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1.
Dimens Crit Care Nurs ; 41(5): 274-280, 2022.
Article in English | MEDLINE | ID: covidwho-2029105

ABSTRACT

BACKGROUND: Critical care nurses experience moral distress, the phenomenon of knowing the "right" thing to do but being unable to do so, at high rates; this contributes to attrition and has severe mental health impacts on nurses. OBJECTIVE: The purpose of this integrative review was to determine if interventions to reduce moral distress have an effect on intensive care unit (ICU) nurses' moral distress levels. METHODS: Three databases were searched, PubMed, APA PsycNet, and CINAHL, using the keywords "moral distress" AND nurs* AND reduc* AND ("intensive care" OR "critical care" OR ICU). Only experimental studies involving adult ICU nurses were included for a total of 6 studies. RESULTS: Interventions fell into 3 categories: (1) educational interventions, (2) interventions to enhance the ICU environment, and (3) interventions to help nurses cope. Two studies detailing educational interventions demonstrated some reduction in moral distress. One study aimed to improve the ICU environment and showed some statistically significant reduction in moral distress. All 6 studies included some focus on coping, and 2 showed statistically significant reductions in moral distress. DISCUSSION: Only a few studies have been conducted examining this issue. These studies had severe limitations, such as small sample sizes, attrition, and inadequate control groups. There were also few statistically significant results. These interventions should be reexamined using larger sample sizes, and other interventions should also be trialed. COVID-19 may have had a significant impact on this issue, and interventions may need to be refocused in the wake of the pandemic.


Subject(s)
COVID-19 , Critical Care Nursing , Nurses , Adult , Humans , Intensive Care Units , Morals , Stress, Psychological/prevention & control , Surveys and Questionnaires
2.
Rev Saude Publica ; 56: 50, 2022.
Article in English, Portuguese | MEDLINE | ID: covidwho-2025533

ABSTRACT

OBJECTIVE: To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD: A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS: Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66-2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45-1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities' regions of influence. CONCLUSION: In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination.


Subject(s)
Measles , Adolescent , Adult , Aged , Brazil/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Immunization , Infant , Male , Measles/epidemiology , Measles/prevention & control , Vaccination , Young Adult
3.
Pan Afr Med J ; 41: 345, 2022.
Article in English | MEDLINE | ID: covidwho-2025519

ABSTRACT

Introduction: on January 7th 2020, SARS-CoV-2 was identified in Wuhan, China, and on March 11th, 2020, the World Health Organization declared it a "Pandemic". The aim of this research is to assess depression, anxiety, work, and social status in healthcare workers during the COVID-19 pandemic. Methods: the research was designed to be a cross-sectional face-to-face survey. The study included 111 healthcare employees and 222 non-healthcare workers between the ages of 18 and 65 who applied to the hospital. For some reason, no one was excluded from the research. Socio-demographic and lifestyle-related questions, depression, anxiety, work-social adjustment scores, and pandemic-social status-operation connections were all assessed using a self-report questionnaire containing psychometric measures. Results: the mean age of the participants in the study was 33.67±10.01 and 59% of the participants were female. PHQ9: 11.67±6.41, GAD7: 9.06±5.81, and W&SAS: 17.55±10.98 were the scores of the healthcare professional groups. PHQ9: 10.25±6.21, GAD7: 7.59±5.65, and W&SAS: 14.75±10.27 were the non-healthcare professional groups' results. When the PHQ9, GAD7, and W&SAS scores of both groups were compared, there was no statistically significant difference in the PHQ9 depression score between the two groups (p=0.107), the GAD7 (p<0.05) and W&SAS (p<0.05) scores of the healthcare professionals were statistically significantly higher. Conclusion: in comparison to the non-healthcare worker group, healthcare professionals had the same level of depression, greater levels of moderate and high anxiety, and higher levels of work-social adjustment disorder. Unlike the literature, we found that the degree of depression fell to the same level as the non-health professional group in our study, but it was still disadvantaged in terms of anxiety and work-social adjustment.


Subject(s)
COVID-19 , Health Personnel , Adolescent , Adult , Aged , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Depression/epidemiology , Female , Health Personnel/psychology , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Turkey/epidemiology , Young Adult
4.
Pan Afr Med J ; 41: 211, 2022.
Article in English | MEDLINE | ID: covidwho-2025501

