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Objectives: The coronavirus disease 2019 (COVID-19) pandemic has imposed significant burden on Brazil's health system. The present study aims to describe patients' demographic and clinical characteristics, vaccine uptake and assess healthcare resource utilization (HCRU) and costs associated with acute COVID-19 in Brazil during the Omicron predominant period. Method(s): A population-based retrospective study was conducted using the National Health Data Network (RNDS), National Vaccination Campaign against COVID-19 data and surveillance data in public setting. Individuals with positive COVID-19 test results between January-April 2022 were identified. Patients' demographics, comorbidities, vaccination status, HCRU for those who were admitted to hospitals and their associated costs were described by age groups. Result(s): A total of 8,160,715 COVID-19 cases were identified and 2.7% were aged <5 years, 11.6% were 5-19 years, 76.9% were 20-64 years and 8.7% were >= 65 years. The presence of comorbidity was 23.1% with a higher prevalence of comorbidities in the elderly (61.8% for 65-74 years and 71.2% for >=75 years). Regarding COVID -19 vaccination uptake, among those aged <=19 years, 20-64 years and >=65 years, 40.6%, 86.5% and 92.2% had primary series, respectively. Among adults, the booster uptake was 47.3% and 75.8% for those aged 20-64 years and >= 65 years, respectively. Among those with confirmed COVID-19, regardless of vaccination status, 87% were being symptomatic and 1.7% were hospitalized (3.8% in aged <5 years, 4.2% in 5-19 years, 34.3% in 20-64 years and 57.6% in >= 65 years). Among hospitalized patients, 32,6% were admitted to ICU and 80% required mechanical ventilation support. The average cost per day in normal wards and ICU without ventilation was R$291,89 and R$923,90, respectively. Conclusion(s): Our results quantify the public health and economic burden of COVID-19 in Brazil, suggesting substantial healthcare resources required to manage the COVID-19 pandemic.Copyright © 2023
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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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Submission content Introduction: At the end of a particularly hectic night shift on the intensive care unit (ICU) I found myself sitting in the relatives' room with the mother and aunt of a young patient, listening to their stories of her hopes and aspirations as she grew up. She had been diagnosed with lymphoma aged 14 and received a bone marrow transplant from her younger sister. Fighting through treatment cycles interposed with school studies, she eventually achieved remission and a portfolio of A-levels. Acceptance into university marked the start of a new era, away from her cancer label, where she studied forensic science and took up netball. Halfway through her first year she relapsed. Main body: When I met this bright, ambitious 20-year-old, none of this history was conveyed. She had been admitted to ICU overnight and rapidly intubated for type-1 respiratory failure. The notes contained a clinical list of her various diagnoses and treatments, with dates but no sense of the context. Rules regarding visitation meant her family were not allowed onto the unit, with next-of-kin updates carried out by designated non-ICU consultants to reduce pressures on ICU staff. No photos or personal items surrounded her bedside, nothing to signify a life outside of hospital. She remained in a medically-induced coma from admission onwards, while various organ systems faltered and failed in turn. Sitting in that relatives' room I had the uncomfortable realisation that I barely saw this girl as a person. Having looked after her for some weeks, I could list the positive microbiology samples and antibiotic choices, the trends in noradrenaline requirements and ventilatory settings. I had recognised the appropriate point in her clinical decline to call the family in before it was too late, without recognising anything about the person they knew and loved. She died hours later, with her mother singing 'Somewhere Over the Rainbow' at her bedside. Poignant as this was, the concept of this patient as more than her unfortunate diagnosis and level of organ failure had not entered my consciousness. Perhaps a coping mechanism, but dehumanisation none-the-less. Conclusion(s): Striking a balance between emotional investment and detachment is of course vital when working in a clinical environment like the ICU, where trauma is commonplace and worst-case-scenarios have a habit of playing out. At the start of my medical career, I assumed I would need to consciously take a step back, that I would struggle to switch off from the emotional aspects of Medicine. However, forgetting the person behind the patient became all too easy during the peaks of Covid-19, where relatives were barred and communication out-sourced. While this level of detachment may be understandable and necessary to an extent, the potential for this attitude to contribute to the already dehumanising experience of ICU patients should not be ignored. I always thought I was more interested in people and their stories than I was in medical science;this experience reminded me of that, and of the richness you lose out on when those stories are forgotten.
