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1.
J Formos Med Assoc ; 120 Suppl 1: S106-S117, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1972181

ABSTRACT

BACKGROUND: Global burden of COVID-19 has not been well studied, disability-adjusted life years (DALYs) and value of statistical life (VSL) metrics were therefore proposed to quantify its impacts on health and economic loss globally. METHODS: The life expectancy, cases, and death numbers of COVID-19 until 30th April 2021 were retrieved from open data to derive the epidemiological profiles and DALYs (including years of life lost (YLL) and years loss due to disability (YLD)) by four periods. The VSL estimates were estimated by using hedonic wage method (HWM) and contingent valuation method (CVM). The estimate of willingness to pay using CVM was based on the meta-regression mixed model. Machine learning method was used for classification. RESULTS: Globally, DALYs (in thousands) due to COVID-19 was tallied as 31,930 from Period I to IV. YLL dominated over YLD. The estimates of VSL were US$591 billion and US$5135 billion based on HWM and CVM, respectively. The estimate of VSL increased from US$579 billion in Period I to US$2160 billion in Period IV using CVM. The higher the human development index (HDI), the higher the value of DALYs and VSL. However, there exits the disparity even at the same level of HDI. Machine learning analysis categorized eight patterns of global burden of COVID-19 with a large variation from US$0.001 billion to US$691.4 billion. CONCLUSION: Global burden of COVID-19 pandemic resulted in substantial health and value of life loss particularly in developed economies. Classifications of such health and economic loss is informative to early preparation of adequate resource to reduce impacts.


Subject(s)
COVID-19 , Global Health , Pandemics , COVID-19/epidemiology , Humans , Quality-Adjusted Life Years , SARS-CoV-2 , Value of Life
2.
Accounting, Auditing & Accountability Journal ; 35(6):1485-1486, 2022.
Article in English | ProQuest Central | ID: covidwho-1973363

ABSTRACT

How do you genuinely show that you care about the elderly, management of COVID-19 vaccinations, education, funding for the arts, healthcare, remediation after fire and flood, Indigenous representation, pork-barrelling, establishing an Independent Commission Against Corruption (ICAC), unemployment and how it is measured, sexual harassment in the corridors of power and workplaces elsewhere, domestic violence, homelessness, the environment, destruction of native animal habitats, the National Disability Scheme (NDIS), climate policy, rorts and much more? “Guilty Me!” by MD Shoaib Ahmed deals, as he has said, with “the precarity of workers in the global supply chains of fast fashion, cocoa farming, and coffee production around the world”. Creative writing in the form of poetry and short prose pieces is edited for the Literature and Insights Section only and does not undergo the refereeing procedures required for all research papers published in the main body of AAAJ.

3.
J Affect Disord ; 308: 155-159, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1972145

ABSTRACT

BACKGROUND: Physical disability is a cause of depression among acute stroke patients. Although previous studies have shown that physical disability, perceived social support, mental resilience, and post-stroke depression are significantly related, the interaction mechanism remains unclear. METHODS: Convenience sampling was used to recruit participants from a tertiary hospital in Daqing City, Heilongjiang Province, China from October 2020 to May 2021. Participants completed the Barthel Index Rating Scale, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and Zung Self-Rating Depression Scale. We used the PROCESS macro for SPSS to determine the mediating effect of perceived social support and resilience between disability and depression. RESULT: A total of 259 acute stroke patients participated in this study and completed the questionnaire survey. Stroke patients' BI scores was positively correlated with perceived social support (r = 0.26, P < 0.01) and resilience (r = 0.25, P < 0.01), and negatively correlated with depression (r = -0.47, P < 0.01). Perceived social support was positively correlated with resilience (r = 0.55, P < 0.01) and negatively correlated with depression (r = -0.41, P < 0.01). Resilience was negatively correlated with depression (r = -0.43, P < 0.01). Perceived social support and resilience played a mediating role of 10.27% and 5.74% of the total effects of disability and post-stroke depression, respectively. Meanwhile, the chain mediating effect of perceived social support and resilience (7%) was also significant. LIMITATIONS: The cross-sectional study design limited the inference of causal relationships between variables. This study used convenience sampling to select research participants from a single hospital, they were all acute stroke patients from the same region of China. Participants in our study were in high BI status, and thirty of them had a low level of education, which may contribute to the possibility of selection bias. Meanwhile, the low level of education and the poor eye-sight of old people prevents them from completing the questionnaire by themselves. So we collected data in the form of "researcher reading questionnaire items and recording participant responses" for the majority of participants (257 subjects), and only 2 participants completed it independently. Furthermore, the findings of this study may not apply to stroke survivors from other backgrounds. CONCLUSION: This study found that disability can directly predict post-stroke depression, and indirectly predict post-stroke depression through the mediating effect of perceived social support and resilience, and the chain mediating effect of perceived social support-resilience. Therefore, reducing the degree of disability of acute stroke patients and improving their perceived social support and resilience may help prevent post-stroke depression.


