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1.
BMJ Glob Health ; 6(12)2021 12.
Article in English | MEDLINE | ID: covidwho-1583127

ABSTRACT

BACKGROUND: The objective of this study was to identify the prevalence of long COVID symptoms in a large cohort of people living with and affected by long COVID and identify any potential associated risk factors. METHODS: A prospective survey was undertaken of an inception cohort of confirmed people living with and affected by long COVID (aged 18-87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented were contacted by face-to-face interview, and were interviewed regarding long COVID, and restriction of activities of daily living using post COVID-19 functional status scale. Cardiorespiratory parameters measured at rest (heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation levels, maximal oxygen consumption, inspiratory and expiratory lung volume) were also measured. RESULTS: Among 2198 participants, the prevalence of long COVID symptoms at 12 weeks was 16.1%. Overall, eight long COVID symptoms were identified and in descending order of prominence are: fatigue, pain, dyspnoea, cough, anosmia, appetite loss, headache and chest pain. People living with and affected by long COVID experienced between 1 and 8 long COVID symptoms with an overall duration period of 21.8±5.2 weeks. Structural equation modelling predicted the length of long COVID to be related to younger age, female gender, rural residence, prior functional limitation and smoking. CONCLUSION: In this cohort, at 31 weeks post diagnosis, the prevalence of long COVID symptoms was 16.1%. The risk factors identified for presence and longer length of long COVID symptoms warrant further research and consideration to support public health initiatives.


Subject(s)
COVID-19 , Activities of Daily Living , Bangladesh/epidemiology , COVID-19/complications , COVID-19 Testing , Cohort Studies , Female , Humans , Prevalence , Prospective Studies , SARS-CoV-2 , Survivors
2.
Biomed Res Int ; 2021: 9928276, 2021.
Article in English | MEDLINE | ID: covidwho-1582875

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19) is a global public health crisis. However, whether it can cause respiratory dysfunction or physical and psychological disorders in patients remains unknown. Thus, this study was conducted to investigate the respiratory function, activities of daily living, quality of life, and mental status of patients with COVID-19. Participants and outcomes. Data was collected from the follow-up of eligible patients who attended the fever clinic of three hospitals in Jiangxi Province, from March to May 2020. The outcomes included respiratory muscle function, degree of dyspnea, aerobic capacity, activities of daily living, quality of life, and mental status. Results: A total of 139 patients (72 men and 67 women) were included in this study. The proportions of mild, moderate, severe, and critical cases of COVID-19 were 7.1% (10 cases), 68.3% (95 cases), 20.1% (28 cases), and 4.2% (6 cases), respectively. The rates of abnormal maximal inspiratory pressure were 10.0%, 25.2%, 25.0%, and 16.7%, respectively. There were 50%, 65.3%, 50%, and 66.7% of the patients with abnormal dyspnea in the four clinical classifications, respectively. Patients generally show a decline in quality of life, anxiety, and depression symptoms. Conclusions: Respiratory dysfunction, decreased quality of life, and psychological disorders were present in each clinical classification of COVID-19. Therefore, it is necessary to carry out respiratory rehabilitation and psychological intervention for COVID-19 patients.


Subject(s)
Activities of Daily Living , COVID-19 , Quality of Life , Respiratory Mechanics , SARS-CoV-2 , Adult , Aged , Anxiety/physiopathology , Anxiety/psychology , Anxiety/rehabilitation , COVID-19/physiopathology , COVID-19/psychology , COVID-19/rehabilitation , Depression/physiopathology , Depression/psychology , Depression/rehabilitation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies
3.
Sensors (Basel) ; 21(22)2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1512573

