Willingness of college students to receive COVID-19 heterologous vaccination in Taizhou, China

This study aimed to determine the willingness of college students to choose COVID-19 heterologous vaccination and its associated influencing factors in Taizhou, China. A population-based, self-administered online questionnaire was conducted from March 15 to 17, 2022. Of the 2,463 participants who had received the invitation, 1,821 responded to the survey (response rate = 73.9%). Only 14% (86/614) of those willing to receive a booster would chose a heterologous vaccination; the perception of better effectiveness of a COVID-19 heterologous vaccination booster was the significant factor (X2 = 22.671, p < .001). Additionally, female college students'older age (χ2 = 7.523, P = .023), major of medical (χ2 = 6.294, P = .012), and better perceived effectiveness of COVID-19 heterologous vaccination booster (χ2 = 22.659, P < .001), were more willing to receive heterologous booster doses. Chinese college students have a strong willingness to receive booster shots, but the percentage of those willing to receive a heterologous vaccine is only 14.0%, and the lack of understanding of its effectiveness is an important factor in the low proportion of heterologous vaccine selection. Health education, public health awareness, and the disclosure of heterologous vaccine information can help improve the public's understanding of heterologous vaccines and provide them with more choices.

Stroke related knowledge, prevention practices and associated factors among stroke patients in Taizhou, China

Stroke is characterized by high morbidity, high mortality and high disability rate, which is a major health problem worldwide. However, most community-based studies report a lack of public knowledge related to stroke. The aim of this study is to investigate stroke-related knowledge and prevention practices among stroke patients in Taizhou, China. A face-to-face survey was conducted and questionnaires were completed by 156 S patients from June 27 to August 30, 2022. A generalized linear model was applied to explore the factors influencing prevention practices. Among the total participants, 36.5% and 40.4% of them had good knowledge of the stroke-related warning signs and risk factors, respectively. Participants who had good stroke prevention practices accounted for 57.7%. The higher score of stroke-related knowledge among inpatients, the better their prevention practices (B = 0.16, 95 %CI: 0.05 ∼ 0.28). In addition, those with age ≥ 60 (B = 1.20, 95 %CI: 0.42 ∼ 1.97), females (B = 0.93, 95 %CI: 0.24 ∼ 1.61), having physical activities (B = 1.01, 95 %CI: 0.33 ∼ 1.68), or without underlying diseases (B = -1.67, 95 %CI:-2.42 ∼ -0.92) were also related with prevention practices. In general, this survey indicated that the stroke-related knowledge and prevention practices of participants were not good enough. Stroke related knowledge, age, sex, physical activity, and underlying disease were significant factors related to stroke prevention practices. These findings suggest the need to focus on stroke health education for stroke patients.

Parental hesitancy against COVID-19 vaccination for children and associated factors in Taiwan

Background

Since July 2021, some countries and regions have initiated the vaccination of minors against coronavirus disease (COVID-19), and parental COVID-19 vaccine hesitancy will affect the vaccination of minors. We aimed to identify the level of parental hesitancy to vaccinate their children against COVID-19 in Taiwan and the factors associated with vaccine hesitancy.

Methods

We conducted a population-based, self-administered online questionnaire in Taiwan to assess parental hesitancy and the factors influencing their children’s vaccination against COVID-19.

Results

Among 384 respondents, 64.1% were hesitant to have their children vaccinated against COVID-19. Mothers were more likely to hesitate to vaccinate their teens than their fathers (67.5% vs. 50%, P < 0.005). Multiple regression results showed that parents who were hesitant to vaccinate themselves (OR = 3.81, 95% CI:2.07–7.02) and those who scored lower on their perception of their children’s vaccination (OR = 9.73, 95% CI:5.62–16.84) were more hesitant to vaccinate their children with COVID-19 vaccine.

Conclusions

According to the study findings, 64.1% of Taiwanese parents were hesitant to vaccinate their children against COVID-19. Parents who were hesitant to receive the COVID-19 vaccine for themselves and had negative views of the vaccine for their children were more likely to be hesitant to vaccinate their children. An in-depth discussion of the factors affecting vaccine hesitancy and targeted health education is conducive to promoting vaccination in children with COVID-19.

Effects of Baduanjin exercise on quality-of-life and exercise capacity in patients with heart failure: A systematic review and meta-analysis

PURPOSE

Exercise training is an efficient non-pharmacological intervention for patients with heart failure (HF). This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life (QOL) and exercise capacity in patients with HF.