Subject(s)
Resilience, Psychological , Stroke , China , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Humans , Social Support , Stroke/complications , Surveys and Questionnaires
4.
Communication Research Trends ; 41(2):19-22, 2022.
Article in English | ProQuest Central | ID: covidwho-1970547

ABSTRACT

[...]we end up with policies or practices that fail to fully address inequalities or, in the worst cases, actually amplify the inequalities and the resulting impacts to life outcomes. The takeaway of this quantitative research chapter is that the technology maintenance framework has profound implications for quality of life outcomes (i.e., academic achievement, careers, health, and social engagement) for users, and should be applied as scholars and policy-makers consider solutions. [...]in Chapter 6 Ellen Helsper concludes this section's discussion of space and place by introducing a network-theory inspired examination of how both geographic and social proximity impact digital inequalities. Gerard Goggin (Ch. 17) offers thoughts on the path forward in researching (and developing policy for) digital inequalities among those with health and disability concerns, while in the final chapter (Ch. 18) of Part 3 Kerry Dobranski and Hargittai mine current and historical data sets to understand how technicians and policymakers can best serve internet users with disabilities.

5.
Journal on Developmental Disabilities ; 27(1):1-10, 2022.
Article in English | ProQuest Central | ID: covidwho-1970497

ABSTRACT

This brief report describes the demographic and clinical profiles of 190 adult home care users with intellectual and developmental disabilities tested for COVID-19 from March 2020 to May 2021. A crosssectional study design (n=190) was conducted. ChiSquare tests, Fisher’s Exact tests, and odds ratios with 95% confidence intervals are reported. Older age and congregate living increased the odds of having a positive COVID-19 test, while dependence in personal dressing was associated with decreased odds. These findings provide useful data from the first 15 months of the pandemic;trends over time should be investigated.  Alternate :Ce rapport bref décrit les profils démographiques et cliniques de 190 résidents adultes recevant des soins à domicile et ayant un trouble développemental ou une déficience intellectuelle qui ont été testés pour la COVID-19 entre mars 2020 et mai 2021. Un devis d’étude transversale (n = 190) a été mené. Des tests du Chi carré, des tests selon la méthode exacte de Fischer, et des rapports des cotes ayant un intervalle de confiance à 95% sont présentés. Un âge avancé et la vie en habitation collective a augmenté la probabilité d’obtenir un résultat positif au test de la COVID19, tandis que la dépendance pour l’habillage était associée à une probabilité moins élevée. Ces  résultats offrent des données utiles issues des 15 premiers mois de la pandémie;les tendances au fil du temps devraient être étudiées. Mots-clés : COVID-19, trouble du développement, déficience intellectuelle, soins à domiciles, interRAI, adultes.

6.
Journal on Developmental Disabilities ; 27(2):19, 2022.
Article in English | ProQuest Central | ID: covidwho-1970233
7.
J Policy Pract Intellect Disabil ; na: 1-13, 2022.
Article in English | MEDLINE | ID: covidwho-1970968

ABSTRACT

Parent-focused interventions have been designed to provide training and support to caregivers who are essential in achieving positive outcomes for children with intellectual and developmental disabilities (IDD). In 2020, significant crises, including the COVID-19 pandemic and continued racial tensions, profoundly impacted the livelihood of children with IDD and their families. Many ongoing efforts to address disparities among this population were halted temporarily and required further adaptations. Researchers adapted interventions and support to address the disparities impacting children with IDD and their families with limited guidance. We provide a descriptive case analysis of four parent-focused interventions that responded to the global crises to continue serving children with IDD and their families. The four distinct programs were based on applied behavior analysis and naturalistic, developmental-behavioral paradigms that were culturally adapted for families of young children with IDD from diverse cultural and socioeconomic backgrounds. We present the qualitative reports on the challenges and benefits that arose with adapting the four parent-focused interventions for telehealth implementation. We focused specifically on adaptations made in recruitment and retention, instrumentation and measurement, research staff training, and intervention delivery. We synthesize our experience with challenges and solutions in adapting parent-focused interventions for racially/ethnically and socioeconomically diverse children with IDD and their families. We conclude with recommendations for researchers and practitioners on methods for adapting parent-focused interventions to address the significant health disparities that impact racially, ethnically, and socioeconomically diverse children with IDD and their families.

