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1.
MMWR Morb Mortal Wkly Rep ; 70(4): 109-113, 2021 Jan 29.
Article in English | MEDLINE | ID: covidwho-1112895

ABSTRACT

On March 19, 2020, the governor of California issued a statewide stay-at-home order to contain the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* The order reduced accessibility to and patient attendance at outpatient medical visits,† including preventive services such as cervical cancer screening. In-person clinic visits increased when California reopened essential businesses on June 12, 2020.§ Electronic medical records of approximately 1.5 million women served by Kaiser Permanente Southern California (KPSC), a large integrated health care system, were examined to assess cervical cancer screening rates before, during, and after the stay-at-home order. KPSC policy is to screen women aged 21-29 years every 3 years with cervical cytology alone (Papanicolaou [Pap] test); those aged 30-65 years were screened every 5 years with human papillomavirus (HPV) testing and cytology (cotesting) through July 15, 2020, and after July 15, 2020, with HPV testing alone, consistent with the latest recommendations from U.S. Preventive Services Task Force.¶ Compared with the 2019 baseline, cervical cancer screening rates decreased substantially during the stay-at-home order. Among women aged 21-29 years, cervical cytology screening rates per 100 person-months declined 78%. Among women aged 30-65 years, HPV test screening rates per 100 person-months decreased 82%. After the stay-at-home order was lifted, screening rates returned to near baseline, which might have been aided by aspects of KPSC's integrated, organized screening program (e.g., reminder systems and tracking persons lost to follow-up). As the pandemic continues, groups at higher risk for developing cervical cancers and precancers should be evaluated first. Ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important.


Subject(s)
/prevention & control , Delivery of Health Care, Integrated , Early Detection of Cancer/statistics & numerical data , Quarantine/legislation & jurisprudence , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , California/epidemiology , Female , Humans , Middle Aged , Young Adult
2.
Pediatr Endocrinol Diabetes Metab ; 26(4): 167-175, 2020.
Article in English | MEDLINE | ID: covidwho-1112834

ABSTRACT

INTRODUCTION: On March 11, 2020 the WHO announced a coronavirus disease 2019 (COVID-19) pandemic. Lockdown restrictions, compromised access to medical care and fear of potential exposure to SARS-CoV-2 have forced patients with non-COVID-19 illnesses such as type 1 diabetes (T1D) to stay home. This situation can lead to delay in T1D diagnosis and insulin treatment resulting in rapid progression to diabetic ketoacidosis (DKA) and therefore increased risk of complications and death.  . AIM: The aim of this study was to evaluate the frequency and severity of DKA at the onset of T1D in children diagnosed in our department during COVID-19 pandemic lockdown from March 2020 till May 2020 in comparison to corresponding period of the previous year. . MATERIAL AND METHODS: We collected data of children with newly diagnosed T1D. DKA was defined according to ISPAD guidelines. . RESULTS: The study cohort comprised 34 children in group 2020 and 52 in group 2019 with an average age 9.90 ±4.9 vs. 9.59±4.7 years with mean HbA1c 12.9 ±2.4 vs. 11.5 ±2.2%, respectively. The incidence of DKA was higher by 12% in group 2020 vs. 2019 (52.94% vs 40.38%; p = 0.276).  Regarding the DKA severity (2020 vs. 2019) 32.35% vs. 11.54% were severe (p = 0.026), 17.65 vs. 13% were moderate (p = 0.759), and 2.94 vs. 15.38% were mild (p = 0.081). None of the analyzed patients were COVID-19 positive. CONCLUSIONS: During the COVID-19 pandemic lockdown changes in society and health care system, the DKA rate has increased by 12 percentage points with more severe cases noted in children with newly diagnosed T1D. Regular education of the whole society about the symptoms of diabetes could contribute to faster diagnosis of T1D and reduction of DKA prevalence. .