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Background/Objectives: Li-Fraumeni Syndrome (LFS) is a rare hereditary cancer predisposition syndrome characterized by high lifetime risks for multiple primary malignancies. Although most individuals with LFS inherit a pathogenic TP53 variant from a parent, approximately 20% have de novo variants with no suggestive family cancer history. This may result in an LFS experience distinct from individuals with affected relatives. This multi-case study report examines the unique psychosocial experiences of three young adults with de novo TP53 variants. Method(s): The National Cancer Institute's LFS study (NCT01443468) recruited adolescents and young adults (AYAs;aged 15-39 years) with LFS for qualitative interviews. Three participants had a de novo TP53 variant and a personal cancer history. An interprofessional team analyzed interview data using extended case study and narrative methods. Result(s): De novo participants lacked familiarity with LFS to situate a cancer diagnosis, interpret genetic test results, or adjust to chronic cancer risk. Communicating with and receiving support from family was challenged by their lack of common experience. De novo participants experienced socioemotional isolation, which was amplified during the COVID-19 pandemic. To cope, they sought support in online rare disease communities or through mental health providers. Conclusion(s): Individuals with de novo variants may lack familial guides and familiar providers to address disease management and uncertainty. Specialty health and mental health providers may support de novo patients across hereditary cancer syndromes by validating their uncertainties and connecting them with diseasespecific patient advocacy groups that support adjustment to chronic cancer risk.
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Self-medication is a widespread public health concern. University students are likely to be more prone to it since self-medication rates increase with educational level. Studies have shown that self-medication rates vary among academics belonging to different faculties, and medical students have the highest self-medication rates. However, it is unknown whether this holds in a vulnerable situation, such as the COVID-19 pandemic. It is also unknown whether differences in technical knowledge of drugs influence self-medication rates among students. Thus, this study analyzes and compares prophylactic self-medication among graduate students of different faculties in the context of the COVID-19 pandemic. This cross-sectional observational study was conducted at a private university in southern Brazil. Students from the medicine, law, life sciences, and fine arts faculties were surveyed, and their responses were compared using a chi-square test. Among 396 respondents, 29.5% reported using preventive medication for COVID-19, and medical students were the least likely to do so. The self-medication rate was 13.6% among respondents, and self-medication did not differ significantly between students of different faculties. Of the students who self-medicated 63% reported having studied the medication before using them. Furthermore, the media did not induce drug use among 81.8% respondents. These results show that medical students used fewer preventive medications during the pandemic and refute the assertion that self-medication rates are higher among medical students. They also show that self-medication rates during the pandemic were significantly lower than those before the pandemic. These revelations show a new aspect of self-medication.Copyright © 2021 Muslim OT et al.
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Background: This study seeks to evaluate the prevalence of and the association between receiving medical care abroad and the level of trust that citizens from the Western Balkans-Albania, Bosnia and Herzegovina, Kosovo and Montenegro-have in their healthcare systems. Method(s): The study is cross-sectional and was carried out during three months (July 25-October 30, 2021) through a self-reported questionnaire administered through the Google Forms platform. The study included approximately two-thousand citizens (N=2,356) aged eighteen (18) to seventy (70). Result(s): More than one-third (37.2%) of respondents stated that they or a relative had received healthcare services abroad during the last twelve (12) months. Citizens of Montenegro had the highest prevalence of receiving healthcare services abroad at 43.8%, followed by those from Bosnia and Herzegovina at 39%. No statistically significant difference was found in the level of trust in the healthcare system in the country between those who received healthcare services abroad (4.41+/-2.88) (out of 10) and those who did not (4.48+/-2.81) (t=-0.587, p=0.557). Conclusion(s): We ultimately conclude that more than one-third of the participants in our study have traveled abroad for healthcare purposes, with females, those living in urban areas, and those who have previously had a negative healthcare experience in their home country all being more likely to rely on health tourism.Copyright © 2023 Maljichi et al.