ABSTRACT

Introduction: coronavirus infectious disease-2019 (COVID-19) is currently a global health threat and an international public health emergency. There is a strong need to reinforce community knowledge, attitude and practice (KAP) to control the spread of the virus. The study aimed to identify the determinants of KAP towards preventive measures of COVID-19 among adult residencies. Methods: a community-based cross-sectional study design was employed in the communities of Silte zone, Southern Ethiopia. A total of 853 participants were selected using multistage stratified sampling technique. We used structured interview administered questionnaire. The KAP level was presented in descriptive and the associated variables conducted in binary logistic regression model. Results: overall, 81.7% had good knowledge, 78.4% had a positive attitude, and 43.9% had good practices. Being a female (Adjusted Odd Ratio (AOR): 2.3; 95% Confidence Interval (CI): 1.6-3.3), age between "31-40" (AOR: 1.99; 95% CI: 1-3.8) and able to read and write (AOR: 2.6; 95% CI: 1.7-3.7) were significantly associated factors of good knowledge towards COVID-19. Being urban resident (AOR: 1.8; 95% CI: 1.2-2.6) was significantly associated variable with positive attitude towards COVID-19. Being a government employee (AOR: 1.7; 95% CI: 1.1-2.7), able to read and write (AOR: 4.5; 95% CI: 3-6.7) and having good knowledge regarding COVID-19 (AOR: 2.4; 95% CI: 1.6-3.7) were significantly associated factors with good preventive practice towards COVID-19. Conclusion: alarmingly low preventive practice towards COVID-19 pandemic was indicated. Therefore, health education and promotion programs aimed at mobilizing and improving COVID-19-related practice are urgently needed, especially for those who are illiterate, having rural residency, or generally among underprivileged populations.


Subject(s)
COVID-19 , Communicable Diseases , Internship and Residency , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Health Knowledge, Attitudes, Practice , Humans , Pandemics , Surveys and Questionnaires
5.
Paidéia (Ribeirão Preto, Online) ; 32: e3217, 2022. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-2022156

ABSTRACT

Abstract The COVID-19 pandemic exerted a tremendous toll on individuals' mental health. This study aimed to examine the associations between men's common mental disorders (CMD), intolerance of uncertainty (IU), and social support (SS). A cross-sectional online study was carried out in all Brazilian states. Participants were 1.006 adult men recruited through social media using a snowball technique. Men completed the Self-Report Questionnaire-20, the Intolerance of Uncertainty Scale, the Two-Way Social Support Scale, and a sociodemographic questionnaire. In addition, a t-Test and a regression analysis were performed. Men in the clinical group reported significantly higher levels of IU and lower levels of SS. Furthermore, SS moderated the relationship between IU and CMD, suggesting that SS might help protect men's mental health against the deleterious effects of IU in a pandemic scenario. These results indicate that different forms of social support seem to be a promising focus of psychosocial intervention in this context.


Resumo A pandemia da COVID-19 impactou consideravelmente a saúde mental dos indivíduos. Este estudo teve por objetivo examinar associações entre transtornos mentais comuns (TMC) de homens, a intolerância à incerteza (II) e apoio social (AS). Trata-se de um estudo transversal online realizado em todos os estados brasileiros, com 1.006 homens adultos recrutados em redes sociais mediante a técnica de bola de neve. Os participantes responderam ao Self-Report Questionnaire-20, à Escala de Intolerância à Incerteza, à Escala de Apoio Social Two-way e a um questionário sociodemográfico. Teste t e análise de regressão foram realizados. Os homens do grupo clínico relataram significativamente níveis maiores de II e níveis inferiores de AS. Além disso, o AS moderou a relação entre II e TMC, sugerindo que AS protege a saúde mental dos homens contra efeitos deletérios da II na pandemia. Esses resultados sugerem que o apoio social parece ser um foco promissor de intervenção psicossocial nesse contexto.


Resumen La pandemia de COVID-19 afectó considerablemente la salud mental individual. Este estudio examinó las asociaciones entre los trastornos mentales comunes (TMC) de los hombres, la intolerancia a la incertidumbre (II) y el apoyo social (AS). Es un estudio transversal online realizado en los estados brasileños, con 1.006 hombres adultos reclutados en redes sociales mediante la técnica de bola de nieve. Respondieron el Self-Report Questionnaire-20, la Escala de Intolerancia a Incertidumbre, la Escala de Apoyo Social Two-way y un cuestionario sociodemográfico. Se realizaron el test t y el análisis de regresión. Hombres del grupo clínico informaron significativamente niveles superiores de II e inferiores de AS. Además, AS moderó la relación entre II y TMC, lo que sugiere que AS protege la salud mental de los hombres contra los efectos nocivos de II en la pandemia. Estos resultados sugieren que el apoyo social es un foco prometedor de intervención psicosocial en este contexto.


