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1.
PLoS One ; 16(3): e0247686, 2021.
Article in English | MEDLINE | ID: covidwho-1574773

ABSTRACT

OBJECTIVES: The aim of this study was to investigate possible patterns of demand for chest imaging during the first wave of the SARS-CoV-2 pandemic and derive a decision aid for the allocation of resources in future pandemic challenges. MATERIALS AND METHODS: Time data of requests for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) lung disease were analyzed between February 27th and May 27th 2020. A multinomial logistic regression model was used to evaluate differences in the number of requests between 3 time intervals (I1: 6am - 2pm, I2: 2pm - 10pm, I3: 10pm - 6am). A cosinor model was applied to investigate the demand per hour. Requests per day were compared to the number of regional COVID-19 cases. RESULTS: 551 COVID-19 related chest imagings (32.8% outpatients, 67.2% in-patients) of 243 patients were conducted (33.3% female, 66.7% male, mean age 60 ± 17 years). Most exams for outpatients were required during I2 (I1 vs. I2: odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.62-0.86, p = 0.01; I2 vs. I3: OR = 1.24, 95% CI 1.04-1.48, p = 0.03) with an acrophase at 7:29 pm. Requests for in-patients decreased from I1 to I3 (I1 vs. I2: OR = 1.24, 95% CI 1.09-1.41, p = 0.01; I2 vs. I3: OR = 1.16, 95% CI 1.05-1.28, p = 0.01) with an acrophase at 12:51 pm. The number of requests per day for outpatients developed similarly to regional cases while demand for in-patients increased later and persisted longer. CONCLUSIONS: The demand for COVID-19 related chest imaging displayed distinct distribution patterns depending on the sector of patient care and point of time during the SARS-CoV-2 pandemic. These patterns should be considered in the allocation of resources in future pandemic challenges with similar disease characteristics.


Subject(s)
COVID-19/diagnostic imaging , Diagnostic Imaging/trends , Thorax/diagnostic imaging , Adult , Aged , COVID-19/epidemiology , Diagnostic Tests, Routine/trends , Female , Humans , Male , Middle Aged , Models, Theoretical , Pandemics , Pilot Projects , SARS-CoV-2/pathogenicity , Thorax/virology
2.
Clinicoecon Outcomes Res ; 13: 279-287, 2021.
Article in English | MEDLINE | ID: covidwho-1211753

ABSTRACT

BACKGROUND: The study evaluated the public administration's policy responses and imperatives of social solidarity to reduce the havoc caused by the COVID-19 pandemic. The pandemic has not only posed a serious health threat but also brought economic, sociocultural and psychological crises to human beings all over the world. The study was conducted to give a clear picture of the COVID-19 pandemic socioeconomic crises in Ethiopia and policy responses given as well as the imperatives of social organizations in Ethiopia to tackle these challenges. PURPOSE: This article aimed to explore the extent to which the COVID-19 pandemic impacted the socio-economic activities of Ethiopia and evaluate the effectiveness and limitations of the policy response given by the public administration vis-à-vis the role of social solidarity to reduce the calamity of the pandemic. METHODS: Qualitative research approach has been used and data were analyzed using narration, description, and exploration analysis method. RESULTS: The findings of the study revealed that the policy responses given by the public administration and the solidarity of social organizations played great role in minimizing the socio-economic crises that the pandemic entailed. Policy responses had limitations and lack of appropriate institutional implementation platforms. CONCLUSION: The policy responses given by the public administration to alleviate the socio-economic crises caused by the pandemic have both success and limitations. Social organizations played a paramount role in alleviating the COVID-19 socio-economic crises on vulnerable and disadvantaged groups.