ABSTRACT

Existing wearable systems that use G-sensors to identify daily activities have been widely applied for medical, sports and military applications, while body temperature as an obvious physical characteristic that has rarely been considered in the system design and relative applications of HAR. In the context of the normalization of COVID-19, the prevention and control of the epidemic has become a top priority. Temperature monitoring plays an important role in the preliminary screening of the population for fever. Therefore, this paper proposes a wearable device embedded with inertial and temperature sensors that is used to apply human behavior recognition (HAR) to body surface temperature detection for body temperature monitoring and adjustment by evaluating recognition algorithms. The sensing system consists of an STM 32-based microcontroller, a 6-axis (accelerometer and gyroscope) sensor, and a temperature sensor to capture the original data from 10 individual participants under 4 different daily activity scenarios. Then, the collected raw data are pre-processed by signal standardization, data stacking and resampling. For HAR, several machine learning (ML) and deep learning (DL) algorithms are implemented to classify the activities. To compare the performance of different classifiers on the seven-dimensional dataset with temperature sensing signals, evaluation metrics and the algorithm running time are considered, and random forest (RF) is found to be the best-performing classifier with 88.78% recognition accuracy, which is higher than the case of the absence of temperature data (<78%). In addition, the experimental results show that participants' body surface temperature in dynamic activities was lower compared to sitting, which can be associated with the possible missing fever population due to temperature deviations in COVID-19 prevention. According to different individual activities, epidemic prevention workers are supposed to infer the corresponding standard normal body temperature of a patient by referring to the specific values of the mean expectation and variance in the normal distribution curve provided in this paper.


Subject(s)
COVID-19 , Activities of Daily Living , Algorithms , Body Temperature , Human Activities , Humans , SARS-CoV-2
4.
Int J Environ Res Public Health ; 18(21)2021 11 01.
Article in English | MEDLINE | ID: covidwho-1512294

ABSTRACT

This study aimed to identify the terminologies of NANDA-I, NOC, NIC, and NNN linkages that have been used for nursing home (NH) residents. This study used a retrospective descriptive design. Data accrued from 57 registered nurses (RNs) in 25 Korean NHs. The RNs randomly selected one resident and assessed for applied NANDA-I, NOC, and NIC from the previous 7 days by reviewing nursing charts and records. Finally, the data of 57 residents in 25 NHs were collected. Results: We identified seven NNN linkages: risk for falls-fall prevention behavior-fall prevention; self-care deficit: bathing/hygiene-self-care: activities of daily living (ADL)-self-care assistance: bathing/hygiene; impaired memory-memory-cognitive stimulation; chronic confusion-neurological status: consciousness-medication management; chronic confusion-memory-medication management; impaired walking-mobility-exercise promotion: strength training; and impaired walking-ambulation-exercise promotion: strength training. The identified core NANDA-I, NOC, NIC, and NNN linkages for NH residents from this study provide a scope of practice of RNs working in NHs.


Subject(s)
Standardized Nursing Terminology , Activities of Daily Living , Humans , Nursing Diagnosis , Nursing Homes , Republic of Korea , Retrospective Studies
5.
BMC Geriatr ; 21(1): 638, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1511727

ABSTRACT

BACKGROUND: This study aimed to determine the frequency of functional decline and to identify the factors related to a greater risk of functional decline among hospitalized older patients with coronavirus disease 2019 (COVID-19). METHODS: We reviewed the medical records of patients aged over 65 years who were admitted to a tertiary care hospital for COVID-19 over 1 year from February 2020. We evaluated the proportion of functional decline, which was defined as a decrease in the Barthel Index score from before the onset of COVID-19 to discharge. Multivariable logistic regression analyses were performed to evaluate the associations between the demographic and clinical characteristics of patients at admission and a greater risk of functional decline. Two sensitivity analyses with different inclusion criteria were performed: one in patients without very severe functional decline before the onset of COVID-19 (i.e., limited to those with Barthel Index score ≥ 25), and the other with a composite outcome of functional decline and death at discharge. RESULTS: The study included 132 patients with COVID-19; of these, 72 (54.5%) developed functional decline. The severity of COVID-19 did not differ between patients with functional decline and those without (P = 0.698). Factors associated with a greater risk of functional decline included female sex (adjusted odds ratio [aOR], 3.14; 95% confidence interval [CI], 1.25 to 7.94), Barthel Index score < 100 before the onset of COVID-19 (aOR, 13.73; 95% CI, 3.29 to 57.25), and elevation of plasma D-dimer level on admission (aOR, 3.19; 95% CI, 1.12 to 9.07). The sensitivity analyses yielded similar results to those of the main analysis. CONCLUSIONS: Over half of the older patients who recovered from COVID-19 developed functional decline at discharge from a tertiary care hospital in Japan. Baseline activities of daily living impairment, female sex, and elevated plasma D-dimer levels at admission were associated with a greater risk of functional decline.


