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Objective To survey the psychological reaction status and influencing factors of the nurses in a class 3A hospital of Chengdu under the normalized prevention and control of COVID-19 epidemic to provide a theoretical basis for the related department of the hospital formulating the interventional strategy. Methods The cluster sampling methods was used to select 1 079 nurses in a class 3A Women and Children Specialized Hospital of Chengdu City as the study subjects under trending to normalized prevention and control after the outbreak of the novel coronavirus infection from May to June 2021.The self-made general data qestionnaire, Generalized Anxiety Disorder（GAD-7) scale and Maslach Burnout Inventory (MBI) were used to conduct the questionnaire survey, and the SPSS25.0 statistical soft was used for conducting the data analysis. Results Among 1 079 nurses, 304 nurses（28.2%） had the GAD-7 score ≥5 points, which was correlated with the education background, working years, professional and technical posts, working post during the epidemic, awareness of the impact of COVID-19 on work and social and family support, and the differences were statistically significant（P＜0.05）.In the work burnout scale, the subjects with meddle and high levels in the emotion burnout sense, work apathy sense and work non-achievement sense accounted for 40.7%（439/1 079）,33.3%（359/1 079） and 65.7%（709/1 079） respectively. Different professional and technical positions, work position and social and family support during the epidemic had the influence on the level of emotional burnout, different professional and technical posts, work positions during epidemic had the influence on the work apathy sense, different the educational backgrounds and profesional and technical posts and work posts during epidemic had the influence on the work non-achievement sense, and the differences were statistically significant（P＜0.05）.The nurses in the first line epidemic prevention posts had significant work burnout sense. Conclusion The nurses had a certain degree of anxiety and work burnout sense from COVID-19 epidemic outbreak to the normalized prevention and control, which needs to give the psychological support and better prevention and control strategies. (English) [ FROM AUTHOR] 目的 调查成都某三甲妇女儿童医院护士在新型冠状病毒感染(新冠)疫情常态化防控下心理反应状况及影响因素，为医院相关部门制定干预策略提供理论依据。方法 采用整群抽样方法选取2021年5-6月新冠疫情暴发流行后逐渐趋于常态化防控下成都市某三甲妇女儿童专科医院护士1 079名作为研究对象，使用自制一般资料问卷、广泛性焦虑量表、工作倦怠感量表对其进行问卷调查，采用 SPSS25.0 统计软件进行数据分析。结果 1 079名护士中广泛性焦虑量表评分大于或等于5分者304名(28.2%),与学历、工作年限、专业技术职务、疫情防控期间所在工作岗位、新冠疫情对工作影响的认知、社会家庭支持相关，差异均有统计学意义(P＜0.05);工作倦怠感量表的情感倦怠感、工作冷漠感、工作无成就感的中、高水平者分别占40.7%(439/1 079)、33.3%(359/1 079)、65.7%(709/1 079),不同专业技术职务、疫情防控期间所在工作岗位、社会家庭支持对情感倦怠感水平有影响，不同专业技术职务、疫情防控期间所在工作岗位对工作冷漠感有影响，不同学历、专业技术职务、疫情防控期间所在工作岗位对工作无成就感有影响，差异均有统计学意义(P＜0.05),一线防疫岗位护士有明显的工作倦怠感。结论 新冠疫情暴发至常态化防控下护士存在一定程度的焦虑症状和工作倦怠感，需要给予心理支持及更好的防控策略 (Chinese) [ FROM AUTHOR] Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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The current study aimed to identify the impact of positive thinking on the anxiety of Coronavirus infection through the lockdown among UNRWA staff in Jordan. To achieve the objectives of the study, three measures were developed, the Positive Thinking Scale, the anxiety level of Coronavirus Infection Scale, and the lockdown Scale. A sample of (2036) employees responded to the measures. The results showed that the level of anxiety for COVID -19 infection among the sample was high, and statistically significant differences were found in the level of Covid-19 infection anxiety according to the sex variable for females, also statistically differences were found in the level of anxiety in COVID-19 infection according to age in favor of (31-40), and statistically differences for the social status in favor of married couples. Results also showed a direct negative impact of positive thinking variable on the level of anxiety associated with COVID-19 infection, and an effect of positive thinking on the level of anxiety during activating the lockdown. The study recommends designing training programs for employees to help them adapt to different circumstances and enable them to continue performing their assigned work. [ FROM AUTHOR] Copyright of An-Najah University Journal for Research, B: Humanities is the property of An-Najah National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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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 P0.05). 