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1.
PLoS ONE [Electronic Resource] ; 17(9):e0274541, 2022.
Article in English | MEDLINE | ID: covidwho-2029793

ABSTRACT

BACKGROUND: The public health response to the global COVID-19 pandemic has varied widely by region. In Africa, uptake of effective COVID-19 vaccines has been limited by accessibility and vaccine hesitancy. The aim of this study was to compare perceptions of COVID-19 infection and vaccination between pregnant women and non-pregnant adults in four regions of Cameroon, located in Central Africa. METHODS: A cross-sectional survey study was conducted at urban and suburban hospital facilities in Cameroon. Participants were randomly selected from a convenience sample of adult pregnant and non-pregnant adults in outpatient clinical settings between June 1st and July 14th, 2021. A confidential survey was administered in person by trained research nurses after obtaining written informed consent. Participants were asked about self-reported sociodemographics, medical comorbidities, perceptions of COVID-19 infection, and vaccination. Descriptive statistics were used for survey responses and univariate and multivariable logistic regression models were created to explore factors associated with COVID-19 vaccine acceptability. RESULTS: Fewer than one-third of participants were interested in receiving the COVID-19 vaccine (31%, 257/835) and rates did not differ by pregnancy status. Overall, 43% of participants doubted vaccine efficacy, and 85% stated that the vaccine available in Africa was less effective than vaccine available in Europe. Factors independently associated with vaccine acceptability included having children (aOR = 1.5;p = 0.04) and higher education (aOR = 1.6 for secondary school vs primary/none;p = 0.03). Perceived risks of vaccination ranged from death (33%) to fetal harm (31%) to genetic changes (1%). Health care professionals were cited as the most trusted source for health information (82%, n = 681). CONCLUSION: COVID-19 vaccine hesitancy and misinformation in Cameroon was highly prevalent among pregnant and non-pregnant adults in 2021 while vaccine was available but not recommended for use in pregnancy. Based on study findings, consistent public health messaging from medical professionals about vaccine safety and efficacy and local production of vaccine are likely to improve acceptability.

2.
Journal of Personalized Medicine ; 12(8):1237, 2022.
Article in English | ProQuest Central | ID: covidwho-2023824

ABSTRACT

Neuropsychiatric diseases and obesity are major components of morbidity and health care costs, with genetic, lifestyle, and gut microbiome factors linked to their etiology. Dietary and weight-loss interventions can help improve mental health, but there is conflicting evidence regarding their efficacy;and moreover, there is substantial interindividual heterogeneity that needs to be understood. We aimed to identify genetic and gut microbiome factors that explain interindividual differences in mental health improvement after a dietary and lifestyle intervention for weight loss. We recruited 369 individuals participating in Digbi Health’s personalized digital therapeutics care program and evaluated the association of 23 genetic scores, the abundance of 178 gut microbial genera, and 42 bacterial pathways with mental health. We studied the presence/absence of anxiety or depression, or sleep problems at baseline and improvement on anxiety, depression, and insomnia after losing at least 2% body weight. Participants lost on average 5.4% body weight and >95% reported improving mental health symptom intensity. There were statistically significant correlations between: (a) genetic scores with anxiety or depression at baseline, gut microbial functions with sleep problems at baseline, and (b) genetic scores and gut microbial taxa and functions with anxiety, depression, and insomnia improvement. Our results are concordant with previous findings, including the association between anxiety or depression at baseline with genetic scores for alcohol use disorder and major depressive disorder. As well, our results uncovered new associations in line with previous epidemiological literature. As evident from previous literature, we also observed associations of gut microbial signatures with mental health including short-chain fatty acids and bacterial neurotoxic metabolites specifically with depression. Our results also show that microbiome and genetic factors explain self-reported mental health status and improvement better than demographic variables independently. The genetic and microbiome factors identified in this study provide the basis for designing and personalizing dietary interventions to improve mental health.

3.
International Journal of Environmental Research and Public Health ; 19(16):10220, 2022.
Article in English | ProQuest Central | ID: covidwho-2023662

ABSTRACT

This study aims to determine the factors influencing HIV-related mortality in settings experiencing continuous armed conflict atrocities. In such settings, people living with HIV (PLHIV), and the partners of those affected may encounter specific difficulties regarding adherence to antiretroviral therapy (ART), and retention in HIV prevention, treatment, and care programs. Between July 2019 and July 2021, we conducted an observational prospective cohort study of 468 PLHIV patients treated with Dolutegravir at all the ART facilities in Bunia. The probability of death being the primary outcome, as a function of time of inclusion in the cohort, was determined using Kaplan–Meier plots. We used the log-rank test to compare survival curves and Cox proportional hazard modeling to determine mortality predictors from the baseline to 31 July 2021 (endpoint). The total number of person-months (p-m) was 3435, with a death rate of 6.70 per 1000 p-m. Compared with the 35-year-old reference group, older patients had a higher mortality risk. ART-naïve participants at the time of enrollment had a higher mortality risk than those already using ART. Patients with a high baseline viral load (≥1000 copies/mL) had a higher mortality risk compared with the reference group (adjusted hazard ratio = 6.04;95% CI: 1.78–20.43). One-fourth of deaths in the cohort were direct victims of armed conflict, with an estimated excess death of 35.6%. Improving baseline viral load monitoring, starting ART early in individuals with high baseline viral loads, the proper tailoring of ART regimens and optimizing long-term ART, and care to manage non-AIDS-related chronic complications are recommended actions to reduce mortality. Not least, fostering women’s inclusion, justice, peace, and security in conflict zones is critical in preventing premature deaths in the general population as well as among PLHIV.

