) were never married, while 23.2% and 13.7% were married and divorced respectively. The most common method of suicide was gunshot wound (63.7%), followed by hanging (24.1%), drug toxicity (4.3%), and asphyxiation (4.3%). CONCLUSION: Suicide rates among adults increased by 11.5% in Marion County, Indiana. While white males had the highest suicide rates during both years, female suicides increased from 20% in 2019 to 26% in 2020. Average age of those who died by suicide was younger in 2020. A rise in suicide was seen in unmarried and employed individuals. Suicide by gunshot wounds and drug toxicity also increased. Our findings echoed the CDC findings.3 Public health measures which target certain population groups such can mitigate suicide rates during a global pandemic.
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Aim: To determine the long term impact of covid-19 infection on sleep and mental health. Study design: Cross-sectional study Place and duration of study: Department of Psychiatry, Ghulam Mohammad Mahar Medical College Sukkur from 1st April 2021 to 30th September 2021. Methodology: Fifty patients were enrolled after their positivity confirmation of coronavirus-19 through nasal swab test polymerase chain reaction. Categorization was done on the basis of disease severity. HRCT was performed for complete chest examination and grading of covid-19. Other laboratory tests were also done for day to day assessment of patient. Patients after their recovery were asked to follow up after six months of their disease. The demographic, gender, clinical history and clinical record were documented on a well-structured questionnaire. Co-morbidities associated were also recorded. Sleep and mental health were assessed by Pittsburgh sleep quality index. This assessment tool is used to identify sleep disturbances. The scoring techniques use seven sub scores ranging between 0-3. Results: The mean age was 49.56±12.2 years with almost equal males and females. In 66% of the participants of severe group and critical group were suffering from poor sleep quality followed by non severe group. Phobic anxieties were more common in non-severe and severe cases while paranoid ideation was normal in severe cases but at borderline in critical cases. Paranoid ideation was more common in married as well as single patients. Conclusion: Corona virus badly influences normal sleep cycle and also leads towards various mental and psychological disorders.
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Objective: To determine the frequency and pattern of myths and misconceptions regarding COVID-19 vaccine in the general population at Isra University Hospital Hyderabad Material and Methods: This cross-sectional survey base study was conducted at the Isra University Hospital Hyderabad, during a period of six months from August 2021 to January 2022. All the patients who visited the OPD and their attendants of any age or gender, were included. All the subjects were properly counseled that their privacy was fully secured and their name and contact numbers were taken. After obtaining sociodemographic information, the participants were interviewed regarding COVID-19 infection in the past, previous vaccination history for diseases other than COVID-19, conceptions, and myths regarding COVID-19 vaccination, acceptance of COVID-19 vaccination, reasons to vaccinate for COVID-19, and reasons not to vaccinate for COVID-19. All the information was gathered via study proforma including questioner and SPSS version 26 was used for the purpose of data analysis. Results: A total of 145 individuals of either gender were studied regarding myths and misconceptions of COVID-19 vaccine, their average age was 27.71+9.86 years and females were in majority 62.1%. Among the study population, doctors, private employee and housewives were the most common as 44.1%, 11%, 11.7% and 9% respectively. Most of the cases 62.1% were unmarried. According to the myths and misconceptions, 8.3% said it can affect fertility, 23.4% had no trust on its effectiveness and safety, 14.5% said it is an artificial infection procedure, 11% were afraid from its dangerous side effects, 3.4% said the vaccine will change their DNA, 13.8% said it is a controversial substance and 6.9% afraid that they will die within 2 years. 24.1% cases heard myths from family, 24.8% heard from friends and 51% heard by social media. 17.2% had idea that it is an international conspiracy and 4.8% said this may cause sexual dysfunction and 4.8% said it is a procedure of implanting microchip to control them. Conclusion: There were several misconceptions in the general population, most myths like effects of male fertility, distrust on vaccine efficacy, they will be infected artificially, fear of dangerous side effects, controversial substances were observed to be the commonest myths and misconceptions regarding the COVID-19 vaccine in the general population. Above ideas were adopted mostly by the friends and social media.