3.
Viruses ; 13(5)2021 04 24.
Article in English | MEDLINE | ID: covidwho-1201582

ABSTRACT

The emerging SARS-CoV-2 pandemic entails an urgent need for specific and sensitive high-throughput serological assays to assess SARS-CoV-2 epidemiology. We, therefore, aimed at developing a fluorescent-bead based SARS-CoV-2 multiplex serology assay for detection of antibody responses to the SARS-CoV-2 proteome. Proteins of the SARS-CoV-2 proteome and protein N of SARS-CoV-1 and common cold Coronaviruses (ccCoVs) were recombinantly expressed in E. coli or HEK293 cells. Assay performance was assessed in a COVID-19 case cohort (n = 48 hospitalized patients from Heidelberg) as well as n = 85 age- and sex-matched pre-pandemic controls from the ESTHER study. Assay validation included comparison with home-made immunofluorescence and commercial enzyme-linked immunosorbent (ELISA) assays. A sensitivity of 100% (95% CI: 86-100%) was achieved in COVID-19 patients 14 days post symptom onset with dual sero-positivity to SARS-CoV-2 N and the receptor-binding domain of the spike protein. The specificity obtained with this algorithm was 100% (95% CI: 96-100%). Antibody responses to ccCoVs N were abundantly high and did not correlate with those to SARS-CoV-2 N. Inclusion of additional SARS-CoV-2 proteins as well as separate assessment of immunoglobulin (Ig) classes M, A, and G allowed for explorative analyses regarding disease progression and course of antibody response. This newly developed SARS-CoV-2 multiplex serology assay achieved high sensitivity and specificity to determine SARS-CoV-2 sero-positivity. Its high throughput ability allows epidemiologic SARS-CoV-2 research in large population-based studies. Inclusion of additional pathogens into the panel as well as separate assessment of Ig isotypes will furthermore allow addressing research questions beyond SARS-CoV-2 sero-prevalence.


Subject(s)
Antibodies, Viral/immunology , Antigens, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Adult , Aged , Aged, 80 and over , Antibodies, Viral/blood , Antibody Formation , COVID-19/blood , COVID-19/virology , Cohort Studies , Coronavirus Nucleocapsid Proteins/genetics , Coronavirus Nucleocapsid Proteins/immunology , Enzyme-Linked Immunosorbent Assay , Escherichia coli , Female , HEK293 Cells , Humans , Immunoglobulin A/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Open Reading Frames , Pandemics , Phosphoproteins , Proteome/immunology , SARS-CoV-2/genetics , Young Adult
4.
BMJ Open ; 11(4): e048825, 2021 04 21.
Article in English | MEDLINE | ID: covidwho-1197263

ABSTRACT

OBJECTIVE: To explore the experiences and lessons learnt by the study team and participants of the Workplace-based HIV self-testing among Men trial during the COVID-19 pandemic in Uganda. DESIGN: An explorative qualitative study comprising two virtual focus group discussions (FGDs) with 12 trial team members and 32 in-depth participant interviews (N=44). Data were collected via telephone calls for in-depth interviews or Zoom for FGDs and manually analysed by inductive content analysis. SETTING: Fourteen private security companies in two Uganda districts. PARTICIPANTS: Members of the clinical trial study team, and men working in private security companies who undertook workplace-based HIV testing. RESULTS: The key themes for participants experiences were: 'challenges in accessing HIV treatment and care, and prevention services', 'misinformation' and 'difficulty participating in research activities'. The effects on HIV treatment and prevention resulted from; repercussions of the COVID-19 restrictions, participants fear of coinfection and negative experiences at health facilities. The difficulty in participating in research activities arose from: fear of infection with COVID-19 for the participants who tested HIV negative, transport difficulties, limited post-test psychosocial support and lack of support to initiate pre-exposure prophylaxis. The key study team reflections focused on the management of the clinical trial, effects of the local regulations and government policies and the need to adhere to ethical principles of research. CONCLUSIONS: Findings highlight the need to organise different forms of HIV support for persons living with HIV during a pandemic. Additionally, the national research regulators and ethics committees or review boards are strongly urged to develop policies and guidelines for the continuity of research and clinical trials in the event of future shocks. Furthermore, this study calls on the appropriate government agencies to ensure public and researchers' preparedness through continuing education and support. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov NCT04164433; Pre-results.