4.
Atmosphere ; 13(8):1272, 2022.
Article in English | ProQuest Central | ID: covidwho-2023117

ABSTRACT

This paper presents the results from field measurements and household surveys on the severity of indoor mold risk and its impact on respiratory health in a typical unplanned neighborhood of kampungs in Bandung, Indonesia. Mold risk was investigated using fungal risk detectors (n = 102), while air pollution levels were established with total suspended particulate (TSP) and particulate matter (PM2.5) (n = 38). The self-reported prevalence of respiratory diseases was obtained using a questionnaire form (ATS-DLD-78) (n = 599). The results showed that respiratory health problems were higher in the rainy season, particularly among children. Most houses suffered from severe mold risk, primarily due to extreme humid weather conditions, especially during rainy season (97%) where water leakage was prevalent (60%). In addition, the TSP and PM2.5 concentrations exceeded the WHO standards in most kampung houses, where around 58% of the houses recorded higher outdoor mean PM2.5 concentrations than indoors. Further, the path analysis showed that allergies followed by humidity rate and smell, which were affected by window-opening duration, directly impacted children’s respiratory health. Smoking behavior and building-related health problems, due to exposure to outdoor air pollution, affected the respiratory health of those aged 15 years old and over.

5.
J Am Board Fam Med ; 2022.
Article in English | PubMed | ID: covidwho-2022517

ABSTRACT

INTRODUCTION: COVID-19 policies such as quarantining, social isolation, and lockdowns are an essential public health measure to reduce the spread of disease but may lead to reduced physical activity. Little is known if these changes are associated with changes in physical or mental health. METHODS: Between September 2017 and December 2018 (baseline) and March 2020 and February 2021 (follow-up), we obtained self-reported demographic, health, and walking (only at follow-up) data on 2042 adults in primary care with multiple chronic health conditions. We examined whether the perceived amount of time engaged in walking was different compared with prepandemic levels and if this was associated with changes in Patient-Reported Outcomes Measurement Information System-29 mental and physical health summary scores. Multivariable linear regression controlling for demographic, health, and neighborhood information were used to assess this association. RESULTS: Of the 2042 participants, 9% reported more walking, 28% reported less, and 52% reported the same amount compared with prepandemic levels. Nearly 1/3 of participants reported less walking during the pandemic. Multivariable models revealed that walking less or not at all was associated with negative changes in mental (ß = -1.0;95% CI [-1.6, -0.5];ß = -2.2;95% CI [-2.9, -1.4]) and physical (ß = -0.9;95% CI [-1.5, -0.3];ß = -3.1;95% CI [-4.0, -2.3]) health, respectively. Increasing walking was significantly associated with a positive change in physical health (ß = 1.3;95% CI [0.3, 2.2]). CONCLUSIONS: These findings demonstrate the importance of walking during the COVID-19 pandemic. Promotion of physical activity should be taken into consideration when mandating restrictions to slow the spread of disease. Primary care providers can assess patient's walking patterns and implement brief interventions to help patients improve their physical and mental health through walking.

