Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 311
Filter
2.
Health Res Policy Syst ; 20(Suppl 1): 110, 2022 Nov 29.
Article in English | MEDLINE | ID: covidwho-2139320

ABSTRACT

BACKGROUND: Populations around the world are ageing faster, with the majority living in low- and middle-income countries where health and social care are yet to be universal and inclusive for the ageing population. This community-integrated intermediary care (CIIC) model is a novel prevention-based, long-term care model enhancing the family-based care system traditionally practised in Thailand and neighbouring Asian countries, and many low-and middle-income countries globally. This study assessed the effectiveness of the CIIC model in Chiang Mai, Thailand. METHODS: The two-arm parallel intervention study was designed as a cluster-randomized controlled trial. The study population at randomization and analysis was 2788 participants: 1509 in six intervention clusters and 1279 in six control clusters. The research protocol was approved by the WHO Research Ethics Review Committee (WHO/ERC ID; ERC.0003064). The CIIC service intervention model is a combination of formal care and informal care in a subdistrict setting consisting of three components: (1) care prevention delivered as community group exercise and home exercise; (2) care capacity-building of the family caregiver; and (3) community respite service. The primary outcome was family caregivers' burden at 6-month follow-up, and secondary outcome was activities of daily living. Analysis applied the intention-to-treat approach using cluster-level analysis via STATA 16 SE. RESULTS: Baseline characteristics did not differ between the two arms. Loss of follow up was 3.7%. Mean age of the participants was 69.53 years. Women constituted 60%. The COVID-19 pandemic caused delayed implementation. The proportion of families with reduced caregiver burden at 6-month follow-up was higher among the intervention clusters (mean 39.4%) than control clusters (mean 28.62%). The intervention clusters experienced less functional decline and fewer people with depression. CONCLUSIONS: When communities are integrated for preventing care, and families are empowered for giving care, it is possible to secure universal access to health and social care for the older persons, with basic resources mobilized from communities. This study had shown the CIIC model as an effective and potential step to the realization of universal health and long-term care coverage being inclusive of ageing populations in Thailand and globally. TRIAL REGISTRATION: This trial was registered at the Thailand Clinical Trial Registry-Trial registration number TCTR20190412004, https://www.thaiclinicaltrials.org/.


Subject(s)
COVID-19 , Long-Term Care , Humans , Female , Aged , Aged, 80 and over , Thailand , Activities of Daily Living , Pandemics
3.
Sci Rep ; 12(1): 20347, 2022 Nov 27.
Article in English | MEDLINE | ID: covidwho-2133639

ABSTRACT

This study examined the association between coronavirus disease 2019 (COVID-19)-related stress, exercise habits, and oral health-related quality of life (OHRQoL) in a sample of 215 community-dwelling older adults in Japan (57 men, 158 women; Mage = 74.2 years, SD = 6.0). Data were collected during wellness checkups in October 2020 and included participants' demographic characteristics, measures of instrumental activities of daily living and depressive tendencies, number of teeth, oral hypofunction, OHRQoL, COVID-19-related stress, and exercise habits. Four mutually exclusive groups were created, using the presence or absence of COVID-19-related stress and lack of exercise habits as risk factors for poor OHRQoL (no COVID-19-related stress and no lack of exercise, COVID-19-related stress only, lack of exercise habits only, and both COVID-19-related stress and lack of exercise habits). Poisson regression with robust standard errors provided the prevalence ratio for poor OHRQoL. The presence of both COVID-19-related stress and lack of exercise habits (adjusted prevalence ratio: 2.20, 95% CI: 1.31- 3.69) was associated with poor OHRQoL. The results indicate that COVID-19-related stress and exercise habits should be considered when designing oral health and public health initiatives.


Subject(s)
COVID-19 , Quality of Life , Male , Humans , Female , Aged , Independent Living , Activities of Daily Living , COVID-19/epidemiology , Japan/epidemiology , Cross-Sectional Studies
4.
Int J Environ Res Public Health ; 19(22)2022 Nov 21.
Article in English | MEDLINE | ID: covidwho-2115990

ABSTRACT

The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients' reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients' musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.


