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2.
Telemed J E Health ; 26(12): 1461-1465, 2020 12.
Article in English | MEDLINE | ID: covidwho-1639432

ABSTRACT

Objective: During the current coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been brought to the forefront of attention. This report aimed to assess psychiatric comorbidities in COVID-19 patients by utilizing telepsychiatry. Methods: COVID-19 patients admitted in Fasa University Hospital and nonhospitalized outpatients of Fasa city were interviewed by a psychiatrist through video chat for a 1-month period (March-April, 2020). Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Assessment (GAD-7), and Perceived Stress Scale-14 (PSS 14) questionnaires were administered for all patients. Each patient's mental status was recorded, and if any psychiatric problem was diagnosed, supportive psychotherapy, pharmacotherapy, and follow-up visits based on the patient's condition were started. Result: From a total of 82 COVID-19 patients who entered the study, 32 (39.03%) and 50 (60.97%) subjects were inpatients and outpatients, respectively. Moreover, 32 (39.03%) subjects were male and 50 (60.97%) were female. Insomnia seen in 24 (29.3%) patients and adjustment disorder in 13 (15.9%) patients were the most common psychiatric disorders among a total of 33 (40.2%) patients suffering from mental illness. Female and hospitalized patients presented significantly more frequent comorbidities than males and outpatients. Conclusions: Psychiatric disorders were significantly more common in patients with hospital admission than those without and more frequent in female versus male subjects. There were no significant differences between male and female subjects with and without admission according to the PHQ-9, GAD-7, and PSS-14 scores. It was concluded that telepsychiatry in the early stages of mental problems during a catastrophic event like the coronavirus pandemic, can be an efficient instrument for the screening of psychosomatic comorbidities, so that pharmacological treatment (considering possible drug interactions with COVID-19 medications) and psychotherapeutic intervention can be optimized by psychiatrists.


Subject(s)
Anxiety Disorders/diagnosis , COVID-19/diagnosis , COVID-19/psychology , Inpatients/statistics & numerical data , Outpatients/statistics & numerical data , Telemedicine/methods , Telemedicine/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , Iran/epidemiology , Male , Middle Aged , Pandemics/statistics & numerical data , Sex Factors , Video Recording/statistics & numerical data
3.
Work ; 71(1): 41-51, 2022.
Article in English | MEDLINE | ID: covidwho-1633874

ABSTRACT

BACKGROUND: Physiotherapists (PTs) play an important role in the well-being and physical rehabilitation of patients with long term health problems. It is important that PTs follow recommended practices that minimize the transmission of SARS-CoV-2 infection in providing Outpatient Physiotherapy services. OBJECTIVE: The aim of this study was to assess the knowledge of COVID-19 among the PTs and evaluate the state of implementation of best practices in Outpatient Physiotherapy to prevent SARS-CoV-2 infections during the ongoing pandemic. METHODS: A self-administered online questionnaire consisting of three sections, including section one on demographic information, section two on evaluating knowledge about SARS-CoV-2 and section three on implementing best practices as a survey tool for collecting data from PTs working in Lahore and Faisalabad in Punjab, Pakistan. RESULTS: A total of 216 completed surveys were received. Correct responses to different questions devised to test the participants' knowledge of SARS-CoV-2 varied from 58.3% to 99%. The implementation of best practices to prevent the infection transmission in the Outpatient Physiotherapy ranged from 22.7% to 92.1% for different domains. The age of the PTs and OPD setting were associated significantly with the PTs' knowledge of COVID-19 and also with the state of implementation of recommended practices to prevent SARS-CoV-2 infections in the Outpatient Physiotherapy (p < .05). CONCLUSION: The majority of the PTs, particularly those working in the clinic setting, possessed a good knowledge of COVID-19 and implemented best practices in their Outpatient Physiotherapy at a good level. However, efforts should be directed towards further improving the knowledge of PTs and ensuring implementation of best practices in Outpatient Physiotherapy, particularly in government and private hospitals.