6.
Journal of Medical Internet Research ; 2022.
Article in English | ProQuest Central | ID: covidwho-2022384

ABSTRACT

Background: HIV and sexually transmitted infections (STIs) are major global public health concerns. Over 1 million curable STIs occur every day among people aged 15 years to 49 years worldwide. Insufficient testing or screening substantially impedes the elimination of HIV and STI transmission. Objective: The aim of our study was to develop an HIV and STI risk prediction tool using machine learning algorithms. Methods: We used clinic consultations that tested for HIV and STIs at the Melbourne Sexual Health Centre between March 2, 2015, and December 31, 2018, as the development data set (training and testing data set). We also used 2 external validation data sets, including data from 2019 as external “validation data 1” and data from January 2020 and January 2021 as external “validation data 2.” We developed 34 machine learning models to assess the risk of acquiring HIV, syphilis, gonorrhea, and chlamydia. We created an online tool to generate an individual’s risk of HIV or an STI. Results: The important predictors for HIV and STI risk were gender, age, men who reported having sex with men, number of casual sexual partners, and condom use. Our machine learning–based risk prediction tool, named MySTIRisk, performed at an acceptable or excellent level on testing data sets (area under the curve [AUC] for HIV=0.78;AUC for syphilis=0.84;AUC for gonorrhea=0.78;AUC for chlamydia=0.70) and had stable performance on both external validation data from 2019 (AUC for HIV=0.79;AUC for syphilis=0.85;AUC for gonorrhea=0.81;AUC for chlamydia=0.69) and data from 2020-2021 (AUC for HIV=0.71;AUC for syphilis=0.84;AUC for gonorrhea=0.79;AUC for chlamydia=0.69). Conclusions: Our web-based risk prediction tool could accurately predict the risk of HIV and STIs for clinic attendees using simple self-reported questions. MySTIRisk could serve as an HIV and STI screening tool on clinic websites or digital health platforms to encourage individuals at risk of HIV or an STI to be tested or start HIV pre-exposure prophylaxis. The public can use this tool to assess their risk and then decide if they would attend a clinic for testing. Clinicians or public health workers can use this tool to identify high-risk individuals for further interventions.

7.
NPJ Primary Care Respiratory Medicine ; 32(1), 2022.
Article in English | ProQuest Central | ID: covidwho-2016705

ABSTRACT

Significant indirect healthcare costs are related to uncontrolled asthma, including productivity loss. Days with short-acting beta-agonist (SABA) use is associated with symptom-related disruptions at work, home, and school. Digital self-management platforms may support fewer days with SABA medication use and may reduce symptom-related disruptions.

8.
Child Youth Care Forum ; : 1-24, 2022.
Article in English | Web of Science | ID: covidwho-2014210

ABSTRACT

Background: The COVID-19 pandemic can have a serious impact on children and adolescents' mental health. We focused on studies exploring its traumatic effects on young people in the first 18 months after that the pandemic was declared, distinguishing them also according to the type of informants (self-report and other-report instruments). Objective: We applied a meta-analytic approach to examine the prevalence of depression, anxiety, posttraumatic stress disorder, and psychological distress among children and adolescents during the COVID-19 pandemic, considering the moderating role of kind of disorder and/or symptom, type of instrument, and continent. Method: We used PsycINFO, PubMed, and Scopus databases to identify articles on the COVID-19 pandemic, applying the following filters: participants until 20 years of age, peer-review, English as publication language. Inclusion required investigating the occurrence of disorders and/or symptoms during the first 18 months of the pandemic. The search identified 26 publications. Results: The meta-analysis revealed that the pooled prevalence of psychological disorders and/or symptoms for children and adolescents, who were not affected by mental health disturbances before the outbreak of the COVID-19 pandemic, was .20, 95% CI [.16, .23]. Moreover, we found a moderating role of type of instrument: occurrence was higher for self-report compared to other-report instruments. Conclusions: The study presented an analysis of the psychological consequences for children and adolescents of the exposure to the COVID-19 pandemic, soliciting further research to identify factors underlying resilience. Notwithstanding limitations such as the small number of eligible articles and the fact that we did not examine the role of further characteristics of the studies (such as participants' age or design), this meta-analysis is a first step for future research documenting the impact of such an unexpected and devastating disaster like the COVID-19 pandemic.

9.
BMC Psychiatry ; 22(1), 2022.
Article in English | EMBASE | ID: covidwho-2009370

ABSTRACT

Background: Previous publications suggested that lockdown is likely to impact daily living issues of individuals with intellectual disabilities. The authors notably suspected an intensification of behavioural, eating and sleep problems. Methods: To test these hypotheses, we conducted an international online survey about the impact of COVID-19-associated first lockdown on people with genetic neurodevelopmental disorders. This survey was carried out using GenIDA, an international participatory database collecting medical information on genetic neurodevelopmental disorders. Patients’ relatives took part in this online survey from 30/04/2020 to 09/06/2020. This survey adapted from GenIDA standard questionnaire requested information on diagnosis, lifestyle and was based on yes/no answers to questions regarding behaviour, diet, and sleep, in the 6-months period before lockdown and during lockdown. We also asked relatives to evaluate the intensity of these problems by severity level. Finally, relatives could freely comment in open fields on the medical and/or quality of life problems they had encountered during lockdown. Results: In total 199 participants—144 children and 45 adults—with neurodevelopmental disorders (intellectual disability (79.4%) and/or autism spectrum disorder (21.6%)) of various genetic origins, with near-equal male/female (96/103) contribution and originating mainly from Europe and Northern America, were included. The average lockdown duration at time of the survey was 57 days. We did not find differences in the frequency of behavioural, eating and sleep problems before and during lockdown. Moreover, there was no apparent difference in the intensity of eating and sleep disorders between both periods. However, for persons with behavioural problems at both periods, relatives reported an increase in aggressivity, self-aggressivity, depressiveness, stereotypies, and restricted interests during lockdown, all of which might be interpreted as consequences of a lack of stimulation or a reaction to unexpected changes in daily habits. Conclusions: Our results support previous studies that suggest that the negative impact of lockdown does not depend on the intellectual disability per se but on the associated comorbidities such as behavioural disorders. This study addresses the need for prevention of behavioural disturbance in the vulnerable population with genetic neurodevelopmental disabilities.