Subject(s)
COVID-19 , Musculoskeletal System , Humans , Aged , COVID-19/epidemiology , Activities of Daily Living , SARS-CoV-2 , Hospitalization
5.
Sensors (Basel) ; 22(22)2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2115974

ABSTRACT

Social isolation is likely to be one of the most serious health outcomes for the elderly due to the COVID-19 pandemic, especially for seniors living alone at home. In fact, two approaches have been used to assess social isolation. The first is a self-reported survey designed for research purposes. The second approach is the use of monitoring technology. The objective of this paper is to provide some illustrative publications, works and examples of the current status and future prospects in the field of monitoring systems that focused on two main activities of daily living: meal-taking activity (shopping, cooking, eating and washing dishes) and mobility (inside the home and the act of going out). These two activities combined seem relevant to a potential risk of social isolation in the elderly. Although current research focuses on identifying only ADLs, we propose to use them as a first step to extract daily habits and risk level of social isolation. Moreover, since activity recognition is a recent field, we raise specific problems as well as needed contributions and we propose directions and research opportunities to accelerate advances in this field.


Subject(s)
Activities of Daily Living , COVID-19 , Humans , Aged , Pandemics/prevention & control , Social Isolation , Technology
6.
Pediatr Ann ; 51(11): e416-e420, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2110338

ABSTRACT

Although children have been largely spared the most severe consequences of acute infection with SARS-CoV-2 virus, it is estimated that up to one-quarter of the more than 14 million children diagnosed as having coronavirus disease 2019 (COVID-19) have developed persistent symptoms of fatigue, postexertional malaise, neurologic and cognitive symptoms, and other symptoms that interfere with activities of daily living for months after their initial illness. Pediatric postacute sequelae of COVID-19 (pPASC), or long-COVID, is a complex, heterogeneous, postviral condition involving multiple body systems and is likely attributable to several concurrent underlying physiologic processes, including damage from direct viral invasion, endovascular dysfunction and microthrombosis, viral persistence, and the development of autoimmunity. In this review, we explore the current state of the literature regarding definition, epidemiology, clinical presentation, and proposed pathophysiologic mechanisms of pPASC. [Pediatr Ann. 2022;51(11):e416-e420.].


Subject(s)
COVID-19 , Child , Humans , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Activities of Daily Living
7.
Int J Environ Res Public Health ; 19(22)2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2110077

ABSTRACT

Studies suggest that persistent symptoms after COVID-19 (long COVID) influence functioning and activities of daily living (ADL). However, it is still uncertain how and to what extent. This study aimed to describe patient-reported mental fatigue, ADL problems, ADL ability, sick leave and functional status among patients with long COVID. In this cross-sectional study, 448 patients, ≥18 years old and referred to occupational therapy at a Danish Post-COVID-19 Clinic, were included. Mental fatigue was measured by the Mental Fatigue Scale, ADL problems and ability were measured by the Canadian Occupational Performance Measure, sick leave was self-reported and functional status was evaluated by the Post-COVID-19 Functional Status Scale. Mean age was 46.8 years, 73% of the patients were female, and 75% suffered from moderate to severe mental fatigue. The majority reported difficulties performing productive and leisure activities. The median performance and satisfaction scores were 4.8 and 3, respectively. In total, 56% of the patients were on sick leave, and 94% were referred to rehabilitation. A decrease in functional status was found between pre-COVID-19 and assessment. Conclusively, the patients were highly affected in their everyday life and had distinct rehabilitation needs. Future research is needed to address causalities and rehabilitation for this patient group.


Subject(s)
COVID-19 , Sick Leave , Humans , Female , Middle Aged , Adolescent , Male , Activities of Daily Living , Cross-Sectional Studies , COVID-19/epidemiology , Functional Status , Canada , Mental Fatigue/epidemiology
8.
J Health Care Poor Underserved ; 33(4): 1844-1864, 2022.
Article in English | MEDLINE | ID: covidwho-2109264

ABSTRACT

In the United States, eight million people have disabilities related to self-care (having serious difficulty with bathing and dressing). Of these, approximately 2.3 million receive paid personal assistance services (PAS) to assist with activities of daily living. The National Survey on Health and Disability asked a series of questions about the impacts of COVID-19 for disabled people including disruptions in PAS. We used data from an open-ended question "How did you manage without the help you needed in your home?" to bring light to both the importance of, and vulnerabilities associated with, receipt of PAS. Themes from qualitative responses (n = 108) included (1) causes of unmet need, (2) consequences of unmet need, and (3) adaptations to overcome the loss of PAS. Results provide compelling evidence about the importance of the personal care attendant workforce and needed policies to address worker shortages to support community-based living options.