METHODS

PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data were searched from the date of their inception until 30 September 2022. All randomised controlled trials (RCTs) evaluating the effects of Baduanjin exercise on QOL and exercise capacity in patients with HF were selected. The primary outcomes were QOL, assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and exercise capacity, evaluated using the 6-min walking test (6-MWT). A meta-analysis was performed by comparing the MLHFQ domain scores. Review Manager 5.3 and Stata 14.0, were used for the data analysis.

RESULTS

Baduanjin exercise showed a favourable improvement of the overall QOL (mean difference = -8.25; 95% confidence interval: -13.62 to -2.89; P = 0.003) and exercise capacity (mean difference = 118.49; 95% confidence interval: 52.57 to 184.41; P = 0.0004). Meta-analyses of the MLHFQ domain score indicated that Baduanjin exercise significantly improved the patients' physical (mean difference = -2.83; 95% confidence interval: -3.76, -1.90; P < 0.00001), emotional (mean difference = -2.52; 95% confidence interval: -3.67 to -1.37; P < 0.0001), and general QOL (mean difference = -2.61; 95% confidence interval: -5.17 to -0.06; P = 0.05), based on the decrease in the MLHFQ domain score. Marked statistical heterogeneity (I2> 70%) was observed for all the QOL and exercise capacity outcomes.

CONCLUSIONS

Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the QOL and exercise capacity in patients with HF. However, more RCTs with rigorous research designs are needed to assist in the rehabilitation of such patients.

Knowledge, attitudes, and behaviors regarding COVID-19 among hospitalized patients in Taizhou, China

Objection

This study investigated the relationship between the knowledge, attitudes, and behaviors among hospitalized patients regarding the prevention and control of COVID-19.

Method

An online cross-sectional survey was conducted among hospitalized patients between July 8 and August 11, 2021, at a tertiary hospital in Taizhou, China. We performed descriptive analysis, t test, ANOVA (analysis of variance), and generalized linear regression modeling on the exported data. All data were analyzed using R software, version 4.1.0.

Results

A total of 1185 valid questionnaires were returned. The average score of the participants on COVID-19 behaviors was 69.3 (SD = 15.6, with a full score of 87), indicating that most inpatients had good COVID-19 prevention and control behaviors. In addition, we found that inpatients with higher COVID-19 awareness also behaved better (B (95%CI) = 1.00 (0.73-1.27)) and were more willing to recommend vaccination to other people (OR (95%CI) = 1.11 (1.06-1.17)). Moreover, hospitalized patients who had positive attitudes toward implementing COVID-19 prevention and control measures had better practices (B (95%CI) = 2.50 (2.24-2.76)) and more willingness to recommend vaccinations (OR (95%CI) = 1.20 (1.14-1.26)).

Conclusion

The research showed that the COVID-19 behaviors of hospitalized patients were positively associated with their knowledge and attitudes. These findings suggested that, for inpatients, hospitals should focus on teaching basic prevention knowledge of COVID-19. Targeted education initiatives should also be developed for patients from rural areas, especially those over 60 years of age, to help improve their knowledge and cultivate good prevention and control behaviors.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-022-01796-y.

The main decision-making competence for willingness-to-pay towards COVID-19 vaccination: a family-based study in Taizhou, China

PURPOSE

This research aimed to explore individuals' willingness to pay (WTP) and studied the role of family decision makers in WTP for COVID-19 vaccines.

METHODS

A self-administered online questionnaire evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China. The logistic regression model was performed to identify the factors associated with WTP for the COVID-19 vaccines, and all data were analysed by R software, version 4.1.0.

RESULTS

44.2% and 43.7% of 824 community residents were willing to pay for the first two doses and the booster dose of the COVID-19 vaccine, respectively. Decision-makers were more willing to pay for both the first two doses and the boost dose of the COVID-19 vaccines, with OR (95%CI) being 1.75 (1.25-2.47) and 1.89 (1.34-2.67), respectively. Besides, participants' WTP for COVID-19 vaccines were also associated with their occupation and monthly household income.

CONCLUSION

This study found that family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines in Taizhou, China. To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision makers in vaccination.Key MessagesA study evaluating the willingness of community residents to pay for booster vaccination of COVID-19 vaccine was conducted among families in a community in Taizhou, China.Family decision-makers were more willing to pay for both the first two doses and the booster dose of COVID-19 vaccines.To improve the WTP for COVID-19 vaccines, public policy programs need to conduct a comprehensive cost-benefit analysis and focus on the role of family decision-makers in vaccination.