10.
Ear, nose, & throat journal ; : 1455613221123737, 2022.
Article in English | MEDLINE | ID: covidwho-2009266

ABSTRACT

OBJECTIVE: To determine whether initiating saline nasal irrigation after COVID-19 diagnosis reduces hospitalization and death in high-risk outpatients compared with observational controls, and if irrigant composition impacts severity. METHODS: Participants 55 and older were enrolled within 24 hours of a + PCR COVID-19 test between September 24 and December 21, 2020. Among 826 screened, 79 participants were enrolled and randomly assigned to add 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240 mL of isotonic nasal irrigation twice daily for 14 days. The primary outcome was hospitalization or death from COVID-19 within 28 days of enrollment by daily self-report confirmed with phone calls and hospital records, compared to the CDC Surveillance Dataset covering the same time. Secondary outcomes compared symptom resolution by irrigant additive. RESULTS: Seventy-nine high-risk participants were enrolled (mean [SD] age, 64 [8] years;36 [46%] women;71% Non-Hispanic White), with mean BMI 30.3. Analyzed by intention-to-treat, by day 28, COVID-19 symptoms resulted in one ED visit and no hospitalizations in 42 irrigating with alkalinization, one hospitalization of 37 in the povidone-iodine group, (1.27%) and no deaths. Of nearly three million CDC cases, 9.47% were known to be hospitalized, with an additional 1.5% mortality in those without hospitalization data. Age, sex, and percentage with pre-existing conditions did not significantly differ by exact binomial test from the CDC dataset, while reported race and hospitalization rate did. The total risk of hospitalization or death (11%) was 8.57 times that of enrolled nasal irrigation participants (SE = 2.74;P = .006). Sixty-two participants completed daily surveys (78%), averaging 1.8 irrigations/day. Eleven reported irrigation-related complaints and four discontinued use. Symptom resolution was more likely for those reporting twice daily irrigation (X2 = 8.728, P = .0031) regardless of additive. CONCLUSION: SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate.

11.
Annals of the Rheumatic Diseases ; 81:130-131, 2022.
Article in English | EMBASE | ID: covidwho-2009090

ABSTRACT

Background: The COVID-19 pandemic, with its uncertainties, fears of contagion, mass lockdowns and containment measures, has dramatically impacted on people's everyday lives leading to an increased risk of mental disorders, particularly Post-Traumatic Stress Disorder (PTSD). Despite evidence in general population and healthcare workers1,2, scant data emerged on vulnerable populations, such as of patients with chronic illness, particularly rheumatic and musculoskeletal diseases (RMDs)3,4, who also underwent difficulties in the management and treatment of their disorders. Objectives: To assess PTSD and post-traumatic stress symptoms in a sample of patients with RMDs, during the COVID-19 pandemic in Italy. Methods: PERMAS is a monocentric prospective observational study led by the Rheumatology Unit, the Psychiatric Clinic and the Institute of Management of the School of Advanced Studies. Patients with a RMD diagnosis, were consecutively enrolled from May 2021 to January 2022. During the visit, sociodemographic characteristics and psychopathological data were collected through online survey, whereas clinical data were collected by physician. The survey included the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Impact of Event Scale-Revised (IES-R), aimed to assess symptomato-logical PTSD and post-traumatic stress symptoms related to the impact of the COVID-19 pandemic. Results: A total of 194 eligible patients, with a mean age of 50.3±12.17 years, was included: 142 (73.19%) were females;112 (57.74%) patients reported connective tissue diseases (CTD), 63 (32.47%) arthritis and 19 (9.8%) vasculitis. A total of 33 (17%) subjects reported a symptomatological PTSD by means of the TALS-SR. The prevalence of Partial PTSD (defned by at least 2 out of the 4 criteria for DSM-5 diagnosis of the disorder) was 56.7%, with signifcant higher rates among females (90, 81.8%) with respect to males (20, 18.2%) (p=.013). Accordingly, a IES-R mean total score of 21.90 ±15.98 was found in the total sample and a gender difference emerged, with higher mean scores among females rather than males (23.42 ±16.26 vs 21.90 ±15.98, p=.031). Conclusion: The present fndings point out high prevalence rates of symptoma-tological PTSD among patients suffering from RMDs, highlighting the potentially traumatic burden of the COVID-19 pandemic in this particular population, especially among females, suggesting the need of further investigations to address tailored prevention and intervention strategies.