Subject(s)
COVID-19 , Disabled Persons , Humans , Activities of Daily Living , COVID-19/epidemiology , COVID-19/psychology , Self Care , United States/epidemiology
9.
Int J Environ Res Public Health ; 19(21)2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2099545

ABSTRACT

The COVID-19 pandemic has created and exacerbated emotional, financial, and technical challenges for informal caregivers of older people. The aim of this study was to explore the caregiving situation and subjective burden of informal caregivers of older family members during COVID-19, and to investigate how a caregiving situation's characteristics predict the subjective burden of care in times of COVID-19. The study was conducted in April and May 2021 via an online access panel. The sample (n = 612) was determined using a screening test that enabled us to focus on a Slovenian population of informal caregivers aged 40+ caring for a person aged 65+ for at least four hours/week on average. Our findings reveal that the subjective burden of care was high among informal caregivers during COVID-19. Multiple regression analysis showed that the provision of activities of daily living, care duration, average hours of care per week, formal care status, and recipients' health problems related to dementia or other memory problems significantly predicted the subjective burden of caregivers. These findings call for better recognition of the role of informal caregivers. The time and effort devoted to informal care should be supported by legislation and social security.


Subject(s)
COVID-19 , Caregivers , Humans , Aged , Caregivers/psychology , Caregiver Burden/epidemiology , Cost of Illness , COVID-19/epidemiology , Activities of Daily Living/psychology , Pandemics , Cross-Sectional Studies
10.
Arq Neuropsiquiatr ; 80(7): 712-717, 2022 07.
Article in English | MEDLINE | ID: covidwho-2096893

ABSTRACT

BACKGROUND: Coronavirus 2 severe acute respiratory syndrome (SARS-CoV-2), generically called COVID-2019, classified as a pandemic by the World Health Organization, has made health practices around the world face unique challenges. Since then, physical distancing and measures such as confinement have been adopted by different governments to control human-to-human transmission. This distance affected the treatment of individuals with progressive diseases such as neuromuscular diseases (NMDs). OBJECTIVE: To identify how patients with NMDs performed the therapeutic routine during social distancing and confinement resulting from the COVID-19 pandemic. METHODS: Application of a questionnaire prepared in the Google forms application, whose link for access and participation was sent by email or WhatssApp for family members and/or individuals with DNMs to respond. The questionnaire consisted of multiple-choice questions, divided into the following sections: personal data, treatments performed before and during the pandemic, activities performed during confinement, and characterization of motor function in activities of daily living comprising the period between September and October 2020. RESULTS: We observed a significant reduction in medical appointments for patients with NMDs. On the other hand, the results showed that most patients underwent motor and/or respiratory physiotherapy in person or by telemonitoring. The study participants reported spending more time playing indoors, and all pointed out motor changes during social distancing. CONCLUSION: There were changes in the therapeutic routine of patients with NMDs during the period of social distancing due to COVID-19.


ANTECEDENTES: A síndrome respiratória aguda grave por coronavírus 2 (SARS-CoV-2), genericamente chamada de COVID-2019, classificada como pandemia pela Organização Mundial da Saúde, tem feito as práticas de saúde em todo o mundo enfrentar desafios únicos. Desde então, o distanciamento físico e medidas como o confinamento foram adotadas por diferentes governos para controlar a transmissão inter-humana. Este distanciamento afetou o tratamento de indivíduos com doenças progressivas, como no caso das doenças neuromusculares (DNMs). OBJETIVO: Identificar como os pacientes com DNMs realizaram a rotina terapêutica durante o distanciamento social e confinamento decorrentes da pandemia de COVID-19. MéTODOS: Aplicação de um questionário elaborado no aplicativo Google forms, cujo link para acesso e participação foi enviado por e-mail ou WhatssApp para familiares e/ou indivíduos com DNMs responderem. O questionário consistiu em questões de múltipla escolha, dividido nas seguintes sessões: dados pessoais, tratamentos realizados antes e durante a pandemia, atividades realizadas durante o confinamento e caracterização das funções motoras nas atividades de vida diária, referente ao período de setembro a outubro de 2020. RESULTADOS: Observamos uma redução significativa nas consultas médicas dos pacientes com DNMs. Por outro lado, os resultados demonstraram que a maior parte dos pacientes realizou fisioterapia motora e/ou respiratória de modo presencial ou por telemonitoramento. Os participantes do estudo relataram gastar mais tempo com atividades dentro de casa, além de todos terem apontado mudanças motoras durante o distanciamento social. CONCLUSãO: Houve mudanças na rotina terapêutica de pacientes com DNM durante o período de distanciamento social da COVID-19.