Subject(s)
Activities of Daily Living , COVID-19 , Aged , Female , Hospitalization , Humans , Male , Retrospective Studies , Risk Factors , SARS-CoV-2
7.
Sci Rep ; 11(1): 20439, 2021 11 05.
Article in English | MEDLINE | ID: covidwho-1504468

ABSTRACT

Seismic ambient noise with frequencies > 1 Hz includes noise related to human activities. A reduction in seismic noise during the COVID-19 pandemic has been observed worldwide, as restrictions were imposed to control outbreaks of the SARS-CoV-2 virus. In this context, we studied the effect of changes in anthropogenic activities during COVID-19 on the seismic noise levels in the Tokyo metropolitan area, Japan, considering time of day, day of the week, and seasonal changes. The results showed the largest reduction in noise levels during the first state of emergency under most conditions. After the first state of emergency was lifted, the daytime noise reverted to previous levels immediately on weekdays and gradually on Sundays. This was likely because economic activities instantly resumed, while non-essential outings on Sundays were still mostly avoided. Furthermore, the daytime noise level on Sundays was strongly reduced regardless of changes on weekdays after the second state of emergency, which restricted activities mainly at night. Sunday noise levels gradually increased from the middle of the second state of emergency, suggesting a gradual reduction in public concern about COVID-19 following a decrease in the number of infections. Our findings demonstrate that seismic noise can be used to monitor social activities.


Subject(s)
COVID-19/epidemiology , Leisure Activities , Noise , Acoustics , Activities of Daily Living , Communicable Disease Control/methods , Disease Outbreaks , Emergency Service, Hospital , Environmental Monitoring/methods , Humans , Pandemics , SARS-CoV-2 , Tokyo/epidemiology
8.
BMJ Open ; 11(7): e048198, 2021 07 20.
Article in English | MEDLINE | ID: covidwho-1495461

ABSTRACT

INTRODUCTION: Myasthenia gravis (MG) is a rare, chronic, autoimmune disease, mediated by immunoglobulin G antibodies, which causes debilitating muscle weakness. As with most rare diseases, there is little patient-reported data with which to understand and address patient needs. This study explores the impact of MG in the real world from the patient perspective. METHODS AND ANALYSIS: This is a 2-year prospective, observational, digital, longitudinal study of adults with MG, resident in the following countries: the USA, Japan, Germany, France, the UK, Italy, Spain, Canada and Belgium. The planned sample size is 2000. Recruitment will be community based, via patient advocacy groups, social media and word of mouth. Participants will use a smartphone application (app) to check eligibility, provide consent and contribute data. Planned data entry is as follows: (1) personal profile on enrollment-covering demographics, MG characteristics and previous care; (2) monthly event tracker-current treatments, healthcare visits, treatment-related adverse events, productivity losses; (3) monthly selection of validated generic and disease-specific patient-reported outcomes instruments: EQ-5D-5L, Myasthenia Gravis Activities of Daily Living, Myasthenia Gravis Quality of Life 15-item revised scale, Hospital Anxiety and Depression Scale and Health Utilities Index III. Analyses are planned for when the study has been running in most countries for approximately 6, 12, 18 and 24 months. ETHICS AND DISSEMINATION: The study protocol has been reviewed and granted ethics approval by Salus IRB for participants resident in the following countries: Germany, the UK and the US. Local ethics approval is being sought for the following study countries: Belgium, Canada, France, Italy, Japan and Spain. Study results will be communicated to the public and participants via conference presentations and journal publications, as well as regular email, social media and in-application communication. TRIAL REGISTRATION NUMBER: NCT04176211.