Subject(s)
COVID-19 , Physical Therapists , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Outpatients , Pandemics , Physical Therapy Modalities , SARS-CoV-2 , Surveys and Questionnaires
4.
Clin Obstet Gynecol ; 65(1): 161-178, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1633726

ABSTRACT

The majority of patients with coronavirus disease 2019 will have mild or asymptomatic disease, however, obstetric patients are uniquely at risk for disease progression and adverse outcomes. Preventive strategies including masking, physical distancing, vaccination, and chemoprophylaxis have been well studied, are critical to disease mitigation, and can be used in the pregnant population. High-quality data are needed to assess safety and effectiveness of therapeutics and vaccination in pregnancy, as well as long-term data on maternal and newborn outcomes.


Subject(s)
COVID-19 , Influenza, Human , Female , Humans , Infant, Newborn , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Outpatients , Pandemics , Pregnancy , SARS-CoV-2 , Vaccination
6.
BMJ Open Qual ; 11(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1613015

ABSTRACT

BACKGROUND: The COVID-19 pandemic has put health systems across the world under significant pressure. In March 2020, a national directive was issued by the National Health Service (NHS) England instructing trusts to scale back face-to-face outpatient appointments, and rapidly implement virtual clinics. METHODS: A multidisciplinary team of change managers, analysts and clinicians were assembled to evaluate initial implementation of virtual clinics at Guy's and St Thomas' NHS Foundation Trust. In-depth interviews were conducted with clinicians who have delivered virtual clinics during the pandemic. An inductive thematic approach was used to analyse clinicians' early experiences and identify enablers for longer term sustainability. RESULTS: Ninety-five clinicians from specialist services across the trust were interviewed between April and May 2020 to reflect on their experiences of delivering virtual clinics during Wave I COVID-19. Key reflections include the perceived benefits of virtual consultations to patients and clinicians; the limitations of virtual consultations compared with face-to-face consultations; and the key enablers that would optimise and sustain the delivery of virtual pathways longer term. CONCLUSIONS: In response to the pandemic, outpatient services across the trust were rapidly redesigned and virtual clinics implemented. As a result, services have been able to sustain some level of service delivery. However, clinicians have identified challenges in delivering this model of care and highlighted enablers needed to sustaining the delivery of virtual clinics longer term, such as patient access to diagnostic tests and investigations closer to home.


Subject(s)
COVID-19 , Pandemics , Humans , Outpatients , SARS-CoV-2 , State Medicine
7.
Gac Med Mex ; 157(3): 257-262, 2021.
Article in English | MEDLINE | ID: covidwho-1603574

ABSTRACT

INTRODUCTION: As a result of COVID-19, many hospitals underwent a conversion for the care for this disease. OBJECTIVE: To analyze COVID-19 hospital epidemiological behavior from March to August 2020. METHODS: Through a series of cases, COVID-19 epidemiological behavior at the hospital was analyzed, for which simple case rates, percentages and incidence of COVID-19 per 100 hospital discharges were estimated. RESULTS: Out of 491 subjects who tested positive for SARS-CoV-2, 156 (31.7 %) were hospitalized for clinical data of moderate to severe disease. Average age was 59.1 years; 121 cases (75 %) were discharged due to improvement, and 32 (20.5 %), due to death. Average age of those who died was 69.7 years, and the most affected age group was 60 to 80 years (45.4 %). Calculated lethality was 20.5 per 100 hospital discharges, while that calculated taking into account positive patients (outpatients and hospitalized patients) was 6.5. CONCLUSIONS: COVID-19 epidemiological behavior was similar to that described in other studies; however, lethality and mortality are above national average. The analysis of this and of the factors that favored it in our population is pending.


Subject(s)
COVID-19/epidemiology , Hospital Mortality , Hospitalization/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/physiopathology , Child , Female , Humans , Incidence , Male , Mexico/epidemiology , Middle Aged , Outpatients , Severity of Illness Index , Tertiary Care Centers , Young Adult
8.
Appl Clin Inform ; 13(1): 10-18, 2022 01.
Article in English | MEDLINE | ID: covidwho-1604728