Subject(s)
COVID-19 , Neuromuscular Diseases , Activities of Daily Living , Humans , Neuromuscular Diseases/epidemiology , Pandemics/prevention & control , Physical Distancing , SARS-CoV-2
11.
J Neurol Sci ; 443: 120487, 2022 Dec 15.
Article in English | MEDLINE | ID: covidwho-2095674

ABSTRACT

BACKGROUND: Limited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19. METHODS: We conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19. Predictors of these outcomes, including demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics, and life stressors, were evaluated using multivariable logistic regression. RESULTS: Of 790 COVID-19 patients who survived hospitalization, 451(57%) completed 6-month (N = 383) and/or 12-month (N = 242) follow-up, and 77/451 (17%) died between discharge and 12-month follow-up. Significant life stressors were reported in 121/239 (51%) at 12-months. In multivariable analyses, life stressors including financial insecurity, food insecurity, death of a close contact and new disability were the strongest independent predictors of worse mRS, Barthel Index, depression, fatigue, and sleep scores, and prolonged symptoms, with adjusted odds ratios ranging from 2.5 to 20.8. Other predictors of poor outcome included older age (associated with worse mRS, Barthel, t-MoCA, depression scores), baseline disability (associated with worse mRS, fatigue, Barthel scores), female sex (associated with worse Barthel, anxiety scores) and index COVID-19 severity (associated with worse Barthel index, prolonged symptoms). CONCLUSIONS: Life stressors contribute substantially to worse functional, cognitive and neuropsychiatric outcomes 12-months after COVID-19 hospitalization. Other predictors of poor outcome include older age, female sex, baseline disability and severity of index COVID-19.


Subject(s)
COVID-19 , Humans , Female , Activities of Daily Living , Prospective Studies , Quality of Life/psychology , Longitudinal Studies , Hospitalization , Fatigue/epidemiology , Fatigue/etiology
12.
Gerontology ; 68(11): 1285-1290, 2022.
Article in English | MEDLINE | ID: covidwho-2088997

ABSTRACT

BACKGROUND: Older adults denoted one of the populations that mostly suffered from the consequences of the COVID-19 pandemic. The cost of confinement was paid in terms of social isolation, distance from relatives and friends, lack of social support, and limited access to the healthcare system, which had a negative impact on health of older adults with comorbidities and frailty. OBJECTIVES: The purpose of the present study was to report the consequences of the COVID-19 pandemic on cognitive performances, functional status, and health-related quality of life among frail outpatients, compared to pre-pandemic status. METHOD: The current sample was part of a larger sample of frail and pre-frail outpatients, who were first evaluated at the clinic between April and May 2019 and who underwent a first follow-up evaluation between April and May 2020. Those outpatients who have undergone the first follow-up evaluation were contacted between April and May 2021 and were asked to voluntarily participate in a second telephone-based evaluation. Cognitive performances (through Mini Mental State Examination - MMSE), functional independency in basic and instrumental daily activities, physical and mental components of health-related quality of life (SF-12 PCS and SF-12 MCS, respectively) were evaluated and compared to previous evaluations. RESULTS: Seventy one outpatients (mean age of 80.69 years) completed the present follow-up evaluation. Patients reported significantly lower cognitive performances (mean MMSE 19.37; p < 0.001), lower physical quality of life (mean score 31.69; p < 0.001), and lower mental quality of life (mean score 38.79; p < 0.001) compared to both pre-pandemic baseline and the first follow-up. Moreover, patients showed a significantly reduced independency in basic daily activities (mean score 3.8; p = 0.004), and a significantly reduced independency in managing telephone (p = 0.012) and medications (p = 0.035), compared to baseline. CONCLUSIONS: The COVID-19 pandemic has been a prolonged stressor over time, which has markedly affected health-related quality of life of outpatients, and it can be considered a stressor that might have contributed to the patients' greater cognitive and functional vulnerability.