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Background: A medical teacher has a very complex job profile, wherein they are expected to train a cohort of newly joined medical aspirants to competent health-care professionals. Description: It was a mixed methods study conducted over a period of nine months from January to September 2021 in a tertiary teaching medical college and hospital of Chengalpet District of Tamil Nadu amongst the faculty members of the teaching medical college and hospital. In the first phase, universal sampling method was employed, wherein all faculty members were asked to complete the pilot-tested and validated semi-structured questionnaire. In the second phase, purposive sampling was employed, wherein all teachers who have a minimum teaching experience of three years and have attended any medical education workshop were included and interviewed using a focus group discussion guide. The quantitative data were analysed using descriptive statistics (frequency and percentages), while the qualitative data was analysed using manual content analysis. Outcome: In the quantitative phase, 149 faculty members filled the online questionnaire, while in the qualitative phase, 45 faculty members were eligible to be part of the study. The manual content analysis of the FGD resulted in the identification of two themes (challenges and utility of workshops) and five categories. The challenges theme consisted of three categories of Faculty, Students, and Administration;while the utility of workshops theme included two categories of refinement of skills and suggestions for future. Conclusion: In conclusion, lack of teamwork in the department, multiple responsibilities assigned to a single person and shortage of clinical material during COVID-19 were identified as the main challenges in teaching-learning. The medical education workshops play a significant role in improving the knowledge in various domains of teaching and assessment, the introduction of innovations, and ensuring better performance of the faculty members.
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Introduction & Objectives: There has been a few report regarding the SARS-CoV-2 infection impact on male sexual function during the coronavirus disease 2019 (COVID-19) epidemic. we aim to discuss the potential clinical impact of the COVID-19 infection on sexual function inactive sexual men, and to evaluate possible risk factors.Materials & Methods: We conducted retrospective study and analyzed data for all active sexual men admitted in two university hospital From Mai2020 to April 2021 for COVID-19 infection. we included subjects had to be men aged 18 years or older, with documented COVID infection, andhad a history of regular sexual intercourse. We didn’t include Patients stayed in intensive care units, history of neurological or psychiatric pathologyand heart disease. All subjects gave written informed consent before entering the study and Ethical committee approval has been obtained. Theevaluation was carried out by self-questionnaire comprising this items: The International Index of Erectile Function-5 items (IIEF-5), PrematureEjaculation Diagnostic Tool (PEDT), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire (PHQ-9), and the detailed frequencyof sexual life and physical exercise. Subjects completed the questionnaires based on both their condition 4 months before and 4 months after theepisode of COVID-19 infection. A significant p was fixed <0,05.Results:Altogether, 235 questionnaires were collected, and 193 (82%) respondents completed the questionnaire. The median age for all subjects was 34years (interquartile range [IQR] 21-52). A total of 96 (40.8%) subjects were unmarried, 129 (55.8%) were married, and 10 (4.2%) were divorced orwidowed. Erectile dysfunction has been reported by 28 patients (12.1%), and 21 subjects (9%) reported deterioration ejaculation control ability.The median score of the IIEF-5 decreased from 22 (range 7-25, IQR 14-24) to 18 (range 5-23, IQR 11-22), and there is significant differenceregarding the mean value (19.13 ± 5.34 vs 16.5 ± 8.35, t = 4.867, P <.000). There was no significant change in the mean PEDT scores beforeand after the COVID infection (3.95 ± 3.24 vs 4.08 ± 2.90, t = 0.968, P =0.334). If we compare Patients with normal (Group I) versus deterioratedsexual function (Group II), we found in G II a higher BMI than GII (P <.001), a history of smoking (P <.001), increased anxiety after the COVIDinfection (P =.001). if we stratified both Group according to the depression and anxiety scale, G II had a higher GAD-7 score before and after theInfection (P =0.025 and P <.001), a higher PHQ-9 score before and after the outbreak (P =.002 and P <.001), a decreased frequency of physicalactivity (P = 0.01) and decreased partner time (P <.001).Conclusions: the COVID-19 infection have an impact on sexual function in a certain proportion of adult men, and the risk factors include increasedanxiety and depression, and decreased frequency of sexual life