Subject(s)
COVID-19 , HIV Infections , HIV Infections/epidemiology , Humans , Male , Pandemics , Qualitative Research , SARS-CoV-2 , Uganda/epidemiology
5.
Eur J Obstet Gynecol Reprod Biol ; 261: 52-58, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1174209

ABSTRACT

OBJECTIVE: The purpose of this study is to evaluate how the obstetrics and gynaecology residency program and trainees have been affected by the Corona Virus Disease-19 (COVID-19) pandemic in Europe. STUDY DESIGN: This study is a cross-sectional explorative survey using an online questionnaire. The questionnaire comprised of 40 questions that were subdivided into 4 subjects; workload, specialist training aspects in obstetrics and gynaecology, health and safety of the trainee and women's health and maternal health issues. Inclusion criteria consisted of being a trainee in Obstetrics and Gynaecology (ObGyn) at the time of the COVID-19 pandemic in Europe or trainees who had recently finished their training during the time of the outbreak. Taking part in the survey was voluntary. The questionnaire was shared on the website of the European Network for Trainees in Obstetrics and Gynaecology (ENTOG), ENTOG social media, in the ENTOG-newsletter and through the national representatives of ENTOG. RESULTS: 110 ObGyn trainees from 25 different countries responded to the questionnaire. Almost all trainees (95 %, N = 105) reported an effect on their training due to COVID-19 pandemic. Training was interrupted in 21 % of cases (n = 23). Trainees observed a decrease in educational activities or lectures and a decrease in number of patients. The possibility of training surgical skills decreased, because 67 % (N = 74) trainees reported that surgeries were cancelled. Trainees expressed concerns about reaching the goals of their ObGyn specialist training in 60 % (n = 66) of cases. A decrease in workload was experienced during the first COVID-19 wave in Europe by 60 % (n = 66) of trainees. On average these trainees worked 33 % less hours compared to a normal workweek. Although 22 % (n = 24) were expected to be available continuously for 24 h a day and 7 days a week for unscheduled duties, 15 % (n = 16) were deployed to work on special COVID-units. Concerning preparation, 45 % of the trainees (n = 50) had not received any training for treating COVID-positive patients. Trainees claimed to have enough personal protective equipment (PPE), although problems were reported. Any form of psychosocial support was arranged for 65 % of trainees (n = 71) by the hospital or department. The results of the survey suggest that obstetric care was not affected much (92 % (n = 102) of the respondents said at least necessary care continued) while patients in need for reproductive medicine were affected the most; out of the 110 departments 58 % (n = 60) were closed and 35 % (n = 36) reduced their activities. Access to family planning and benign gynaecology were also significantly reduced; 77 % and 87 % respectively of the departments were less accessible or only open to emergency cases. CONCLUSION: COVID-19 pandemic has had a tremendous effect on the ObGyn training in Europe. Exposure to learning opportunities, surgeries and teaching has been decreased during the outbreak and may result in a decrease in quality of care provided to women in the future if impairment of training is not recovered.


Subject(s)
COVID-19 , Gynecology , Obstetrics , Cross-Sectional Studies , Europe/epidemiology , Female , Humans , Pandemics , Pregnancy , SARS-CoV-2 , Surveys and Questionnaires
6.
Int J Equity Health ; 20(1): 78, 2021 03 15.
Article in English | MEDLINE | ID: covidwho-1136225