Subject(s)
COVID-19 , Quality of Life , Humans , Aged , Aged, 80 and over , Frail Elderly/psychology , Geriatric Assessment , Pandemics , Activities of Daily Living , COVID-19/epidemiology , Outpatients , Functional Status , Cognition
13.
J Int Med Res ; 50(9): 3000605221126657, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2053627

ABSTRACT

OBJECTIVE: To investigate the correlations between clinical, functional, and radiological outcomes in inpatients with coronavirus disease 2019 (COVID-19). METHODS: In this observational study, we recruited inpatients affected by moderate COVID-19 disease. The clinical evaluation comprised the Cumulative Illness Rating Scale (CIRS), numerical rating scale (NRS), modified Rankin scale (mRS), and the modified Borg dyspnea scale (mBDS). Respiratory involvement was assessed with computed tomography (CT) and graded with a CT-severity score (CT-SS). We retrospectively assessed functioning using the International Classification of Functioning, Disability and Health (ICF) codes of the Clinical Functioning Information Tool (ClinFIT) COVID-19 in the acute phase. Correlation analysis was performed 1) between clinical, instrumental, and functional parameters and 2) between ICF categories. RESULTS: The data showed statistically significant moderate correlations between CT-SS and the following categories: b152 "emotional functions" and b440 "respiratory functions". CONCLUSION: This is the first study to use the ICF framework in people with a moderate form of COVID-19 in the acute phase. Considering the correlations between some ICF categories and radiological findings, our results support the use of the ClinFIT COVID-19 for a comprehensive assessment of COVID-19 patients.


Subject(s)
COVID-19 , International Classification of Functioning, Disability and Health , Activities of Daily Living , Disability Evaluation , Humans , Inpatients , Retrospective Studies
14.
JAMA ; 328(10): 941-950, 2022 09 13.
Article in English | MEDLINE | ID: covidwho-2047346

ABSTRACT

Importance: During the COVID-19 pandemic, the US federal government required that skilled nursing facilities (SNFs) close to visitors and eliminate communal activities. Although these policies were intended to protect residents, they may have had unintended negative effects. Objective: To assess health outcomes among SNFs with and without known COVID-19 cases. Design, Setting, and Participants: This retrospective observational study used US Medicare claims and Minimum Data Set 3.0 for January through November in each year beginning in 2018 and ending in 2020 including 15 477 US SNFs with 2 985 864 resident-years. Exposures: January through November of calendar years 2018, 2019, and 2020. COVID-19 diagnoses were used to assign SNFs into 2 mutually exclusive groups with varying membership by month in 2020: active COVID-19 (≥1 COVID-19 diagnosis in the current or past month) or no-known COVID-19 (no observed diagnosis by that month). Main Outcomes and Measures: Monthly rates of mortality, hospitalization, emergency department (ED) visits, and monthly changes in activities of daily living (ADLs), body weight, and depressive symptoms. Each SNF in 2018 and 2019 served as its own control for 2020. Results: In 2018-2019, mean monthly mortality was 2.2%, hospitalization 3.0%, and ED visit rate 2.9% overall. In 2020, among active COVID-19 SNFs compared with their own 2018-2019 baseline, mortality increased by 1.60% (95% CI, 1.58% to 1.62%), hospitalizations decreased by 0.10% (95% CI, -0.12% to -0.09%), and ED visit rates decreased by 0.57% (95% CI, -0.59% to -0.55%). Among no-known COVID-19 SNFs, mortality decreased by 0.15% (95% CI, -0.16% to -0.13%), hospitalizations by 0.83% (95% CI, -0.85% to -0.81%), and ED visits by 0.79% (95% CI, -0.81% to -0.77%). All changes were statistically significant. In 2018-2019, across all SNFs, residents required assistance with an additional 0.89 ADLs between January and November, and lost 1.9 lb; 27.1% had worsened depressive symptoms. In 2020, residents in active COVID-19 SNFs required assistance with an additional 0.36 ADLs (95% CI, 0.34 to 0.38), lost 3.1 lb (95% CI, -3.2 to -3.0 lb) more weight, and were 4.4% (95% CI, 4.1% to 4.7%) more likely to have worsened depressive symptoms, all statistically significant changes. In 2020, residents in no-known COVID-19 SNFs had no significant change in ADLs (-0.06 [95% CI, -0.12 to 0.01]), but lost 1.8 lb (95% CI, -2.1 to -1.5 lb) more weight and were 3.2% more likely (95% CI, 2.3% to 4.1%) to have worsened depressive symptoms, both statistically significant changes. Conclusions and Relevance: Among skilled nursing facilities in the US during the first year of the COVID-19 pandemic and prior to the availability of COVID-19 vaccination, mortality and functional decline significantly increased at facilities with active COVID-19 cases compared with the prepandemic period, while a modest statistically significant decrease in mortality was observed at facilities that had never had a known COVID-19 case. Weight loss and depressive symptoms significantly increased in skilled nursing facilities in the first year of the pandemic, regardless of COVID-19 status.