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 P0.05). 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 P0.05). 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, P0.01), 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, P0.01) 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 (P0.05). 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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This study explores how China's education responses to COVID-19 from a perspective of policy analysis. Specifically, it involves building an educational policy system for COVID-19 to examine educational governance framework, school management and teaching, policies for teachers during the epidemic. The education policy during the epidemic has achieved positive results. Those results aim to ensure the physical and mental health of teachers and students, ensure the supply of epidemic prevention materials and educational resources, ensure the quality of students' learning, and enhance the application ability of teachers' teaching technology. The process of policy changes and effects of policy implementation have been examined to analyze how China's education responses to COVID-19. The characteristics and experience of China's education policy in response to the epidemic concentrate on forming a governance system under the centralized and unified leadership of the Communist Party of China, building a pattern in which families and schools cooperate closely to promote the smooth development of education and teaching, transforming from an emergency substitute during the crisis into an important motivation to promote the transformation of education paradigm, and paying great attention to remote and poor areas and disadvantaged student groups.
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Objective: To analyze the clinical manifestations, diagnostic methods and treatment process of the patients with non-Hodgkin's lymphoma complicated with human coronavirus(HCoV)-HKU1 pneumonia and improve the clinical medical staff's awareness of the disease, and to reduce the occurrence of clinical adverse events. Method(s): The clinical data of a patient with non-Hodgkin's lymphoma complicated with HCoV-HKU1 pneumonia with hot flashes and night sweats, dry cough and dry throat as the main clinical features who were hospitalized in the hospital in January 2021 were analyzed, and the relevant literatures were reviewed and the clinical manifestations and diagnosis of HCoV-HKU1 were analyzed. Result(s): The female patient was admitted to the hospital due to diagnosed non-Hodgkin's lymphoma for more than 2 months. The physical examination results showed Karnofsky score was 90 points;there was no palpable enlargement of systemic superfical lymph nodes;mild tenderness in the right lower abdomen, no rebound tenderness, and slightly thicker breath sounds in both lungs were found, and a few moist rales were heard in both lower lungs. The chest CT results showed diffuse exudative foci in both lungs, and the number of white blood cells in the urine analysis was 158 muL-1;next generation sequencing technique(NGS) was used the detect the bronchoalveolar lavage fluid, and HCoV-HKU1 pneumonia was diagnosed. At admission, the patient had symptoms such as dull pain in the right lower abdomen, nighttime cough, and night sweats;antiviral treatment with oseltamivir was ineffective. After treatment with Compound Sulfamethoxazole Tablets and Lianhua Qingwen Granules, the respiratory symptoms of the patient disappeared. The re-examination chest CT results showed the exudation was absorbed. Conclusion(s): The clinical symptoms of the patients with non-Hodgkin's lymphoma complicated with HCoV-HKU1 pneumonia are non-specific. When the diffuse shadow changes in the lungs are found in clinic, and the new coronavirus nucleic acid test is negative, attention should still be paid to the possibility of other HCoV infections. The NGS can efficiently screen the infectious pathogens, which is beneficial to guide the diagnosis and treatment of pulmonary infectious diseases more accurately.Copyright © 2023 Jilin University Press. All rights reserved.