Subject(s)
Humans , Male , Adult , Social Support , Mental Health , Psychological Distress , Psychosocial Intervention , COVID-19 , Mental Disorders , Surveys and Questionnaires
6.
Int J Environ Res Public Health ; 19(15)2022 Jul 29.
Article in English | MEDLINE | ID: covidwho-2023582

ABSTRACT

Identifying potential rapid methods to track COVID-19 trends within schools has become a necessity in understanding how to provide both education and maintain health and safety during a pandemic. This study examined COVID-19 trends and sociodemographic information in New Jersey (NJ) schools during the 2020-2021 school year. A database was compiled for this study in Microsoft Excel using various state and federal resources. Data used in the study are a combination of extracted data from weekly NJ Spotlight reports, weekly NJ COVID-19 Activity Level Index (NJ CALI) reports, and reports of school-based outbreaks via the NJ Department of Health (NJDOH). In 2020-2021, in NJ K-12 schools, the NJDOH defined a school-based outbreak incidence as two or more students and/or adult staff with a laboratory-confirmed positive molecular test for COVID-19 based on transmission occurring on campus. Data were organized into six regions across 21 counties within NJ (3-4 counties per region per NJDOH). COVID-19 trends in NJ schools mirrored trends in their districts, i.e., communities, within the state's region; noticeably, there were consistently high trends during the winter holiday season (November 2020-January 2021). The cumulative number of incidences of school-based outbreaks remained relatively low but, nevertheless, increased throughout the 2020-2021 school year. This study recommends increased accessibility to COVID-19 reports for school and public health officials, and in the future for data to be reported to identify rates of transmission of other communicable diseases within K-12 students, and to further reinforce established mandates and other preventative measures in public while traveling during holiday seasons.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Disease Outbreaks , Humans , New Jersey/epidemiology , Pandemics , Schools
7.
Int J Environ Res Public Health ; 19(15)2022 Jul 28.
Article in English | MEDLINE | ID: covidwho-2023570

ABSTRACT

This study investigated the five-year (2016-2020) trend in physical activity adherence rate (PAR)-before and after the onset of the COVID-19 pandemic-and its association with socioeconomic status and community environment among Korean adults. Data were analyzed from the Korea Community Health Survey 2016-2020 concerning adults (19-65 years old) living in seven metropolitan municipalities of South Korea (N = 190,761). The independent variables were socioeconomic status (household income and educational attainment) and community environment (density of physical activity facilities and social cohesion), and the dependent variable was the PAR, as measured by the International Physical Activity Questionnaire-Short Form, a recall-based subjective survey. Multilevel logistic regression models with age, sex, and body mass index as covariates were applied. The results showed that the PAR increased from 37.26% (2016) to 40.84% (2019), during the pre-COVID-19 pandemic, but it sharply decreased to 31.59% (2020) during the COVID-19 confinement (trend p < 0.001); PAR disparities were observed following socioeconomic status, as indicated by household income (trend p < 0.001) and educational attainment (trend p < 0.001). Furthermore, significant moderation effects were observed from socioeconomic status and community environment, but the direction of the effects varied by indicator and COVID-19-related confinement period. Lower educational attainment and higher income were associated with a greater decrease in PAR during the pandemic. This study shows that PAR substantively decreased in South Korea during the COVID-19 pandemic, although it had shown a steady increase through 2019. In addition, PAR disparities by socioeconomic status were found, and socioeconomic status and community environment had distinct influences on PAR trends, depending on their indicators and pre- and post-pandemic periods. Lower educational attainment is associated with greater decreases in PAR during the pandemic, suggesting the necessity for a public campaign to maintain a physically active lifestyle during such social disaster.


Subject(s)
COVID-19 , Adult , Aged , COVID-19/epidemiology , Cities , Exercise , Humans , Middle Aged , Pandemics , Public Health , Republic of Korea/epidemiology , Surveys and Questionnaires , Young Adult
8.
Genes (Basel) ; 13(8)2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-2023338

ABSTRACT

CD71+ erythroid cells (CECs) were only known as erythrocyte progenitors not so long ago. In present times, however, they have been shown to be active players in immune regulation, especially in immunosuppression by the means of ROS, arginase-1 and arginase-2 production. Here, we uncover organ-of-origin differences in cytokine gene expression using NanoString and protein production using Bio-Plex between CECs from healthy human adult bone marrow and from human fetal liver parenchyma. Namely, healthy human adult bone marrow CECs both expressed and produced IFN-a, IL-1b, IL-8, IL-18 and MIF mRNA and protein, while human fetal liver parenchymaCECs expressed and produced IFN-a, IL15, IL18 and TNF-b mRNA and protein. We also detected TLR2 and TLR9 gene expression in both varieties of CECs and TLR1 and NOD2 gene expression in human fetal liver parenchymaCECs only. These observations suggest that there might be undiscovered roles in immune response for CECs.