Subject(s)
COVID-19 , Health Status , Skilled Nursing Facilities , Activities of Daily Living , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , COVID-19 Vaccines , Environmental Exposure/statistics & numerical data , Health Policy , Humans , Medicare/statistics & numerical data , Pandemics/statistics & numerical data , Quality of Life , Retrospective Studies , Skilled Nursing Facilities/statistics & numerical data , United States/epidemiology
15.
Sensors (Basel) ; 22(19)2022 Sep 21.
Article in English | MEDLINE | ID: covidwho-2043922

ABSTRACT

Recently, due to the COVID-19 pandemic and the related social distancing measures, in-person activities have been significantly reduced to limit the spread of the virus, especially in healthcare settings. This has led to loneliness and social isolation for our most vulnerable populations. Socially assistive robots can play a crucial role in minimizing these negative affects. Namely, socially assistive robots can provide assistance with activities of daily living, and through cognitive and physical stimulation. The ongoing pandemic has also accelerated the exploration of remote presence ranging from workplaces to home and healthcare environments. Human-robot interaction (HRI) researchers have also explored the use of remote HRI to provide cognitive assistance in healthcare settings. Existing in-person and remote comparison studies have investigated the feasibility of these types of HRI on individual scenarios and tasks. However, no consensus on the specific differences between in-person HRI and remote HRI has been determined. Furthermore, to date, the exact outcomes for in-person HRI versus remote HRI both with a physical socially assistive robot have not been extensively compared and their influence on physical embodiment in remote conditions has not been addressed. In this paper, we investigate and compare in-person HRI versus remote HRI for robots that assist people with activities of daily living and cognitive interventions. We present the first comprehensive investigation and meta-analysis of these two types of robotic presence to determine how they influence HRI outcomes and impact user tasks. In particular, we address research questions regarding experience, perceptions and attitudes, and the efficacy of both humanoid and non-humanoid socially assistive robots with different populations and interaction modes. The use of remote HRI to provide assistance with daily activities and interventions is a promising emerging field for healthcare applications.


Subject(s)
COVID-19 , Robotics , Activities of Daily Living , Humans , Pandemics , Social Isolation
16.
Int J Environ Res Public Health ; 19(19)2022 Sep 22.
Article in English | MEDLINE | ID: covidwho-2043720

ABSTRACT

Social frailty among older adults has become a growing concern from a public health perspective in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study's aim was to investigate the influence of various aspects of social frailty in community-dwelling older adults during the COVID-19 pandemic. This study carried out a secondary analysis of data collected from the 2020 National Survey of Older Koreans and performed multinomial logistic regression analysis to identify the predictive factors of social frailty. The affected factors for the social frailty group were health conditions (depression), behavioral and metabolic risk factors (exercise, nutritional status, current smoking status, drinking frequency), intrinsic capacity (cognitive functions, activities of daily living), and digital literacy (use of smartphone or tablet PCs). Since multidimensional factors could affect older adults' social frailty, comprehensive strategies are urgently needed to reduce their rate of social frailty.