Post-vaccination adverse reactions, decision regret, and willingness to pay for the booster dose of COVID-19 vaccine among healthcare workers: A mediation analysis

This study aimed to explore the relationship between post-vaccination adverse reactions, decision regret, and willingness to pay (WTP) for the booster dose. An online survey was conducted in Taizhou, China. Questionnaires were completed by 1,085 healthcare workers (HCWs) and 1,054 (97.1%) have received two doses of the COVID-19 vaccine. Mediation analysis method was adopted. Our study presented that post-vaccination adverse reactions in HCWs could decrease their WTP for the booster dose. Of note, HCWs experienced adverse reactions after vaccination would more likely regret their previous vaccination decisions, which, in turn, further reduced their WTP for a booster shot. Decision regret mediated the relationship between adverse post-vaccination reactions and WTP for the booster dose. The findings implied inextricable relationships among post-vaccination adverse reactions, decision regret, and WTP of the booster dose. It suggested that these post-vaccination adverse reactions should be further incorporated into vaccine campaigns to improve vaccine intention and potentially increase willingness to pay for booster doses of COVID-19 vaccine.

Adverse reactions to inactivated COVID-19 vaccination in patients with chronic liver disease: The effect of anxiety

Studies have shown that patients with chronic liver disease are at a higher risk of contracting novel coronavirus pneumonia than healthy individuals, and many guidelines state that patients with chronic liver disease should be prioritized for COVID-19 vaccination, but there are a few studies on its safety in CLD patients. We aimed to evaluate the safety of the inactivated COVID-19 vaccine in patients with chronic liver disease, and the effect of anxiety on adverse reactions. A questionnaire survey for self-administered post-vaccination adverse reaction monitoring was conducted from June 17, 2021, to August 11, 2021, in patients with chronic liver disease attending a tertiary care hospital in Taizhou, China. We analyzed the data from of a total of 160 participants who scanned the QR code on social media to respond to the questionnaire. The overall incidence of adverse reactions after COVID-19 vaccination in patients with chronic liver disease was 44.4% (71/160), and the most common adverse reaction was local injection site reaction, accounting for 80.3% of adverse reactions (57/71). No serious adverse reactions were reported. Approximately 53.1% of the patients had anxiety about vaccination, and 51.8% of those who felt anxious reported adverse reactions. The safety of COVID-19 vaccination in patients with chronic liver disease is good, and there is a strong association between adverse reactions and vaccine anxiety. Pre-vaccination education for patients with vaccine anxiety and psychological counseling may reduce reports of adverse reactions and improve patients' confidence in the vaccine.

Willingness to pay for booster dose of COVID-19 vaccine among healthcare workers in Taizhou,China

PURPOSE

We explored the willingness to pay for booster dose of COVID-19 vaccine among health-care workers in Taizhou, China.

METHODS

A population-based self-administered online questionnaire evaluating the willingness of health-care workers to pay for booster vaccination of COVID-19 vaccine was conducted in Taizhou, China. Of the 1102 health-care workers received the invitation, 1072 (97.3%) had received twice vaccination of COVID-19 vaccine.

RESULTS

There were 1569 (53.1%) out of 1072 health-care workers not willing to pay for thebooster dose of COVID-19 vaccines, 348 (32.5%) were willing to pay less than 100CHY for the booster dose of COVID-19 vaccines, only 155 (14.5%) were willing to pay more than 100 CHY. The factors related to willingness to pay for booster dose of COVID-19 vaccines were education level (c² = 9.42, P = .01) or whether they had adverse effect to COVID-19 vaccines (c² = 11.87, P < .01) .

CONCLUSION

This study found that about half of health-care workers were willing to pay for booster dose of inactivated SARS-CoV-2 vaccines in Taizhou, China, most of them are willing to pay less than 100 CHY. Health-care workers' willingness to pay for booster dose of COVID-19 vaccines were related to sex, education level, whether they had adverse effect to COVID-19 vaccines.

Relationship between nosocomial infections and coronavirus disease 2019 in the neurosurgery unit: clinical characteristics and outcomes from a Chinese Tertiary-Care Hospital

Background

The COVID-19 pandemic has raised awareness of infection prevention and control. We found that the incidence of nosocomial infection in neurosurgery has changed. This study aimed to evaluate the impact of “coronavirus disease 2019 (COVID-19) prevention and control measures” on nosocomial infections in neurosurgery.

Methods

To explore changes in nosocomial infections in neurosurgery during the COVID-19 pandemic, the clinical data of inpatients undergoing neurosurgery at Taizhou Hospital of Zhejiang Province between January 1 and April 30, 2020 (COVID-19 era) were first analyzed and then compared with those from same period in 2019 (first pre-COVID-19 era). We also analyzed data between May 1 and December 31, 2020 (post-COVID-19 era) at the same time in 2019 (second pre-COVID-19 era).