12.
Journal of Public Health in Africa ; 13:52-53, 2022.
Article in English | EMBASE | ID: covidwho-2006812

ABSTRACT

Introduction/ Background: Non-pharmaceutical interventions are important public health measures targeted at behavioral changes to interrupt the transmission of coronavirus in humans. This study evaluated the challenges of implementing non-pharmaceuticalinterventions, assessed adherence, and identified requirements to the successful control of the spread of COVID-19 among individuals living in an urban-slum setting in Lagos-Nigeria. Methods: A cross-sectional study conducted among resident of an urban-slum in Makoko, Lagos-Nigeria. Adult members of households aged 18 years and above were selected via convenient sampling. An interviewer administered semi-structured questionnaire was used to obtain information on sociodemographic characteristics, living conditions and adherence to non-pharmaceutical interventions over a period of five-months from May to September 2020. Adherence to nonpharmaceutical intervention was determined by calculating an adherence index from 10 evidence based protective behaviors and a self-report of adhering to the measures. Descriptive-statistics and multiple-logistics regression model were used to determine challenges and factors associated with adherence to COVID-19 preventive measures. Results: A total of 357 participants with a mean-age of 45.8 ± 12.9 years were included in the analysis. Majority were males (62.2%) and married (83.8%). Most participants (93.8%) had no space for selfisolation as majority lived in a one-roomapartment (72.8%), shared toilets/kitchen-space (63.6%) with other families and had no constant source of water-supply (61.9%). About 98.8% are aware of the pandemic but only 33.9% adhered to the preventive-measures. The ability to afford facemasks/hand-sanitizers (aOR:6.7;95% CI:3.8-11.6), living-alone (aOR:3.7;95%CI:1.3-10.6), and ability to buy-water (aOR:0.3;95% CI:0.1-0.5) were found to be associated with adherence to the preventivemeasures after adjusting for covariates in a multilogistic- regression-model. Impact: This study gives insight on the realities/challenges of implementing non-pharmaceutical-intervention against COVID-19 disease in a setting of economically disadvantaged individuals who are at a great risk of being a hub for circulating the virus. This will aid the government in addressing cogent factors that might fuel re-occurrence of the pandemic waves. Conclusion: Implementation of non-pharmaceutical interventions for COVID-19 prevention was a challenge as only a quarter of residents adhered to national guidelines. Government should prioritize vaccinating these cohort of individuals and address factors like poor housing, overcrowding and lack of public water supply that affects adherence to public health measures in this setting.

13.
Journal of Public Health in Africa ; 13:23-24, 2022.
Article in English | EMBASE | ID: covidwho-2006772

ABSTRACT

Introduction/ Background: The risk of hospitalisation/death from Covid-19 in the UK is disproportionately high in black populations. In people of African ancestry, variants of the APOL1 gene (G1 and G2) are associated with risk of noncommunicable diseases, and sleeping sickness. We hypothesise that adverse Covid-19 outcomes are also associated with these variants. Methods: The UK Biobank contains genetic, lifestyle, and health information from 7,643 individuals who self-report as being of black ethnicity. Within this cohort there had been 142 hospitalisations and 36 deaths attributed to Covid-19 as of September 2021. Taking risk factors previously associated with poor Covid-19 outcomes (age, sex, chronic kidney disease, atrial fibrillation, hypertension, depression, chronic obstructive pulmonary disease, dementia, type 2 diabetes, obesity, and Townsend deprivation index) as covariates, we used Firth's Bias Reduced Logistic Regression in R to identify APOL1 genotypes that were associated with hospitalisation and death. Results: Individuals who are heterozygous for variants at both the G1 and the G2 loci are termed G1/G2 compound heterozygotes. G1/G2 compound heterozygosity was associated with hospitalisation (odds ratio = 2.4, 95% confidence interval: 1.2-4.5, p = 0.010) and death (odds ratio = 5.4, 95% confidence interval: 1.8-15.4, p = 0.004). This association has not previously been detected in genome wide association studies, as they usually examine individual loci separately rather than considering combinations of loci. Impact: This has implications at the individual and population level by identifying those at higher risk of severe Covid-19 who would benefit from early vaccination and treatment. This is especially relevant to geographical regions where APOL1 G1 and G2 variants are common, such as West and Central Africa and their diaspora. Conclusion: This data supports hypotheses proposing APOL1 genotype (and specifically G1/G2 compound heterozygosity) as a significant contributory factor in the increased rates of poor Covid-19 outcomes observed in people of African ancestry.