Subject(s)
COVID-19 , Frailty , Activities of Daily Living , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Frail Elderly , Frailty/epidemiology , Frailty/psychology , Geriatric Assessment/methods , Humans , Independent Living , Pandemics
17.
Clin Interv Aging ; 17: 1393-1404, 2022.
Article in English | MEDLINE | ID: covidwho-2043233

ABSTRACT

Purpose: We aimed to investigate the prevalence and factors associated with falls in older adult outpatients during the coronavirus disease (COVID-19) pandemic in Vietnam. Patients and Methods: From February 2022 to June 2022, this cross-sectional study included 814 patients (aged ≥60 years; mean age 71.8 ± 7.3 years; women, 65.2%) attending three geriatric clinics for a comprehensive geriatric assessment. Self-reported fall events in the past 12 months and post-COVID-19 falls were assessed. Factors associated with falls were determined using logistic regression analysis. Results: In total, 188 patients (23.1%) had falls (single fall, 75.5%; recurrent falls, 24.5%). The most frequent location, time, and circumstance of falls were the bedroom (43.1%), morning (54.3%), and dizziness (34.6%), respectively. Most patients experienced health issues after falls (bruise/grazes, 53.7%; fracture, 12.8%; immobility, 9.6%; hospital admission, 14.9%). In the adjusted model, factors associated with falls were being underweight (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.37-4.56, P = 0.003), limitations in instrumental activities of daily living (OR 2.03, 95% CI 1.05-3.95, P = 0.036), poor sleep quality (OR 1.83, 95% CI 1.10-3.05, P = 0.020), and fear of falling (OR 3.45, 95% CI 2.23-5.33, P <0.001). Among 357 COVID-19 infected patients, post-COVID-19 falls occurred in 35 patients (9.8%) and were associated with fear of falling (OR 3.14, 95% CI 1.18-8.40, P = 0.023) and post-COVID-19 lower limb weakness (OR 2.55, 95% CI 1.07-6.10, P = 0.035). Conclusion: Our study found a substantial prevalence of falls among older outpatients during the COVID-19 pandemic in Vietnam. Management of factors associated with falls may be needed to reduce the burden of falls in the older population.


Subject(s)
Accidental Falls , COVID-19 , Accidental Falls/prevention & control , Activities of Daily Living , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Fear , Female , Humans , Pandemics , Risk Factors , Vietnam/epidemiology
18.
World J Emerg Surg ; 17(1): 46, 2022 08 29.
Article in English | MEDLINE | ID: covidwho-2038830

ABSTRACT

BACKGROUND: Pleural empyema (PE) is a frequent disease, associated with a high morbidity and mortality. Surgical approach is the standard of care for most patients with II-III stage PE. In the last years, the minimally invasive surgical revolution involved also thoracic surgery allowing the same outcomes in terms of safety and effectiveness combined to better pain management and early discharge. The aim of this study is to demonstrate through our experience on uniportal-video-assisted thoracoscopy (u-VATS) the effectiveness and safety of its approach in treatment of stage II PE. As secondary endpoint, we will evaluate the different pattern of indication of u-VATS in adult and elderly patients with literature review. METHODS: We retrospectively reviewed our prospectively collected database of u-VATS procedures from November 2018 to February 2022, in our regional referral center for Thoracic Surgery of Regione Molise General Surgery Unit of "A. Cardarelli" Hospital, in Campobasso, Molise, Italy. RESULTS: A total of 29 patients underwent u-VATS for II stage PE. Fifteen (51.72%) patients were younger than 70 years old, identified as "adults," 14 (48.28%) patients were older than 70 years old, identified as "elderly." No mortality was found. Mean operative time was 104.68 ± 39.01 min in the total population. The elderly group showed a longer operative time (115 ± 53.15 min) (p = 0.369). Chest tube was removed earlier in adults than in elderly group (5.56 ± 2.06 vs. 10.14 ± 5.58 p = 0.038). The Length of Stay (LOS) was shorter in the adults group (6.44 ± 2.35 vs. 12.29 ± 6.96 p = 0.033). Patients evaluated through Instrumental Activities of Daily Living (IADL) scale returned to normal activities of daily living after surgery. CONCLUSION: In addition, the u-VATS approach seems to be safe and effective ensuring a risk reduction of progression to stage III PE with a lower recurrence risk and septic complications also in elderly patients. Further comparative multicenter analysis are advocated to set the role of u-VATS approach in the treatment of PE in adults and elderly patients.