Results

The nosocomial infection rate was 7.85% (54/688) in the first pre-COVID-19 era and 4.30% (26/605) in the COVID-19 era (P = 0.01). The respiratory system infection rate between the first pre-COVID-19 and COVID-19 eras was 6.1% vs. 2.0% (P < 0.01), while the urinary system infection rate was 1.7% vs. 2.0% (P = 0.84). Between the first pre-COVID-19 and COVID-19 eras, respiratory system and urinary infections accounted for 77.78% (42/54) vs. 46.15% (12/26) and 22.22% (12/54) vs. 46.15% (12/26) of the total nosocomial infections, respectively (P < 0.01). Between the second pre-COVID-19 and post-COVID-19 eras, respiratory system and urinary accounted for 53.66% (44/82) vs. 40.63% (39/96) and 24.39% (20/82) vs. 40.63% (39/96) of the total nosocomial infections, respectively (P = 0.02).

Conclusions

The incidence of nosocomial infections in neurosurgery reduced during the COVID-19 pandemic. The reduction was primarily observed in respiratory infections, while the proportion of urinary infections increased significantly.

Intentions of Patients with Hypertension to Receive a Booster Dose of the COVID-19 Vaccine: A Cross-Sectional Survey in Taizhou, China

COVID-19 patients with hypertension have increased hospital complications and mortality rates. Moreover, these patients also have lower antibody titers after receiving the coronavirus disease (COVID-19) vaccine. Therefore, patients with hypertension should receive a COVID-19 vaccine booster. To promote the uptake of COVID-19 vaccine booster among hypertensive patients, this study investigated patients’ willingness and factors that influence patients with hypertension to receive the COVID-19 vaccine booster. From July 2021 to August, 410 patients with hypertension were surveyed. Overall, 76.8% of patients were willing to receive the COVID-19 vaccine booster, as 82.7% of patients without comorbidities and 72.7% of patients with comorbidities were willing to receive the vaccine booster. The main factors that influenced the willingness of patients with hypertension to receive a booster dose were the preventive effect of the vaccine (χ2 = 52.827, p < 0.05), vaccine safety (χ2 = 42.423, p < 0.05), vaccine knowledge (χ2 = 7.831, p < 0.05), presence of comorbidities (χ2 = 4.862, p < 0.05), disease control (χ2 = 5.039, p < 0.05), and antihypertensive treatments (χ2 = 12.565, p < 0.05). This study’s findings highlight the need to promote knowledge about booster vaccination among patients and health management. These measures would improve patients’ willingness and knowledge about the vaccine and their health status, which are the main factors that influence patients’ intention to receive booster vaccines.

Relationship between knowledge, attitudes, and practices and COVID-19 vaccine hesitancy: A cross-sectional study in Taizhou, China

Objective

This study aimed to explore COVID-19 vaccine hesitancy in Chinese adults and analyzed the relationship between knowledge, attitudes, practices (KAP), and COVID-19 vaccine hesitancy.

Methods

A population-based self-administered online survey was conducted in Taizhou, China to evaluate the population's hesitancy to receive COVID-19 vaccination. A total of 2.463 adults received the invitation for the survey through WeChat (A Chinese app that is used for chat, social media, and mobile payment), and 1.788 interviewees answered the structured questionnaire. The overall response rate was 72.6%.

Results

Total 45.2% of people were hesitant about the COVID-19 vaccination. Using binary logistic regression analysis, we found low perception of safety (Model 3: Odds ratio = 2.977, Confidence interval: 2.237–3.963) and efficacy (Model 3: OR = 1.904, 95%CI: 1.462–2.479) of the COVID-19 vaccine in adults is the most important risk factor for COVID-19 vaccine hesitation. People who know more about COVID-19 vaccination are less hesitant (Model 2: OR = 0.967, 95% CI: 0.951–0.983). People who did not seek information independently about the COVID-19 vaccine are more likely to be skeptical (Model 4: OR = 1.300, 95% CI: 1.058–1.598, P = 0.013).

Conclusion

In China, the population had higher levels of COVID-19 vaccine hesitation, and their knowledge of the COVID-19 vaccine, perceptions of safety and efficacy, and physical health status were significantly associated with vaccine hesitation. These results provide ideas for promoting COVID-19 vaccination and intervention and have far-reaching implications for further strengthening research on vaccine hesitancy in COVID-19 and exploring strategies for COVID-19 vaccine promotion.