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Statement of the problem: Unconscious bias and systemic racism is evident in published reports that describe persistent asymmetric outcomes in our entire health care system including oncology. Framework of the solution: There already is a very large set of publications that describe the extent and outcomes of health disparities. An extensive data set also describes mitigation strategies. Changing the outcomes includes policy changes within the health care system but also with regulatory agencies and the legislative branch of government. It is critical that these different systems are armed with the totality of available information in a manner that can be leveraged to improve the health care of all. We have developed a system of describing large sets of data manually extracted from published articles. These results are aggregated together independent of the framework of the manuscript so that similar outcomes can be placed side by side. This system can provide the necessary comprehensive data that is available today to begin to implement changes. Results to date: We have used COVID-19 publications as a prototype topic that has so many articles no single person can comprehend or manage. We extracted data from 1000 COVID-19 manuscripts that presented new data. This rendered 26,000 note fields arranged in a parent child relationship. The data base described 12,000 individual observations. A read only version is available at COVIDpublications.org. We are now applying this system to bias and stigma of the health care profession to persons who use drugs, and a demo of this project is available at (https://app.refbin.com/app/embed?m=1188). We have now established the rules to manually extract data from any clinical article that presents new data. This involves 4 types of note fields per observation arranged in parent child relationships. 1) The observation, 2) description of the observation, 3) the population, and 4) the topic. This system allows the observations from an unlimited number of studies to share parents. This results in about a 5-fold reduction in the total number of note fields. It also allows grouping of information so that a user can scan the data base and access the entirety of information without specifically knowing what they are looking for. Conclusions: We are expanding this data base bias and systemic racism of the health care system on persons with substance use disorder to include the broader range of patients. By capturing all of the data that is known we hope to influence implementation of improved health care to patients including those with cancer. These results will be presented in October.
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COVID-19 has changed the way we live and made the future come faster. Although changes such as work from home are changing how we commute, studies on the association between commuting time and mental health are lacking. We used the Korean Working Condition Survey, a nationally representative cross-sectional survey. A total of 23,415 waged workers in 20-59 years of age were selected. It was investigated that the association between commuting time and depressive symptoms which were measured by the World Health Organisation- Five Well-Being Index (WHO-5). Compared with the shortest commuting time (< 30 min), those who spent 60 min or longer commuting had a significantly higher odd ratio (OR) for depressive symptoms (1.16;95% CI: 1.04, 1.29). Among males, workers aged 40–49, in the lowest income quartile, unmarried, not having children, having white-collar jobs, working standard hours groups, and without shiftwork showed a significant association between long commuting time and increased depressive symptoms. Among females, workers aged 20–29, in the lowest income quartile, having 2 or more children, and shiftwork showed higher ORs for the association between long commuting time and depressive symptoms. In our study, long commuting time was associated with increased depressive symptoms measured by the WHO-5 well-being index. In the future, it is not expected that changes in commuting will equally and simultaneously be applied to workers with various socio-economical statuses. Our study implies that an approach to mental health according to the characteristics is necessary.
ABSTRACT
Introduction: The COVID19 pandemic that started since March 2020, has forced companies to reduce the number of workers on site and to prolong the on-site working duration. With this change, there was possibility of increased mental health problem among the workers including mental emotional disorder (MED). Material and Methods: The data was obtained from an online form filled by workers. The variables were sex, age, education level, marital status, physical activity, employment status, duration of working in the said company, the position of work, presence of shift work, rotation system, change in working system, change of work load, change of working time, and change of income. We also integrated the Indonesian version of Self-Reporting Questionnaire (SRQ) 20 to determine MED. Results: The prevalence of MED among the 1542 respondents from 27 companies was 8.8%. Female sex (OR 3.37, p value <0.001), Age < 40 years-old (OR 3.68, p value <0.001), Single marital status (OR 2.36, p value <0.001), higher education level (OR 3.56, p value <0.001), poor physical activity (OR 1.72, p value <0.013), Working period ≤ 10 years (OR 1.84, p value <0.03), presence of change of working time (OR 1.55, p value <0.016), and presence of work load change (OR 3.07, p value <0.001) were factors significantly associated with presence of mental emotional disorder. Conclusion: The prevalence of MED among the workers was higher than national data. Both personal and occupational factors were significantly associated with MED.