ABSTRACT

OBJECTIVES: This study aimed to develop a virtual electronic health record (EHR) training and optimization program and evaluate the impact of the virtual model on provider and staff burnout and electronic health record (EHR) experience. METHODS: UCHealth created and supported a multidisciplinary EHR optimization and training program, known as the Epic Sprint Program. The Sprint Team conducted dozens of onsite Sprint events over the course of several years prior to the pandemic but transitioned to a fully virtual program and successfully "sprinted" 21 outpatient clinics from May to December 2020. Core program components of group and 1:1 training, workflow analysis, and new or adjusted EHR build were unchanged from the onsite model. Pre- and post-Sprint surveys provided detailed, objective data about EHR usability, EHR proficiency, job satisfaction, and burnout. RESULTS: The EHR Net Promoter Score (NPS), a likelihood to recommend metric, increased by 39 points (-3 pre and 36 post; p < 0.001) for providers and 29 points (8 pre and 37 post; p = 0.001) for staff post-Sprint. Positive provider (NPS = +53) and staff (NPS = +47) NPS scores indicated a high likelihood to recommend the Sprint Program. Post-Sprint surveys also reflect an increase in providers (10%; p = 0.04) and staff (9%; 0.13) who indicated "no burnout" or "did not feel burned out." DISCUSSION: The UCHealth Sprint Team transitioned this comprehensive, enterprise level initiative from an onsite model to a fully virtual EHR training and optimization program during the first few months of the novel coronavirus disease (COVID-19) pandemic. Despite this change in program delivery, survey data clearly demonstrated improved EHR satisfaction, a high likelihood to recommend a sprint to a friend or colleague, and a trend toward burnout reduction in providers and staff. CONCLUSION: Changing an existing on-site EHR optimization program to a purely virtual format can be successful, and this study showed improved provider and staff EHR satisfaction with reduced burnout.


Subject(s)
Burnout, Professional , COVID-19 , Electronic Health Records , Humans , Outpatients , SARS-CoV-2
9.
Vopr Kurortol Fizioter Lech Fiz Kult ; 98(6): 16-21, 2021.
Article in Russian | MEDLINE | ID: covidwho-1599984

ABSTRACT

Searching for drug and non-drug modalities for the rehabilitation of patients with the post-COVID syndrome is an urgent public health challenge during the COVID-19 pandemic. Hyperbaric oxygenation is a promising method as a part of complex rehabilitation after COVID-19 due to its antihypoxic, anti-inflammatory, antioxidant and anticoagulant effects. OBJECTIVE: To study the effect of hyperbaric oxygenation as a part of comprehensive outpatient rehabilitation on clinical and functional parameters in COVID-19 convalescents. MATERIAL AND METHODS: The effect of hyperbaric oxygenation on clinical and functional parameters of 45 COVID-19 convalescents was studied: 22 males and 23 females aged 40-60 years. Patients were divided into three groups of 15 subjects each, depending on the CT stage of COVID-associated pneumonia (CT-0, CT-1, and CT-2-3). RESULTS: Patients in group 3 (CT-2-3) were on average in the older age group, had a higher body weight and a higher percentage of fat mass according to bioimpedance measurements, compared to the other groups. Most clinical-functional and laboratory parameters in this group were within normal or subnormal ranges. In addition, high cholesterol levels (total cholesterol 6.5±1.2 mmol/L) and subnormal levels of C-reactive protein (9.3 mg/L) were noted in group 3 patients. After comprehensive rehabilitation, an increase in the distance walked in the 6-minute walking test with a significant trend in the CT-0 (467.9±37.7→531.5±44.3 m; p<0.01) and CT-1 (533.9±74.3→570.1±57.8 m; p<0.05) groups was observed. A significant decrease in norepinephrine level in the group of COVID-19 convalescents with CT-2-3 (Δ 13%), and a decrease in glutathione peroxidase in all three groups (6465.0±1637.3→5101.0±1353.3, 6587.8±1919.3→5418.1±1289.7, 7699.5±1747.9→6620.1±1702.1 units/L in groups 1, 2 and 3, respectively; p<0.05) were recorded. CONCLUSION: The use of hyperbaric oxygenation in comprehensive outpatient rehabilitation of COVID-19 convalescents was associated with benefits, given the improvement of functional parameters, laboratory signs of limiting low-grade inflammation, sympathoadrenal activity, and oxidative stress.


