ReCOV: recovery and rehabilitation during and after COVID-19 - a study protocol of a longitudinal observational study on patients, next of kin and health care staff.

BACKGROUND: The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients' experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff. METHODS: This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts. DISCUSSION: This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients', next of kins' and staffs' views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.

Publication outcomes of neonatology abstracts presented at the Pediatric Academic Societies meeting.

OBJECTIVE: To examine publication outcomes of neonatology abstracts presented at Pediatric Academic Society (PAS) meeting, and to analyze variables affecting publication. STUDY DESIGN: All neonatology studies accepted for presentation (oral or poster) at 2008 PAS meeting were identified. A biphasic manual PubMed search of published articles was performed using a pre-designed algorithm. RESULTS: A total of 1078 neonatology abstracts were presented at the meeting, among them 481 (44.62%) published by 2016. Abstracts presented orally versus posters (56.11 versus 42.32%; P<0.001) and basic science versus clinical abstracts (53.08 versus 40.2%; P<0.001) were more likely to be published. Positive or negative results of a study or its sample size did not predict rates of publication. CONCLUSIONS: Less than half of the abstracts presented at the PAS meeting were published within 8 years. Oral presentations were more likely to be published than posters.Journal of Perinatology advance online publication, 6 April 2017; doi:10.1038/jp.2017.46.

Behavioral Pain Scale - translation, reliability, and validity in a Swedish context.

BACKGROUND: Assessing pain in the intensive care unit (ICU) is challenging. Due to intubation and sedation, communication can be limited. International guidelines recommend assessing pain with instruments based on behavioral parameters when critically ill patients are unable to self-report their pain level. One of the recommended instruments, the Behavioral Pain Scale (BPS), has shown good validity and reliability in international studies. The aim of this study was to translate and adapt the BPS for critically ill intubated and non-intubated patients in a Swedish ICU context and to assess inter-rater reliability and discriminant validity. METHODS: The BPS (both for intubated and non-intubated patients) was translated and adapted into Swedish using a translation method consisting of ten steps. The Swedish version was then tested for inter-rater reliability and discriminant validity on 20 critically ill patients (10 intubated and 10 non-intubated) before and directly after a potentially painful procedure (repositioning). RESULTS: The Swedish version of the BPS showed inter-rater reliability with a percentage agreement of 85% when tested on a sample of critically ill patients. The instrument also showed discriminant validity between assessments at rest and after repositioning. CONCLUSION: Results of the Swedish version of the BPS support its use in critically ill patients who cannot self-report their pain level. Still, additional studies are needed to further explore its reliability and validity in the Swedish ICU context.

[Neurotic disorders in industrial workers]. / Nevroticheskie rasstroistva u rabotnikov promyshlennogo predpriiatiia.

Mass clinico-epidemiological screening of the workers of a large industrial enterprise provided data on the genuine prevalence and the clinico-dynamic structure of neurotic disorders in the given population group, on social and industrial factors giving rise to their development, social and labor adaptation of patients afflicted with this pathology. The programs for the primary and secondary care of the neurotic disorders in the industrial workers have been tried on the basis of the Center for Mental Health Care set up at one of the large industrial enterprises in Tomsk. The rendering of extradispensary specialized assistance to neurotic patients at the enterprise itself, including early diagnosis of neuroses, observation over time, application of the differentiated preventive and rehabilitation programs made it possible to diminish the incidence of neurotic disorders, to minimize temporary disability because of the pathology in question, and to raise output per man-hour.

Does rigidity in structure of muscarinic agonists and antagonists reflect drug specificity?

The present work is an attempt to elucidate: (1) whether highly rigid structural analogs of acetylcholine are still capable of activating the muscarinic receptor; (2) whether such analogs, be they agonists or antagonists, discriminate among the various ACh-mediated functions, thereby providing a tool for the study of a possible receptor heterogeneity; (3) whether structural rigidity is a significant factor in the kinetics of drug-receptor interaction. To this end, we investigated some properties of drugs in the spiro-(1,3-dioxolane-4,3')-quinuclidine system (SDQ) which embodies the muscarinic pharmacophore in a framework of utmost rigidity. Wherever possible, these properties were compared with those of a closely related but more flexible analog. Variation in effect between members of a rigid-flexible pair or among drugs of varying rigidity is considered to reflect varying affinities towards various sites of action. 2-Methyl-spiro-(1,3-dioxolane-4,3')-quinuclidine (AF-30) is a weak but selective muscarinic agonist. It can be viewed as a highly rigid version of 3-acetoxyquinuclidine (3-AcQ) and it can be used as a probe for detection of heterogeneity among muscarinic receptors. AF-30 is equipotent with 3-AcQ in causing tremors (mice), but has 1/17th the activity of 3-AcQ in the guinea-pig ileum, 1/30th in lowering blood pressure (cats) and 1/10th in inducing analgesia (mice). 2-Diphenylmethyl-spiro(1,3-dioxolane-4',3)-quinuclidine (AF-41) and 2.2-diphenyl-spiro-(1,3-dioxolane-4,3')-quinuclidine (AF-32 are potent antagonists and possess KD values in the same range as those of the more flexible congener 3-diphenylacetoxy-quinuclidine (AF-43) and atropine (0.6--2 nM) but with koff = 0.1 msec-1 (AF-41) and koff = 1 msec-1 (AF-43) (carp atrium). Thus, duration of drug action of drug action at the receptor is a function of structural rigidity in the drug molecule, termination of action being fastest with the flexible molecules. Differences in rigidity among various antagonists also find expression in an unequal distribution of potencies in various tests; thus the rigid antagonists differentiate between two central effects in mice, viz., prevention of oxotremorine-induced tremors and fall from the rotating rod by a factor of 1:20 (especially AF-41 versus AF-43), whereas the more flexible antagonists (AF-43, atropine or even 3-quinuclidinyl-benzilate) do not show such as a selectivity. The existence of heterogenous muscarinic receptors can be inferred from data presented. Both theoretical and practical implications are discussed.