COVID-19 Vaccination in China: Adverse Effects and Its Impact on Health Care Working Decisions on Booster Dose

Although many research studies have concentrated on people’s willingness to take the COVID-19 vaccine, little attention has been paid to the underlying mechanism of consent. An understanding of potential factors and mechanisms that affect the willingness to receive a vaccination can contribute information critical for containing the pandemic. This study explored the effects of post-vaccination adverse reactions on the willingness to take the booster dose and the role of decision regret. A self-administered online survey was carried out in Taizhou, China. Questionnaires were completed by 1085 healthcare workers (HCWs), 1054 (97.1%) of whom had completed two doses of the COVID-19 vaccine. Mediation analysis methodology was applied in this study. Our study showed that post-vaccination adverse reactions in HCWs could decrease their willingness to take the booster dose. Of note, HCWs who experienced adverse reactions after vaccination would be more likely to regret their previous vaccination decisions, which, in turn, further reduced their willingness to receive a booster shot. Decision regret mediated the relationship between adverse post-vaccination reactions and a willingness to take the booster dose. The findings implied inextricable relationships among post-vaccination adverse reactions, decision regret, and willingness to take the booster dose. It is suggested that notice of these post-vaccination adverse reactions should be further incorporated into vaccine communication campaigns and policy interventions advocating booster doses to improve vaccine uptake intent and increase the willingness to receive booster doses of a COVID-19 vaccine.

Quality of Life and Mental Health Status in Recovered COVID-19 Subjects at Two Years after Infection in Taizhou, China: A Longitudinal Cohort Study

According to previous studies, mental status in 1-year COVID-19 survivors might range from 6–43%. Longer-term psychological consequences in recovered COVID-19 subjects are unknown, so we analyzed longer-term quality of life and mental status in recovered COVID-19 subjects at 2 years after infection. Among 144 recovered COVID-19 subjects in the Taizhou region, 73 and 45 completed face-to-face follow-ups at the first year and second year after infection, respectively, with a 61.7% follow-up rate. The questionnaire, which was administered at both follow-ups, included questions about quality of life, psychological health, and post-traumatic stress disorder (PTSD). The Mann-Whitney U test was used to the differences of each scale between the first and second year. Among the 45 people who completed both follow-up visits, the incidence of psychological problems was 4.4% (2/45) in the first year, and no new psychological abnormalities were observed in the second year. Quality of life improved, while the General Health Questionnaire (GHQ-12) and Impact of Event Scale-Revised (IES-R) scores did not improve over time. The incidence of mental disorders was lower than those in previous studies. Multidisciplinary management for COVID-19 in this study hospital may have reduced the frequency to a certain extent. However, among those with mental health problems, such problems may exist for a long time, and long-term attention should be given to the psychological status of recovered COVID-19 subjects.

The Effects of Learning Transfer on Clinical Performances Among Medical Staff: A Systematic Review of Randomized Controlled Trials

Purpose

This study aimed to evaluate the influence of learning transfer on the clinical performance of medical staff.

Methods

We searched PubMed, Embase, and the Cochrane Library for all associated studies without any language restrictions from the inception until 31 December 2021.

Results

This systematic review screened out 14 eligible studies that met the inclusion criteria. Most of these studies showed that learning transfer contributed to the clinical performance of medical staff. Through education, or when knowledge and skills have common basic principles, learning transfer will be more apparent than for those who learn by themselves and those without simulation training.

Conclusions

The findings of this review support an association between learning transfer and the clinical performance of medical staff. However, it was noted that due to the lack of relevant research and the major differences in the methods and indicators used in previous studies, we are restricted in conducting an effective meta-analysis. Further comprehensive trials will be needed to assess the impact of learning transfer on the clinical performance of medical staff.

Systematic Review Registration

PROSPERO, identifier: 341439.

Prevalence of Sarcopenia in Patients With COVID-19: A Systematic Review and Meta-Analysis

Background

It has been speculated that patients with sarcopenia are aggravated by the current novel coronavirus disease 2019 (COVID-19) epidemic. However, there is substantial uncertainty regarding the prevalence of sarcopenia in patients with COVID-19.

Objectives

The purpose of the study was to systematically evaluate the prevalence of sarcopenia in patients with COVID-19, including stratification by gender, study location, study population, study design, and diagnostic criteria.

Design

This is the systematic literature review and meta-analysis.

Methods

An electronic search was performed in MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science and Scopus to identify observational studies reporting a prevalence estimate for sarcopenia in patients with COVID-19. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed. Risk of bias (RoB) was assessed using the Newcastle–Ottawa Scale (NOS) for cohort studies and Joanna Briggs Institute (JBI) manual for cross-sectional studies, and Stata 14.0 was used to perform meta-analyses.