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Social determinants of mental and physical health that influence young peoples' trajectories into adulthood are often remediable through law. To address inequalities, including those exacerbated since the COVID-19 pandemic, there is a need to better understand young people's need for and uptake of advice for social welfare legal problems. This scoping review aimed to review available evidence and identify gaps to inform further research. To identify studies relevant to social welfare legal advice among young adults we conducted searches of eight bibliographic databases (compiled between January 1998 and June 2020), hand searches of included article reference lists and targeted grey literature searches. 35 peer reviewed and grey literature studies were selected based on inclusion and exclusion criteria including evaluations of interventions to promote access to advice, general population surveys, observational studies, and audits of charity data or targeted surveys. Evidence suggests considerable and inequitable need for social welfare legal advice among young adults with adverse consequences for health and wellbeing. Needs among higher risk groups are likely underestimated. Evidence for interventions to enhance access/uptake of advice is limited and methodologically weak. We identify several gaps in the literature to inform research and to enable systematic reviews around more specific questions to inform practice.
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Objectives: Treatment of severe respiratory distress syndrome (ARDS) due to COVID-19 by veno-venous extracorporeal membrane oxygenation (VV-ECMO) had a mortality of up to 70% in Germany. Many patients with COVID-19 need VV-ECMO support longer than 28 days (long-term VV-ECMO). Evidence on mortality, complications during intensive care, functional status after discharge and mortality-predictors for patients supported with long-term VV-ECMO is lacking. Method(s): Retrospective study of 137 consecutive patients treated with VV-ECMO for ARDS due to COVID-19 at University Hospital Regensburg from March 2020 to March 2022. Result(s): 38% (n=52;87% male) of patients needed longterm VV-ECMO support. In these, SOFA score (median [IQR]) at ECMO initiation was 9 [8-11], age 58.2 [50.6- 62.5] years, PaO2/FiO2-ratio 67 [52-88] mmHg, pCO262 [52-74] mmHg, Murray-Score 3.3 [3.0-3.6] and PEEP 15 [13 - 16] cmH2O. Duration of long-term support was 45 [35-65] days. 26 (50%) patients were discharged from the ICU. Only one patient died after hospital discharge. At VVECMO initiation, baseline characteristics did not differ between deceased and survivors. Complications were frequent (acute kidney injury: 31/52, renal replacement therapy: 14/52, pulmonary embolism: 21/52, intracranial hemorrhage 8/52, major bleeding 34/52 and secondary sclerosing cholangitis: 5/52) and more frequent in the deceased. Karnofsky index (normal 100) after rehabilitation was 70 [57.5-82.5]. Twelve of the 18 patients discharged from rehabilitation had a satisfactory quality of life according to their own subjective assessment. Four patients required nursing support. Mortality-predictors within the first 30 days on VV-ECMO only observed in those who deceased later, were: Bilirubin >5mg/dl for > 7 days, pulmonary compliance <10ml/mbar for >14 days, and repeated serum concentrations of interleukin 8 >150ng/L. Conclusion(s): Long-term extracorporeal lung support in patients with COVID-19 resulted in 50 % survival and subsequently lead to a satisfactory quality of life and functionality in the majority of patients. It should preferably be performed in experienced centers because of a high incidence of complications. Several findings during the early course were associated with late mortality but need validation in large prospective studies.
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Background: This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium. Method(s): Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021. Result(s): Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores. Conclusion(s): The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.Copyright © 2022, The Author(s).