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Background: The coronavirus disease (COVID-19) pandemic has affected the medical education throughout the world. A study was done to assess the effect of education and psychological behavior on medical students. Aims and Objectives: The objective of the study is to evaluate the effect of COVID-19 on medical graduates in various aspects such as education, effect on clinical rotations, impact on the technology used for online classes, effect on quality of life, loneliness, sleep, and depressive symptoms. Material(s) and Method(s): A set of questions were distributed to Government Medical college, Suryapet students during November 2021-January 2022. Questionnaire aimed to study students' viewpoint of COVID-19's impact on their education, mental health, and willingness to participate clinically. Result(s): One hundred medical students from Government Medical College, Suryapet participated in this study. Most students (88%) agreed that pandemic had disrupted their medical education. About 64% agreed to attend clinical rotations and 68% of students accepting the risk of contracting COVID-19 in clinical rotations. COVID-19 had an impact on technology tools used for medical education. Students reported that COVID-19 had moderate impact on quality of life, sleep quality, anxiety, and depressive symptoms. Conclusion(s): The COVID-19 had an overall significant negative impact on undergraduate medical education. It is recommended that measures need to be taken to relieve students' stress.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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Previous studies have demonstrated that low-intensity intervention is effective in improving mental health in young people. Whilst interventions have majorly been offered online during COVID-19 pandemic, it is not known whether low-intensity interventions delivered online can also help reduce the level of distress experienced by young people. The study aimed to determine whether a low-intensity online intervention (LiON) can reduce levels of distress in young people greater than those in similar initial distress levels but received no intervention. Young people aged 15 to 24 were recruited for the 4-weekly LiON intervention consisting of three modules namely sleep and relaxation, stress-coping and problem-solving. The reductions in distress level after intervention were compared to those that occurred over a period of 3 months among community young people with similar baseline K6 distress levels. Seventy-four young people (mean age 20.24 [SD 2.26] years, 71.6% female) received the LiON intervention from December 2021 to July 2022. We observed a greater improvement in their distress levels after receiving the intervention than those with no intervention in the community (beta -4.13, 95%CI -5.12, -3.07, p < .001, Cohen's f2 0.027). The findings offered evidence that the LiON intervention significantly reduced young people's distress level in addition to the improvement that may occur naturally. The use of LiON is adaptable to a wider variety of frontline community organizations. Future evaluation of its cost-effectiveness is warranted.
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Objectives: Post COVID-19 conditions or long COVID continues to burden the healthcare system. With the introduction of new code in October 2021 to appropriately capture this condition (U09.9), we have enough data to understand the detailed demographic and clinical characterization of the patients with long COVID. As this new clinical entity continues to evolve, our study will provide insights for care management and planning. Method(s): We conducted a retrospective cohort study from a large deidentified database of US health insurance claims. The study population included all individuals with at least one ICD-10 code for COVID (U07.1) between June 1, 2021, and November 30, 2022. Individuals with at least one ICD-10 code for long COVID (U09.9), at least 7 days after COVID diagnosis were termed "Long COVID" patients. Index date was defined as the first long COVID diagnosis date. We also assessed the most prevalent diagnosis codes within the 30 days pre- and post-index to understand top symptoms. Result(s): A cohort of 253,145 patients (62% female patients;38% male patients) were identified. Among this cohort, 3.2% were pediatric patients aged 0 - 17 years;73.3 % aged 18 - 64 years and 23.5 % aged 65+ years. Most prevalent symptoms that increased in the 30 day pre- and post-index: Nervous system symptoms (6 fold), fatigue (7 fold), Dyspnea (4.3 fold), esophagitis (1.6 fold) chronic kidney disease (1.3 fold) among others. Conclusion(s): Our findings indicate that long COVID is more prevalent in females, with fatigue and dyspnea emerging as top symptoms. These findings are consistent with the published literature. However, we uncovered additional symptoms such as nervous system symptoms, chronic kidney disease among others. Additional analysis is planned to evaluate the association of these symptoms with sociodemographic features to understand the health inequity aspects of long COVID.Copyright © 2023
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OnTrackNY is a nationally recognized Coordinated Specialty Care model disseminated across New York state for young people experiencing early non-affective psychosis. OnTrackNY is a network of 22 teams located in licensed outpatient clinics, serving over 2500 individuals. OnTrackNY offers medication management, case management, individual and group cognitive behaviourally oriented therapy, family support and psychoeducation, supported employment and education, and peer support services. Teams receive training for implementation through an intermediary organization called OnTrack Central. OnTrackNY was selected as a regional hub of the National Institute of Mental Health Early Psychosis Intervention Network (EPINET), a national learning healthcare system (LHS) for young adults with early psychosis. This symposium will present the different ways in which EPINET OnTrackNY implemented systematic communitybased participatory processes to ensure robust stakeholder involvement to improve the quality of OnTrackNY care. Florence will present results of an assessment of stakeholder feedback experiences used to develop strategies for assertive outreach and engagement of program participants, families and providers. Bello will present on mechanisms for integrating of co-creation principles to design, develop and execute quality improvement projects in EPINET OnTrackNY. Stefancic will present on quality improvement projects that used rapid cycle qualitative methods, tools, and strategies to build team capacity and flexibility to respond to an LHS. Montague will present adaptations to OnTrackNY services during the COVID-19 pandemic using an implementation science framework. Finally, Patel will lead a discussion on the implications of involving individuals with lived experiences in all phases of the process to maximize learning in an LHS.