ABSTRACT

BACKGROUND: The importance of community involvement in the response against disease outbreaks has been well established. However, we lack insights into local communities' experiences in coping with the current COVID-19 pandemic. This study explored both the impact of, and response to, COVID-19 within the Orthodox Jewish communities of Antwerp (Belgium) during the first lockdown period (March 2020 - May 2020). METHODS: We conducted an explorative qualitative study using a participatory approach. First, we performed a community mapping to identify relevant stakeholders. Through the active involvement of a community advisory board and based on qualitative interviews with key-informants and community members, we elicited lived experiences, attitudes, and perceptions towards COVID-19. Interviews were conducted both face-to-face and using online web conferencing technology. Data were analyzed inductively according to the principles of thematic analysis. RESULTS: Government-issued outbreak control measures presented context-specific challenges to the Orthodox Jewish communities in Antwerp. They related mainly to the remote organization of religious life, and practicing physical distancing in socially and culturally strongly connected communities. Existing community resources were rapidly mobilized to adapt to the outbreak and to self-organize response initiatives within communities. The active involvement of community and religious leaders in risk communication proved to be of great importance to facilitate the coverage and uptake of pandemic control measures while protecting essential community values and traditions. Creating bottom-up and community-adapted communication strategies, including addressing language barriers and involving Rabbis in the dissemination of prevention messages, fostered a feeling of trust in government's response measures. However, unmet information and prevention needs were also identified, such as the need for inclusive communication by public authorities and the need to mitigate the negative effects of stigmatization. CONCLUSION: The experiences of Orthodox Jewish communities in Antwerp demonstrate a valuable example of a feasible community-centered approach to health emergencies. Increasing the engagement of communities in local decision-making and governance structures remains a key strategy to respond to unmet information and prevention needs.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/methods , Community Participation/psychology , Jews/psychology , Trust/psychology , Adult , Aged , Belgium/epidemiology , Communicable Disease Control/legislation & jurisprudence , Community-Based Participatory Research , Female , Humans , Male , Middle Aged , Qualitative Research , Quarantine/legislation & jurisprudence
7.
J Subst Abuse Treat ; 128: 108364, 2021 09.
Article in English | MEDLINE | ID: covidwho-1129095

ABSTRACT

OBJECTIVE: The purpose is to determine whether a facilitated local change team (LCT) intervention improves linkage to medication for opioid use disorder (MOUD) and implementation outcomes, and whether participant-level outcomes are further enhanced by use of peer support specialists (PSS). METHODS: This Type 1 hybrid implementation-effectiveness study involves a pre-post design (implementation study) followed by a randomized trial of PSS (effectiveness study). Participants are at least 114 justice and service staff from 7 sites in three states: probation officers, community treatment providers, a supervisor from each agency, and key stakeholders. The study will recruit up to 680 individuals on probation from seven adult community probation offices; eligible individuals will be recently committed, English speakers, with opioid use disorder (OUD). Core Implementation Study: The study will use the exploration, preparation, implementation, sustainability (EPIS) framework to guide system-change through facilitated LCTs of probation and community treatment staff given a core set of implementation strategies to set goals. The study will collect program-level and staff survey data at the end of each EPIS stage. Implementation outcomes: Organizational engagement in MOUD (primary), plus changes in staff knowledge/attitudes and organizational outcomes (secondary). Effectiveness Study of PSS: After completing implementation, the study will randomize adults on probation to receive PSS vs. treatment as usual, with assessments at baseline, 3, 6 and 12 months. Effectiveness outcomes include participant engagement in MOUD (primary), probation revocation, illicit opioid use, and overdoses. Other aims include identifying barriers and facilitators, and cost-benefit analysis of PSS. Adaptations in response to COVID-19 included moving many procedures to remote methods.


Subject(s)
COVID-19 , Opioid-Related Disorders , Analgesics, Opioid/therapeutic use , Humans , Opioid-Related Disorders/drug therapy , SARS-CoV-2 , Treatment Outcome
8.
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 , Ischemic Stroke , Pancreatic Neoplasms , Stroke , Adenocarcinoma/epidemiology , Aging , COVID-19 , Cellular Senescence , Cohort Studies , Comorbidity , Female , Germany/epidemiology , Humans , Male , Pancreatic Neoplasms/epidemiology , Prospective Studies , Quality of Life , SARS-CoV-2 , Stroke/epidemiology
9.
Front Neurol ; 11: 615172, 2020.
Article in English | MEDLINE | ID: covidwho-1063344