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Objectives: Social determinants of health (SDoH) including income, education, employment, and housing are known to affect health outcomes;while use in real-world database studies are limited. This study assessed socioeconomic differences in burden of disease and utilization of COVID-19 specific medications in a large cohort of patients in the US. Method(s): A total of 17,682,111 patients having a COVID-19 diagnosis between 4/1/2020 and 4/30/2022 were identified in the IQVIA longitudinal medical and pharmacy claims databases of >277 million patients. For SDoH, a 3-digit zip code median Area Deprivation Index (ADI) (v2.0 University of Wisconsin School of Medicine and Public Health 2015) was calculated for each patient, maintaining patient privacy. The ADI is a validated tool ranking neighborhoods by socioeconomic disadvantage. Medical and pharmacy utilization was assessed and stratified by ADI pentiles, where 0-20 was the least disadvantaged, and 81-100 was the most disadvantaged. Result(s): The proportion of patients having a claim with COVID-19 diagnosis was higher in the most disadvantaged (7.75%) compared to the least disadvantaged group (5.94%) (US overall: 6.37%). Medical claims prior to COVID-19 diagnosis were highest in the least disadvantaged, while prior pharmacy utilization was highest in the most-disadvantaged group. There was sparse use of COVID-19 medications overall;the least disadvantaged patients had the lowest use of COVID-19 specific medications. Casirivimab/imdevimab use was highest in the 61-80 (2.01%) and 81-100 (1.79%) ADI groups, and remdesivir use was highest in the moderately disadvantaged (ADI 41-60 and 61-80) groups (both 2.33%). Utilization of hydroxychloroquine (unapproved for COVID-19) increased from 0.91% in the least to 2.13% in the most disadvantaged groups. Conclusion(s): This study shows unequal burden of COVID-19 prevalence by SDoH, with the most disadvantaged having a higher disease burden and utilization of certain approved and unapproved COVID-19 medications, highlighting the need for further study of the reasons for these disparities.Copyright © 2023
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Objectives: COVID-19 infected over 150 million people and caused over 1 million deaths in the US. This study evaluates several variables thought to be associated with mortality risk in the COVID-19 population. Method(s): The IQVIA longitudinal medical and pharmacy claims databases identified 17,682,111 patients with a COVID-19 diagnosis between 4/1/2020-4/30/2022 from a population of >277 million patients in the US. Patients were linked to Veritas Data Research fact-of-death records (90% complete compared to CDC reporting) and confirmed deaths were flagged. Confirmed mortality rates (CMR) were evaluated by age group, socioeconomic status (SES) using the Area Deprivation Index (v2.0, University of Wisconsin, 2015), co-morbidities and COVID-specific (approved and unapproved) treatments. Result(s): Of the 563,744 patients (3.2%) identified as dead (3.67% in men, 2.85% in women overall), CMR was lowest in patients aged 0-17 (0.08%), highest in age 65-75 (5.92%) and >75 (16.40%). Patients in the lowest 40% of SES had CMR of 4.43% while in the highest 20% was 1.56%. Respiratory failure, pneumonia and sepsis were the most common acute diagnoses accompanying COVID-19 deaths in all SES. In patients with comorbid dementia or Alzheimer's disease, CMR were 21.62% and 23.40% respectively. Additionally, congestive heart failure (15.79%), atrial fibrillation (15.50%), chronic kidney disease (15.30%) and COPD (12.19%) were associated with high CMR. Among patients receiving approved therapies, casirivimab/imdevimab and remdesivir had CMR of 1.41% and 12.63% respectively, while for those receiving unapproved therapies, ivermectin and hydroxychloroquine had CMR of 2.54% and 2.45%. Conclusion(s): Compared to the 1.1% case-mortality rate (Johns Hopkins 2023) among US COVID-19 patients, we found CMR exceeded 3% among those with a medical claim for COVID-19. Advanced age, dementia, and cardio-renal disease were associated with mortality. Patients with the lowest SES had approximately 3 times the confirmed mortality rate compared to those in the highest SES group.Copyright © 2023
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BACKGROUND: The lockdown would become the primary strategy for facing covid-19 as it quickly mutates which might cause repeated pandemics;however, it negatively affects individuals' quality of life (QOL). The schizophrenia caregivers experience considerable stress. The research on the impact of the COVID-19 lockdown on QOL of schizophrenia caregivers is essential, especially for those who reside in rural areas. AIM: This study aimed to investigate the impact of lockdown-related COVID-19 on QOL among primary caregivers of schizophrenia patients living in a rural area. METHOD(S): This study recruited 204 primary caregivers (15-79 years). This study used the World Health Organization Quality of Life instrument (WHOQOL-BREF) to asses QOL's primary caregiver. Evaluate the possible change in caregivers' QOL before and during the COVID-19 lockdown using paired t-test for repeated measures. RESULT(S): The mean age of the caregivers was 46.61 years (SD = 12.79), ranging from 15 to 79 years, with a preponderance of male (54.5%), aged 38-47 years old (29.7%), married (81.2%), employed (57.4%), and had senior high school level of education (34.7%). Majority were parents (26.2%) of the ill relative, and took care of the patients more than 5 years (52.5%). There was a statistical difference (p < 0.05) in caregivers' QOL between before and during the COVID-19 lockdown, including in physical health, psychological, social relationships, and environment domain. CONCLUSION(S): Implementing a lockdown policy related to COVID-19 has negatively impacted the caregivers' QOL. The degradation of caregivers' QOL showed from before to during COVID-19 lockdown. Further study needs to explore the QOL of other mental illness caregivers regarding COVID-19 lockdown. This finding becomes a reference for a government to modify some policy-related lockdowns to minimize their negative impact.Copyright © 2023 Utomo Utomo, Eko Mulyadi, Endang Fauziyah.