Subject(s)
COVID-19 , Hyperbaric Oxygenation , Aged , Female , Humans , Male , Outpatients , Pandemics , SARS-CoV-2 , Treatment Outcome
10.
Vestn Otorinolaringol ; 86(6): 69-73, 2021.
Article in Russian | MEDLINE | ID: covidwho-1599955

ABSTRACT

OBJECTIVE: To evaluate the therapeutic and preventive efficacy of the drug with antiviral and immunotropic activity Cytovir-3 in children with COVID-19 on an outpatient basis. MATERIAL AND METHODS: A retrospective analysis the treatment of 52 pediatric patients aged 1 to 17 years with a confirmed new coronavirus infection SARS-CoV-2 with the drug Cytovir-3 was carried out. 28 people, contacts in the family, received the drug for prophylactic purposes. Clinical observation of patients was carried out with an assessment of the severity and duration of fever, the anosmia, catarrhal symptoms in the nasopharynx and analysis indicator of saturation. In the control group, there were 27 patients of the same age who received the medicine Umifenovir and 25 contact family members who did not receive the medicine for prophylactic purposes. RESULTS: The use of Cytovir-3 in the COVID-19 treatment in children led to a decrease in intoxication symptoms 3.2-3.4 days after taking the medicine, a significant reduction of anosmia period recovery time, and elimination of the pathogen according to PCR analysis. The patients receiving the drug did not have ENT- complications and did not require hospitalization. Prophylactic administration of the drug in contact family members statistically significantly reduced the likelihood of developing the disease 3.6 times. The clinical efficacy and feasibility of using Cytovir-3 in the treatment and prevention of new coronavirus infection in patients of different ages has been shown.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19 , Adolescent , COVID-19/drug therapy , COVID-19/prevention & control , Child , Child, Preschool , Humans , Infant , Outpatients , Post-Exposure Prophylaxis , Retrospective Studies
11.
J Med Internet Res ; 23(12): e25899, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1596879

ABSTRACT

BACKGROUND: The McIsaac criteria are a validated scoring system used to determine the likelihood of an acute sore throat being caused by group A streptococcus (GAS) to stratify patients who need strep testing. OBJECTIVE: We aim to compare McIsaac criteria obtained during face-to-face (f2f) and non-f2f encounters. METHODS: This retrospective study compared the percentage of positive GAS tests by McIsaac score for scores calculated during nurse protocol phone encounters, e-visits (electronic visits), and in person f2f clinic visits. RESULTS: There was no difference in percentages of positive strep tests between encounter types for any of the McIsaac scores. There were significantly more phone and e-visit encounters with any missing score components compared with f2f visits. For individual score components, there were significantly fewer e-visits missing fever and cough information compared with phone encounters and f2f encounters. F2f encounters were significantly less likely to be missing descriptions of tonsils and lymphadenopathy compared with phone and e-visit encounters. McIsaac scores of 4 had positive GAS rates of 55% to 68% across encounter types. There were 4 encounters not missing any score components with a McIsaac score of 0. None of these 4 encounters had a positive GAS test. CONCLUSIONS: McIsaac scores of 4 collected during non-f2f care could be used to consider empiric treatment for GAS without testing if significant barriers to testing exist such as the COVID-19 pandemic or geographic barriers. Future studies should evaluate further whether non-f2f encounters with McIsaac scores of 0 can be safely excluded from GAS testing.


Subject(s)
COVID-19 , Pharyngitis , Electronics , Humans , Outpatients , Pandemics , Pharyngitis/diagnosis , Retrospective Studies , SARS-CoV-2 , Triage
13.
Appl Ergon ; 100: 103672, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1588309

ABSTRACT

This study examines the impact of the sound environment on spatial knowledge acquisition in a virtual outpatient polyclinic. Outpatient polyclinics have a salient role in determining early outpatient treatments of COVID-19 to prevent hospitalization or death and reduce the burden on hospitals. However, they have not been widely investigated in the literature. The studies on spatial knowledge have identified environmental elements mainly related to vision with no focus on sound. Currently, there is limited research on the effect of sound environment on spatial knowledge acquisition in virtual outpatient polyclinics. In this study, a virtual simulated outpatient polyclinic has been created with varying levels of visual and audio cues. Eighty participants were assigned to one of the four groups: a control (no visual signage), a visual (visual signage), an only audio (no landmarks and no visual signage), and an audio-visual group. The virtual environment was presented as a video walkthrough with passive exploration to test spatial knowledge acquisition with tasks based on the landmark-route-survey model. The results showed that a combination of visual signage and sound environment resulted in higher spatial knowledge acquisition. No significant difference was found between the performance of the visual group and the control group that shows that signage alone cannot aid spatial knowledge in virtual outpatient polyclinics. Data from the only audio group suggests that landmarks associated with sound can compensate for the lack of visual landmarks that may help design a wayfinding system for users with visual disabilities.