ABSTRACT
COVID-19 has created a general state of worry and distress, especially among vulnerable groups such as those with psychiatric diagnoses. Worldwide, psychiatric care provision has drastically suffered during the pandemic, with many patients unable to access proper care, which may have implications for increased mental health consequences in patients with psychiatric disorders (e.g., relapse and suicide). This cross-sectional study used structural equation modeling to investigate COVID-19-related trauma and distress among Arab psychiatric population during COVID-19 quarantine. Patients with pre-existing psychiatric disorders (N = 168) completed an online survey that comprised the Depression Anxiety Stress Scale 21 (DASS-21), the Impact of Event Scale-Revised (IES-R), and a questionnaire on COVID-19-related attitudes/perceptions, sources of information, used protective measures, and socio-demographic information. Respondents commonly reported feeling down-hearted/blue, trouble concentrating, along with symptoms of avoidance and rumination related to the pandemic. Patients with depression and sleep disorders expressed higher COVID-19-related trauma than patients with other disorders. Perceived physical health mediated the effect of co-morbid chronic physical disorders on COVID-19 trauma, psychological distress, perceived vulnerability to COVID-19, and perceived likelihood of recovery in case of contracting COVID-19. Perceived physical health and perceived vulnerability to COVID-19 were strong direct predictors of COVID-19-related trauma and psychological distress. Staying at home negatively predicted COVID-19 trauma and exerted an indirect negative effect on psychological distress via COVID-19 trauma. COVID-19 trauma, age, and marital status directly predicted psychological distress, with COVID-19 trauma being the strongest predictor. Educational level, income, having family members working in the medical field, keeping up to date with the news on deaths/infected cases or the development of COVID-19 drugs or vaccines, satisfaction with available information on COVID-19, and using different protective measures were not associated with significant differences in COVID-19 trauma and psychological distress scores. Immuno-psychiatric interventions should be designed to target COVID-19-trauma and distress among younger single patients with perceived poor physical health, especially those diagnosed with depression and sleep disorders.
Subject(s)
COVID-19 , Psychological Distress , Psychological Trauma , Sleep Wake Disorders , Cross-Sectional Studies , Depression/epidemiology , Humans , Independent Living , SARS-CoV-2ABSTRACT
Introduction: The Optimal Health Program (OHP) is a collaborative self-management program that promotes clients to be actively involved in their own healthcare and overall wellbeing. Program Kesihatan Optimum (SANUBARI) is a Malay version of the OHP after a translational process and cultural adaptation by psychiatrists, clinical psychologist and family medicine specialists in 2017. The program is of a low intensity, patient-centred program, advocating self-health management to improve health literacy by enhancing self-efficacy, building strengths and values, and initiating change and planning, ultimately enhancing wellbeing of people. The programme can be used as a form of early psychosocial intervention during the current pandemic in maintaining the general mental wellbeing of COVID-19 patients. Methods: This is an open labelled interventional study of a virtual brief psychosocial intervention, called SANUBARI. The program was conducted among COVID-19 patients hospitalized in the COVID-19 wards of two centres from May 2020 until August 2020. Inclusion criteria include patients aged eighteen years and above, diagnosed with COVID-19, medically stable, speaking and reading Bahasa Melayu or English. All study subjects attended two sessions on OHP via telecommunication method and answered questionnaires (General Self-Efficacy (GSE) Scale, Patient Health Questionnaire and Generalized Anxiety Disorder Questionnaire) via computer-assisted self-interview. Data collection was done before the start of the intervention, at the end of the intervention and a month post-intervention. Results: A total of 37 patients were recruited and more than half of the subjects were males (62.2%), single (75.5%) and from the Malay ethnicity (78.4%). Seventy-three per cent of subjects had received tertiary education, and most of them were students reflecting a higher unemployment status (73%). Most subjects have no comorbid chronic medical illness (89.2%), and none has a comorbid psychiatric illness. Comparison of the GSE score across 3-time points (pre-intervention, immediate post-intervention and a month post-intervention) showed statistically significant improvement in the mean total GSE score immediate and a month post-intervention as compared to the pre-intervention;from mean total GSE score of 29.78 pre-intervention to 34.73 (mean difference 4.946, 95% Confidence Interval 95%CI: 3.361, 6.531) immediate post-intervention and 33.08 (mean difference 3.297, 95%CI: 1.211, 5.348) a month post-intervention. There was no significant association between the socio-demographic or clinical data, depressive and anxiety symptoms, and changes in GSE scores over three time points. Conclusion: COVID-19 patients improved their self-efficacy levels after the virtual brief OHP intervention, and it maintained a month post-intervention, protecting them from psychological stress and ultimately enhances wellbeing during this coronavirus pandemic.