8.
Archivos de Neurociencias ; 26(1):43-48, 2021.
Article in Spanish | EMBASE | ID: covidwho-1970004

ABSTRACT

In December 2019, the first cases of COVID-19 were reported in Wuhan, China. Up to now, it has affected over 60 million people worldwide. COVID-19 is a multi-systemic disease;in addition to respiratory manifestations, various neurological complications have been identified, including encephalitis, stroke, and Guillain-Barré syndrome. Guillain-Barré syndrome is a condition of immune-mediated polyneuropathies frequently associated with infections. We present the case of a 41-year-old man that, after a 5-day history of non-productive cough, headache, muscle pain, joint pain, anosmia, ageusia, and non-quantified temperature rise;developed loss of tendon flexes and lower limbs weakness that progressed to walking disability, upper limbs weakness, and bilateral facial paresis. An oropharyngeal swab polymerase chain reaction confirmed SARS-CoV-2 infection, and the cerebrospinal analysis reported albuminocytologic dissociation. Nerve conduction studies showed acute inflammatory demyelinating polyradiculoneuropathy (AIDP). He received a 5-day course of intravenous immune globulin. There have been numerous reports of Guillain-Barré syndrome associated with SARS-CoV-2 infection worldwide;however, few cases have been reported in Latin America.

9.
MEDICINA BALEAR ; 37(4):58-64, 2022.
Article in Spanish | Web of Science | ID: covidwho-1968983

ABSTRACT

Background: Hospitalized patients with COVID-19 can have persistent symptoms a medium term. However, it is unknown the consequences a long term of survivors none hospitalized. The aim of this study was to describe the functional state and the quality of life in COVID-19 survivors that did not require hospitalisation. After this, physical activity, dyspnoea, disability and anxiety/ depression was evaluated and relationship between them. Methods: A multicentre cross-sectional study with Primary Care patients was carried out. By means of an interview, status functional was valued with Post-COVID-19 Functional Status Scale (PCFS) and the 1-Minute-Sit-to-Stand (1MSTS) test. Health-Related Quality of life was measured with EuroQol (EQ-5D-5L). Level of physical activity was quantified with International Physical Activity Questionnaire (IPAQ). Dyspnoea was valued with Modified Medical Research Council scale (mMRC). Disability was measured with General Activity Limitation Indicator (GALI). And, anxiety/depression was calculated with Hospital Anxiety and Depression scale (HADS). Results: The study included 120 patients with an evolution time of 6.33 +/- 3.15 months. According to PCFS scale, 2.5% of patients showed severe functional limitations, 31.7% moderate and 16.7% slight. 45.8% had a score in 1-MSTS test lower for percentile 25 and 63,3% showed decline of quality of life. 43.3% showed a low physical activity level and 50% moderated. 57.5% had dyspnoea, 24.2% suffer from anxiety/depression and 46.6% claimed that they felt limited. Conclusion: Results suggest that people who had suffered from mild COVID-19, who have not required hospitalisation, they show functional limitations and a decrease in Health-Related Quality of life.