ABSTRACT

Self-perceived unmet needs in people with typical and atypical parkinsonism (PwP) and their caregivers, support network, personalized ways to address self-perceived unmet needs during confinement, as well as the prevalence of self-reported COVID-19 related symptoms, confirmed SARS-CoV-2 infection, and self-reported COVID-19 related hospitalization in Luxembourg and the Greater Region were assessed. From 18th March to 10th April 2020, 679 PwP were contacted by phone. Data was collected in the form of a semi-structured interview. The thematic synthesis identified 25 themes where PwP need to be supported in order to cope with consequences of the pandemic, and to adapt their daily and health-related activities. The present work highlights that in the context of personalized medicine, depending on the individual needs of support of the patient the identified self-perceived unmet needs were addressed in various ways ranging from one-directed information over interaction up to proactive counseling and monitoring. Family and health professionals, but also other support systems were taking care of the unmet needs of PwP (e.g., shopping, picking-up medication, etc.) during the pandemic. 7/606 PwP (1.15%) reported COVID-19 related symptoms, 4/606 (0.66%) underwent a rRT-PCR-based diagnostic test and 2/606 (0.33%) were confirmed as SARS-CoV-2 positive. None of these PwP reported being hospitalized due to COVID-19. Our results will allow health professionals to expand their services in a meaningful way i.e., personalize their support in the identified themes and thus improve the healthcare of PwP in times of crisis.

10.
J Affect Disord ; 283: 66-70, 2021 03 15.
Article in English | MEDLINE | ID: covidwho-1019193

ABSTRACT

BACKGROUND: Prevalence estimates of suicidal thoughts and behaviours (STB) among clinically active healthcare professionals during the first wave of COVID19 pandemic are non-existing. The main aim of this study was to investigate the 30-day prevalence of STB and associated risk factors. METHODS: As part of the Recovering Emotionally from COVID study (RECOVID), 30-day STB among healthcare professionals (N = 6,409) was assessed in an e-survey in healthcare settings in Belgium. The prevalence of STB and associated risk factors were estimated in multivariable models with individual-level and society-level measures of association. We used post-stratification weights to make the data representative for the entire clinical workforce in Belgium. RESULTS: Prevalence was 3.6% death wish, 1.5% suicide ideation, 1.0% suicide plan, and 0.0% suicide attempt. Thirty-day STB was (a) increased among respondents with lifetime and current mental disorders (mostly depression) and those hospitalized for COVID19 infection, (b) decreased among respondents with social support, and (c) unrelated to work environment. LIMITATIONS: This is an explorative cross-sectional study using multivariate models that generates specific hypotheses on the prevalence of and risk factors for STB during the COVID19 pandemic rather than testing specific pathways that lead to STB onset. CONCLUSIONS: Across age, gender, professional discipline, and exposure to COVID, lifetime and current mental disorders were highly associated with STB. These factors could guide governments and healthcare organizations in taking up responsibilities in preventing emotional problems and developing resilience among healthcare professionals during, but probably beyond, the current COVID19 pandemic.


Subject(s)
COVID-19 , Suicide , Belgium , Cross-Sectional Studies , Delivery of Health Care , Humans , Prevalence , Risk Factors , SARS-CoV-2 , Suicidal Ideation
11.
Int J Older People Nurs ; 16(2): e12362, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1004019

ABSTRACT

BACKGROUND AND OBJECTIVES: The aim of this study was to gain in-depth knowledge and an increased understanding on how isolation from close relatives and carers, during the COVID-19 pandemic, impacted older patients during hospitalisation in a Geriatric department. METHOD: We conducted a qualitative study using semi-structured interviews and a phenomenological-hermeneutic approach, to get an understanding of the older participants' perspectives and lived experiences. Complete interviews were available for 11 patients-six men and five women, between 69 and 91 years of age. RESULTS: The participants' narratives identified several themes. Feeling isolated from and having no contact with close relatives or carers was prominent. The COVID-19 pandemic created fear and anxiety among hospitalized patients. Relationships with family members and some staff became strained. The transformation from being "a person" to being "a patient" and loss of dignity, autonomy and a "sense of self" were themes identified in the analysis. Although virtual contact can't replace the real world, the use of technology to maintain contact with family and carers, and the need for help from hospital staff in facilitating this contact was deemed important. The environment of care was a prominent theme. The attitude of staff made a difference to how patients felt and some patients expressed a loss of decision-making capability. The interviews were challenging in some cases because the interviews had to be interrupted or shortened due to ethical considerations around the individual person's needs and condition. CONCLUSIONS AND IMPLICATION FOR PRACTICE: Our study provided in-depth knowledge on how older patients experienced hospitalisation during the COVID-19 pandemic in a Danish hospital. The results emphasise that compassionate care includes a willingness to listen to older patients' narratives and to imagine life as depicted by them. This can lead to better understanding of an individual person's needs and increase the quality of care provided.