Subject(s)
/psychology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/drug therapy , Diabetic Ketoacidosis/diagnosis , Diabetic Ketoacidosis/etiology , Health Services Accessibility/statistics & numerical data , Quarantine/statistics & numerical data , Adolescent , Child , Child, Preschool , Cohort Studies , Diabetes Mellitus, Type 1/epidemiology , Diabetic Ketoacidosis/epidemiology , Female , Humans , Incidence , Male , Pandemics/statistics & numerical data , Poland/epidemiology , Prevalence , Quarantine/trends , Risk Factors
3.
Int J Environ Res Public Health ; 18(4)2021 02 10.
Article in English | MEDLINE | ID: covidwho-1112722

ABSTRACT

This study describes self-reported physical activity (PA), motivation to exercise, physical and mental health and feelings towards PA during the March-May 2020 COVID-19 lockdown in New Zealand. Adults over the age of 18 years (n = 238; 80.2% female) completed the International Physical Activity Questionnaire (IPAQ), the Behavioural Regulation in Exercise Questionnaire 3, the Short Form-36 and open-ended questions about PA through an anonymous online survey. Regular exercise was undertaken by 85% of respondents prior to lockdown, but only 49.8% were able to maintain their usual level of PA. Although respondents were considered sufficiently physically active from the IPAQ, 51.5% reported not being able to maintain their usual level of PA primarily due to the closure of their gym facilities. Sixty percent of respondents reported that PA had a positive effect on their overall wellbeing. When asked to specify which aspects of wellbeing were affected, the effect on mental health was reported the most while the effect on body image or fitness was reported the least. Strategies to increase or maintain engagement in physical activity during lockdowns should be encouraged to promote positive mental health during the COVID-19 pandemic.


Subject(s)
/psychology , Exercise , Mental Health , Pandemics , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Self Report , Young Adult
4.
Int J Environ Res Public Health ; 18(4)2021 02 10.
Article in English | MEDLINE | ID: covidwho-1112717

ABSTRACT

The COVID-19 emergency has imposed distanced education and has interrupted most rehabilitation services. Adolescents with disabilities have been isolated, and the burden on their families has been exacerbated. A cross-sectional survey was administered to adolescents with disability and to parents of disabled children to describe their experience during lockdown and their concerns or expectations about rehabilitation. A sample of 53 adolescents and 239 parents completed the survey. Adolescents were ages 13-18 years old (45.3% female). Most parents were between 35 and 55 years old (84.9% female). While 53.6% of the parents reported no positive effects of the lockdown, 92.5% of the adolescents expressed favorable consequences. The increased time spent with family members was judged positively by 27.2% of parents and by 64.2% of adolescents. Concern for their child's disability was expressed by 47.3% of parents, while 73.6% of adolescents expressed concerns regarding the ban on meeting friends. In both groups, anxiety symptoms were correlated with the fear of contracting COVID-19 and with financial problems. Parents would have liked even more remote support from school and healthcare professionals, which was available for most participants. Thus, socioeconomic support, assistive technology and telerehabilitation strategies might help families with disabilities during a lockdown.


Subject(s)
Communicable Disease Control , Disabled Children/rehabilitation , Adolescent , Adult , Cross-Sectional Studies , Family , Female , Humans , Interpersonal Relations , Italy , Male , Middle Aged , Pandemics , Social Behavior , Surveys and Questionnaires
5.
Int J Environ Res Public Health ; 18(4)2021 02 09.
Article in English | MEDLINE | ID: covidwho-1112712

ABSTRACT

The study aimed to explore the influence of the COVID-19 lockdown on the mental status and dietary intake of residents in Saudi Arabia. In this cross-sectional study, an online survey was conducted from 11 May to 6 June 2020 corresponding to almost two weeks during and after Ramadan (23 April-23 May 2020). The Patient Health Questionnaire was used to assess anxiety, depression, and insomnia. Logistic regression analysis was used to identify predictors of anxiety, depression, and insomnia. The prevalence of anxiety, depression, and insomnia among the participants was 25.4%, 27.7%, and 19.6%, respectively. Participants aged ≥50 years with high income (≥8000 SAR) were at a lower risk of developing depression, whereas participants of the same age group with income 5000-7000 SAR were at high risk of developing anxiety. Students and master-educated participants suffer from median elevated depression and are required to take more multivitamins and vitamin D than others. Anxiety and depression were more common among married participants with low income. There is a wide range of Saudi residents who are at a higher risk of mental illness during the COVID-19 pandemic. Policymakers and mental healthcare providers are advised to provide continuous monitoring of the psychological consequences during this pandemic and provide mental support.