Subject(s)
Activities of Daily Living , Myasthenia Gravis , Adult , Belgium , Canada , France , Germany , Humans , Italy , Japan , Longitudinal Studies , Observational Studies as Topic , Prospective Studies , Quality of Life , Spain , Treatment Outcome
9.
Sci Rep ; 11(1): 21342, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1493216

ABSTRACT

Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed "Cohort Studies", where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children's condition, 4-6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of "Problematic Behavior" could serve to mitigate future risk.


Subject(s)
Autism Spectrum Disorder/psychology , COVID-19/prevention & control , Cell Phone Use , Child Behavior/psychology , Child Care/methods , Quarantine/psychology , SARS-CoV-2 , Activities of Daily Living , Aggression , Autism Spectrum Disorder/epidemiology , Bangladesh/epidemiology , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Cohort Studies , Communication , Female , Humans , Male , Self-Injurious Behavior/psychology , Sleep , Social Skills
10.
Int J Environ Res Public Health ; 18(21)2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1488586

ABSTRACT

Understanding of strategies to support individuals recovering from coronavirus disease 2019 (COVID-19) is limited. 'Long COVID' is a multisystem disease characterised by a range of respiratory, gastrointestinal, cardiovascular, neurological, and musculoskeletal symptoms extending beyond 12 weeks. The aim of this study was to explore individuals' experiences of recovering from COVID-19 to provide a better understanding of the acute and long-term impact of the disease on physical activity (PA). Individualised semi-structured interviews were conducted with 48 adults recovering from COVID-19 at 6-11 months post-infection. An inductive thematic analysis approach was used, reaching saturation at 14 interviews (10 female; 47 ± 7 years). Four overarching themes were identified: (i) Living with COVID-19, including managing activities of daily living; (ii) Dealing with the Unknown and self-management strategies; (iii) Re-introducing physical activity; and (iv) Challenges of returning to work. The return to PA, whether through activities of daily living, work or exercise, is often associated with the exacerbation of symptoms, presenting a range of challenges for individuals recovering from COVID-19. Individually tailored support is therefore required to address the unique challenges posed by COVID-19.


Subject(s)
Activities of Daily Living , COVID-19 , Adult , COVID-19/complications , Exercise , Female , Humans , SARS-CoV-2
11.
Proc Natl Acad Sci U S A ; 118(41)2021 10 12.
Article in English | MEDLINE | ID: covidwho-1486398

ABSTRACT

The COVID-19 pandemic led to widespread mandates requiring the wearing of face masks, which led to debates on their benefits and possible adverse effects. To that end, the physiological effects at the systemic and at the brain level are of interest. We have investigated the effect of commonly available face masks (FFP2 and surgical) on cerebral hemodynamics and oxygenation, particularly microvascular cerebral blood flow (CBF) and blood/tissue oxygen saturation (StO2), measured by transcranial hybrid near-infrared spectroscopies and on systemic physiology in 13 healthy adults (ages: 23 to 33 y). The results indicate small but significant changes in cerebral hemodynamics while wearing a mask. However, these changes are comparable to those of daily life activities. This platform and the protocol provides the basis for large or targeted studies of the effects of mask wearing in different populations and while performing critical tasks.


Subject(s)
Brain/physiology , Masks , Activities of Daily Living , Adult , Brain/blood supply , Brain/metabolism , COVID-19/prevention & control , Female , Healthy Volunteers , Hemodynamics , Humans , Male , Microcirculation , Monitoring, Physiologic , Oxygen/metabolism , SARS-CoV-2 , Spectroscopy, Near-Infrared , Young Adult
12.
Am J Phys Med Rehabil ; 100(11): 1027-1030, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1483697