Subject(s)
COVID-19/psychology , Hospitalization , Patients/psychology , Social Isolation , Aged , Aged, 80 and over , COVID-19/epidemiology , Caregivers , Family , Female , Humans , Interviews as Topic , Male , Pandemics , Qualitative Research , SARS-CoV-2
12.
Front Psychol ; 11: 588159, 2020.
Article in English | MEDLINE | ID: covidwho-971512

ABSTRACT

On March 9, 2020, Italy has gone into "lockdown" because of COVID-19 pandemic, with a national quarantine. All non-essential working activities and schools of all levels have been temporarily closed: consequently, the entire population have been forced to dramatically change their daily habits. The pandemic raised important psychological, moral, social, and economic issues. Our research focused on the moral decision-making of people during an emergency. This paper reports two studies. The aim of Study 1 was to evaluate moral decision-making, level of perceived stress, ability of mentalizing and empathy in university students and Italian workers. 224 front-line workers (FLW), 413 second-line workers (SLW), and 663 university students (US), during Italian Phase 1 of lockdown, completed an online questionnaire. The results of Study 1 showed that participants in the FLW group are more likely to choose utilitarian solutions and judge as morally acceptable actions finalized to saving lives of more people if this requires sacrificing a low number of individuals. At the same time, decision-making was experienced as less unpleasant and less arousing with respect to the other two groups, demonstrating a greater ability to keep emotional control under pressure. In Study 2, we compared the same variables used in Study 1, selecting two professional categories from the FLW group engaged in emergency during COVID-19, namely healthcare providers (n = 82) and public safety personnel (n = 117). Our results showed that healthcare providers were more stressed and emotionally involved than public safety personnel, with higher empathic concern and arousal in moral decision-making. We suggest it is essential providing immediate psychological support and monitoring physical and emotional well-being for workers in the front-line during emergencies like the COVID-19 pandemic, in order to prevent experiences of moral distress or mental health problems.

13.
Crit Care Med ; 49(1): e11-e19, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-910342

ABSTRACT

OBJECTIVES: Many trials investigate potential effects of treatments for coronavirus disease 2019. To provide sufficient information for all involveddecision-makers (clinicians, public health authorities, and drug regulatory agencies), a multiplicity of endpoints must be considered. The objectives are to provide hands-on statistical guidelines for harmonizing heterogeneous endpoints in coronavirus disease 2019 clinical trials. DESIGN: Randomized controlled trials for patients infected with coronavirus disease 2019. SETTING: General methods that apply to any randomized controlled trial for patients infected with coronavirus disease 2019. PATIENTS: Coronavirus disease 2019 positive individuals. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We develop a multistate model that is based on hospitalization, mechanical ventilation, death, and discharge. These events are both categories of the ordinal endpoint recommended by the World Health Organization and also within the core outcome set of the Core Outcome Measures in Effectiveness Trials initiative for coronavirus disease 2019 trials. To support our choice of states in the multistate model, we also perform a brief review of registered coronavirus disease 2019 clinical trials. Based on the multistate model, we give recommendation for compact, informative illustration of time-dynamic treatment effects and explorative statistical analysis. A majority of coronavirus disease 2019 clinical trials collect information on mechanical ventilation, hospitalization, and death. Using reconstructed and real data of coronavirus disease 2019 trials, we show how a stacked probability plot provides a detailed understanding of treatment effects on the patients' course of hospital stay. It contributes to harmonizing multiple endpoints and differing lengths of follow-up both within and between trials. CONCLUSIONS: All ongoing clinical trials should include a stacked probability plot in their statistical analysis plan as descriptive analysis. While primary analysis should be on an early endpoint with appropriate capability to be a surrogate (parameter), our multistate model provides additional detailed descriptive information and links results within and between coronavirus disease 2019 trials.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Pandemics/prevention & control , Randomized Controlled Trials as Topic/methods , COVID-19/prevention & control , Endpoint Determination , Humans , Research Design
14.
Psychiatr Danub ; 32(Suppl 1): 15-20, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-743503