Subject(s)
/psychology , Diet , Mental Health , Pandemics , Adult , Anxiety/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Eating , Female , Humans , Income , Male , Middle Aged , Saudi Arabia/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Young Adult
6.
Int J Environ Res Public Health ; 18(4)2021 02 09.
Article in English | MEDLINE | ID: covidwho-1112710

ABSTRACT

The aim of the study was to examine whether, and to what extent, fear of contracting Covid-19 and compliance with the mandatory rules of isolation affected Polish adults' nutritional behaviors. The online study was carried out during the first wave of the pandemic on a sample of 926 adults. Through cluster analysis, three groups of respondents were isolated: 1. People who fear a Covid-19 infection and follow the isolation rules (FFR), 2. People moderately afraid of the disease and following the rules loosely (MFFR), 3. People who are not afraid of the infection and do not follow the rules of isolation. (NFFR). The clusters were profiled with consideration of different aspects of eating behaviors as well as socio-demographic and economic features. The results of the study show a close relationship between the level of fear of contracting Covid-19 and the degree to which isolation rules are followed. These two factors were found to have a significant impact on eating behaviors, such as food purchases, eating patterns, and levels of consumption. It was stated that the FFR group changed their eating behaviors the most in terms of food purchasing, eating habits (excluding diversity and quality of diet), and food product consumption. The greatest stability in the majority of the analyzed areas of nutritional behaviors was observed in the MFFR cluster. The NFFR group shown the greatest decrease both in regularity and quality of their meals. This group also exhibited a significant increase in the consumption of alcoholic beverages. The results of the study can be useful in the decision making process when introducing restrictions or managing information. They also point to the need for extensive nutritional education focused on explaining the relationship between nutrition and health during a pandemic.


Subject(s)
/psychology , Consumer Behavior , Fear , Feeding Behavior , Adolescent , Adult , Aged , Communicable Disease Control , Female , Humans , Male , Middle Aged , Pandemics , Poland , Young Adult
7.
F1000Res ; 9: 1286, 2020.
Article in English | MEDLINE | ID: covidwho-1110755

ABSTRACT

Background: Case fatality rate of COVID-19 patients in Surabaya is higher than global cases. Thus, it is important to identify risk factors to reduce the mortality rate. This study aimed to assess the factors associated with hospital mortality of COVID-19 patients, and develop a prediction score based on these findings. Methods: We analyzed 111 patients, who were diagnosed with COVID-19 based on reverse-transcriptase polymerase chain reaction. The following patient characteristics were obtained from records: age, gender, type of symptoms, onset of symptoms, neutrophil lymphocyte ratio (NLR), absolute lymphocyte count, chest x-ray abnormalities, lung involvement, type of lesion, radiographic assessment of the quantity of lung edema (RALE) score, and mortality. Data were analyzed using SPSS 25.0. Results Multivariate analysis showed that age >50 years ( p=0.043), NLR score >5.8 ( p=0.016) and RALE score >2 ( p=0.002) can predict the mortality of COVID-19 patients in the hospital. ROC curve analysis of the score ability to predict mortality showed an area under the curve of 0.794. The cut-off point is 4.5, with a sensitivity of 96.7% and specificity of 49.4% to predict the mortality of COVID-19 patient in the hospital. Conclusions Age, NLR score and RALE score were associated with mortality of COVID-19 patients in the hospital and could be used as a predictor for discharge probability of COVID-19 patients in low health care resource setting. The prediction score may be useful for frontline physicians to effectively manage patients with a higher score to prevent mortality.


Subject(s)
Age Factors , Edema/diagnostic imaging , Hospital Mortality , Lymphocytes/cytology , Neutrophils/cytology , Adult , Aged , Female , Humans , Lung/diagnostic imaging , Lung/physiopathology , Male , Middle Aged , Respiratory Sounds , Retrospective Studies
9.
Ann Intern Med ; 174(2): JC16, 2021 02.
Article in English | MEDLINE | ID: covidwho-1110694

ABSTRACT

SOURCE CITATION: Stone JH, Frigault MJ, Serling-Boyd NJ, et al. Efficacy of tocilizumab in patients hospitalized with Covid-19. N Engl J Med. 2020;383:2333-44. 33085857.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Respiratory Insufficiency/drug therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Multicenter Studies as Topic , Randomized Controlled Trials as Topic , Respiratory Insufficiency/mortality , Respiratory Insufficiency/virology
10.
Tidsskr Nor Laegeforen ; 140(2)2021 02 02.
Article in English, No | MEDLINE | ID: covidwho-1110519