ABSTRACT

ABSTRACT: Rehabilitation experts play an important role in preventing hospital-acquired debility, increasing patients' abilities to safely perform activities of daily living, and facilitating discharge to the home setting for patients with COVID-19. Surges in COVID-19 hospitalization rates combined with increases in length of hospital stay and decreases in postacute care placements have necessitated the opening of COVID-19 field hospitals around the country. Most field hospitals lack the resources to offer a full suite of rehabilitation services, but there are opportunities for small teams of rehabilitation experts to increase their reach by using innovative strategies. This article describes the implementation of a small team of rehabilitation experts in a COVID-19 field hospital and strategies used by this team to maximize patient activity and mobility, facilitate timely discharge, and maximize the number of patients discharged to the home setting. Strategies include training nonclinical staff to assist with activity and mobility promotion and using a rehabilitation triage system to determine needs of individual patients and facilitate efficient resource utilization. The authors reflect on successful aspects of these strategies, as well as barriers to rehabilitation implementation, and make recommendations for other field hospitals seeking to implement rehabilitation during the COVID-19 pandemic or future health crises.


Subject(s)
COVID-19/rehabilitation , Mobile Health Units/organization & administration , Activities of Daily Living , Baltimore , Female , Humans , Length of Stay , Male , Pandemics , Patient Discharge , Recovery of Function , SARS-CoV-2 , Subacute Care
13.
J Rehabil Med ; 53(11 (November)): jrm00239, 2021 Nov 23.
Article in English | MEDLINE | ID: covidwho-1468295

ABSTRACT

OBJECTIVES: To investigate functioning, activity and disability in people with post-COVID syndrome. DESIGN: Cross-sectional. SUBJECTS/PATIENTS: Participants were recruited online via Facebook and a stakeholders' organization for post-COVID syndrome in Sweden. METHODS: Sociodemographic data and International Classification of Functioning, Disability and Health (ICF)-based questionnaire were collected via an online platform and analysed. RESULTS: A total of 100 participants were included (mean age 44.5 years, 82% women, 61% with higher education, and 56% working full- or part-time). For the ICF component Body Functions, the most impaired functions were: fatigability and energy drive (98-99%); higher cognitive functions (74-94%); sleep functions (98%); muscle functions (93%); respiratory functions (92%); heart functions (82%); emotional functions (80%); sexual functions (77%); pain problems (56-90%); and thermoregulatory functions (68%). For the component Activity, the most frequent limitations were: handling stressful situations (98%); remunerative employment (95%); recreation and leisure (94%); climbing the stairs (94%); doing housework (84%); and informal socializing (64%). The most frequent degrees of impairment/limitations were light and moderate, except for severe-complete for fatigue, higher cognitive functions, multitasking, handling stressful situations; and recreation and leisure activities. CONCLUSION: Post-COVID syndrome following a mild COVID-19 infection can result in impaired body functions and activities. These results support the importance of a multidisciplinary rehabilitation approach for these patients.


Subject(s)
COVID-19 , Disabled Persons , Activities of Daily Living , Adult , Cross-Sectional Studies , Disability Evaluation , Female , Humans , International Classification of Functioning, Disability and Health , Male , SARS-CoV-2
14.
Int J Environ Res Public Health ; 18(19)2021 09 24.
Article in English | MEDLINE | ID: covidwho-1463635

ABSTRACT

OBJECTIVE: To evaluate the responsiveness of the Spanish version of the Newcastle Stroke-specific Quality of Life measure (NEWSQOL) to assess quality of life in Spanish people after suffering a stroke. DESIGN: A prospective observational study was conducted to assess the responsiveness of the Spanish version of NEWSQOL. The sample contained 128 patients who filled in the questionnaires before and after a physical therapy intervention. The responsiveness was assessed with p-values using the effect size (ES) and the standardized response means (SRMs) of the change. Besides, two other external criteria were used to distinguish patients who improved with the treatment from those who remained stable. This classification was based on one functional independence measure (the Barthel Index) and one disability measure (the modified Rankin Scale). RESULTS: There was a statistically significant correlation (Spearman's coefficient = p < 0.01) between the domains of the Spanish version of NEWSQOL in relation to the Barthel Index and the modified Rankin Scale. All domains showed between marked-to-mild change responsiveness except sleep and relationships; mobility (ES 0.66 and SRM 0.92) and activities of daily living (ES 0.75 and SRM 0.87) were markedly responsive; communication (ES 0.38 and SRM 0.61) was moderately responsive; and pain, vision, cognition, feelings, emotions and fatigue were mildly responsive (ES 0.21-0.41 and SRM 0.23-0.44). CONCLUSION: The Spanish version of NEWSQOL shows between marked and mild responsiveness to measure the perception of QoL in post-stroke patients. Therefore, its use can be suitable for evaluation studies, clinical trials and clinical practice.