Results

A total of 4,639 studies were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 151 full-text studies. A total of 21 studies, including 5,407 patients, were eligible for inclusion in this review finally. The prevalence of sarcopenia in patients with COVID-19 in individual studies varied from 0.8 to 90.2%. The pooled prevalence of sarcopenia in COVID-19 was 48.0% (95% confidence interval, CI: 30.8 to 65.1%, I² = 99.68%, p = 0.000). We did not find any significant differences in the prevalence estimates between gender specificity (OR = 1.34; 95% CI = 0.80–2.26; p = 0.001). By sex, the prevalence was 42.5% (95% CI: 31.7 to 53.4%) in men and 35.7% (95% CI: 24.2 to 47.2%) in women. The prevalence estimates significantly varied based on population settings and different diagnostic criteria of sarcopenia. ICU patients (69.7, 95% CI: 51.7 to 85.2%) were more likely to suffer from sarcopenia compared to other population settings.

Conclusion

To our knowledge, this is the first meta-analysis reporting on the prevalence of sarcopenia in patients with COVID-19. Sarcopenia is frequently observed in patients with COVID-19, with varying prevalence across population settings. This study would be useful for clinicians to prompt the increasing awareness of identifying sarcopenia and developing interventions at patients with COVID-19 with high risk of sarcopenia. Further prospective longitudinal studies to define the association of sarcopenia and its prognostic outcomes in COVID-19 survivors are urgently needed to propose the most appropriate treatment strategies during their admission and discharge.

Systematic Review Registration

[www.crd.york.ac.uk/prospero/], identifier [CRD42022300431].

Patients' Responses to COVID-19 Pandemic: The Relationship Between Potential Pandemic-Induced Disruptions, Ontological Security, and Adaptive Responses in Taizhou, China

Background

The COVID-19 pandemic has changed the social environment of most individuals around the world and has profoundly impacted people's lives, ontological security, and behavior. Among them, the patients are one of the groups most influenced by the pandemic.

Objective

The present research aimed to study the relationship of COVID-19 pandemic-induced disruption to patients' daily lives, ontological security, and patients' responses to prevent the spread of COVID-19, and explore the role of ontological security.

Methods

This article was based on an online structured questionnaire study conducted among hospitalized patients in Taizhou Hospital of Zhejiang Province, Taizhou, China, from 8 July to 11 August 2021. We analyzed the data using the multivariate regression model and mediation analysis method.

Results

The results showed that the higher the pandemic-induced disruption to inpatients' lives, the better behavior would be taken by hospitalized patients to prevent the spread of COVID-19, and the perceived scarcity of ontological security played a mediating role in this process. Higher pandemic-induced disruption to patients' lives increased the ontological insecurity which further, in turn, reduced patients' good practice toward measures to prevent the novel coronavirus.

Conclusion

These findings provided direct evidence for the relationship between pandemic-induced disruption, scarcity of ontological security, and patients' prevention behavior. It suggested that there was a need to emphasize patients' ontological security. Overall, these findings suggested that it is important to emphasize the mental health among patients during the COVID-19 pandemic, and implement strategies to offer psychological support when needed.

Blood Glucose Meter Buying Behavior of Diabetic Patients: Factors Influencing Purchase

Objective

To understand the blood glucose meter buying behavior of type 2 diabetic patients with poor glycemic control (two or more HbA1c ≥ 8% during visits in one year) and identify factors influencing it.

Methods

A survey was conducted among 585 diabetic patients with poor glycemic control who were treated in the outpatient or inpatient clinics of the Department of Endocrinology, Taizhou Hospital, Zhejiang Province from June 2020 to May 2021. The questionnaire collected general information and clinical data, and assessed blood glucose meter buying behavior. Chi-square test was used to compare the essential characteristics and clinical data between buyers and non-buyers of blood glucose meters. Additionally, stepwise logistic regression was used to analyze the factors influencing purchase.

Results

Of the 585 questionnaires distributed, 527 (90.09%) valid questionnaires were collected. Of the 527 respondents, 285 (54.08%) had purchased blood glucose meters. Not receiving insulin therapy (OR: 1.77, 95% CI: 1.13–2.77) and unawareness of self-monitoring of blood glucose (OR: 19.46, 95% CI: 12.51–30.26) were risk factors for non-purchase.

Conclusion

There is a need to actively increase the purchase of glucose meters among diabetic patients, by educating them about the importance of self-monitoring of blood glucose.

The impact of the Omicron epidemic on the health behavior in Cape Town, South Africa

Background

South Africa was the first country with a case of Omicron variant infection diagnosed; therefore, this study aimed to elucidate the impact of the Omicron mutant strain outbreak on the health behavior of the South African population and encourage the population to adopt timely protective behaviors against Omicron mutant strain infection.