10.
BMJ Global Health ; 7:A35, 2022.
Article in English | EMBASE | ID: covidwho-1968281

ABSTRACT

Objective The health systems costs of COVID-19 are high in many countries, including Pakistan. Without increases in fiscal space, COVID-19 interventions are likely to displace other activities within the health system. We reflect on the inclusion of COVID-19 interventions in Pakistan's Essential Package of Health Services (EPHS) and, from a financial optimisation perspective, propose which interventions should be displaced to ensure the highest possible overall health utility within budgetary constraints. Methods We estimated the costs of all 88 interventions currently included in the EPHS and collected published data on their cost-effectiveness. We also estimated total costs and costeffectiveness of COVID-19 vaccination in Pakistan. We ranked all EPHS interventions and COVID-19 vaccination by costeffectiveness, determining which interventions are comparatively least cost-effective and, in the absence of additional funding, no longer affordable. Results The EPHS assumes a spending per capita of US $12.96, averting 40.36 million disability-adjusted life years (DALYs). From a financial optimisation perspective, and assuming no additional funds, the introduction of a COVID-19 vaccine (US$3 per dose) should displace 8 interventions out of the EPHS, making the EPHS more cost-effective by averting 40.62 million DALYs. A US$6 dose should displace a further intervention and avert 40.56 million DALYs. A US$10 dose would partially fall out of the package, displacing four additional interventions. If health spending per capita decreased to US$8, a US$3 dose would still be affordable, but not US$6 or US$10 doses. Discussion Cost-effectiveness is only one criterion considered when deciding which interventions are included in (or removed from) a health benefits package. While displacing certain interventions to create fiscal space for the COVID-19 vaccine may lead to a financially optimal scenario, doing so may be politically unfeasible or socially undesirable. We highlight the difficult trade-offs that health systems face in the era of COVID-19.

11.
BMJ Global Health ; 7:A5, 2022.
Article in English | EMBASE | ID: covidwho-1968248

ABSTRACT

The COVID-19 pandemic has increased the necessity of setting priorities in health and beyond. To set such priorities in health, we need meaningful and consistent health measures. The global burden of disease study plays an important role during the pandemic. Disease burden is largely measured through the lens of disability-adjusted life years (DALYs). Since its conception in the early 1990s, the DALY has gained traction and increased popularity. Several revisions of the value assumptions built into the DALY have followed. Moreover, discussions have been made of the different potential purposes of the DALYs, whether it be monitoring patterns and inequalities in disease burden, aggregating morbidity and mortality, or setting priorities within large health programs. However, much less attention has been on the main assumption of the DALY, that is, that DALYs = YLDs + YLLs. To elaborate, the DALY is the aggregation of years lived with disability (YLDs) and years of life lost (YLLs). However, are YLDs and YLLs entities that can be aggregated? Epicurus famously argued that existence is necessary for anything to matter to you, therefore, death is nothing to you. If Epicurus was right that death (i.e., the incident of death, not the process of dying) is not bad for those who die, then DALY's addition of years lost by death may not give a meaningful result. There are at least three responses to this foundational DALY problem, of which a counterfactual account of harm might be the most viable approach. This counterfactual strategy, however, comes with severe challenges. I argue that Epicurus was correct in claiming that the incident of death is not bad for the dying or the dead. Death, for epicureans, means permanent non-existence, and hence, it remains questionable whether YLD + YLL makes sense.

12.
Clinical and Experimental Neuroimmunology ; 2022.
Article in English | EMBASE | ID: covidwho-1968077

ABSTRACT

Various effective monoclonal antibodies (mAbs) have been approved for both multiple sclerosis (MS) and anti-aquaporin-4-seropositive neuromyelitis optica spectrum disorders worldwide, including in Japan. As these newer mAbs have distinct modes of action that effectively suppress the recurrence of inflammation and slow disability progression, they can modulate and interfere with the protective immune response against pathogens, resulting in various infectious complications. Among various mAbs, natalizumab (NTZ) has the highest risk of causing progressive multifocal leukoencephalopathy (PML), a rare but fatal opportunistic brain infection caused by John Cunningham polyomavirus. Switching from NTZ to B-cell-depleting mAbs, such as ocrelizumab, is also a possible risk factor for PML development. Alemtuzumab carries the risk of reactivation of varicella-zoster virus (VZV);therefore, prophylactic acyclovir treatment is required. NTZ has also been associated with VZV reactivation. Eculizumab can cause severe meningococcal infection due to Neisseria meningitis, and vaccination prior to treatment induction is required. Attention to the reactivation of hepatitis B or Mycobacterium tuberculosis is also needed during mAb therapy. Additionally, in the era of severe acute respiratory syndrome coronavirus 2 infection (COVID-19), the risk for of developing severe COVID-19 may be associated with some mAbs, such as B-cell-depleting agents. Thorough understanding and mitigation strategies for infectious risks are essential.