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Background: Coronavirus disease-2019 (COVID-19) poses expectant mothers to a higher risk of serious complications and mortality. Following a risk-benefit review, a number of governmental and professional bodies from across the globe recently approved the COVID-19 vaccination during pregnancy. Aim(s): This study aimed to investigate knowledge, actual acceptance, and concerns about the COVID-19 vaccine among the obstetric population. Material(s) and Method(s): Participants were selected from among the expecting women who came for antenatal checkup during the study period (October 1, 2021-November 30, 2021). About 150 pregnant women who met the inclusion criteria and consented were recruited into the study. Data related to socio-demographic and clinical characteristics as well as knowledge, actual acceptance, and concerns about COVID-19 vaccine were collected through in-person interviews using a prestructured questionnaire. The SPSS version 23 was used to analyze data. The association between the attitude (acceptance and hesitance) of participants toward the COVID-19 vaccine and their sociodemographic and clinical profile was found by Fisher's exact test. Result(s): The actual acceptance of the COVID-19 vaccine among expecting women was 52.0%. The primary motive for accepting COVID-19 immunization was to protect the fetus, followed by the protection of one's own health. A significant association was found between COVID-19 vaccine acceptance and the level of education, socio-economic status, and presence of comorbidities. The leading causes for vaccine reluctance were concerns about the efficacy and safety of the vaccines and lack of awareness about their usage during pregnancy. Conclusion(s): Multifaceted activities are required to promote the effectiveness and safety profile of the COVID-19 vaccine as well as disseminate knowledge about its usage during pregnancy. Clinical significance: Unlike numerous other studies that have investigated the accepting attitude only, the present one has investigated the actual COVID-19 vaccine uptake among the obstetric population.Copyright © The Author(s).
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Objective: to study the causes and predictors of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness. Patients and methods. We examined 100 patients who turned to a psychiatrist due to a deterioration in their mental state during the pandemic, 50 patients were newly diagnosed (Group 1) and 50 with previously diagnosed mental disorders (Group 2). The study was carried out by a clinical method using a specially designed map, followed by statistical processing of the obtained data. Results and discussion. Mental disorders caused by the COVID-19 pandemic more often occurred at a young age, in patients with higher and secondary specialized education, and in single patients. In the 1st group, as a result of exposure to psychogenic factors (the influence of the media, quarantine, economic changes), anxiety (36.8%) and depressive (21.1%) disorders occurred more often, and after the coronavirus infection, depressive disorders were in the first place (54.2%). The 2nd group mostly included patients with endogenous disorders (bipolar affective disorder - 24%, recurrent depressive disorder - 20%, schizophrenia - 20%), which were exacerbated more often as a result of COVID-19, to a lesser extent - psychogenic (experiences associated with a change in material status and illness of relatives). Obsessive-compulsive disorder, generalized anxiety disorder, somatoform disorders have been associated with epidemic factors. Conclusion. The results obtained indicate that there are differences between the mental disorders that first appeared during the pandemic and the exacerbations of the condition in mentally ill patients, which relate to the predictors, causes and clinical manifestations of these disorders.Copyright © 2022 Ima-Press Publishing House. All rights reserved.