Subject(s)
COVID-19 , Outpatients , Humans , SARS-CoV-2 , Space Perception , Spatial Behavior
14.
Int J Environ Res Public Health ; 19(1)2021 12 28.
Article in English | MEDLINE | ID: covidwho-1580798

ABSTRACT

Since the outbreak of the COVID-19 pandemic, outpatient nurses have been exposed to a double burden of already known occupational and new pandemic-related stressors. Recent studies suggest that increased pandemic-related stress can affect mental health and promote the development of negative mental health outcomes for nurses. This includes a decrease in sleep quality and work engagement. In addition, certain groups appear to be particularly vulnerable to pandemic-related stress. The aim of this study was to investigate the stress perception of German outpatient nurses during the COVID-19 pandemic. The aim was to determine associations between their pandemic-related stress and variables such as sleep quality, work engagement, pandemic-related worries and concerns. For this purpose, a questionnaire was developed based on well-established measurement instruments such as the 10-item Perceived Stress Scale, the Pittsburgh Sleep Quality Index and the Copenhagen Psychosocial Questionnaire to conduct a cross-sectional online survey among outpatient nurses from Germany. Participants (n = 166) showed rather moderate overall pandemic-related stress levels, good sleep quality, high work engagement, and moderate pandemic-related worries and concerns. Pandemic-related stress proved to be a predictor of decreased sleep quality and work engagement of outpatient nurses with weak effect sizes. Despite the surprisingly moderate stress levels, the effects of pandemic-related stress on selected aspects of participants' mental health could be demonstrated. Therefore, behavioural and organisational health promotion measures are recommended to support outpatient nurses during the pandemic. However, further research is needed to determine the causal relationships and long-term effects of pandemic-related stress on the mental health of outpatient caregivers.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Humans , Outpatients , Perception , SARS-CoV-2 , Surveys and Questionnaires , Work Engagement
15.
Infect Control Hosp Epidemiol ; 42(11): 1340-1344, 2021 11.
Article in English | MEDLINE | ID: covidwho-1574695

ABSTRACT

BACKGROUND: Widespread testing for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) is necessary to curb the spread of coronavirus disease 2019 (COVID-19), but testing is undermined when the only option is a nasopharyngeal swab. Self-collected swab techniques can overcome many of the disadvantages of a nasopharyngeal swab, but they require evaluation. METHODS: Three self-collected non-nasopharyngeal swab techniques (saline gargle, oral swab and combined oral-anterior nasal swab) were compared to a nasopharyngeal swab for SARS-CoV-2 detection at multiple COVID-19 assessment centers in Toronto, Canada. The performance characteristics of each test were assessed. RESULTS: The adjusted sensitivity of the saline gargle was 0.90 (95% CI 0.86-0.94), the oral swab was 0.82 (95% CI, 0.72-0.89) and the combined oral-anterior nasal swab was 0.87 (95% CI, 0.77-0.93) compared to a nasopharyngeal swab, which demonstrated a sensitivity of ˜90% when all positive tests were the reference standard. The median cycle threshold values for the SARS-CoV-2 E-gene for concordant and discordant saline gargle specimens were 17 and 31 (P < .001), for the oral swabs these values were 17 and 28 (P < .001), and for oral-anterior nasal swabs these values were 18 and 31 (P = .007). CONCLUSIONS: Self-collected saline gargle and an oral-anterior nasal swab have a similar sensitivity to a nasopharyngeal swab for the detection of SARS-CoV-2. These alternative collection techniques are cheap and can eliminate barriers to testing, particularly in underserved populations.