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Introduction: Colorectal cancer is the third most common cause of cancer in the world, after lung and breast cancer, while in Croatia is the most common malignant disease. Among the EU members, Croatia ranks ninth in terms of the incidence of colon cancer and a high second place by mortality. Since 2007, Croatia has had a National Colon Cancer Early Detection Program, but the response rate is still very low - 36% (25-52% depending on county and year).2 Despite the prevention program, approximately 13% of patients in Croatia is initially diagnosed with metastatic disease.1 According to the results of the CONCORD 3 study3, Croatia is at the bottom of the five-year survival (48%) compared to some other western countries (up to 71%) in the world. Method(s): A retrospective analysis was conducted at the Clinic of Oncology and Radiotherapy, CHC Split. Patients with newly diagnosed colorectal adenocarcinoma enrolled in the clinic from January 1, 2020 to December 31, 2020 were processed. The data were analyzed using descriptive statistics methods, with the use of Microsoft Excel tools. Result(s): A retrospective analysis of the medical history identified 269 patients (compared to 387 in 2017) presented at the multidisciplinary team (MDT) of CHC Split who were diagnosed with colorectal adenocarcinoma in 2020. All patients were presented to the MDT before starting the treatment. The median age of patients was 66 years, and the youngest patient was 22 years old. Patients from other counties who did not undergo the entire treatment/monitoring in our institution were excluded from the analysis. 52 patients (19.3%) were diagnosed in the metastatic stage of the disease, in stage 0 4 patients (1.5%), in stage I 32 (12%), in stage II 91 (34%), and in stage III 88 (33%). In 2 patients, the stage couldn't be precisely determined. There is a significant decrease in the number (81 in 2017 and 52 in 2020) but no percentage wise (20.9% in 2017 and 19.3% in 2020) of patients diagnosed with de novo metastatic colorectal cancer compared to the previous analysis from 2017, when 81 of them were detected. Patients diagnosed with metastatic disease were mostly in good general condition: ECOG 0 status 21 patients (40.3%), ECOG 1 24 patients (46.2%), ECOG 2 7 patients (13.5%), while no patient was ECOG status 3 or 4. 32 (57.7%) patients had a left-sided tumor, while 20 (42.3%) patients had a right-sided tumor. Conclusion(s): The results of our retrospective analysis showed a significant decrease in the number of patients compared to previous years. The effect of the smaller number of newly diagnosed patients will be analyzed and the real consequences will be seen, however, the appearance of patients in the later stages of the disease is to be expected.
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Background/Objectives: During COVID-19 pandemic, it is essential to detect patients potentially at risk of life-threatening complications, due to possible specific genetic mutations. The aim of our work is to show a practical application of genetic testing, allowing a diagnosis of alpha 1 antitrypsin deficiency in cases with a severe clinical course during COVID-19 infection. Method(s): During hospitalization for COVID-19, we identified 5 patients (3 female, 2 males from two different families, age range 18-47 years) with a severe course of COVID-19 infection, requiring high pressure ventilation with high volume oxygen supply. Two months after discharge, those patients were reevaluated with respiratory function tests, biochemical tests, genetic counselling and genetic testing. A peripheral blood sampling for SERPINA1 genetic testing has been performed, using Sanger sequencing. Result(s): Two months after discharge, in all 5 patients respiratory function tests were consistent with a dysventilatory obstructive syndrome, in contrast with usual findings related to COVID-19 infection. Blood test still showed increase plasmatic transaminase concentration in 3 out of 5 patients, one having increased serum bilirubin as well. We performed SERPINA1 genetic testing showing homozygosity for SERPINA1 pathogenic mutations (c.193del and c.875C>T, respectively) in all 5 patients. Conclusion(s): These cases showed the importance of genetic testing for patients with unexplained severe COVID-19 infection. Genetic testing allowed the diagnosis of cases affected by alpha 1 antitrypsin deficiency, associated with dysventilatory obstructive syndrome, that may worsen the short and long term prognosis of COVID-19.