ABSTRACT

BACKGROUND: Cardiovascular disease and cancer have been described as possible risk factors for COVID-19 mortality. The purpose of this study was to investigate whether a history of cardiovascular disease or cancer affects the risk of dying after a COVID-19 diagnosis in Norway. MATERIAL AND METHOD: Data were compiled from the Norwegian Surveillance System for Communicable Diseases, the Norwegian Cardiovascular Disease Registry and the Cancer Registry of Norway. Univariable and multivariable regression models were used to calculate both relative and absolute risk. RESULTS: In the first half of 2020, 8 809 people tested positive for SARS-CoV-2 and 260 COVID-19-associated deaths were registered. Increasing age, male sex (relative risk (RR): 1.5; confidence interval (CI): 1.2-2.0), prior stroke (RR: 1.5; CI: 1.0-2.1) and cancer with distant metastasis at the time of diagnosis (RR: 3.0; CI: 1.1-8.2) were independent risk factors for death after a diagnosis of COVID-19. After adjusting for age and sex, myocardial infarction, atrial fibrillation, heart failure, hypertension, and non-metastatic cancer were no longer statistically significant risk factors for death. INTERPRETATION: The leading risk factor for death among individuals who tested positive for SARS-CoV-2 was age. Male sex, and a previous diagnosis of stroke or cancer with distant metastasis were also associated with an increased risk of death after a COVID-19 diagnosis.


Subject(s)
/mortality , Cardiovascular Diseases/complications , Neoplasms/complications , Female , Humans , Male , Norway/epidemiology , Risk Factors
12.
J Sports Med Phys Fitness ; 61(2): 294-300, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1106688

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, the Italian government took security measures to try to limit infections. Restrictive measures included social distancing, home confinement and the closure of all public structures like gyms and swimming pools. The impact of these limitations on health and lifestyle was inevitably negative. The purpose of this study was to establish the level of physical activity (PA), expressed as energy expenditure (MET-minute/week) in a Southern Italian population before and during the COVID-19 lockdown. METHODS: An adapted version of the International Physical Activity Questionnaire-short form (IPAQ-SF) was published on the official website of the National Institute of Gastroenterology IRCCS S. de Bellis, Castellana Grotte, Bari, Italy and on several social media in May 2020. RESULTS: Three hundred ten replies (72% women) from Apulia (60%), Calabria (28%), Campania (11%) and Sicily (1%) were included in the study. The COVID-19 lockdown had a negative effect on the vigorous PA intensity level and on walking, but not on the moderate PA intensity level. Additionally, daily time spent sitting down increased by more than 12% during the COVID-19 lockdown. CONCLUSIONS: Isolation changed PA behaviors. The decreased energy expenditure (MET-minute/week) during the lockdown had a negative impact in both genders, especially on the young adults and adults' groups.


Subject(s)
/epidemiology , Communicable Disease Control , Exercise , Adult , Aged , Cross-Sectional Studies , Energy Metabolism , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Sitting Position , Surveys and Questionnaires , Walking
13.
PLoS Pathog ; 17(1): e1009287, 2021 01.
Article in English | MEDLINE | ID: covidwho-1105834

ABSTRACT

The COVID-19 pandemic has revealed that infection with SARS-CoV-2 can result in a wide range of clinical outcomes in humans. An incomplete understanding of immune correlates of protection represents a major barrier to the design of vaccines and therapeutic approaches to prevent infection or limit disease. This deficit is largely due to the lack of prospectively collected, pre-infection samples from individuals that go on to become infected with SARS-CoV-2. Here, we utilized data from genetically diverse Collaborative Cross (CC) mice infected with SARS-CoV to determine whether baseline T cell signatures are associated with a lack of viral control and severe disease upon infection. SARS-CoV infection of CC mice results in a variety of viral load trajectories and disease outcomes. Overall, a dysregulated, pro-inflammatory signature of circulating T cells at baseline was associated with severe disease upon infection. Our study serves as proof of concept that circulating T cell signatures at baseline can predict clinical and virologic outcomes upon SARS-CoV infection. Identification of basal immune predictors in humans could allow for identification of individuals at highest risk of severe clinical and virologic outcomes upon infection, who may thus most benefit from available clinical interventions to restrict infection and disease.