Subject(s)
Arginase , Bone Marrow , Adult , Erythroid Cells , Humans , Liver , RNA, Messenger , Secretome , Transcriptome
9.
Int J Public Health ; 67: 1604226, 2022.
Article in English | MEDLINE | ID: covidwho-2023032

ABSTRACT

Objectives: This study examined factors associated with COVID-19 vaccination intention at the very beginning of the vaccination campaign in a representative sample of the population in southern Switzerland. Methods: In March 2021, we measured vaccination intention, beliefs, attitudes, and trust in a sample of the Corona Immunitas Ticino study. Results: Of the 2681 participants, 1933 completed the questionnaire (response rate = 72%; 55% female; meanage = 41, SD = 24, rangeage = 5-91). Overall, 68% reported an intention to get vaccinated. Vaccination intention was higher in social/healthcare workers, and increased with age, trust in public health institutions, and confidence in the vaccine efficacy. Prior infection of a family member, predilection for waiting for more evidence on the safety and efficacy of the vaccine, and for alternative protective means were negatively associated with intention. Conclusion: In view of needs of COVID-19 vaccine boosters and of suboptimal vaccination coverage, our results have relevant public health implications and suggest that communication about vaccine safety and efficacy, and aims of vaccination programs, should be bi-directional, proportionate, and tailored to the concerns, expectations, and beliefs of different population subgroups.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Intention , Male , Middle Aged , SARS-CoV-2 , Switzerland , Vaccination , Young Adult
10.
J Med Internet Res ; 24(8): e37434, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-2022369

ABSTRACT

BACKGROUND: New research fields to design social robots for older people are emerging. By providing support with communication and social interaction, these robots aim to increase quality of life. Because of the decline in functioning due to cognitive impairment in older people, social robots are regarded as promising, especially for people with dementia. Although study outcomes are hopeful, the quality of studies on the effectiveness of social robots for the elderly is still low due to many methodological limitations. OBJECTIVE: We aimed to review the methodologies used thus far in studies evaluating the feasibility, usability, efficacy, and effectiveness of social robots in clinical and social settings for elderly people, including persons with dementia. METHODS: Dedicated search strings were developed. Searches in MEDLINE (PubMed), Web of Science, PsycInfo, and CINAHL were performed on August 13, 2020. RESULTS: In the 33 included papers, 23 different social robots were investigated for their feasibility, usability, efficacy, and effectiveness. A total of 8 (24.2%) studies included elderly persons in the community, 9 (27.3%) included long-term care facility residents, and 16 (48.5%) included people with dementia. Most of the studies had a single aim, of which 7 (21.2%) focused on efficacy and 7 (21.2%) focused on effectiveness. Moreover, forms of randomized controlled trials were the most applied designs. Feasibility and usability were often studied together in mixed methods or experimental designs and were most often studied in individual interventions. Feasibility was often assessed with the Unified Theory of the Acceptance and Use of Technology model. Efficacy and effectiveness studies used a range of psychosocial and cognitive outcome measures. However, the included studies failed to find significant improvements in quality of life, depression, and cognition. CONCLUSIONS: This study identified several shortcomings in methodologies used to evaluate social robots, resulting in ambivalent study findings. To improve the quality of these types of studies, efficacy/effectiveness studies will benefit from appropriate randomized controlled trial designs with large sample sizes and individual intervention sessions. Experimental designs might work best for feasibility and usability studies. For each of the 3 goals (efficacy/effectiveness, feasibility, and usability) we also recommend a mixed method of data collection. Multiple interaction sessions running for at least 1 month might aid researchers in drawing significant results and prove the real long-term impact of social robots.


Subject(s)
Dementia , Robotics , Adult , Aged , Dementia/psychology , Dementia/therapy , Feasibility Studies , Humans , Quality of Life , Social Interaction
11.
JMIR Public Health Surveill ; 8(8): e37039, 2022 Aug 09.
Article in English | MEDLINE | ID: covidwho-2022361

ABSTRACT

BACKGROUND: Obesity is a global epidemic causing at least 2.8 million deaths per year. This complex disease is associated with significant socioeconomic burden, reduced work productivity, unemployment, and other social determinants of health (SDOH) disparities. OBJECTIVE: The objective of this study was to investigate the effects of SDOH on obesity prevalence among adults in Shelby County, Tennessee, the United States, using a geospatial machine learning approach. METHODS: Obesity prevalence was obtained from the publicly available 500 Cities database of Centers for Disease Control and Prevention, and SDOH indicators were extracted from the US census and the US Department of Agriculture. We examined the geographic distributions of obesity prevalence patterns, using Getis-Ord Gi* statistics and calibrated multiple models to study the association between SDOH and adult obesity. Unsupervised machine learning was used to conduct grouping analysis to investigate the distribution of obesity prevalence and associated SDOH indicators. RESULTS: Results depicted a high percentage of neighborhoods experiencing high adult obesity prevalence within Shelby County. In the census tract, the median household income, as well as the percentage of individuals who were Black, home renters, living below the poverty level, 55 years or older, unmarried, and uninsured, had a significant association with adult obesity prevalence. The grouping analysis revealed disparities in obesity prevalence among disadvantaged neighborhoods. CONCLUSIONS: More research is needed to examine links between geographical location, SDOH, and chronic diseases. The findings of this study, which depict a significantly higher prevalence of obesity within disadvantaged neighborhoods, and other geospatial information can be leveraged to offer valuable insights, informing health decision-making and interventions that mitigate risk factors of increasing obesity prevalence.