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Background: Approximately two years ago, COVID-19 was declared a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and through genomic surveillance, we have seen the emergence of variants of SARS-CoV-2. In the United States, over 78 million cases and >900,000 deaths attributable to COVID-19 have been reported. SCD was identified as a risk factor for severe COVID-19 disease in adults and pediatric patients. The emergence of novel SARs- CoV-2 variants has led to challenges in diagnosis, treatment, and prediction of long-term sequelae in individuals with SCD and COVID-19. Aim(s): We compare the overall seasonal variation of COVID-19 variants and patterns of healthcare utilization and clinical presentation over time in pediatric patients with SCD and COVID-19 at Children's National Hospital (CNH). Method(s): Our single-center, observational cohort study included 193 pediatric patients with SCD (0-21 years) with PCR-confirmed SARSCoV- 2 infection between March 31, 2020, and January 31, 2022. Per the SECURE SCD Registry definitions, clinical severity was classified as asymptomatic, mild, moderate, and severe. Result(s): A total of 193 unique patients with SCD and positive SARS-CoV-2 PCRs between March 2020-January 2022 were included in our registry. Most patients were female (51.8%), and the mean age was 11.2 years (SD 6.5 years). Most of the cohort resides in Maryland (N=135), and HbSS was the dominant genotype (69.4%). During the alpha dominant variant of the COVID-19 pandemic (March 2020- June 2021) there were 70 cases, followed by 40 cases during the Delta variant (July 2021- December 19, 2021), and 83 cases during the Omicron variant dominance (from December 20, 2021-January 31,2022). There were 149 patients (77%) that presented to the emergency department (ED) or were hospitalized. There were a total of 80 hospitalizations (41.5%), and a relative comparison showed that the percentage of hospitalizations was highest during the delta wave (47.5%) and lowest during the omicron wave (36.1%) (p= 0.407). ED-only utilization was highest in the era of omicron (43.4%, N=36), followed by delta (32.5%, N=13), and then alpha (30%, N=21)(p=0.197). The most common SCD-related complication was vaso-occlusive (VOC) pain (33%, N=64) which accounted for half of all hospital admissions (51%, N=41 of 80). Acute chest syndrome (ACS) was reported in 40% (N=32) of admitted patients and was highest in the alpha era (54.8%, N=17). The use of blood transfusion therapy was highest in the alpha (N=17) and delta (N=14) variants, while Remdesivir use was highest in omicron (N=15). A total of 6 patients received monoclonal antibodies (Delta, N=4;omicron, N=2). Throughout all the variants, there was a significant difference in COVID-19 clinical severity (p>0.005). Of the patients classified as asymptomatic (13%, N=25), seventy-two percent (n=18) were diagnosed during the alpha variant. Mild severity was the most prevalent (69%, N=134), with the omicron variant having the highest cases (51.5%, N=69). Severe cases were observed in all variants (6.7%, N=13) but were most prevalent during the alpha variant (46.2%, N=6). Summary - Conclusion(s): Interestingly, while the relative percentage of hospitalizations was lowest during the omicron wave, it saw the highest percentages of ER utilization. Overall, COVID-19 remains mild in pediatric patients with SCD, and notably, there was higher health care utilization in the omicron era.