14.
Clinical Neuropsychiatry ; 19(4):206-219, 2022.
Article in English | EMBASE | ID: covidwho-2006727

ABSTRACT

Objective: The COVID-19 pandemic has presented unprecedented challenges for health systems as it has proven to be an extraordinary emergency. Exposure to such chronic stress can have detrimental effects on the psychophysical well-being of healthcare workers, with possible manifestation of stress-related symptoms. The present study aimed to develop and validate the Healthcare Workers Emergency Distress Questionnaire (HEDQ), a self-report screening questionnaire with the purpose of identifying the healthcare workers at risk for psychological and moral distress, and PTSD-related symptoms during emergencies. Method: The HEDQ was administered to 250 healthcare workers of the AULSS 3 Serenissima and 47 citizens from the general population in Venice (Italy) during the health emergency period (from April to June 2020). In the second administration (from August to September 2020), data were collected from 101 of the 250 healthcare workers who had participated in the first administration. To test for the convergent validity, the Depression Anxiety Stress Scale (DASS-21) was also administered. Results: Exploratory and hierarchical confirmatory factor analyses validated the 21-item structure of the questionnaire. Internal consistency, and factorial and convergent validity were good. Moreover, the HEDQ discriminated between those who worked in COVID-19 hospital units and those who did not (including the general population), showing good known-group validity. The two-month temporal stability of the questionnaire was excellent. The HEDQ scale scores significantly decreased from the first to the second administration, thus supporting that the tool is a measure of acute stress in healthcare workers. Conclusions: Our results provide support for the use of the HEDQ as a brief, multidimensional measure of emergency-related stress reactions in healthcare workers. Consequently, the HEDQ can be considered a useful instrument supporting clinical activity to identify those who may be more easily affected by stress reactions in the event of atypically high levels of risk exposure during crises.

15.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005725

ABSTRACT

Background: Cancer clinical trial enrollment rates are low, with Black individuals especially underrepresented. We tested Partnering Around Cancer Clinical Trials (PACCT), a multi-level intervention designed to improve patient-physician communication and increase trial invitations among Black and White men with prostate cancer. This study reports only on PACCT Phase 1, the patient-focused intervention, because data collection for PACCT Phase 2, the physician-focused intervention, was halted by the COVID-19 pandemic. Methods: Black and White men with prostate cancer and their physicians were invited to participate. Patients were tracked <two years for trial eligibility, with eligible patients randomized to usual care or intervention. Intervention patients received a brochure that included text promoting patient-physician partnerships and a trial-focused Question Prompt List to encourage them to participate actively in clinic visits, such as by asking questions or stating concerns. Patient-physician visits with eligible patients were video-recorded. After the visits, communication (i.e., patient active participation and physician patient-centered communication) was assessed via patient self-report and observer ratings of video-recordings. Medical chart ions determined trial invitations. Univariable logistic mixed-effects models nesting patients within physicians tested intervention effects by race on communication and trial invitation. Results: Among 199 participants (91 Black;108 White), 22% (n = 44;20 Black, 24 White) became eligible for a trial and received the intervention (n = 19) or usual care (n = 25). Regarding communication, Black intervention patients reported participating more actively than those in usual care (difference = 0.41, 95% CI -0.27-1.08), while White intervention patients reported participating less actively than those in usual care (difference = -0.34, 95% CI -0.72-0.05). No differences in observer ratings of active participation or self-report or observer ratings of physician communication were found. Regarding trial invitations, findings were nonsignificant, but showed more intervention patients (74%) than usual care patients (60%) received invitations (logOR = 1.97, 95% CI -0.30 to 4.24), with Black intervention patients having higher odds of receiving invitations (80%) than White intervention patients (67%) (logOR = 3.84, 95% CI -0.92 to 8.59 vs. logOR = -0.14, 95% CI -4.61 to 4.50). Conclusions: Few patients (22%, n = 44) became eligible for a trial during PACCT Phase 1. Despite this small sample, the PACCT intervention showed promise in increasing active participation among Black patients and in increasing clinical trial invitations for both Black and White patients. Future research should test this intervention in a larger sample and in combination with the physician-focused intervention.

16.
Surgery for Obesity and Related Diseases ; 18(8):S73, 2022.
Article in English | EMBASE | ID: covidwho-2004522

ABSTRACT

Alexandra Harvey Philadelphia PA1, Melissa Butt Hershey PA2, Antoinette Hu Hershey PA2, Ann Rogers Hershey PA2, Andrea Rigby Hershey PA2 Penn State College of Medicine1 Penn State Health2 The COVID-19 pandemic increased challenges to bariatric patients’ strict diet and exercise regimen, increasing reliance on social support and effective coping strategies for post-operative success. Social support and adaptive coping can be effective in the prevention and treatment of weight recurrence. Social support is associated with increased weight loss in bariatric patients and has been perceived by patients as necessary for effective post-operative care. The objective of this study is to investigate perceived social support and coping methods among bariatric patients and its association with weight during the COVID-19 pandemic. Adults (n=99) who underwent bariatric surgery prior to March 2020 completed a self-report questionnaire regarding coping strategies and perceived support during the COVID-19 pandemic. Respondents reported a wide range of weight recurrence (0.00 - 31.40 kg) from their lowest recorded weight. Participants also reported a high level of perceived social support, but it was not significantly associated with weight recurrence. Problem-focused coping strategies were significantly associated with weight recurrence (r=0.21, p=0.04), possibly due to an increase in weight prompting patients to engage in problem-focused coping. Weight recurrence was also significantly associated with venting (r=0.21, p=0.04), behavioral disengagement (r=0.20 p=0.048), and planning (r=0.30, p=0.003) coping methods during the pandemic. Our findings suggest that utilization of problem-focused coping methods are associated with weight recurrence regardless of perceived social support. Understanding which coping methods are associated with better post-operative health outcomes (such as increased weight loss) will help clinicians better counsel patients on how to address stressors they may encounter post-operatively.