Subject(s)
Obesity , Residence Characteristics , Adult , Humans , Machine Learning , Obesity/epidemiology , Socioeconomic Factors , Tennessee/epidemiology , United States
12.
J Med Internet Res ; 24(8): e34858, 2022 Aug 15.
Article in English | MEDLINE | ID: covidwho-2022335

ABSTRACT

BACKGROUND: A computer application called the National Death Information System (SINADEF) was implemented in Peru so that physicians can prepare death certificates in electronic format and the information is available online. In 2018, only half of the estimated deaths in Peru were certified using SINADEF. When a death is certified in paper format, the probability being entered in the mortality database decreases. It is important to know, from the user's perspective, the factors that can influence the successful implementation of SINADEF. SINADEF can only be successfully implemented if it is known whether physicians believe that it is useful and easy to operate. OBJECTIVE: The aim of this study was to identify the perceptions of physicians and other factors as predictors of their behavioral intention to use SINADEF to certify a death. METHODS: This study had an observational, cross-sectional design. A survey was provided to physicians working in Peru, who used SINADEF to certify a death for a period of 12 months, starting in November 2019. A questionnaire was adapted based on the Technology Acceptance Model. The questions measured the dimensions of subjective norm, image, job relevance, output quality, demonstrability of results, perceived usefulness, perceived ease of use, and behavioral intention to use. Chi-square and logistic regression tests were used in the analysis, and a confidence level of 95% was chosen to support a significant association. RESULTS: In this study, 272 physicians responded to the survey; 184 (67.6%) were men and the average age was 45.3 (SD 10.1) years. The age range was 24 to 73 years. In the bivariate analysis, the intention to use SINADEF was found to be associated with (1) perceived usefulness, expressed as "using SINADEF avoids falsifying a death certificate" (P<.001), "using SINADEF reduces the risk of errors" (P<.001), and "using SINADEF allows for filling out a certificate in less time" (P<.001); and (2) perceived ease of use, expressed as "I think SINADEF is easy to use" (P<.001). In the logistic regression, perceived usefulness (odds ratio [OR] 8.5, 95% CI 2.2-32.3; P=.002), perceived ease of use (OR 10.1, 95% CI 2.4-41.8; P=.001), and training in filling out death certificates (OR 8.3, 95% CI 1.6-42.8; P=.01) were found to be predictors of the behavioral intention to use SINADEF. CONCLUSIONS: The behavioral intention to use SINADEF was related to the perception that it is an easy-to-use system, the belief that it improves the performance of physicians in carrying out the task at hand, and with training in filling out death certificates.


Subject(s)
Physicians , Adult , Aged , Cross-Sectional Studies , Female , Humans , Information Systems , Male , Middle Aged , Peru , Surveys and Questionnaires , Young Adult
13.
PLoS One ; 17(6): e0270060, 2022.
Article in English | MEDLINE | ID: covidwho-2021817

ABSTRACT

BACKGROUND: An ideal test for COVID-19 would combine the sensitivity of laboratory-based PCR with the speed and ease of use of point-of-care (POC) or home-based rapid antigen testing. We evaluated clinical performance of the Diagnostic Analyzer for Selective Hybridization (DASH) SARS-CoV-2 POC rapid PCR test. METHODS: We conducted a cross-sectional study of adults with and without symptoms of COVID-19 at four clinical sites where we collected two bilateral anterior nasal swabs and information on COVID-19 symptoms, vaccination, and exposure. One swab was tested with the DASH SARS-CoV-2 POC PCR and the second in a central laboratory using Cepheid Xpert Xpress SARS-CoV-2 PCR. We assessed test concordance and calculated sensitivity, specificity, negative and positive predictive values using Xpert as the "gold standard". RESULTS: We enrolled 315 and analyzed 313 participants with median age 42 years; 65% were female, 62% symptomatic, 75% had received ≥2 doses of mRNA COVID-19 vaccine, and 16% currently SARS-CoV-2 positive. There were concordant results for 307 tests indicating an overall agreement for DASH of 0.98 [95% CI 0.96, 0.99] compared to Xpert. DASH performed at 0.96 [95% CI 0.86, 1.00] sensitivity and 0.98 [95% CI 0.96, 1.00] specificity, with a positive predictive value of 0.85 [95% CI 0.73, 0.96] and negative predictive value of 0.996 [95% CI 0.99, 1.00]. The six discordant tests between DASH and Xpert all had high Ct values (>30) on the respective positive assay. DASH and Xpert Ct values were highly correlated (R = 0.89 [95% CI 0.81, 0.94]). CONCLUSIONS: DASH POC SARS-CoV-2 PCR was accurate, easy to use, and provided fast results (approximately 15 minutes) in real-life clinical settings with an overall performance similar to an EUA-approved laboratory-based PCR.