Study design and methods

This was a population-based, cross-sectional study conducted in Cape Town, South Africa, in December 2021. We distributed 300 questionnaires to adults aged >18 years, and they were all returned.

Results

Of the South African population, 60.3% expressed a high level of concern regarding Omicron; 89.3% improved on at least one of the following three health behaviors: mask-wearing, washing hands, and reducing socialization; and only 10.7% exhibited no improvement in health behaviors. Of these, 71.3% and 57.0% increased the length of time they wore a mask and washed their hands, respectively, and 47% decreased the number of times they socialized. Age, residence, education level, chronic disease, and whether they had received the COVID-19 vaccine were significantly different (p < 0.05) between the presence and absence of enhanced health behaviors. The levels of concern and knowledge regarding the Omicron virus significantly influenced health-behavior change (all P < 0.05).

Conclusion

There has been a positive change in the South African population toward adopting mask-wearing, hand washing, and reducing socialization in response to the Omicron virus strain epidemic. Based on one health approach, it is important to focus on populations with chronic diseases, those who have not yet received the COVID-19 vaccine, and other populations with low rates of health behavior change.

Effects of Tocilizumab on Adults With COVID-19 Pneumonia: A Meta-Analysis

Background

Coronavirus disease-2019 (COVID-19), a worldwide disaster, has already affected lots of people. Effective care and therapy are currently being evaluated in full swing.

Purpose

Our purpose was to investigate the effects of tocilizumab, an interleukin-6 receptor inhibitor, on treatment of adult patients with COVID-19 pneumonia.

Data Sources, Study Selection, and Data Extraction

We conducted a meta-analysis and searched for relevant studies on Pubmed, Embase, and the Cochrane Library without restrictions on language from inception until February 1, 2021. Fifteen studies were included for this meta-analysis. Two authors independently selected and screened these studies, assessed the quality of included studies, and extracted related information.

Results

Fifteen studies were included in this meta-analysis. The main studies showed that tocilizumab was associated with lower mortality (risk ratio = 0.62, 95% confidence interval = 0.46–0.83; and hazard ratio = 0.61, 95% confidence interval = 0.51–0.72). Using tocilizumab might also affect biochemistry indicators (lowered C-reactive protein and ferritin, increased lymphocyte count).

Conclusion

These current bodies of evidence could indicate that early use of tocilizumab was associated with lower mortality in adult patients with COVID-19. Early use of tocilizumab could reduce the mortality rate of adult patients with COVID-19 without obvious fatal side effects, which may be a treatment option in patients with COVID-19 pneumonia.

Systematic Review Registration

The study protocol was registered on PROSPERO (ID:242811).

Effects of physical exercise on the quality-of-life of patients with haematological malignancies and thrombocytopenia: A systematic review and meta-analysis

BACKGROUND

Annually, there are an estimated 1187000 new patients worldwide diagnosed with haematological malignancies. Effective strategies are needed to alleviate side effects and prevent the physical and psychosocial degeneration of patients in active treatment for haematological malignancies.

AIM

To explore the effects of physical exercise on quality of life (QoL) of patients with haematological malignancies and thrombocytopenia.

METHODS

Cochrane Library, PubMed and Embase were searched for all relevant articles reporting randomized controlled trials (RCTs) that were published up to 31 July 2021. Two authors independently selected articles in accordance with the inclusion criteria, evaluated their quality, and collected information. Any controversy was resolved through discussion with a third senior author. The PRISMA 2009 checklist was followed.

RESULTS

Seven RCTs were selected in the systematic review and three were included in the final meta-analysis. There were significant differences in QoL between physical exercise groups [mean score difference = 8.81; 95% confidence interval (CI): 1.81-15.81, P = 0.01], especially in emotional functioning (mean score difference = 12.34; 95%CI: 4.64-20.04, P = 0.002) and pain (mean score difference = –12.77; 95%CI: -3.91 to -21.63, P = 0.005).

CONCLUSION

Physical exercise has clinical effects on QoL and improves emotional function and pain indices of patients with haematological malignancies and thrombocytopenia.

Sex Differences in Adverse Reactions to an Inactivated SARS-CoV-2 Vaccine Among Medical Staff in China

Objective: We investigated whether there were sex differences in adverse reactions to an inactivated SARS-CoV-2 vaccine among medical staff in China. Methods: From 24 February to 7 March 2021 an online cross-sectional survey was conducted with a self-administered COVID-19 vaccine questionnaire among medical staff in Taizhou, China. In total, 1397 interviewees (1,107 women and 290 men) participated in the survey. Results: In our study, 178 (16.1%) women and 23 (7.9%) men reported adverse reactions following their first vaccination, and 169 (15.3%) women and 35 (12.1%) men reported adverse reactions following their second vaccination. After adjusting for confounding factors, adverse reactions to other vaccines, worry about adverse reactions, knowledge of the inactivated vaccine being used in the hospital, taking the vaccine for one's family proactively and receiving an influenza vaccination were significantly related to adverse reactions to both injections in women. In contrast, in men, concerns about adverse reactions independently increased the risk of adverse reactions following either vaccination, and a history of adverse reactions to other vaccines also increased the risk of adverse reactions to both injections. Conclusions: Sex differences in the frequency of reported adverse reactions to an inactivated SARS-CoV-2 vaccine and potential factors were demonstrated in a sample of medical staff.