17.
Psychosomatic Medicine ; 84(5):A8-A9, 2022.
Article in English | EMBASE | ID: covidwho-2003487

ABSTRACT

Background: While long-term physical and psychological effects of COVID-19 remain unknown, it is clear that a proportion of COVID-19 survivors develop protracted respiratory, cardiovascular, neurologic, dermatologic, and/or gastrointestinal symptoms and complications following acute illness, herein referred to as long COVID (LC) syndrome.Females appear to be at higher risk for LC, and also have higher rates of childhood trauma, which is associated with a heightened inflammatory response to stress. The present study investigated the impact of childhood trauma on COVID-19 illness course and recovery, including mental health outcomes. Methods: Participants (N=244), recruited via social media, Prolific.au, and from a post-COVID clinical treatment trial, completed online self-report measures of premorbid health, COVID-19 positivity, symptoms, and recovery, along with measures of depression, anxiety, post-traumatic stress disorder (PTSD), and childhood (CTE) and recent (RTE) traumatic experiences. Results: Compared to recovered participants (N=110), the LC group (N=158) was older and predominantly female. Those who reported one or more CTE were nearly 3-fold more likely to develop LC (OR=2.87, CI, 0.95 to 8.60) while those who endorsed two or more CTE were 4.5 times more likely (OR=4.56, CI, 1.61 to 12.33). A binary logistic regression analysis revealed that chest pain (p<.001), fatigue (p=.031), burning sensation (p=.002), and olfactory hallucinations (p<.001) during acute COVID, along with sex (p=.001) and age (p<.001) predicted LC. Compared to pre-COVID diagnoses, rates of PTSD (p<.001), depression (p<.001), and generalized anxiety (χ2=12.32, p<.001) increased across the entire sample and current PTSD (p=.001, partial η2=.042), depression (p<.001, partial η2=.048), and anxiety (p=.017, partial η2=.022) severity were higher in the LC group. Discussion: These findings suggest that childhood trauma or early adversity may prove relevant to the development of long COVID via central nervous system changes and dysfunction in the form of central sensitization, somatosensory disruptions, and/or dysautonomia, resulting from a heightened inflammatory response. Psychiatric outcomes should be assessed following acute COVID-19, and future research is needed to determine the unique contributions of COVID-19 and general pandemic stress to post-illness mental health.

18.
Psychosomatic Medicine ; 84(5):A56, 2022.
Article in English | EMBASE | ID: covidwho-2003476

ABSTRACT

Background: Recent studies have reported increased rates of mood and anxiety disorders in COVID-19 patients after acute illness, possibly resulting from inflammation, which is linked to depression and childhood trauma. Increased rates of anxiety and depression have also been observed at the population level following past viral outbreaks (e.g. SARS-CoV-1, MERS) and pandemic associated stress could also impact mental health. Thus, the present study compared depression, anxiety, and perceived stress scores in university students who tested positive for COVID-19 to those who never contracted the disease, and to scores prior to the pandemic. Methods: University students completed self-report measures of depression, anxiety, and perceived stress before (N=150) and during (N=334) the COVID-19 pandemic. The pandemic sample also completed measures of COVID-19 positivity, symptoms, and recovery. One third of the sample tested positive for COVID-19 (N=109). Three x (pre-pandemic, COVID-19 positive, COVID-19 negative) x two (male, female) ANOVAs examined differences in depression, anxiety, and perceived stress. A two (COVID-19 positive, COVID-19 negative) x two (male, female) ANOVA compared PTSD severity. Results: There were significant group effects for depression (F(1,477)=3.06, p=.048, partial η2=.013), anxiety (F(1,477)=3.03, p=.049, partial η2=.013), and perceived stress (F(1,376)=5.62, p=.004, partial η2=.029). Post-hoc analyses indicated that depression and anxiety were higher in the COVID-19 positive (all p's <.034) and negative (all p's <.042) groups compared to the pre-pandemic sample, but did not differ across the pandemic samples (all p's >.584). In contrast, perceived stress was higher in the pre-pandemic group compared to those who were COVID-19 positive (p=.033) and negative (p=.011). PTSD severity did not differ between the COVID-19 positive and negative groups (p=.645). Females were more depressed (p=.036), anxious (p<.001) and stressed (p=.006) than males but did not differ in PTSD severity (p=.305). Discussion: These results suggest that rates of depression and anxiety have increased during the pandemic regardless of COVID-19 positivity. Reduced stress during the pandemic may reflect reduced extracurricular commitments due to university activity restrictions. Future research should examine if these results generalize beyond university students.