13.
Health Soc Care Community ; 2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-1968133

ABSTRACT

Social distancing restrictions are undoubtedly important for controlling the spread of COVID-19 however, they are also adversely impacting population health and health service access. It is important that priority populations with a disability which may already have adverse health, access to health services, and autonomy and participation compared to those without disability, are able to receive preventative health and social care during periods of restriction. The impact of social distancing restrictions on people with disability is not uniform nor well-understood. Research has been cross-sectional and considered data gathered during social distancing restrictions, or longitudinal, considering data gathered during a pre-pandemic baseline. This longitudinal study investigated the impact of lifting social distancing restrictions on priority domains for people with disability including autonomy and participation, access to health services, health issues and quality of life. People with spinal cord injury in Victoria, Australia (n = 71) completed a survey towards the end of social-distancing restrictions (T1) and 6-months post social distancing restrictions (T2). Non-parametric tests for significant differences confirmed that 6-months post-lifting social distancing restrictions participants experienced a significant increase in health conditions, a significant decrease in the number of inaccessible health services, and a significantly lower level of limitations across participation and autonomy, outdoor autonomy and work and education domains. QOL improved 6-months post lifting restrictions, however not to a significant level. The adverse health experienced by people with spinal cord injury after lifting restrictions may in part result from limited health service access and reduced participation during the time of restrictions. Clear definitions of what constitutes as essential care may ensure that eligible and required care remains received during lockdown or instances when service provision is compromised. Health and social care providers should be equipped with the knowledge of priority populations so that their support can be targeted to those most in need.

14.
Laryngo- Rhino- Otologie ; 101:S320, 2022.
Article in English | EMBASE | ID: covidwho-1967682

ABSTRACT

Introduction We report on three patients, who presented themselves at our clinic between February and June 2021 with impaired voice, which resulted in an aphonia after having had Covid-19 infection. Material & methods Indirect laryngoscopy and videostroboscopy were performed in all patients. The voice quality was limited in all patients. Voice analysis was performed perceptively (RHB scheme) and objectively by computer-assisted analysis (Göttingen hoarseness diagram, voice field). Self-assessment was performed using the Voice Handicap Index (VHI). Results Laryngoscopically, all patients showed laterally mobile vocal folds, non-irritant mucosal conditions and a wide glottis. All patients showed wide, irregular vibration amplitudes and incomplete glottis closure by videostroboscopy. Objective voice analysis revealed pathological values for the irregularity and noise components as well as the Dysphonia Severity Index (DSI). In the VHI all patients documented a high-grade voice disorder with a mean score > 62. Our patients continued to suffer from dysphonia 6-9 months after initial presentation. Voice therapy did not provide satisfactory voice improvement. Discussion Whether glottic hypofunction is due to sensorimotor dysfunction caused by neurotropic coronavirus remains a conjecture. In addition, the hy-pofunction may be related to the general reduced performance of the patients in post-covid-syndrome. Conclusion According to our literature research, this is the first description of dysphonia as a possible symptom in post-covid-syndrome.

15.
Laryngo- Rhino- Otologie ; 101:S308, 2022.
Article in English | EMBASE | ID: covidwho-1967678

ABSTRACT

Introduction Symptoms and severity of SARS-CoV-2 infection vary greatly. Dizziness is a frequently reported symptom of SARS-CoV-2 viral infection. However, the extent to which this symptom is a result of the effect of SARS-CoV-2 on the vestibular system remains unclear. Material & methods In the present single-centre study, 50 patients with a previous SARS-CoV-2 infection underwent a vestibular assessment consisting of dizziness handicap inventory to assess dizziness during and after infection, clinical examination, video head impulse test and subjective visual vertical test (SVV). When SVV was abnormal, vestibular evoked myogenic potentials were performed. In addition, a retrospective data analysis of patients admitted to hospital presenting with acute symptoms of dizziness who were also diagnosed with acute SARS-CoV-2 infection was performed. Results During and after the SARS-CoV-2 infection, women were significantly more likely to suffer from dizziness than men. A significantly reduced semicircular canal or otolith function was not observed in either women or men. Acute SARS-CoV-2 infection was diagnosed in three patients who presented to with acute vestibular syndrome. One of the patients exhibited acute peripheral unilateral vestibulopathy upon diagnosis. A different patient was diagnosed with vestibular migraine and another with a posterior inferior cerebellar artery infarct. Conclusion Past SARS-CoV-2 infection does not usually lead to a hypofunction of the vestibular organs. However, individual patients with acute infection have been reported to show symptoms of acute vestibular syndrome. Although the underlying pathomechanism has not yet been elucidated, SARS-CoV-2-induced neuropathy or ischemia should be considered in the differential diagnosis.