Subject(s)
COVID-19 , Outpatients , Humans , Nasopharynx , SARS-CoV-2 , Saliva , Specimen Handling
16.
Int J Eat Disord ; 55(1): 145-150, 2022 01.
Article in English | MEDLINE | ID: covidwho-1568024

ABSTRACT

OBJECTIVE: Findings show virtual therapy (conducted using internet-based videoconferencing techniques) to be a viable alternative to in-person therapy for a variety of mental-health problems. COVID-19 social-distancing imperatives required us to substitute virtual interventions for in-person sessions routinely offered in our outpatient eating disorder (ED) program-and afforded us an opportunity to compare the two treatment formats for clinical efficacy. METHODS: Using self-report assessments, we compared outcomes in a historical sample of 49 adults with heterogeneous EDs (treated in-person over 10-14 weeks in individual and group therapies) to those of 76 patients receiving comparable virtual treatments, at distance, during the COVID-19 outbreak. Linear mixed models were used to study symptom changes over time and to test for differential effects of treatment modality. RESULTS: Participants in both groups showed similar improvements on eating symptoms, levels of weight gain (in individuals in whom gain was indicated), and satisfaction with services. DISCUSSION: Our results suggest that short-term clinical outcomes with virtual and in-person ED therapies are comparable, and point to potentials of virtual therapy for situations in which geographical distance or other barriers impede physical access to trained therapists or specialized treatments.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Adult , Feeding and Eating Disorders/therapy , Humans , Outpatients , SARS-CoV-2 , Videoconferencing
17.
Rev. latinoam. enferm. (Online) ; 29: e3502, 2021. tab
Article in English | LILACS (Americas) | ID: covidwho-1533470

ABSTRACT

Objective: to verify the quality of life and eating habits of patients with obesity during the COVID-19 pandemic. Method: cross-sectional study with 68 outpatients, candidates for bariatric surgery, at university hospital in the Southern Brazil. Data collection was carried out by telephone, with questions about the profile of the participants and social distancing; questionnaires on quality of life and eating habits were also used. The data analysis, the logistic regression model, Spearman correlation, Mann-Whitney U and Student t-tests were used for independent samples. Results: the general quality of life was 57.03 points and the eating habit with the highest score was cognitive restraint (61.11 points). Most patients (72.1%) were socially distancing themselves and 27.9% had not changed their routine. The chance of isolation was 3.16 times greater for patients who were married. There is a positive correlation between the domains of the Quality of Life questionnaire and cognitive restraint from the questionnaire about eating habits. Conclusion: we found that the participants tended to have a better quality of life as cognitive restraint increased.


Objetivo: evaluar la calidad de vida y la conducta alimentaria de los pacientes con obesidad durante la pandemia de COVID-19. Método: estudio transversal con 68 pacientes atendidos en un servicio ambulatorio de cirugía bariátrica de un hospital universitario del sur de Brasil. La recolección de datos se realizó por vía telefónica, con preguntas sobre el perfil de los participantes y el distanciamiento social; también se utilizaron cuestionarios sobre calidad de vida y conducta alimentaria. Para el análisis de los datos se utilizó el modelo de regresión logística, la correlación de Spearman, las pruebas de la U de Mann-Whitney y la t de Student para muestras independientes. Resultados: la calidad de vida general fue de 57,03 puntos y la conducta alimentaria con mayor puntuación fue la restricción cognitiva (61,11 puntos). La mayoría de los pacientes (72,1%) mantenía el distanciamiento social y el 27,9% no habían cambiado la rutina. La probabilidad de adherir al aislamiento fue 3,16 veces mayor para los pacientes casados. Existe una correlación positiva entre los dominios del cuestionario de calidad de vida y la restricción cognitiva de las preguntas sobre la conducta asociada a los hábitos alimentarios. Conclusión: se verificó que los participantes tendían a tener una mejor calidad de vida a medida que aumentaba la restricción cognitiva.