19.
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2003387

ABSTRACT

Background: Early reports show pregnant and postpartum women have increased rates of anxiety and depression during the COVID-19 pandemic. These elevations could be related to fear of contracting COVID or mitigation strategies, such as social distancing and stay-at-home orders. First-time mothers may be uniquely vulnerable to these stressors. We examined whether 1) exposure to potentially stressful COVID-19 events, perceived impact of COVID-19, and COVID-19 distress are related to anxiety and depression symptoms reported by first-time mothers, and 2) whether the relationship between COVID-19 related stressors and anxiety and depression is stronger for mothers reporting less social support. Methods: We interviewed 125 first-time mothers of infants less than 3 months old from four pediatric primary care offices in Pennsylvania and Delaware (June 2020 - February 2021). Mothers completed a self-report interview asking about social support, COVID-19 experiences, and anxiety and depression symptoms (EPDS Total, Anxiety, Depression). The COVID-19 measure yielded three variables: 1) number of potentially stressful COVID-19 pandemic-related events (Event Exposure), 2) perceived impact of the COVID-19 pandemic on family (Family Impact), and 3) overall perceived distress related to the pandemic (Distress). Results: Participants (mean age = 29.18, SD: 5.50) were racially representative of the recruitment clinics (40.8% White;37.6% Black;11.2% Asian/Asian American;6.4% Latina). Hierarchical linear regression found COVID-19 Event Exposure was unrelated to Depression (β = 0.03, n.s.) and Anxiety (β = 0.04, n.s.). Controlling for Event Exposure, Family Impact was associated with higher EPDS Total (β = 0.32, p = 0.001), Depression (β = 0.29, p =.003), and Anxiety (β = 0.23, p = 0.02). Distress was significantly associated with higher EPDS Total (β = 0.21, p = 0.04) and Depression (β = 0.26, p = 00.01) but not Anxiety (β = 0.08, n.s.). Mothers reporting less social support had higher Depression scores (r = 0.26, p =.003), but social support was unrelated to Anxiety (r = 0.08, p = 0.41). The interaction of Family Impact and social support produced a nonsignificant trend (p = 0.09, Figure). Conclusion: While experience of more COVID-19 related events was unrelated to maternal anxiety and depression symptoms, maternal report of impact of COVID-19 on the family was associated with both anxiety and depression symptoms. Additionally, higher maternal distress reports and less perceived social supports were related to increased maternal depression symptoms. Therefore, future work should explore how to mitigate impact of COVID-19 families and connect mothers to social support to support maternal mental health.

20.
Psychosomatic Medicine ; 84(5):A19, 2022.
Article in English | EMBASE | ID: covidwho-2003367

ABSTRACT

Background: Prior research indicates that asthma is associated with greater stress. Individuals with asthma are also more likely to experience sleep problems, and poorer sleep health has been linked to higher stress levels. However, the role of sleep in the relation between asthma and stress remains understudied. We sought to explore the relationship between asthma and chronic stress, and the potential mediating role of sleep quality components in this association, during July 2020-November 2020 of the COVID-19 pandemic, a period of sustained naturalistic stress. Method: Participants (adults, mean age 55.53 years, N=241, n=115 adults with asthma) completed self-report measures assessing sleep efficiency, sleep duration, nocturnal asthma symptoms, and chronic stress. Hierarchical multiple linear regression models controlling for age and sex examined asthma and sleep quality components as predictors of chronic stress during the COVID-19 pandemic. Using the distribution of products method, sleep efficiency and sleep duration were examined as mediators of the association between asthma and chronic stress. Within the sample of adults with asthma, nocturnal asthma symptoms were examined as an additional predictor of chronic stress during COVID-19. Results: Asthma independently predicted greater chronic stress during the COVID-19 pandemic. Asthma was not associated with lower sleep efficiency, nor was there a significant relation between sleep efficiency and chronic stress. However, asthma was significantly associated with shorter sleep duration, and shorter sleep duration predicted greater chronic stress during the COVID-19 pandemic. Sleep duration, but not sleep efficiency, mediated the relation between asthma and chronic stress. Within the sample of adults with asthma, shorter sleep duration, but not sleep efficiency nor nocturnal asthma symptoms, predicted chronic stress during the COVID-19 pandemic. These findings suggest that sleep plays a role in health in asthma, above the influence of nocturnal asthma symptoms. Overall, findings highlight the importance of maintaining adequate sleep duration during stressful periods for individuals with asthma.

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