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Objectives: The Covid-19 pandemic highlighted the importance of considering Social Determinants of Health (SDoH) in healthcare research. Administrative claims databases are widely used for research, but often lack SDoH data or sufficient transparency in how these data were obtained. This study describes innovative methods for integrating SDoH data with administrative claims to facilitate health equity research. Method(s): The HealthCore Integrated Research Database (HIRD) contains medical and pharmacy claims from a large, national US payer starting in 2006 and includes commercial (Comm), Medicare Advantage (MCare), and Medicaid (MCaid) populations. The HIRD includes individually identifiable information, which was used for linking with SDoH data from the following sources: national neighborhood-level data from the American Community Survey, the Food Access Research Atlas, and the National Center for Health Statistics' urbanicity classification;and member-level data on race/ethnicity from enrollment files, medical records, self-attestation, and imputation algorithms. We examined SDoH metrics for members enrolled as of 05-July-2022 and compared them to the respective US national data using descriptive statistics. We also examined telehealth utilization in 2022. Result(s): SDoH data were available for ~95% of currently active members in the HIRD (Comm/MCare/MCaid 12.5m/1m/7.6m). Socioeconomic characteristics at the neighborhood-level differed by membership type and vs. national data: % of members with at least a high-school education (90/88/84 vs. 87);median family income ($98k/$76k/$70k vs. $82k);% of members living in low-income low-food-access tracts (9/14/18 vs. 13);urban (57/52/47 vs. 61). At the member-level, the % of White Non-Hispanics, Black Non-Hispanics, Asian Non-Hispanics, and Hispanics were 61/6/5/6 (Comm), 76/12/2/2 (MCare), and 45/26/5/19 (MCaid). Imputation contributed 15-60% of race/ethnicity values across membership types. Telehealth utilization increased with socioeconomic status. Conclusion(s): We successfully integrated SDoH data from a variety of sources with administrative claims. SDoH characteristics differed by type of insurance coverage and were associated with differences in telehealth utilization.Copyright © 2023
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This study compares the serological antibody level post-COVID-19 vaccine among healthy subjects and psychiatric patients on antidepressant therapy. It also examines the difference in antidepressants' side effects experienced by psychiatric patients following the completion of two vaccine doses. A comparative posttest quasi-experimental study was conducted among healthy subjects and psychiatric patients on antidepressant medication in a teaching hospital in Malaysia. Elecsys Anti-SARS-CoV-2 assay was used to detect the antibody titre between weeks 4 and 12 post vaccination. The antidepressant side-effect checklist (ASEC) was used to monitor the occurrence of antidepressant-related side effects pre-and post-vaccination. 24 psychiatric patients and 26 healthy subjects were included. There was no significant difference in the antibody level between the patients (median = 1509 u/ml) and the healthy subjects (median = 995 u/ml). There was no significant worsening in the antidepressant-related side effects. The antibody level post-COVID-19 vaccine did not differ significantly between patients on antidepressant therapy and healthy subjects. Additionally, there was no change in the antidepressant side effects experienced by the patients following the completion of the vaccine.Copyright © 2022, Research Trends (P) LTD.. All rights reserved.