Subject(s)
/immunology , /physiology , T-Lymphocytes/immunology , Animals , Female , Humans , Male , Mice , Mice, Inbred C57BL , Phenotype , Viral Load
14.
Adv Physiol Educ ; 45(1): 84-88, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1105547

ABSTRACT

Medical education has gone online because of the COVID-19 pandemic. Formative assessment is essential to facilitate the learning process in medical education. However, various challenges arise during online assessment, which include reliability, when done without monitoring and practical concerns like Internet connectivity issues. This study was done to assess the medical students' perceptions of the reliability, usefulness, and practical challenges of online tests. One hundred first-year undergraduate medical students taking up online classes and tests in the subject of physiology were enrolled in this study. A questionnaire with items regarding practical challenges, reliability, and usefulness of the online tests, in general, and about different types of online assessment methods, in particular, were sent to the students online. Each item was rated on a five-point Likert scale, and the responses were analyzed anonymously. A large percentage of students used mobile phones (81.4%) to undertake online tests. Although most students (73.2%; P < 0.001) felt that online tests helped them substantially in learning the subject, network connectivity issues were considered to be a matter of serious concern (85.5%, P < 0.001). Among the assessment methods used, viva voce by video conferencing was thought to be most reliable (83%, P < 0.001). Multiple-choice question-based assessment when done online was felt to be more practically feasible with faster feedback than classroom assessment. The results of the study suggest that medical students find online formative assessments helpful for their learning, despite their concerns about reliability and practical challenges.


Subject(s)
Education, Distance/standards , Education, Medical/standards , Educational Measurement/standards , Students, Medical/psychology , Surveys and Questionnaires , Education, Distance/methods , Education, Medical/methods , Educational Measurement/methods , Feasibility Studies , Female , Humans , Male , Reproducibility of Results
15.
Span J Psychol ; 24: e8, 2021 Feb 08.
Article in English | MEDLINE | ID: covidwho-1101609

ABSTRACT

In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.


Subject(s)
Adaptation, Psychological , Anxiety Disorders/psychology , Depressive Disorder/psychology , Mental Health , Psychological Distress , Substance-Related Disorders/psychology , Adolescent , Adult , Aged , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Cross-Sectional Studies , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Female , Health Surveys , Humans , Income , Internet , Loneliness/psychology , Male , Middle Aged , Pregnancy , Quality of Life/psychology , Risk Factors , Spain/epidemiology , Substance-Related Disorders/diagnosis , Substance-Related Disorders/epidemiology , Young Adult
16.
BMJ Open ; 10(12): e039560, 2020 12 17.
Article in English | MEDLINE | ID: covidwho-1102180

ABSTRACT

INTRODUCTION: Ageing-related processes such as cellular senescence are believed to underlie the accumulation of diseases in time, causing (co)morbidity, including cancer, thromboembolism and stroke. Interfering with these processes may delay, stop or reverse morbidity. The aim of this study is to investigate the link between (co)morbidity and ageing by exploring biomarkers and molecular mechanisms of disease-triggered deterioration in patients with pancreatic ductal adenocarcinoma (PDAC) and (thromboembolic) ischaemic stroke (IS). METHODS AND ANALYSIS: We will recruit 50 patients with PDAC, 50 patients with (thromboembolic) IS and 50 controls at Rostock University Medical Center, Germany. We will gather routine blood data, clinical performance measurements and patient-reported outcomes at up to seven points in time, alongside in-depth transcriptomics and proteomics at two of the early time points. Aiming for clinically relevant biomarkers, the primary outcome is a composite of probable sarcopenia, clinical performance (described by ECOG Performance Status for patients with PDAC and the Modified Rankin Scale for patients with stroke) and quality of life. Further outcomes cover other aspects of morbidity such as cognitive decline and of comorbidity such as vascular or cancerous events. The data analysis is comprehensive in that it includes biostatistics and machine learning, both following standard role models and additional explorative approaches. Prognostic and predictive biomarkers for interventions addressing senescence may become available if the biomarkers that we find are specifically related to ageing/cellular senescence. Similarly, diagnostic biomarkers will be explored. Our findings will require validation in independent studies, and our dataset shall be useful to validate the findings of other studies. In some of the explorative analyses, we shall include insights from systems biology modelling as well as insights from preclinical animal models. We anticipate that our detailed study protocol and data analysis plan may also guide other biomarker exploration trials. ETHICS AND DISSEMINATION: The study was approved by the local ethics committee (Ethikkommission an der Medizinischen Fakultät der Universität Rostock, A2019-0174), registered at the German Clinical Trials Register (DRKS00021184), and results will be published following standard guidelines.