16.
Gastroenterology ; 162(7):S-57-S-58, 2022.
Article in English | EMBASE | ID: covidwho-1967238

ABSTRACT

Purpose: The COVID-19 pandemic has the potential to influence the well-being of families and children with Functional Abdominal Pain Disorders (FAPDs). Given the known relationship between stress and abdominal pain in children with FAPDs, we hypothesized pandemicrelated changes (e.g., reductions in family finances, social interactions) could affect health outcomes. Our aim was to examine the potential impact of the pandemic on abdominal pain, quality of life, psychological and physiological symptoms, and functional disability in children with FAPDs. Methods: Ninety-one parents of children ages 7-12 who met the Rome IV criteria for a FAPD completed baseline questionnaires as part of an ongoing randomized controlled intervention trial on their child's Quality of life (PedsQL), Pain Behavior and Response (PBQ, PBCL, PRI), Pain Catastrophizing (PCS), Psychological Symptoms (SCL-90), Functional Disability (FDI), and sleep habits (CSHQ). Heart rate was also measured. Participants were categorized into two groups, based on the date of entry into the original study, as before or during the COVID-19 pandemic, allowing us to take advantage of a naturally occurring opportunity to assess potential impacts of the pandemic. Results: Sixty-one participants were consented before, and 30 participants were consented during the COVID-19 pandemic. Parents in the latter group reported their children to have more days of abdominal pain, higher pain frequency, pain behavior, disability, helplessness, and depression, and significantly lower quality of life, compared to the before COVID group (Table 1). Finally, child sleep anxiety and overall sleep difficulty were significantly higher during COVID. Children also had a significantly higher mean heart rate during the COVID- 19 pandemic. Conclusions: Our findings suggest that the COVID-19 pandemic has impacted children with FAPDs in multiple domains. Of concern, parents of children with FAPDs reported greater child pain frequency, disability, and pain behaviors during the pandemic than before the pandemic. Parents also reported significant increased child emotional distress during the COVID-19 pandemic and impacts on quality of life during COVID-19;in fact, most scores on the PedsQL were lower than those previously reported for children receiving cancer treatment. Child sleep anxiety and overall disordered sleep also worsened during the pandemic. Additionally, physiological changes (mean heart rate) were observed during the pandemic (Figure 1). Possible explanations for these findings could include increases in child and family stress, and greater parental awareness of child symptoms due to increased time at home together, or parents' own increased stress levels. Clinicians and researchers should be aware of the potential impact of COVID-19 pandemic on these areas to inform research as well as treatment of children with FAPDs.(Table Presented) (Figure Presented)

17.
Sleep Medicine ; 100:S185, 2022.
Article in English | EMBASE | ID: covidwho-1967127

ABSTRACT

Introduction:Mental health conditions such as anxiety represent a growing health concern for students in institutions of higher education. Postsecondary students are a vulnerable population that is increasingly recognized to be at risk for both mental health problems and significant sleep problems. While it has been hypothesized that poor sleep quality may be a risk factor for developing anxiety, little is known about the frequency and severity of sleep problems and their association with anxiety within the postsecondary student population. The aim of this systematic review was to synthesize the best evidence on the association between sleep quality and anxiety in postsecondary students. Materials and Methods: An experienced librarian developed systematic search strategies in four databases: MEDLINE, Embase, APA PsycInfo (through Ovid Technologies Inc.) and CINAHL, Cumulative Index to Nursing and Allied Health Literature (through EBSCOhost). Databases were searched from inception to September 2020. Random pairs of independent reviewers screened titles and s for eligibility and critically appraised all eligible studies. We assessed the quality of studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for cohort studies, and the Hoy tool for cross-sectional studies. One author extracted and synthesized the results from all of the low and moderate risk of bias studies. We synthesized our results by study design and population. Results: Once duplicates were removed, a total of 3203 unique citations were screened. Fifty-one articles were eligible and critically appraised. Studies with low and moderate risk of bias were included in our final synthesis of which 24 were cross-sectional studies and four were cohort studies. With the exception of one study, all cross-sectional studies reported a statistically significant association between poor sleep quality and anxiety. All four of the cohort studies found that students who reported poor sleep quality were more likely to develop future anxiety and students with anxiety were more likely to develop future poor sleep quality. Conclusions: Poor sleep quality is associated with anxiety in postsecondary students. Due to the cross-sectional nature of most studies, we cannot determine the direction of this association. Future studies should focus on developing high-quality prospective cohort or longitudinal studies to help understand the impact and direction that this association has in postsecondary populations. This research has the potential to inform the development and design of mental health policies and programs that are created by postsecondary institutions to address the increasing rates of student mental health issues. Acknowledgements: Canadian Institutes of Health Research (CIHR) Operating Grant: Knowledge synthesis: COVID-19 in Mental Health & Substance Use;University of Ontario Institute of Technology;Institute of Disability and Rehabilitation Research.