Systematic Review of the Effect of a Zero-Markup Policy for Essential Drugs on Healthcare Costs and Utilization in China, 2015-2021

Objective: This systematic review aimed to discuss the effects of a zero-markup policy for essential drugs (ZPED) on healthcare costs and utilization in China in the years 2015–2021.

Methods: We searched the PubMed, Embase, Scopus, and CINAHL databases for all associated studies carried out from January 1, 2015, to May 31, 2021, without any limitations regarding the language the studies were written in. To prevent selection bias, gray documents were tackled by other means. The methodological approaches were assessed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Newcastle-Ottawa Scale (NOS) collaboration tool.

Results: Forty studies were selected at first and then 15 studies that met the inclusion criterion. Most of the studies showed a considerable decrease in total medical spending and drug spending in both outpatient and inpatient services. After the implementation of ZPED, studies showed that the medical services increased and total hospital income sustained, despite a decrease in drug revenue. Minimal or no government subsidy is required from a financial perspective.

Conclusions: Although, the government could implement ZEPD with lower medical cost and drug cost to patients, and sustained income for health facilities, we have limited understanding of whether the increase in medical services was induced by the provider or was a response to unmet needs in the population. Further, studies using rigorous and advanced methods to study health policy, patient behaviors, provider behaviors, and government decisions are warranted.

Effect of Exercise-Based Cardiac Rehabilitation on Left Ventricular Function in Asian Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials

(1) Background: The effects of exercise-based cardiac rehabilitation (CR) on left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) are important but poorly understood. (2) Purpose: To evaluate the effects of an exercise-based CR program (exercise training alone or combined with psychosocial or educational interventions) compared with usual care on left ventricular function in patients with AMI receiving PCI. (3) Data sources, study selection and data extraction: We searched PubMed, WEB OF SCIENCE, EMBASE, EBSCO, PsycINFO, LILACS and Cochrane Central Register of Controlled Trials databases (CENTRAL) up to 12th June 2021. Article selected were randomized controlled trials and published as a full-text article. Meta-analysis was conducted with the use of the software Review manager 5.4. (4) Data synthesis: Eight trials were included in the meta-analysis, of which three trials were rated as high risk of bias. A significant improvement was seen in the exercise-based CR group compared with the control group regarding left ventricular ejection fraction (LVEF) (std. mean difference = 1.33; 95% CI:0.43 to 2.23; p = 0.004), left ventricular end-diastolic dimension (LVEDD) (std. mean difference = −3.05; 95% CI: −6.00 to −0.09; p = 0.04) and left ventricular end-systolic volume (LVESV) (std. mean difference = −0.40; 95% CI: −0.80 to −0.01; p = 0.04). Although exercise-based CR had no statistical effect in decreasing left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic volume (LVEDV), it showed a favorable trend in relation to both. (5) Conclusions: Exercise-based CR has beneficial effects on LV function and remodeling in AMI patients treated by PCI.

The Relationship Between Fragility Fractures and Pain Experience: A Systematic Review

Purpose: This systematic review is conducted to explore the relationship between fragility fractures and pain experience.

Methods: We searched for relevant studies on Pubmed, Embase, Web of Science, and the Cochrane library without restrictions on language from inception until February 4th, 2021. The risk of bias and methodological quality was evaluated using the Newcastle-Ottawa Scale and ROBINS-I tool.

Results: Twenty-one studies were included in this systematic review. The so-called study reported participants with continuous post-fracture pain. The included studies showed that post- fractured pain can decrease with time, however, the continual pain can last at least 1 year even longer, and some participants would need to self-manage pain. Moreover, the limited range of motion was considered as a factor that might distress the normal development of daily activities.

Conclusions: The current evidence could not fully support that pain continues to influence patients' lives after a fragility fracture. However, it still showed the pain might come with fracture. The findings also could be useful to help health care providers better recognize and manage this clinical consequence of fractures. Nonetheless, future large-scale longitudinal studies will be required to evaluate the long-term effects of pain in fragility fractures.