Subject(s)
Adenocarcinoma , Brain Ischemia , Pancreatic Neoplasms , Stroke , Adenocarcinoma/epidemiology , Aging , Cellular Senescence , Cohort Studies , Comorbidity , Female , Germany/epidemiology , Humans , Male , Pancreatic Neoplasms/epidemiology , Prospective Studies , Quality of Life , Stroke/epidemiology
17.
Medicine (Baltimore) ; 100(6): e24141, 2021 Feb 12.
Article in English | MEDLINE | ID: covidwho-1101918

ABSTRACT

BACKGROUND: The global neo-coronary pneumonia epidemic has increased the workload of healthcare institutions in various countries and directly affected the physical and psychological recovery of the vast majority of patients requiring hospitalization in China. We anticipate that post-total knee arthroplasty kinesiophobia may have an impact on patients' postoperative pain scores, knee function, and ability to care for themselves in daily life. The purpose of this study is to conduct a micro-video intervention via WeChat to verify the impact of this method on the rapid recovery of patients with kinesiophobia after total knee arthroplasty during neo-coronary pneumonia. METHODS: Using convenience sampling method, 78 patients with kinesiophobia after artificial total knee arthroplasty who met the exclusion criteria were selected and randomly grouped, with the control group receiving routine off-line instruction and the intervention group receiving micro-video intervention, and the changes in the relevant indexes of the two groups of patients at different time points on postoperative day 1, 3 and 7 were recorded and analyzed. RESULTS: There were no statistical differences in the scores of kinesiophobia, pain, knee flexion mobility (ROM) and ability to take care of daily life between the two groups on the first postoperative day (P > .05). On postoperative day 3 and 7, there were statistical differences in Tampa Scale for kinesiophobia, pain, activities of daily living scale score and ROM between the two groups (P < .01), and the first time of getting out of bed between the two groups (P < .05), and by repeated-measures ANOVA, there were statistically significant time points, groups and interaction effects of the outcome indicators between the 2 groups (P < .01), indicating that the intervention group reconstructed the patients' postoperative kinesiophobiaand hyperactivity. The level of pain awareness facilitates the patient's acquisition of the correct functional exercises to make them change their misbehavior. CONCLUSIONS: WeChat micro-video can reduce the fear of movement score and pain score in patients with kinesiophobia after unilateral total knee arthroplasty, shorten the first time out of bed, and improve their joint mobility and daily living ability. ETHICS: This study has passed the ethical review of the hospital where it was conducted and has been filed, Ethics Approval Number: 20181203-01.


Subject(s)
Arthroplasty, Replacement, Knee/psychology , Phobic Disorders/psychology , Pneumonia/epidemiology , Activities of Daily Living , Aged , Arthroplasty, Replacement, Knee/adverse effects , /diagnosis , Case-Control Studies , China/epidemiology , Female , Humans , Knee Joint/physiopathology , Knee Joint/surgery , Male , Middle Aged , Pain, Postoperative/diagnosis , Pain, Postoperative/psychology , Pneumonia/virology , Postoperative Period , Prospective Studies , Range of Motion, Articular , Recovery of Function , Rehabilitation/methods , Rehabilitation/psychology , Videoconferencing/instrumentation , Videoconferencing/statistics & numerical data
18.
Holist Nurs Pract ; 35(2): 98-107, 2021.
Article in English | MEDLINE | ID: covidwho-1101897