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PurposeThis study is aimed at developing an understanding of the consequences of the pandemic on families' socioeconomic resilience, and the strategies adopted by the families in overcoming social vulnerabilities amid uncertainty.Design/methodology/approachThe materials for this study consist of semi-structured interviews with 21 families spread across the South Sumatra Province, Indonesia. Families in the study represent four different income levels, namely very high, high, middle and low, and who also work in the informal sector. Each family has at least 1 or more members who fall into the vulnerable category (children, the elderly, people with disabilities unemployed or having potential economic vulnerability).FindingsTwo main findings are outlined. Regardless of their socioeconomic status, many of the families analyzed adopted similar strategies to remain resilient. Among the strategies are classifying the urgency of purchasing consumer goods based on financial capacity rather than needs, leveraging digital economic opportunities as alternative sources of income, utilizing more extensive informal networks and going into debt. Another interesting finding shows that the pandemic, to some extent, has saved poor families from social insecurity. This is supported by evidence showing that social distancing measures during the pandemic have reduced the intensity of sociocultural activities, which require invited community members to contribute financially. The reduction of sociocultural activities in the community has provided more potential savings for the poor.Research limitations/implicationsIn this study, informants who provided information about their family conditions represent a major segment of the workforce and tend to be technologically savvy and younger, due to the use of Zoom as a platform for conducting interviews. Therefore, there may be a bias in the results. Another limitation is that since the interviewees were recommended by our social network in the fields, there is a risk of a distorted selection of participants.Originality/valueThis study offers insights that are critical in helping to analyze family patterns in developing countries in mitigating the risks and uncertainties caused by COVID-19. In addition, the literature on social policy and development could benefit from further research on COVID-19 as an alternative driver to identify mechanisms that could bring about change that would result in "security.” Critical questions and limitations of this study are presented at the end of the paper to be responded to as future research agenda.
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Aim: Our institute provided the required monthly insulin free to patients with type 1 diabetes, where either patients or parents became unemployed and/or economically weaker during the pandemic. Method(s): All 296 patients with type 1 diabetes were given questionnaires to assess their or their family's economic status during Covid-19. 33 patients fell below poverty line and had a Priority Household Card (with 35kgs of free rice every month) and ration cards enrolled for monthly free insulin scheme. The patients were given monthly requirements of insulin based on existing regimens. Their weight, HbA1c and episodes of ketoacidosis were measured at 3-and 6-months following initiation of the scheme. Additional financial and material support were organized from NGO's and philanthropic individuals. Measurable impact of this project was ascertained through glycaemic control through HbA1C levels prior and after, overall wellbeing and prevention of acute complications like ketoacidosis. Result(s): 33 patients enrolled for the study, 9 were less than 15 years of age, 19 between 15 and 30 years and 5 above 30 years of age. HbA1c levels fell cumulative by 0.8% by 3 months and 1.2% by six months. Weight increased by 1 kg by 3 months and 1.5 kg by six months. Few episodes of ketoacidosis were reported during six months primarily due to engagement issues issue rather than availability of insulin. Conclusion(s): There was a dramatic impact on overall wellbeing of these patients with type 1 diabetes with significant improvement on glycaemic control and on emotional by reducing the financial burden of procuring monthly doses of insulin.
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The aim of the current study was to assess the influence of the first wave of COVID-19 (March- June 2020) on individuals with depression and anxiety, evaluating the impact of different groups of factors in a complex (holistic) manner. Material(s) and Method(s): The study is cross-sectional, including outpatients with depressive and anxiety disorders in remission (n = 60), outpatients in relapse (n = 65), a group of healthy controls (n = 30), and a control group with relatives of the patients with depression and anxiety (n = 30) for the period July-October 2020. Socio-demographic factors, the presence of somatic comorbidity and risk factors related to it, and the need for medical care during the first COVID wave were analyzed. Result(s): Patients with deteriorated anxiety disorders have a significantly lower educational status (p < 0.001) in comparison to the other groups. Individuals with deteriorated major depressive disorder and controls-relatives have significantly more somatic comorbidity compared to healthy controls (p < 0.05). Individuals with anxiety disorders do not differ from healthy controls on this measure. Visits to medical specialists in those with worsening depression increased during the analyzed period but were comparable to the control groups. In persons with anxiety - worsened or in remission, there is a significant increase in this indicator compared to healthy controls (p < 0.05). Conclusion(s): In the conditions of the first COVIDwave, individuals with worsened depression, as well as relatives of anxious and depressed patients have significantly more somatic problems compared to healthy controls. However, individuals with anxiety but not depression seek significantly more healthcare consultations, despite the isolation. The holistic approach implies a complex assessment of somatic and mental comorbidity and the need for additional knowledge and resources in the service of persons with anxiety and depression, although there is relatively easy access to consultation care in our country.Copyright © 2023, Central Medical Library Medical University - Sofia. All rights reserved.