Objetivo: verificar a qualidade de vida e o comportamento alimentar de pacientes com obesidade durante a pandemia por COVID-19. Método: estudo transversal com 68 pacientes atendidos em ambulatório de cirurgia bariátrica em hospital universitário do sul do Brasil. A coleta de dados foi realizada por telefone, com perguntas sobre o perfil dos participantes e o distanciamento social; também foram utilizados questionários de qualidade de vida e de comportamento alimentar. Para a análise de dados, foram utilizados o modelo de regressão logística, a correlação de Spearman e os testes U de Mann-Whitney e t de Student, para amostras independentes. Resultados: a qualidade de vida geral foi de 57,03 pontos e o comportamento alimentar que apresentou maior pontuação foi a restrição cognitiva (61,11 pontos). Grande parte dos pacientes (72,1%) estava fazendo distanciamento social e 27,9% não haviam mudado a rotina. A chance de fazer isolamento foi 3,16 vezes maior para os pacientes que estavam casados. Existe uma correlação positiva entre os domínios do questionário de qualidade de vida e a restrição cognitiva das perguntas sobre o comportamento associado ao hábito alimentar. Conclusão: verificou-se que os participantes apresentaram tendência em ter uma melhor qualidade de vida conforme a restrição cognitiva aumentava.


Subject(s)
Humans , Male , Female , Outpatients , Patient Care Planning , Patient Isolation , Quality of Life , Behavior , Feeding Behavior , Physical Distancing , COVID-19 , Nursing Assessment , Obesity
18.
Front Public Health ; 9: 731981, 2021.
Article in English | MEDLINE | ID: covidwho-1528870

ABSTRACT

To date, most of the evidence suggests that smoking is negatively associated with testing positive for SARS-CoV-2. However, evidence has several methodological limitations. Using an outpatient sample population, we analyzed the association of testing positive for SARS-CoV-2 and smoking considering comorbidities, socioeconomic and demographic factors. Baseline data were obtained from a cohort during the first wave of the pandemic in Geneva, Switzerland (March-April 2020). RT-PCR tests were carried out on individuals suspected of having SARS-CoV-2 according to the testing strategy at that time. Logistic regressions were performed to test the association of smoking and testing positive for SARS-CoV-2 and further adjusted for comorbidities, socioeconomic and demographic factors. The sample included 5,169 participants; 60% were women and the mean age was 41 years. The unadjusted OR for testing positive for SARS-CoV-2 was 0.46 (CI: 0.38-0.54). After adjustment for comorbidities, socioeconomic and demographic factors, smoking was still negatively associated with testing positive for SARS-CoV-2 (OR: 0.44; CI: 0.35-0.77). Women (OR: 0.79; CI: 0.69-0.91), higher postal income (OR: 0.97; CI: 0.95-0.99), having respiratory (OR: 0.68; CI: 0.55-0.84) and immunosuppressive disorders (OR: 0.63; CI: 0.44-0.88) also showed independent negative associations with a positive test for SARS-CoV-2. Smoking was negatively associated with a positive test for SARS-CoV-2 independently of comorbidities, socioeconomic and demographic factors. Since having respiratory or immunosuppressive conditions and being females and healthcare workers were similarly negatively associated with SARS-CoV-2 positive testing, we hypothesize that risk factor-related protective or testing behaviors could have induced a negative association with SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Female , Humans , Outpatients , Smoking/adverse effects , Switzerland/epidemiology
20.
BMC Psychiatry ; 21(1): 586, 2021 11 20.
Article in English | MEDLINE | ID: covidwho-1526608

ABSTRACT

BACKGROUND: The COVID-19-pandemic and especially the physical distancing measures drastically changed the conditions for providing outpatient care in adolescent psychiatry. METHODS: We investigated the outpatient services of adolescent psychiatry in the Helsinki University Hospital (HUH) from 1/1/2015 until 12/31/2020. We retrieved data from the in-house data software on the number of visits in total and categorized as in-person or remote visits, and analysed the data on a weekly basis. We further analysed these variables grouped according to the psychiatric diagnoses coded for visits. Data on the number of patients and on referrals from other health care providers were available on a monthly basis. We investigated the data descriptively and with a time-series analysis comparing the pre-pandemic period to the period of the COVID-19 pandemic. RESULTS: The total number of visits decreased slightly at the early stage of the COVID-19 pandemic in Spring 2020. Remote visits sharply increased starting in 3/2020 and remained at a high level compared with previous years. In-person visits decreased in Spring 2020, but gradually increased afterwards. The number of patients transiently fell in Spring 2020. CONCLUSIONS: Rapid switch to remote visits in outpatient care of adolescent psychiatry made it possible to avoid a drastic drop in the number of visits despite the physical distancing measures during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Adolescent , Ambulatory Care , Humans , Outpatients , SARS-CoV-2
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