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Objectives: To describe the use of extracorporeal membrane oxygenation (ECMO) among hospitalized coronavirus disease 2019 (H-COVID-19) patients in a linked closed claims (CC) and open claims (OC) database. Method(s): This analysis identified H-COVID-19 patients between April 2020 (Q2 2020) and June 2022 (Q2 2022) in CHRONOS, a linked CC and OC database. The index event was the date of hospitalization, defined as an inpatient claim within 21 days of a COVID-19 diagnosis in the CC. The occurrence of ECMO 30 days after index was identified using CC data alone and then CC and OP data in combination to assess missing data. Study exclusions included patients under the age of 18, a first COVID-19 diagnosis that did not result in hospitalization, and less than 12-months of continuous enrollment in the CC before index. Study criteria were defined by the presence of an ICD-10-CM, ICD-10-PCS, or CPT code on a claim. Results are reported as percentages and 95% confidence intervals. Result(s): Of 321,687 patients with H-COVID-19, the mean age was 50.1 (SD:12.8) with the highest proportion of hospitalizations occurring in Q3 2021 (19.4%). Overall, 0.50% (0.48%-0.52%) of patients in the CC data received ECMO, increasing to 0.61% (0.58%-0.64%) with the inclusion of OC data. The use of ECMO to treat H-COVID-19 patients decreased between Q2 2021 and Q2 2022, with the highest rates occurring in Q2 of 2020 (0.78%) and Q2 2021 (0.80%). The addition of OC data increased rates to 1.12% and 0.89% in Q2 of 2020 and Q2 2021. Conclusion(s): Although use of ECMO decreased in the later months of the pandemic, it represents a substantial burden. The current analysis demonstrates that CC data, often sourced from payers, may underestimate the use of ECMO in real-world settings. Opportunities exist to mitigate issues of missing data by linking CC, OC, and other real-world data sources.Copyright © 2023
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The COVID-19 pandemic is a challenge for health practitioners, where there are many suspected and confirmed patients with COVID-19, including obstetric patients. Perioperative treatment of COVID-19 patients must be under applicable standards, for both patients and the medical personnel. Personal protective equipment is essential for health workers who treat patients with COVID-19 to prevent the transmission of the virus. The method of delivery ideally should be adapted to the clinical condition of the patient. At the same time, the management of anesthesia for patients with cesarean sections should also be adjusted to the patient's clinical condition by taking into consideration the availability of facilities and infrastructure that we have. Through this report, we want to show how we manage COVID-19 in obstetric cases using the available resources in a third-world country.Copyright © 2021 Bali Journal of Anesthesiology. All rights reserved.
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Purpose: One of the areas most affected by the sudden restrictions caused by the Covid-19 pandemic was the education system and students. The aim of this study was to compare the fear of Covid-19, physical activity levels, mental health, academic motivation and sleep quality of students who received distance education and face-to-face education during the pandemic period. Method(s): In our study 93 university students who received distance education (age: 20.33+/- 1.82 years, height: 167.08+/-8.86 cm, weight: 61.41+/-12.08 kg) and 110 university students who received face-to-face education (age: 20.13+/-0.98 years, height: 167.62+/-8.12 cm, weight: 62.20+/-13.32 kg) were included. Fear of Covid-19 were evaluated by the Covid-19 Fear Scale, physical activity levels by International Physical Activity Questionnaire, mental healths by Depression Anxiety Stress Scale, academic motivations by Academic Motivation Scale, and sleep quality by the Pittsburg Sleep Quality Index. Result(s): There was no difference between the two groups in the parameters of mental health (p=0.335), academic motivation (p=0.629) and sleep quality (p=0.230). It was observed that the fears of Covid-19 (p=0.001) and physical activity levels (p=0.023) of the students who received distance education were lower than those who received face-to-face education, and the sitting times (p=0.001) were higher. Conclusion(s): During the Covid-19 pandemic, it was observed that there was no difference in mental health, academic motivation and sleep quality between distance education and face-to- face education. However, we think that it is important to plan for reducing the sitting times and to increase their physical activity levels of students who receive distance education.Copyright © 2022 Turkish Physiotherapy Association. All rights reserved.