Subject(s)
COVID-19 , Adult , COVID-19/diagnosis , COVID-19 Testing , COVID-19 Vaccines , Clinical Laboratory Techniques/methods , Cross-Sectional Studies , Female , Humans , Male , Point-of-Care Systems , Polymerase Chain Reaction , SARS-CoV-2/genetics , Sensitivity and Specificity
14.
PLoS One ; 17(6): e0269727, 2022.
Article in English | MEDLINE | ID: covidwho-2021799

ABSTRACT

As a member state of the European Union, where vaccines against COVID-19 are available and affordable, Bulgaria reports the lowest immunization coverage and the most pronounced vaccine distrust. The present study aimed to assess the self-reported adverse reactions following COVID-19 vaccination as a possible tool to increase the trust in vaccines. A cross-sectional survey-based study, covering 761 vaccinated respondents, was conducted in Plovdiv (469 with an mRNA vaccine and 292 with an adenoviral vector vaccine). Descriptive statistics parametric and non-parametric methods were applied. Statistical significance was set at p<0.05. The median age of the respondents was 42 years, females (72.5%). At least one adverse reaction was reported in 89.9% of those immunized with mRNA vaccine and 93.8% in the adenoviral vector vaccine group (p>0.05). They were mild to moderate and resolved within several days. The levels of local reactions were comparable: 91.7% in those who received mRNA and 89.7% in those who received an adenoviral vector vaccine (p = 0.366). The most common types of systemic reactions were fatigue, headache, and muscle pains. An association was found between the systemic reactions and the type of vaccine administered: 59.7% in mRNA recipients and 89.4% in adenoviral vector vaccinees (p<0.001). None of the registered systemic reactions required medical attention. There were 3 reports of generalized urticaria after an mRNA and 2 after an adenoviral vector vaccine. The reported reactions are relatively high but expected and no adverse events have been reported that are not listed in the official Summary of Product Characteristics.


Subject(s)
COVID-19 Vaccines , COVID-19 , Viral Vaccines , Adult , Bulgaria , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Female , Humans , RNA, Messenger , Self Report , Vaccination , Vaccines, Synthetic/adverse effects , Viral Vaccines/adverse effects , mRNA Vaccines
15.
PLoS One ; 17(6): e0269471, 2022.
Article in English | MEDLINE | ID: covidwho-2021787

ABSTRACT

BACKGROUND: Acute hypoxic respiratory failure (AHRF) is a hallmark of severe COVID-19 pneumonia and often requires supplementary oxygen therapy. Critically ill COVID-19 patients may require invasive mechanical ventilation, which carries significant morbidity and mortality. Understanding of the relationship between dynamic changes in blood oxygen indices and clinical variables is lacking. We evaluated the changes in blood oxygen indices-PaO2, PaO2/FiO2 ratio, oxygen content (CaO2) and oxygen extraction ratio (O2ER) in COVID-19 patients through the first 30-days of intensive care unit admission and explored relationships with clinical outcomes. METHODS AND FINDINGS: We performed a retrospective observational cohort study of all adult COVID-19 patients in a single institution requiring invasive mechanical ventilation between March 2020 and March 2021. We collected baseline characteristics, clinical outcomes and blood oxygen indices. 36,383 blood gas data points were analysed from 184 patients over 30-days. Median participant age was 59.5 (IQR 51.0, 67.0), BMI 30.0 (IQR 25.2, 35.5) and the majority were men (62.5%) of white ethnicity (70.1%). Median duration of mechanical ventilation was 15-days (IQR 8, 25). Hospital survival at 30-days was 72.3%. Non-survivors exhibited significantly lower PaO2 throughout intensive care unit admission: day one to day 30 averaged mean difference -0.52 kPa (95% CI: -0.59 to -0.46, p<0.01). Non-survivors exhibited a significantly lower PaO2/FiO2 ratio with an increased separation over time: day one to day 30 averaged mean difference -5.64 (95% CI: -5.85 to -5.43, p<0.01). While all patients had sub-physiological CaO2, non-survivors exhibited significantly higher values. Non-survivors also exhibited significantly lower oxygen extraction ratio with an averaged mean difference of -0.08 (95% CI: -0.09 to -0.07, p<0.01) across day one to day 30. CONCLUSIONS: As a novel cause of acute hypoxic respiratory failure, COVID-19 offers a unique opportunity to study a homogenous cohort of patients with hypoxaemia. In mechanically ventilated adult COVID-19 patients, blood oxygen indices are abnormal with substantial divergence in PaO2/FiO2 ratio and oxygen extraction ratio between survivors and non-survivors. Despite having higher CaO2 values, non-survivors appear to extract less oxygen implying impaired oxygen utilisation. Further exploratory studies are warranted to evaluate and improve oxygen extraction which may help to improve outcomes in severe hypoxaemic mechanically ventilated COVID-19 patients.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Respiratory Insufficiency , Adult , COVID-19/therapy , Cohort Studies , Female , Humans , Hypoxia , Male , Oxygen , Respiration, Artificial , Respiratory Insufficiency/therapy , Retrospective Studies , SARS-CoV-2
16.
PLoS One ; 17(6): e0269299, 2022.
Article in English | MEDLINE | ID: covidwho-2021778