ABSTRACT

BACKGROUND: This study seeks to explore the use of humor during the period of isolation caused by lockdown measures imposed in Italy as a result of the Coronavirus SARS-CoV-2 pandemic. SUBJECTS AND METHOD: The study is based on a non-clinical sample. The ad hoc questionnaire measures people's readiness to search for, publish and distribute humorous material during lockdown. It investigates the intentions behind sending content via social media (WhatsApp or similar) and the emotions experienced on receiving such content. RESULTS: The responses have been analyzed quantitatively, and using Excel's IF function they have been analyzed qualitatively. In the present sample of 106 Italian respondents, searching for content was less common than publishing it (yes 44.34%, no 54.72%). Positive emotions were more frequently the motivation (total 61.32%). A high percentage sent amusing content via social media or SMS (79%). Responses demonstrating a desire to lessen the situation's negative impact or a desire for cohesion were common. Receiving material was similarly associated with positive emotions and a sense of being close to others. CONCLUSIONS: humorous material appears to have served as a means of transmitting positive emotions, distancing oneself from negative events and finding cohesion.


Subject(s)
Coronavirus Infections/psychology , Pneumonia, Viral/psychology , Wit and Humor as Topic , Betacoronavirus , COVID-19 , Humans , Italy , Pandemics , SARS-CoV-2 , Social Media , Surveys and Questionnaires
15.
Int J Environ Res Public Health ; 17(15)2020 07 22.
Article in English | MEDLINE | ID: covidwho-670560

ABSTRACT

BACKGROUND: The 2019 coronavirus disease epidemic (Covid-19) is a public health emergency of international concern and poses a challenge to the labor market. The pandemic has a devastating and disproportionate effect on young workers, their interest in entrepreneurship, and their mental health. Research is needed to develop evidence-based strategies to improve coping and reduce adverse psychological problems. The objective of this study was to analyze the impact that Covid-19 pandemic perception and psychological need satisfaction have on university students and their self-employment intention. In addition, we also analyzed the role of moderation played by psychological aspects. These psychological factors (i.e., Optimism and Proactiveness) can also improve young people's mental health and well-being. METHODS: An explorative study (online survey) was conducted in March 2020 934 university students from Latin America. Regression analysis models were built to examine the relationships between Covid-19 pandemic perception, personality variables, and entrepreneurial intention. Mediation models, through the bootstrapping method, were performed to analyze the mediating role of proactiveness and optimism. RESULTS: Results indicate that students' perception of Covid-19 and psychological need satisfaction are associated with entrepreneurial intention. Additionally, the present study argues that proactiveness and optimism mediate these relationships. CONCLUSIONS: This study identifies psychological factors associated with a lower level of Covid-19 impact and that can be used for psychological interventions that result in an improvement in the mental health of these vulnerable groups during and after the Covid-19 pandemic. Theoretical and practical implications are discussed.


Subject(s)
Adaptation, Psychological , Betacoronavirus/isolation & purification , Coronavirus Infections/psychology , Employment/psychology , Intention , Pneumonia, Viral/psychology , Students/psychology , Adolescent , Adult , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Economics , Female , Humans , Latin America , Male , Mental Health , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
16.
Pers Individ Dif ; 167: 110263, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-663311

ABSTRACT

There is little existing research on why some people stockpile goods and others do not at a time of crisis. More research on this phenomenon and the individual differences associated with it is needed in order to gain a better understanding of what is a potentially economically and socially disruptive behavior. In this study, 175 adult participants from Denmark and 90 from the United Kingdom responded to a survey about the activity of extra shopping (stockpiling) during the first weeks of the Coronavirus outbreak. Questions exploring the "big five" personality traits, Social Dominance Orientation, Health Literacy, and attitudes to the governmental response to the crisis were included in the survey. The explorative analysis showed that stockpiling was associated with high scores on Extraversion and Neuroticism, and low scores on Conscientiousness and Openness to Experience. Stockpiling was also associated with the view that the government should be doing more to stop the Coronavirus epidemic. An explorative factor analysis of reasons for stockpiling identified the two factors "Panic" and "Action".

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