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Currently, 640 million cases of coronavirus disease 2019 (COVID-19) and 6.6 million deaths have been reported world-wide. Risk factors for severe COVID-19 are known, including those with compromised immunity. Among patients with inborn errors of immunity (IEI), early reports of severe outcomes lead to strict masking and social distancing measures. While this resulted in relatively low infection rates among those with IEI, real-world data describing the clinical course of COVID-19 in this patient population have remained limited. We performed a retrospective study of adult IEI patients followed by our center in which a positive test (rapid antigen or PCR) for COVID-19 was determined between November 2021-November 2022. Medical charts were reviewed, and patient interviews conducted. All patients provided informed consent. Twenty-nine patients were enrolled (22 females, 7 males), aged between 18-69 years (median: 20-29 years). The cohort included those with antibody deficiencies (41.37%), combined immunodeficiencies (34.48%;HIES, CARD11, STAT1-GOF), immune dysregulation disorders (20.69%;LRBA deficiency, AIRE deficiency) and phagocyte defect (3.45%;CGD). The duration of symptoms ranged between 3 days-4 weeks (median: < 1 week). Upper respiratory symptoms (including sore throat, congestion) were reported in 97% while fever was present in 41% of patients. Prior to infection, 14 (48%) patients had underlying asthma or bronchiectasis - 2 subsequently experienced shortness of breath and were treated with inhalers or Sotrovimab, respectively. No treatment was required in 65.5% of cases. The remaining received Paxlovid (10.3%), Sotrovimab (13.79%), or antibiotics (10.3%). Of the 2 patients with STAT1-GOF, one tested positive during a repeat episode of febrile neutropenia which required hospitalization. No other patients were hospitalized or needed ICU admission. No deaths were recorded. In light of these favourable outcomes, patients with IEI can gradually and safely return to normal activities.Copyright © 2023 Elsevier Inc.
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Aims: (1) To describe how occupational possibilities of young adults experiencing a first episode of psychosis changed during the pandemic;(2) to describe how mental health practitioners, working in two first episode clinics, strived to assist their clients in maintaining a meaningful daily life during the COVID-19 pandemic. Method(s): This exploratory study used an interpretative descriptive design. Young adults (n = 6), attending a specialized clinic, participated in two semi-directed interviews: they explored how their daily lives changed during the pandemic, their (re)actions in light of the changes and which occupations were (im)possible to pursue. A focus group discussion with the practitioners will allow to explore the adjustments made to clinical practices to enrich young adults' daily lives. The interviews and focus groups were transcribed and analysed independently by two members of the research team, using a thematic analysis approach. Result(s): Preliminary results suggest that if some occupational possibilities were lost, many were transformed or newly envisioned by young adults. They engaged in occupations within existing niches. The presentation will also include the perspective of mental health practitioners, as focus groups will be concluded in early Winter 2023. Conclusion(s): This presentation offers a novel perspective on the daily lives of young adults during the pandemic, focusing on the nature of their occupational engagement, whilst considering how the context shaped their occupational possibilities. Likewise, it will document the innovative practices and challenges experienced by practitioners, as they strived to expand possibilities for their clients and to support their transition into adulthood.
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A global spreading corona virus at 2019 (COVID-19) declared as emergent worldwide, due to its quick spreading and high rates of mortality that serious disruptions. The objective of this research is to explore further into effect of different types of covid-19 vaccinations (Pfizer, AstraZeneca and Sinopharm) on some coagulation parameters from random samples of students in college of pharmacy/ university of Ker-bala. A case-control study was carried out with Iraqis living in Kerbala city particularly college students in Kerbala University/ College of Pharmacy from 2021/1/16 to 2022/4/16. This study was done to encompass quantitative and qualitative analysis of covid 19 vaccination types and possible thrombosis that occur after vaccination. The enrolled sixty participants of male and female were aged 18years and above. A questionnaire was made questions pertaining age were inquired to make sure participants fulfilled the criteria for in-clusion, past medical history, previous infection with covid 19 were incorporated into the survey. The scien-tific and ethical committee provided their ethical approval in college of pharmacy at University of Kerbala. Our results in this study indicate significant differences in coagulation parameters readings of (Pt, Ptt) between vaccination groups and control by using ANOVA statistical analysis of SPSS. Our study showed that the difference between the vaccinated and unvaccinated groups was considerable (Pfizer, AstraZeneca & Sinopharm Covid 19 vaccines) and control group in thrombotic measurements time and platelet mean value. The most effective and economical method of preventing COVID-19 infection is still vaccination. A number of COVID-19 vaccines have been developed quickly, but more research needs to be done on any side effects that may appear.Copyright © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.