ABSTRACT

The second wave of the COVID-19 pandemic left the Indian healthcare system overwhelmed. The severity of a third wave will depend on the success of the vaccination drive; however, even with a safe and effective COVID-19 vaccine, hesitancy can be an obstacle to achieving high levels of coverage. Our study aims to estimate the population's acceptance of the COVID-19 vaccine in an Indian district. A pilot community-based cross-sectional study was conducted from March-May 2021. The data was collected from eight primary health centres in Tamil Nadu. The eligible study participants were interviewed using a self-constructed questionnaire. A total of 3,130 individuals responded to the survey. Multinomial logistic regression was performed to assess the factors influencing COVID-19 vaccine hesitancy and refusal. Results of our study showed that 46% percent (n = 1432) of the respondents would accept the COVID-19 vaccine if available. Acceptance for the COVID-19 vaccine was higher among males (54%), individuals aged 18-24years (62%), those with higher education (77%), having the higher income (73%), and employed (51%). Individuals with no education (OR: 2.799, 95% CI = 1.103-7.108), and low income (OR: OR: 10.299, 95% CI: 4.879-21.741), were significant predictors of vaccine hesitancy (p < 0.05). Living in urban residence (OR: 0.699, 95% CI = 0.55-0.888) and age between 18 to 25 years (OR: 0.549, 95% CI = 0.309-0.977) were protective factor of COVID-19 vaccine hesitancy. While individuals in the age group 25-54years (OR = 1.601, 95%CI = 1.086-2.359), fewer education (OR = 4.8, 95% CI = 2.448-9.412,), low income (OR = 2.628, 95% CI = 1.777-3.887) and unemployment (OR = 1.351, 95% CI = 1.06-1.722) had high odds of refusing the COVID-19 vaccine. Concerns and suspicions about the safety of the COVID-19 vaccine (63%) was the major reasons causing hesitancy towards the COVID-19 vaccine The public health authorities and government need to design, develop and implement targeted interventions to enhance awareness about COVID-19 vaccines, and barriers and enablers to vaccine acceptance among individuals across diverse settings. Emphasis on involving local and religious leaders, ASHA workers, community healthcare workers, Anganwadi workers, and auxiliary nurse midwives can help to overcome context-specific barriers in areas of low COVID-19 vaccine acceptance, especially in rural settings.


Subject(s)
COVID-19 , Urination Disorders , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Cross-Sectional Studies , Humans , India/epidemiology , Male , Pandemics , Patient Acceptance of Health Care , Vaccination , Young Adult
17.
PLoS One ; 17(6): e0269018, 2022.
Article in English | MEDLINE | ID: covidwho-2021768

ABSTRACT

The outbreak of the COVID-19 virus urged all members of the society to adopt COVID-responsible behavioral patterns and practice them in everyday life. Given the variability in its adoption, it is critical to understand psychological factors associated with socially responsible behavior during the pandemic. This might be even more important among adolescents, who are less endangered by the virus but contribute to its spread. In this article, we focus on adolescent boys' and girls' agency and communion orientations to explain the level of importance they attribute to the instituted measures to contain the spread of the COVID-19 virus (personal norm), as well as their behavioral adherence to those measures. In total, 12,552 adolescents (67.6% girls, Mage = 15.06, SDage = 2.44, age range 10-21) answered inventory assessing adolescents' agentic and communal orientation (GRI-JUG) and items related to personal norm regarding the instituted measures and behavioral adherence to the measures. The results showed a small positive role of communion in both boys' and girls' personal norm and behavioral adherence, whereas agency played a very small negative role in boys' and girls' personal norm and boys' behavioral adherence to measures. Nevertheless, these findings could indicate the importance of enhancing communal traits and behaviors in both genders in order to assure socially responsible behavior during the pandemic.


Subject(s)
Adolescent Behavior , COVID-19 , Adolescent , Adult , COVID-19/epidemiology , Child , Female , Gender Identity , Humans , Male , Pandemics , Social Behavior , Young Adult
18.
PLoS One ; 17(6): e0267392, 2022.
Article in English | MEDLINE | ID: covidwho-2021694