Subject(s)
Quality of Life , Stroke , Activities of Daily Living , Humans , Physical Therapy Modalities , Reproducibility of Results , Stroke/therapy , Surveys and Questionnaires
15.
Disabil Rehabil ; 43(10): 1342-1358, 2021 05.
Article in English | MEDLINE | ID: covidwho-1455011

ABSTRACT

PURPOSE: Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning. MATERIALS AND METHODS: An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. RESULTS: After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. CONCLUSIONS: In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.


Subject(s)
Activities of Daily Living , Cognitive Dysfunction , Adult , Cognition , Cognitive Dysfunction/diagnosis , Executive Function , Humans , Neuropsychological Tests
16.
Proc Natl Acad Sci U S A ; 118(41)2021 10 12.
Article in English | MEDLINE | ID: covidwho-1450314

ABSTRACT

The COVID-19 pandemic led to widespread mandates requiring the wearing of face masks, which led to debates on their benefits and possible adverse effects. To that end, the physiological effects at the systemic and at the brain level are of interest. We have investigated the effect of commonly available face masks (FFP2 and surgical) on cerebral hemodynamics and oxygenation, particularly microvascular cerebral blood flow (CBF) and blood/tissue oxygen saturation (StO2), measured by transcranial hybrid near-infrared spectroscopies and on systemic physiology in 13 healthy adults (ages: 23 to 33 y). The results indicate small but significant changes in cerebral hemodynamics while wearing a mask. However, these changes are comparable to those of daily life activities. This platform and the protocol provides the basis for large or targeted studies of the effects of mask wearing in different populations and while performing critical tasks.


Subject(s)
Brain/physiology , Masks , Activities of Daily Living , Adult , Brain/blood supply , Brain/metabolism , COVID-19/prevention & control , Female , Healthy Volunteers , Hemodynamics , Humans , Male , Microcirculation , Monitoring, Physiologic , Oxygen/metabolism , SARS-CoV-2 , Spectroscopy, Near-Infrared , Young Adult
17.
Int J Immunopathol Pharmacol ; 35: 20587384211044344, 2021.
Article in English | MEDLINE | ID: covidwho-1440890

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has changed many aspects of everyday life. Patients with primary immunodeficiency (PID) are in a particularly difficult situation. The purpose of the present study was to contribute to the very limited research on the everyday aspects of functioning in PID patients during the COVID-19 pandemic. METHODS: The survey included 85 adult PID patients treated with immunoglobulin replacement therapy in four reference centers for immunology. Everyday functioning of the patients as well as their opinion concerning new solutions in medical care were analyzed. RESULTS: During the pandemic, the percentage of patients experiencing fear/anxiety has increased from 47% to 70%. The wide dissemination of information about the SARS-CoV-2 in the media has increased anxiety in 40% of the patients. Patients diagnosed with PID were most afraid of the exposure to contact with strangers, especially in public places. As many as 67 respondents (79%) considered the introduction of restrictions concerning social functioning as good. Only every fifth person learned about the pandemic from reliable sources. Eighty three percent of the patients receiving immunoglobulin substitution experienced less fear of SARS-CoV-2 infection. The patients positively evaluated the solutions related to the direct delivery of drugs to the place of residence in order to continue home IgRT therapy. Fifty three respondents (62.5%) believed that the possibility of a remote consultation was a very good solution. CONCLUSION: It is necessary to increase educational activities concerning the pandemic provided by health care professionals, as patients obtain information mainly from the media and the Internet, which adversely affects the feeling of anxiety. The pandemic, in addition to the very negative impact on patients and the deterioration of their daily functioning, has made patients appreciate their life more, devote more time to family and friends, and do things they like.