Subject(s)
Empyema, Pleural , Thoracic Surgery, Video-Assisted , Activities of Daily Living , Adult , Aged , Empyema, Pleural/surgery , Humans , Length of Stay , Multicenter Studies as Topic , Retrospective Studies , Thoracic Surgery, Video-Assisted/methods
19.
BMC Geriatr ; 22(1): 752, 2022 09 15.
Article in English | MEDLINE | ID: covidwho-2029692

ABSTRACT

BACKGROUND: Minimal research has leveraged qualitative data methods to gain a better understanding of the experiences and needs of older adults (OAs) and care partners of OAs with and without Alzheimer's Disease (AD) and AD-related dementias (AD/ADRD) during the first surge of the COVID-19 pandemic. In this study, we: 1) quantitatively evaluated the psychosocial health of community-dwelling OAs; 2) quantitatively evaluated the perceived stress of care partners for OAs; 3) qualitatively characterized the experiences and needs of community-dwelling OAs and their care partners; and 4) explored differences in the experiences of care partners of OAs with and without AD/ADRD during the first surge of the COVID-19 pandemic in the New York metropolitan area. METHODS: In this mixed-methods study, telephone interviews were conducted with 26 OAs and 29 care partners (16 of whom cared for OAs with AD/ADRD) from April to July 2020. Quantitative data included: demographics; clinical characteristics (Katz Index of independence in activities of daily living (Katz ADL) and the Lawton-Brody instrumental activities of daily living scale (Lawton-Brody)); and psychosocial health: stress was assessed via the Perceived Stress Scale (PSS), social isolation via the Lubben Social Network Scale (LSNS), loneliness via the DeJong Loneliness Scale (DeJong), and depression and anxiety via the Patient Health Questionnaire-Anxiety and Depression (PHQ). Qualitative questions focused on uncovering the experiences and needs of OAs and their care partners. RESULTS: OAs (N = 26) were mostly female (57.7%), and White (76.9%), average age of 81.42 years. While OAs were independent (M = 5.60, Katz ADL) and highly functional (M = 6.92, Lawton-Brody), and expressed low levels of loneliness, stress, depression and anxiety (M = 1.95 on DeJong; M = 12.67 on PSS; M = 1.05 on PHQ depression; and M = 1.09 on PHQ anxiety), open-ended questions elicited themes of fear and worry. Care partners (N = 29) were mostly female (75.9%), White (72.4%), and married (72.4%), and reported moderate stress (M = 16.52 on the PSS), as well as a psychological impact of the pandemic. CONCLUSIONS: Early in the pandemic, OAs reported minimal stress and loneliness; this may have been related to their reports of frequent interaction with family, even if only virtually. By contrast, care partners were moderately stressed and worried, potentially more than usual due to the additional challenges they face when trying to meet their loved ones' needs during a pandemic.


Subject(s)
Alzheimer Disease , COVID-19 , Activities of Daily Living , Aged , Aged, 80 and over , Alzheimer Disease/psychology , COVID-19/epidemiology , Caregivers , Female , Humans , Loneliness/psychology , Male , Pandemics
20.
AACN Adv Crit Care ; 33(3): 247-252, 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-2024641

ABSTRACT

Extracorporeal membrane oxygenation is emerging as a vital resource for survival of patients with acute respiratory distress syndrome related to COVID-19. Although recent research provides much insight into the advantages of extracorporeal membrane oxygenation in this patient population, little has been published on its use in pregnancy. This case study describes the use of venovenous extracorporeal membrane oxygenation in a young pregnant woman with acute respiratory distress syndrome due to COVID-19. It illustrates the benefits of a multidisciplinary approach to this treatment modality, allowing time for a fetus to become viable while preserving the life of the mother. In this case, the mother was able to return home after receiving this therapy and resume normal activities of daily living independently.


Subject(s)
COVID-19 , Extracorporeal Membrane Oxygenation , Respiratory Distress Syndrome , Activities of Daily Living , COVID-19/therapy , Female , Humans , Pregnancy , Respiratory Distress Syndrome/therapy
SELECTION OF CITATIONS
SEARCH DETAIL