ABSTRACT
INTRODUCTION: The study aimed to evaluate whether the administration of monoclonal antibodies (MABs) in mildly symptomatic unvaccinated COVID-19-positive pregnant patients reduced the need for maternal hospitalization and to evaluate whether this medication affected the rate of adverse neonatal outcomes and severe maternal disease. We hypothesized that MAB use would reduce the need for hospitalization. METHODS: This retrospective cohort study was completed by obtaining electronic medical record data of all pregnant patients between August 2020 and January 2022 who met criteria for MAB therapy. The two comparison groups were patients who received outpatient MAB therapy during pregnancy and those who were eligible for therapy but declined. Demographic and hospitalization data were obtained. Exclusion criteria included severe illness upon diagnosis requiring hospitalization, or patients for whom delivery and neonatal data were not available. RESULTS: During the study period, 49 patients qualified for MAB therapy, of which delivery data were available for 39 patients. Twenty patients (51%) elected to receive MAB therapy and 19 (49%) declined. Among those who received MAB therapy, 10 (26% of the population) were vaccinated, and among those who declined, 6 (15% of the population) were vaccinated. The two groups were similar in gestational age at delivery (38 weeks 4 days versus 37 weeks 5 days) and gestational age at diagnosis (19 weeks 0 days versus 22 weeks 6 days). Among patients who did not receive MABs, both absolute and relative maternal hospitalization rate was higher (26.3% versus 5%, 12.8% versus 3%, P >.05). When stratified by vaccination status, those who were vaccinated had a 5% probability of hospitalization regardless of MAB therapy. The probability of hospitalization was highest among unvaccinated women who did not receive MAB therapy (67%) and lowest among unvaccinated women who received MAB therapy (0%). CONCLUSION: Unvaccinated patients who declined MAB therapy had a higher rate of hospitalization, although not statistically significant. These preliminary findings warrant further study with a larger cohort. [ FROM AUTHOR] Copyright of Obstetrics & Gynecology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The number of people with long-term consequences of COVID-19 is increasing worldwide. The long-term prognosis for patients remains poorly understood. Objective. To study cardiometabolic and psychocognitive features in comorbid elderly patients with atrial fibrillation (AF), de-pending on the presence of post-COVID syndrome (PCS). Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (coronary artery disease, hypertension, obesity, type 2 diabetes mellitus) aged 60-74, who were divided into two groups: group 1 included 123 patients without COVID-19 and group 2 included 110 patients with a history of COVID-19 and the presence of PCS. The study evaluated laboratory and instrumental tests, and a general clinical study assessing psychocognitive disorders using the SPMSQ and HADS questionnaires was conducted. Results and discussion. In COVID-19 survivors, compared with patients of group 1, there were more pronounced atherogenic changes in total cholesterol (TC) (p=0.003), low-density lipoprotein cholesterol (p<0.001), and triglycerides (p=0.011). Lower dia-stolic blood pressure was found in COVID-19 survivors (p<0.001). In addition, patients in group 2 had higher median pulse pressure (p<0.001) and heart rate (p<0.001). In group 2 patients, a larger ascending aorta diameter was observed (p<0.001). The anx-iety-depressive syndrome was more common in COVID-19 survivors with comorbidities, and a statistically significant difference was found in clinical anxiety (24%, p=0.041) and subclinical depression (21%, p=0.015). When assessing cognitive function, mod-erate cognitive impairment was detected in 22% (p=0.005) of patients with PCS and severe cognitive impairment in 2% (p=0.007). Conclusion. In comorbid elderly patients with the post-COVID syndrome, a high prevalence of psychocognitive disorders and adverse cardiometabolic changes were observed, supporting the need for long-term monitoring of the general clinical condition and psychocognitive status of COVID-19 survivors.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.