ABSTRACT

This study was conducted to analyze health care personnel's attitudes toward traditional and complementary medicine (TCM) and life satisfaction due to coronavirus disease-2019 (COVID-19) pandemic. This cross-sectional descriptive study was conducted between April 2 and 9, 2020. The Questionnaire form was sent to health care personnel online. A total of 560 individuals who answered the questionnaires were included in the study. The data were collected by using the Personal Information Form, Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and Life Satisfaction Scale (LSS). Average age of the participants was 30.88 ± 7.68 years, 82.5% were male, and 65.5% were working as nurses. It was found that 45.5% of the participants used TCM methods for COVID-19 during the last month; 48.7% of the health care personnel stated that they used TCM methods to strengthen their immune system. The HCAMQ total average score was 27.96 ± 5.49; the holistic health subdimension total average score was 9.59 ± 3.04; the complementary and alternative medicine subdimension total average score was 18.37 ± 3.58; and the LSS total average score was 20.78 ± 6.32. A positive weak statistically significant association was found between the HCAMQ and complementary and alternative medicine subdimension and the LSS (P < .05). Participants had moderately positive attitudes toward TCM and life satisfaction. As the participants' positive attitudes toward TCM increased, their life satisfaction was also found to increase.


Subject(s)
Attitude of Health Personnel , Complementary Therapies/psychology , Health Personnel/psychology , Personal Satisfaction , Adult , /psychology , Complementary Therapies/standards , Cross-Sectional Studies , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Pandemics/prevention & control
19.
BMJ Open ; 11(2): e047216, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1096996

ABSTRACT

OBJECTIVES: To assess the seroprevalence of anti-SARS-CoV-2 IgG among health careworkers (HCWs) in our university hospital and verify the risk of acquiring the infection according to work area. DESIGN: Cross-sectional study. SETTING: Monocentric, Italian, third-level university hospital. PARTICIPANTS: All the employees of the hospital on a voluntary base, for a total of 4055 participants among 4572 HCWs (88.7%). PRIMARY AND SECONDARY OUTCOME MEASURES: Number of anti-SARS-CoV-2 positive serology according to working area. Association of anti-SARS-CoV-2 positive serology to selected variables (age, gender, country of origin, body mass index, smoking, symptoms and contact with confirmed cases). RESULTS: From 27 April 2020 to 12 June 2020, 4055 HCWs were tested and 309 (7.6%) had a serological positive test. No relevant difference was found between men and women (8.3% vs 7.3%, p=0.3), whereas a higher prevalence was observed among foreign-born workers (27/186, 14.5%, p<0.001), employees younger than 30 (64/668, 9.6%, p=0.02) or older than 60 years (38/383, 9.9%, p=0.02) and among healthcare assistants (40/320, 12.5%, p=0.06). Working as frontline HCWs was not associated with an increased frequency of positive serology (p=0.42). A positive association was found with presence and number of symptoms (p<0.001). The symptoms most frequently associated with a positive serology were taste and smell alterations (OR 4.62, 95% CI: 2.99 to 7.15) and fever (OR 4.37, 95% CI: 3.11 to 6.13). No symptoms were reported in 84/309 (27.2%) HCWs with positive IgG levels. Declared exposure to a suspected/confirmed case was more frequently associated (p<0.001) with positive serology when the contact was a family member (19/94, 20.2%) than a patient or colleague (78/888, 8.8%). CONCLUSIONS: SARS-CoV-2 infection occurred undetected in a large fraction of HCWs and it was not associated with working in COVID-19 frontline areas. Beyond the hospital setting, exposure within the community represents an additional source of infection for HCWs.


Subject(s)
Antibodies, Viral , Immunoglobulin G , Personnel, Hospital , Adult , Antibodies, Viral/blood , /epidemiology , Cross-Sectional Studies , Female , Hospitals, University , Humans , Immunoglobulin G/blood , Italy/epidemiology , Male , Middle Aged , Personnel, Hospital/statistics & numerical data , Seroepidemiologic Studies
20.
BMJ Open ; 11(2): e045482, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1096995

ABSTRACT

OBJECTIVES: Recent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes. DESIGN: We analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection. SETTING: Patients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included. PARTICIPANTS: Admitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics. PRIMARY AND SECONDARY OUTCOMES MEASURES: The primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors. RESULTS: We included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91). CONCLUSIONS: The accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.


Subject(s)
Aged , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Prospective Studies , Treatment Outcome
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