18.
Arts in Psychotherapy ; 80, 2022.
Article in English | EMBASE | ID: covidwho-1966275
19.
Anasthesiologie und Intensivmedizin ; 63:S177-S178, 2022.
Article in English | EMBASE | ID: covidwho-1965293

ABSTRACT

Despite the tremendous impact of the Sars-CoV-2 global pandemic and becoming focus of scientific research[1], many aspects of the disease and its pathophysiology, especially concerning prognostic parameters and treatments remain uncertain. The aim of our study is to assess and link immune profiles of the dysregulated cellular immune response in patients hospitalized with severe Covid-19 to their outcomes. Therefore, we immune phenotyped severly ill Sars-CoV-2 patients on our ICU and to surviving to non-surviving patients and healthy controls. Methods Using flow cytometry (BD-Fortessa), we created a 14-parameter immunoprofile of 25 Covid-19 patients from our ICU and 11 of healthy control individuals. The analysis was based on live/dead control, CD3, CD4, CD8, CD19, CD66b, CD14, CD16, IL-10, TNF-α, IL-1β, HLA-DR and IL-6 antibodies. Both clusters (survivors, n=16;non-survivors, n=9) and healthy controls (n=11) were compared with each other by Kruskal-Wallis test with Dunns-Ls post-test correction for multiple testing (Prism V.9.0). The patients in both groups had a similar age and at the time of analysis (Fig. 1A), the treatment was insignificantly more invasive in non-survivors than in survivors (7-point WHO ordinal scale means 5.8 vs. 5.3, p = 0.43) (Fig.1 D). Similarly, the blood tests and the viral loads were comparable in both groups. Study has permission from the ethic commission (AZ-249/20 S-EB). Results The study showed that cell specific cytokine expressions are distinct in survivors compared to non-survivors even at an early stage of the critical disease. Surviving Covid patients showed increased TFNá levels throughout all cell populations, which met significance in CD4+ T (Fig.2 A) Cells and CD135+ DC. (Fig. 4 C). IL-6 levels, however, were significantly lower in CD4+ T cells of survivors (Fig. 2 B). Similarly, proinflammatory, classical CD16+ monocytes of non-survivors exhibited an increase in IL-6 and IL-1â. Moreover, dendritic cells of non-survivors seemed to be exhausted revealing less TNFá and IL-6 and IL-1â (Fig 4) Conclusion: Taken together, a disability of monocyte activation and exhaustion of dendritic cell reaction was associated with a worsened outcome of severely ill Covid-19 patients [2,3]. On the contrary a sufficient TNFá response, especially of CD4 and dendritic cells might be required to overcome the infection. Therefore, our findings suggest that measuring cell specific levels of cytokines and cell population shifts might be of high clinical relevance to predict the outcome of the disease and offer new therapeutical options for these patients.

20.
Front Public Health ; 10: 907012, 2022.
Article in English | MEDLINE | ID: covidwho-1963637

ABSTRACT

Objectives: Quantifying the combined impact of morbidity and mortality is a key enabler to assessing the impact of COVID-19 across countries and within countries relative to other diseases, regions, or demographics. Differences in methods, data sources, and definitions of mortality due to COVID-19 may hamper comparisons. We describe efforts to support countries in estimating the national-level burden of COVID-19 using disability-adjusted life years. Methods: The European Burden of Disease Network developed a consensus methodology, as well as a range of capacity-building activities to support burden of COVID-19 studies. These activities have supported 11 national studies so far, with study periods between January 2020 and December 2021. Results: National studies dealt with various data gaps and different assumptions were made to face knowledge gaps. Still, they delivered broadly comparable results that allow for interpretation of consistencies, as well as differences in the quantified direct health impact of the pandemic. Discussion: Harmonized efforts and methodologies have allowed for comparable estimates and communication of results. Future studies should evaluate the impact of interventions, and unravel the indirect health impact of the COVID-19 crisis.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cost of Illness , Humans , Morbidity , Pandemics , Quality-Adjusted Life Years
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