Subject(s)
Activities of Daily Living , COVID-19 , Immunocompromised Host , Immunoglobulin G/therapeutic use , Primary Immunodeficiency Diseases/drug therapy , Access to Information , Adult , Affect , Anxiety/etiology , Anxiety/psychology , Cost of Illness , Drug Substitution , Fear , Female , Health Care Surveys , Health Knowledge, Attitudes, Practice , Humans , Immunoglobulin G/adverse effects , Male , Middle Aged , Patient Education as Topic , Poland , Primary Immunodeficiency Diseases/diagnosis , Primary Immunodeficiency Diseases/immunology , Primary Immunodeficiency Diseases/psychology , Social Behavior , Telemedicine , Treatment Outcome
18.
BMC Health Serv Res ; 21(1): 1003, 2021 Sep 22.
Article in English | MEDLINE | ID: covidwho-1435247

ABSTRACT

BACKGROUND: COVID-19 isolated home-dwelling people with dementia (PwD) from home care services, respite care, and daytime activities. We aimed to investigate the consequences of these restrictions on informal (family, friends) and formal (homecare staff) resource utilization among co-residing (e.g., spouses) and visiting caregivers (e.g., children). METHODS: 105 PwD (≥65 years old) and their caregivers were included in the prospective PANdemic in DEMentia (PAN.DEM) study, which was initiated when the ongoing stepped-wedge, cluster randomized LIVE@Home.Path trial (N = 438) was temporarily halted due to the pandemic. Primary outcome was change in resource utilization assessed by the Resource Utilization in Dementia Care (RUD) instrument in pre- (12 Dec. 2019 to 11 Mar. 2020) and during the lockdown periods (20 April 2020 to 15 May 2020). Degree of cognitive impairment was assessed by Mini-Mental Status Examination (MMSE), and physical functioning and independent living skills by Physical Self-Maintenance Scale and Lawton Instrumental Activities of Daily Living Scale. Associations between informal and formal care utilization, socio-demographics, and clinical variables were assessed by descriptive statistics and Ordinary Least Squares models (OLS). RESULTS: Mean age for PwD was 81.8 years; 61% were female; 45.6% lived alone, and the mean MMSE score was 20.8 (SD ± 3.7). PwD with co-residents (44%) were younger (78.4 years) than those who were living alone (84.5 years; P < 0.001). During the first 2 months of lockdown, PwD missed on average 20.5 h of formal care in a month (P < 0.001) leading to an approximately 100% increase in informal care, which was particularly pronounced in personal hygiene (6.9 vs. 11.4 days in a month, P < 0.001) and supervision (9.2 vs. 17.6 days in a month; P < 0.001). Visiting caregivers increased by 1.9 days (SD ± 11.5), but co-residing caregivers increased their number of days providing ADL by approximately 7 days per month (ß = 6.9; CI, 0.39-13.1, P < 0.05) after adjusting for PwD and caregiver demographics and clinical variables. Decrease in home nursing care was particularly visible for PwD living alone (- 6.1 vs. -1.3 h per month, P = 0.005). Higher cognitive function (ß = - 0.64, CI, - 1.26 - 0.02, P = 0.044) was associated with reduction in home nursing service during the lockdown. CONCLUSION: The care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need. TRIAL REGISTRATION: ClinicalTrials.gov ; NCT04043364 .


Subject(s)
COVID-19 , Dementia , Activities of Daily Living , Aged , Aged, 80 and over , Caregivers , Communicable Disease Control , Cross-Sectional Studies , Dementia/epidemiology , Dementia/therapy , Female , Humans , Male , Pandemics , Prospective Studies , SARS-CoV-2
20.
Int J Environ Res Public Health ; 18(18)2021 09 11.
Article in English | MEDLINE | ID: covidwho-1409588

ABSTRACT

BACKGROUND: The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. METHODS: A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. RESULTS: More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. CONCLUSIONS: The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers.


Subject(s)
COVID-19 , Depression , Activities of Daily Living , Caregivers , Cost of Illness , Cross-Sectional Studies , Depression/epidemiology , Humans , Pandemics , SARS-CoV-2
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