ABSTRACT

INTRODUCTION: There have been more than 425 million COVID-19 infections worldwide. Post-COVID illness has become a common, disabling complication of this infection. Therefore, it presents a significant challenge to global public health and economic activity. METHODS: Comprehensive clinical assessment (symptoms, WHO performance status, cognitive testing, CPET, lung function, high-resolution CT chest, CT pulmonary angiogram and cardiac MRI) of previously well, working-age adults in full-time employment was conducted to identify physical and neurocognitive deficits in those with severe or prolonged COVID-19 illness. RESULTS: 205 consecutive patients, age 39 (IQR30.0-46.7) years, 84% male, were assessed 24 (IQR17.1-34.0) weeks after acute illness. 69% reported ≥3 ongoing symptoms. Shortness of breath (61%), fatigue (54%) and cognitive problems (47%) were the most frequent symptoms, 17% met criteria for anxiety and 24% depression. 67% remained below pre-COVID performance status at 24 weeks. One third of lung function tests were abnormal, (reduced lung volume and transfer factor, and obstructive spirometry). HRCT lung was clinically indicated in <50% of patients, with COVID-associated pathology found in 25% of these. In all but three HRCTs, changes were graded 'mild'. There was an extremely low incidence of pulmonary thromboembolic disease or significant cardiac pathology. A specific, focal cognitive deficit was identified in those with ongoing symptoms of fatigue, poor concentration, poor memory, low mood, and anxiety. This was notably more common in patients managed in the community during their acute illness. CONCLUSION: Despite low rates of residual cardiopulmonary pathology, in this cohort, with low rates of premorbid illness, there is a high burden of symptoms and failure to regain pre-COVID performance 6-months after acute illness. Cognitive assessment identified a specific deficit of the same magnitude as intoxication at the UK drink driving limit or the deterioration expected with 10 years ageing, which appears to contribute significantly to the symptomatology of long-COVID.


Subject(s)
COVID-19 , Acute Disease , Adult , COVID-19/complications , Fatigue/etiology , Female , Humans , Lung , Male
19.
BMC Health Serv Res ; 22(1): 797, 2022 Jun 20.
Article in English | MEDLINE | ID: covidwho-2021285

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19) has led to changes in how healthcare is delivered. Here, through the administration of surveys, we evaluated telehealth use and views in US intensive care units (ICUs) during the pandemic. METHODS: From June 2020 to July 2021, voluntary, electronic surveys were provided to ICU leaders of Johns Hopkins Medical Institution (JHMI) hospitals, members of the Neurocritical Care Society (NCS) who practice in the US, and Society of Critical Care Medicine (SCCM) members practicing adult medicine. RESULTS: Response rates to our survey were as follows: 18 of 22 (81.8%) JHMI-based ICU leaders, 22 of 2218 (1.0%) NCS members practicing in the US, and 136 of 13,047 (1.0%) SCCM members. COVID-19 patients were among those cared for in the ICUs of 77.7, 86.4, and 93.4% of respondents, respectively, in April 2020 (defined as the peak of the pandemic). Telehealth technologies were used by 88.9, 77.3, and 75.6% of respondents, respectively, following the start of COVID-19 while only 22.2, 31.8, and 43.7% utilized them prior. The most common telehealth technologies were virtual meeting software and telephone (with no video component). Provider, nurse, and patient communications with the patient's family constituted the most frequent types of interactions utilizing telehealth. Most common reasons for telehealth use included providing an update on a patient's condition and conducting a goals of care discussion. 93.8-100.0% of respondents found telehealth technologies valuable in managing patients. Technical issues were noted by 66.7, 50.0, and 63.4% of respondents, respectively. CONCLUSIONS: Telehealth use increased greatly among respondents following the start of COVID-19. In US ICUs, telehealth technologies found diverse uses during the pandemic. Future studies are needed to confirm our findings.


Subject(s)
COVID-19 , Telemedicine , Adult , COVID-19/epidemiology , Humans , Intensive Care Units , Pandemics , Surveys and Questionnaires
20.
Percept Mot Skills ; 129(4): 1210-1225, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2020729

ABSTRACT

The World Health Organization declared the COVID-19 pandemic an international public health emergency in January 2020, and, soon thereafter, a worldwide adoption of quarantine and physical isolation measures restricted regular practitioners of indoor group physical exercise from many of their usual practices. Some, with exercise dependence (ED), may have experienced exercise withdrawal symptoms that triggered unhealthy anxiety levels. In February 2021, during Portugal's second COVID-19 lockdown, we characterized and compared ED and anxiety levels among different groups of indoor exercise practitioners (cross trainers [CG], bodybuilders [BG] and gym practitioners [GG]). In this cross-sectional study, we recruited 234 adult participants through the internet. To assess participants' ED and anxiety levels, we used Portuguese versions of the ED Scale-21 (EDS-21) and the State-Trait Anxiety Inventory (STAI-State; STAI-Trait). ED symptoms were evident in all participant subgroups, and we found no gender differences in ED. Anxiety was higher among women than men in CG and GG groups, and there were significant differences in ED between groups such that BG practitioners showed higher ED than GG and CG practitioners (small effect size). Bodybuilders reported most ED behavior, followed by CG and regular gym exercisers, but on some criteria BG and CG groups had similar ED levels. Our results are in line with prior ED prevalence reports conducted before COVID-19 restrictions among regular GG, but these are the first data to report a higher ED prevalence among BG and CG, relative to GG.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Exercise , Female , Humans , Male , Pandemics
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